bluuebunny/crossref_metadata_2025 huggingface dataset:
Internet-based cognitive rehabilitation for WORking Cancer survivors (i-WORC): study protocol of a randomized controlled trial.
Authors: Klaver Kete , Duijts Saskia , Geusgens Chantal , Aarts Maureen , Ponds Rudolf , Beek Allard van der , Schagen Sanne
Published: May 2020

Background Cognitive problems are common in non-central nervous system cancer survivors. These problems are perceived as an important contributor to decline in work performance and work ability. Various interventions for cognitive problems have been proposed, but effectiveness regarding work-related outcomes has not yet been established. Effective treatment options to alleviate the adverse influence of cognitive problems on work performance are needed for working cancer survivors. In this paper, we will describe the design of a randomized, controlled, multicenter trial that evaluates the (cost-)effectiveness of an internet-based cognitive rehabilitation program for occupationally active cancer survivors confronted with cognitive problems. Methods/ Design A three-armed randomized controlled trial will be conducted, including two intervention groups (i.e., basic and extensive cognitive rehabilitation program) and one waitlist control group. In total, 261 cancer survivors (18 – 65 years) who have returned to work, and who experience cognitive problems will be recruited. Patients with and without cognitive impairment as established in a neuropsychological assessment, will be eligible; stratification will take place based on the presence of this cognitive impairment. The extensive intervention arm will contain a comprehensive training program (including psycho-education, fatigue management, and cognitive strategy training) with individual guidance (blended intervention). The basic intervention arm will contain a brief cognitive training program (including psycho-education and fatigue management) without individual guidance. The primary outcome will be accomplishment of an individually defined work-related treatment goal. Secondary outcomes include, among others, subjective cognitive functioning, work functioning, and quality of life. Primary and secondary outcomes will be measured at baseline (T0), and at 12 weeks (T1) and 26 weeks (T2) post-randomization. Discussion About 40-50% of the cancer patients worldwide are of working age at time of diagnosis. Many of the occupationally active cancer survivors experience cognitive problems. Both from an individual and a societal perspective, it is important to sustain cancer survivors’ employability. An effective treatment to alleviate the impact of cognitive decline and to improve work ability might help cancer survivors to sustain employability.Trial registration The trial is registered at ClinicalTrials.gov (NCT03900806) at 03 April 2019 (current status: ongoing),https://clinicaltrials.gov/ct2/show/NCT03900806?term=NCT03900806&draw=2&rank=1.
The Effects of Immediate Programmed Cryotherapy and Continuous Passive Motion in Patients after Computer-Assisted Total Knee Arthroplasty: A prospective, randomized controlled trial
Authors: Chen Mei-Chu , Lin Chiu-Chu , Ko Jih-Yang , Kuo Feng-Chih
Published: May 2020

Background: The postoperative nursing intervention with immediate cryotherapy and continuous passive motion (CPM) remains elusive regarding the postoperative pain and range of motion (ROM) for patients undergoing computer-assisted total knee arthroplasty (CAS-TKA).Methods: A prospective, randomized controlled trial with a purposive sampling method was utilized. Sixty patients scheduled for a unilateral CAS-TKA at a medical center were randomly assigned to the intervention group (n=30) and control group (n=30). The intervention group applied programed cryotherapy and CPM within one hour while returning to the ward on the day of surgery, while the control group did not. Data were analyzed using mixed models to compare the numeric rating scale (NRS) for pain, ROM, and swelling at postoperative day (POD) 4.Results: There was no significant difference in the NRS score between the groups (p = 0.168). The intervention group had significantly higher ROM than the control group (98 degrees vs. 91 degrees, p = 0.004) at POD 4. Although no significant difference in joint swelling was found between groups (p = 0.157), the intervention group had lower mean joint swelling (32.2 cm) than the control group (33.9 cm).Conclusions: Immediate programmed cryotherapy and continuous passive motion could help to improve ROM quickly after CAS-TKA. It should be incorporated into the daily nursing plan for patients undergoing CAS-TKA.Keywords: Postoperative nursing intervention, total knee arthroplasty, continuous passive motion, cryotherapy, computer-assistedTrial registration: ClinicalTrials.gov: NCT04136431. Registered 23 October 2019 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04136431
Identification and validation of quantitative trait loci for ascites syndrome in broiler chickens using whole genome resequencing.
Authors: Parveen Alia , Jackson Christa D. , Dey Shatovisha , Tarrant Katy , Anthony Nicholas B , Rhoads Douglas D.
Published: May 2020

Background Ascites syndrome is a hypertensive, multifactorial, multigene trait affecting meat-type chickens imposing significant economic losses on the broiler industry. A region containing the CPQ gene has been previously identified as significantly affecting ascites phenotype. The region was discovered through whole genome resequencing focused on chicken chromosome 2. The association was confirmed through further genotyping in multiple broiler populations. Results The whole genome resequencing analyses have now been extended to the current chicken genome assembly. DNA samples were pooled according to gender and phenotype and the pools subjected to next generation sequencing. Loci were identified as clusters of single nucleotide polymorphisms where frequencies of the polymorphisms differed between resistant and susceptible chickens. The chickens are an unselected line descended from a commercial elite broiler line. Regions identified were specific to one or both genders. The data identify a total of 28 regions as potential quantitative trait loci for ascites. The genes from these regions have been associated with hypertensive-related traits in human association studies. One region on chicken chromosome 28 contains the LRRTM4 gene. Additional genotyping for the LRRTM4 region demonstrates an epistatic interaction with the CPQ region for ascites phenotype. Conclusions The 28 regions identified were not previously identified in a multi-generational genome wide association study using 60k Single Nucleotide Polymorphism panels. This work demonstrates the utility of whole genome resequencing as a cost effective, direct, and efficient method for identifying specific gene regions affecting complex traits. The approach is applicable to any organism with a genome assembly and requires no a priori assumptions.
Non-inferiority test for a continuous variable with a flexible margin in an active controlled trial : An application to the "Stratall ANRS 12110 / ESTHER" trial
Authors: Sandie Arsene , Molinari Nicholas , Wanjoya Anthony , Kouanfack Charles , Laurent Christian , Tchatchueng-Mbougua Jules Brice
Published: May 2020

Background: The non-inferiority trials are becoming increasingly popular in public health and clinical research. The choice of the non-inferiority margin is the cornerstone of the non-inferiority trial. When the effect of active control intervention is unknown, it can be interesting to choose the non-inferiority margin as a function of the active control intervention effect. In this case, the uncertainty surrounding non-inferiority margin should be taken into account in statistical tests.Methods: It was proposed in this study two procedures for the non-inferiority test with a flexible margin for the continuous endpoint. The proposed test procedures are based on the asymptotic test and confidence interval approach. Simulations have been used to assess the performances and properties of the proposed test procedures. An application was done on clinical real data. The purpose of this study was to assess the effectiveness and safety of clinical monitoring alone versus laboratory and clinical monitoring in HIV infected adults patients.Results: The two proposed test procedures have good properties for large sample sizes. It has been found that the confidence interval level determines approximately the level of significance. The The 80%, 90% and 95% two-sided confidence interval levels led approximately to a type I error of 5%, 2:5% and 1%respectively. For small sample sizes, the test with 80% confidence interval level was the most powerful.Conclusions: This study highlights the choice of non-inferiority margin as flexible and depending on the reference treatment in an active trial of non-inferiority. The results of the study show that the proposed methods are applicable in the practice.Trial registration : The trial data used in this study was from the "Stratall ANRS 12110 / ESTHER", registered with ClinicalTrials.gov, number NCT00301561. Date : March 13, 2006, url : https://clinicaltrials.gov/ct2/show/NCT00301561.
Clinical and economic outcomes of hospital pharmaceutical care: A systematic review and meta-analysis
Authors: Lin Guohua , Huang Rong , Zhang Jing , Li Gaojie , Chen Lei , Xi Xiaoyu
Published: May 2020

Background: Hospital clinical pharmacists have been working in many countries for many years and clinical pharmaceutical care have a positive effect on the recovery of patients. In order to evaluate the clinical effectiveness and economic outcomes of clinical pharmaceutical care, relevant clinical trial studies were reviewed and analysed. Methods: Two researchers searched literatures published from January 1992 to October 2019, and screened them by keywords like pharmaceutical care, pharmaceutical services, pharmacist interventions, outcomes, effects, impact, etc. Then, duplicate literatures were removed and the titles, abstracts and texts were read to screen literatures according to inclusion and exclusion criteria. Key data in the literature were extracted, and Meta-analysis was conducted using the literature with common outcome indicators. Results: A total of 3299 articles were retrieved, and 42 studies were finally included. Twelve of them were used for meta-analysis. Among the 42 studies included, the main results of pharmaceutical care showed positive effects, 36 experimental groups were significantly better than the control group, and the remaining 6 studies showed mixed or no effects. Meta-analysis showed that clinical pharmacists had significant effects on reducing systolic blood pressure and diastolic blood pressure and shortening hospitalization days (P<0.05), but no statistical significance in reducing medical costs (P>0.05). Conclusion: clinical pharmacists' pharmaceutical care has a significant positive effect on patients' clinical effects, but has no significant economic effect.
LINC02418 promotes colon cancer progression by suppressing apoptosis via interaction with miR-34b-5p/BCL2 axis
Authors: Tian Jun , Cui Peng , Li Yifei , Yao Xuequan , Wu Xiaoyu , Wang Zhirong , Li Chunsheng
Published: May 2020

Background
LncRNAs have been demonstrated to be functional regulators in tumor progression through interaction with various signaling pathways in multiple cancer types. However, the effect of LINC02418 on CRC progression still remains unclear.
Methods
LncRNA expression profile in CRC tissues was explored by using the TCGA database. The expressional level of LINC02418 in CRC patients was confirmed by qRT-PCR. Kaplan-Meier analyses was used to investigate the correlations between LINC02418 and OS of patients with CRC. After stably transducing sh-LINC02418 and sh-NC into HCT116 and LoVo cells, cell proliferative, migratory and invasive abilities were detected by CCK-8 assay, colony formation assay and trans-well assay, respectively. The binding between LINC02418 and miR-34b-5p, and the interaction between miR-34b-5p and BCL2 were determined by dual-luciferase assay. Western blot experiments were conducted to further explore the effect of miR-34b-5p on BCL2 signaling pathway. Rescue experiments were performed to uncover the role of LINC02418 /miR-34b-5p/ BCL2 axis in CRC progression.
Results
LINC02418 was upregulated in human colon cancer samples and its high expression correlated with poor prognosis. LINC02418 promoted cancer progression by enhancing tumor growth, cell mobility and invasiveness of colon cancer cells. Additionally, LINC02418 could physically bind to miR-34b-5p and subsequently interact with BCL2 signaling pathway. Down-regulation of LINC02418 reduced cell proliferation, but transfection of miR-34b-5p inhibitor or BCL2 in LINC02418-silenced colon cancer cells significantly promoted cell growth.
Conclusions
LINC02418 was upregulated in human colon cancer samples and could be used as indicator for prediction of prognosis. LINC02418 acted as a tumor driver by negatively regulating cell apoptosis through LINC02418 /miR-34b-5p/ BCL2 axis and in colorectal cancer.
How to Restore Rotation Center in Total Hip Arthroplasty for Developmental Dysplasia of the Hip with the Assistance of Three Dimensional Printing Technology? A Pilot Study
Authors: Zhang Heng , Liu Yang , Li Kuanxin , Zhang Zheng , Guan Jianzhong , Dong Qirong , Zhou Jiansheng
Published: May 2020

Background: It is technically challenging to restore hip rotation center exactly in total hip arthroplasty (THA) for patients with end-stage osteoarthritis secondary to developmental dysplasia of the hip (DDH) due to the complicated acetabular morphology changes.In this study, we developed a new method to restore hip rotation center exactly and rapidly in THA with the assistance of three dimensional (3-D) printing technology.Methods: Seventeen patients (21 hips) with end-stage osteoarthritis secondary to DDH who underwent THA were included in this study. Simulated operations were performed on 3-D printed hip models for preoperative planning. The Harris fossa and acetabular notches were recognized and restored to locate acetabular center. The agreement in the size of acetabular cup and bone defect between simulated operations and actual operations were analyzed.Clinical and radiographic outcomes were recorded and evaluated.Results: The sizes of the acetabular cup of simulated operations on 3-D printing models showed a high rate of coincidence with the actual sizes in the operations(ICC value=0.930) There was no significant difference statistically between the sizes of bone defect in simulated operations and the actual sizes of bone defect in THA( t value=0.03，P value=0.97). The average Harris score of the patients was improved from (38.33±6.07) preoperatively to the last follow-up (88.61±3.44) postoperatively.The mean vertical and horizontal distances of hip rotation center on the pelvic radiographs were restored to (15.12 ± 1.25）mm and ( 32.49±2.83) mm respectively. No case presented dislocation or radiological signs of loosening until last follow-up.Conclusions: The application of 3-D printing technology faciliate orthopedists to recognize the morphology of Harris fossa and acetabular notches , locate the acetabular center and restore the hip rotation center rapidly and acurately.
Skin Rash Following Administration of Apalutamide in Japanese Patients with Advanced Prostate Cancer: An Integrated Analysis of the Phase 3 SPARTAN and TITAN Studies and a Phase 1 Open-Label Study
Authors: Uemura Hiroji , Koroki Yosuke , Iwaki Yuki , Imanaka Keiichiro , Kambara Takeshi , Lopez-Gitlitz Angela , Smith Andressa , Uemura Hirotsugu
Published: May 2020

Background A higher incidence of apalutamide-related skin rash has been observed in Japanese patients with prostate cancer (PC).Methods This integrated analysis of data of Japanese patients from 2 global Phase 3 studies, SPARTAN (NCT01946204; patients with nonmetastatic castration-resistant PC [nmCRPC]) and TITAN (NCT02489318; patients with metastatic castration-sensitive PC [mCSPC]), and the Phase 1 study 56021927PCR1008 (NCT02162836; patients with metastatic CRPC [mCRPC]), assessed clinical risk factors of apalutamide-related skin rash as well as the potential correlation with plasma exposure to apalutamide. Kaplan-Meier method was used for time-to-event analyses. Clinical risk factors for skin rash were assessed using odds ratio.Results Data from 68 patients (SPARTAN: n = 34, TITAN: n = 28, 56021927PCR1008: n = 6) receiving apalutamide 240 mg orally once-daily were analysed. Rash (13 [19.1%]) and maculo-papular rash (11 [16.2%]) were the most frequently reported skin rash. All Grade and Grade 3 skin rash occurred in 35 (51.5%) and 10 (14.7%) patients, respectively. Most (85.7%) skin rash occurred within 4 months of apalutamide initiation and resolved in a median time of 1 month following the use of antihistamines, topical or systemic corticosteroids, with/without apalutamide dose interruptions/reductions. No significant clinical risk factors for the incidence of skin rash were observed. Areas under the curve (0–24 hours) (AUC0 − 24ss) at steadystate of plasma apalutamide concentration were numerically slightly higher in patients with skin rash than those without.Conclusions No clinical risk factors for rash could be detected. There is a potential correlation between incidence of skin rash and plasma exposure to apalutamide. In general, apalutamiderelated skin rash is easily managed, with appropriate treatment with or without dose adjustment.
The Expression and Prognostic Significance of the Nicotinic Receptor Cluster on 15q25 about CHRNA5 and PSMA4 mRNA in Lung Adenocarcinoma Utilizing TCGA Datasets
Authors: Wang Yuxiu , Wang Xiaolin , Wang Liping , Gu Jianjun , Gong Daohui , Jiang Jixin , Xu Xingxiang , Hu Suwei , Shu Yusheng , Min Lingfeng
Published: May 2020

Background To explore the mutations expression and prognostic significance of 15q25 (CHRNA5 and PSMA4) mRNA in lung adenocarcinoma (LAC) based on immunohistochemistry, TCGA and bioinformatics.Methods Mutations expression on chromosome 15q25 of 576 primary LAC patients was selected. And their survival and gene expression data were extracted from TCGA. The cell experiment about Beas-2b, A549 and H1299 cell lines were done to further prove the CHRNA5 and PSMA4 expression difference between lung cancer and normal cells. Immunohistochemistry data of CHRNA5 and PSMA4 were detected in LAC and normal tissues from 122 patients.Finally, Gene enrichment analysis (GSEA) was used to predict the regulatory genes of CHRNA5 and PSMA4.Results CHRNA5 and PSMA4 are frequently mutated in the TCGA (CHRNA5, 1.7%; PSMA4, 1.3%).The expression of CHRNA5 and PSMA4 were obviously higher in A549 and H1299 cells. Immunohistochemical staining revealed that the level of CHRNA5 and PSMA4 was considerably higher in LAC group than in normal group. There was a significant association between high expression of CHRNA5 and Smoking History (P = 0.011), Smoking History Pack Year Value(P = 0.010). Besides, there was a significant correlation between CHRNA5 and PSMA4 expression level and prognosis (P = 0.003; P = 0.008),and the higher expression, the worse prognosis. GSEA results suggested that CHRNA5 and PSMA4 high expression samples were respectively enriched to cell cycle, base excision repair, oxidative phosphorylation, protein export, aminoacyl tRNA biosynthesis etc.Conclusions The expression of CHRNA5 and PSMA4 mRNA has a significant impact on survival of LAC, they may be a potential target for treating patients with lung adenocarcinoma.
MicroRNA-214-3p Inhibits the Stem-Like Properties of Lung Squamous Cell Cancer by Targeting YAP1
Authors: Lu Tingting , Yang Ying , Li Ziming , Lu Shun
Published: May 2020

Background: Emerging evidence reveals that microRNAs (miRNAs) play a crucial role in tumor progression, but the underlying mechanism in lung squamous cell cancer (LSCC) remains unclear.Method : Western-blotting, Quantitative Real-time PCR (q-PCR) or was carried out to detect protein expression. Cell proliferation was evaluated by Cell Counting Kit-8 (CCK-8), Colony-forming assay or sphere-forming assay, respectively.Results: MiR-214-3p was found to be markedly de-regulated in LSCC tissues and was inversely related to the level of Yes-associated protein1 (YAP1), which is the core transcription regulator of the Hippo signaling. The Kaplan-Meier survival curves illustrated that patients with high miR-214 expression demonstrated more favorable clinical outcomes. The miR-214-3p overexpression repressed proliferation and cancer stem-like cells (CSCs) properties in vitro and in vivo xenograft mouse model. Mechanistically, luciferase activity assay revealed YAP1 was a direct target gene of miR-214-3p.Conclusion: Our findings illustrated that miR-214-3p plays a pivotal role in CSCs properties by targeting YAP1, which provides a potential treatment strategy for LSCC patients.
The evaluation of primary care physicians' knowledge on common respiratory diseases: Findings of Action Now Study: an online survey of primary care physicians in China
Authors: Pan Zihan , Yang Ting , Chi Chunhua , Liao Jiping , Chen Yahong , Huang Kewu , Wang Chen
Published: May 2020

Background

Primary care plays an important role in the management of respiratory diseases and primary care physicians’ ability is the cornerstone.
Methods

An e-questionnaire was distributed to attendees of respiratory diseases academic conferences in China from July, 2017 to December, 2018 to assess primary care physicians’ knowledge level of asthma, CAP, COPD and influenza in China.
Results

The feedback rate was 100%, including 4815 valid questionnaires, 3802 (79.0%) from community hospitals and 1013 (21.0%) from township hospitals. The average score of the questionnaire was 83.31(± 20.397) and 72.12(± 20.898) in township and community hospitals (P༜0.05), respectively. 61.4%, 48.7% and 42.5% of the primary care physicians were aware of clinical manifestations of COPD, asthma and simple influenza. 85.7%, 8.1%, 16.1% and 1.0% knew how to diagnose COPD, asthma, CAP and influenza, respectively. 94.4% of the physicians didn’t know bronchodilators for COPD; 53.7% knew non-pharmacological treatments for COPD. 73.6% were unable to deal with asthma attacks. 65.1% didn’t know what the most essential and important treatment for influenza was. 92% physicians didn’t know the management for stable COPD; 3.0% knew all prevention and management measures for asthma. 37.9% knew all the preventive measures for CAP. 44.9% didn’t know the important role of influenza vaccine in preventing influenza and its complications.
Conclusions

Primary care physicians in China had a poor knowledge on asthma, CAP, COPD and influenza, but township hospitals physicians had a better knowledge than community hospitals physicians.
Synergistic Effect of Platelet-rich Fibrin Releasate and Bone Marrow Stem Cells in Preventing Bone Loss in Ovariectomized Mouse
Authors: wong chin chean , Liao Jeng-Hao , Sheu Shi-Yuan , Lin Po-Yu , Chen Chih-Hwa , Kuo Tzong-Fu
Published: May 2020

Background:Osteoporosis is a metabolic bone disorder characterized by deterioration in the quantity and quality of bone tissue, with a consequent increase susceptibility to fracture.Methods: In this study, we sought to determine the efficacy of platelet-rich fibrin releasate (PRFr) in augmenting the therapeutic effects of stem cell-based therapy in treating osteoporotic bone disorder. An osteoporosis mouse model was established through bilateral ovariectomy on 12 week-old female ICR (Institute of Cancer Research) mice. Eight weeks postoperatively, the ovariectomized(OVX) mice were left untreated (control) or injected with PRFr, bone marrow stem cells (BMSCs), or the combination of BMSCs and PRFr. Two different injection (single versus quadruple)dosages were testedto investigate the accumulative effects of BMSCS and PRFr on bone quality. Eightweeksafter injection, the changes in tibial microstructural profiles included the percentage of bone volume versus total tissue volume (BV/TV, %), bone mineral density (BMD, g/cm3), trabecular number (Tb.N, number/mm), and trabecular separation (Tb.Sp, mm) and bony histology were analyzed. Results: Postmenopausal osteoporosismodel was successfully established in OVX mice, evidenced by reduced BMD, decreased BV/TV, lower Tb.N but increased Tb.Sp..Eight weeks after injection, there was no significant changes to BMD and bone trabeculae could be detected in mice that received low-dose regimen. In contrast, in mice which received 4 doses of combined PRFr and BMSCs, the BMD, BV/TV, and TB.N increased, and the TB.Sp decreased significantly compared to untreated OVX mice. Moreover, the histological analysis showed the trabecular spacingbecome narrower in OVX-mice treated with high-dose injection of BMSCs and combined PRFr and BMSCs than untreated control.Conclusion: The systemic administration of combined BMSCs and PRFr protected against OVX-induced bone mass loss in mice. Moreover, the improvement of bony profile scores in quadruple injection group is better than the single-injection group, probably through the increase in effect size of cells and growth factors. Our data also revealed the combination therapy of BMSCs and PRFr has a synergistic effect in enhancing osteogenesis, which may provide insight for the development of a novel therapeutic strategy in osteoporosis treatment.
Neuropathic Pain During Common Lumboradiculalgia in Subsaharian Africa: Bicentric Study About 409 Patients.
Authors: Kaboré Fulgence , Ouattara Baly , Tiendrébéogo Stéphanie Wendlassida Joelle , Diomandé Mohamed , Sougué Charles , Coulibaly Abidou , Nikiéma Pascal Ismaël , Eti Edmond , Ouedraogo Dieu-Donné
Published: May 2020

Background: Neuropathic pain is defined as pain caused by injury or disease of the somatosensory nervous system. Our purpose was to study the frequency of neuropathic pain among common lumboradiculalgia patients in subsaharian Africa patients. Methods: This was a bicentric cross-sectional study from February 2015 to 30 July 2015 in the first center and then from February 2017 to 30 July 2017 in the second center, i.e. a duration of 6 months for each study site. All patients with a common lomboradiculalgie were included. DN4 questionnaire was used for the diagnosis of neuropathic pain.Results : Four hundred and nine patients with common lumboradiculalgia were included. There were 278 females (67.97%) and 131 males (32.03%), for a sex ratio of 0.47. The average age was 51.75 ± 13.84 years with extremes of 16 and 88 years. One hundred and seventy-five patients ( 42.8%) had NP. Statistical analysis showed a statistically significant association between the existence of NP and age over 60 years and the existence of radiculalgia. Conclusions: Our study confirms the high frequency of neuropathic pain during common lumboradiculalgia. Age over 60 years and Poorly systematized radiculalgia were associated to NP.
Predictors of an Unfavourable Outcome After Mechanical Thrombectomy for Acute Ischaemic Stroke
Authors: Deng Qi-Wen , Zhou Feng , Zhang Guoxing , Hou Jian-Kang , Liu Yu-Kai , Chen Xiang-Liang , Zhang Yu-Qiao , Jiang Teng , Wang Wei , Sun Hui-Ling , Shen Rui , Shi Hong-Chao , Zhou Jun-Shan
Published: May 2020

Background: Mounting evidence has shown that mechanical thrombectomy (MT) improves clinical outcomes for large vessel occlusions (LVOs) in patients with acute ischaemic stroke (AIS) of the anterior circulation. The present study aimed to provide a comprehensive analysis of risk factors associated with clinical outcomes in AIS patients receiving MT.Methods: A total of 212 consecutive patients who underwent MT for AIS were enrolled in the present study. Clinical characteristics were recorded at admission. Two endpoints were defined according to the 3-month modified Rankin scale (mRS) score after AIS (good outcome, mRS 0–2; and death, mRS 6). Additionally, we compared the clinical outcomes and safety of MT alone and bridging therapy in AIS patients.Results: Of the 212 patients treated with MT, 114 (53.77%) patients had a good outcome and 31 (14.62%) died. The incidence of a worse outcome after MT was significantly elevated in males and patients with high WBC counts, high admission blood glucose levels, high baseline NIHSS scores and a long interval time from groin puncture to reperfusion in AIS patients treated with MT after adjustment for covariates (P < 0.05); these risk factors were further confirmed by our constructed nomograms. In addition, we observed no significant benefit of bridging therapy compared to MT alone in AIS patients.Conclusions: The factors associated with an unfavourable outcome in AIS patients treated with MT were male sex, admission WBC, admission blood glucose, NIHSS, and the interval time from groin puncture to reperfusion.
Adaptation strategies in energy sector enterprises
Authors: Borowski Piotr
Published: May 2020

Background

Energy companies face challenges arising from the ecological, social and legal environment. The reduction of negative impact on the environment and society while maintaining sustainable development affects the formation of new development strategies. Adaptation strategy to external requirements is the subject of completed research.
Methods

As a new approach to carrying out strategic analysis, two models were used simultaneously (inductive and hypothetical-deductive) which allows for realization qualitative (interviews, observations) and quantitative (statistical analysis) research methods generally called multimode methods. That is why induction and hypothetical-deductive models were used in the study to correctly formulate generalizations and put forward appropriate hypotheses. The study was conducted on the basis of enterprises from the energy sector, and the adaptation strategy was presented as a new approach in the energy sector, moving out or proposing the theory of active and passive adaptation. The study analyzed the relationship between the macro environment (political, legal, social, technological) and the implemented adaptation strategy in energy enterprises.
Results

The results of the conducted surveys show the impact of macroenironmental elements on strategic decisions. Power companies quite highly assess the impact of the national and EU legal and political environment on the actions taken. There is also association in the decision process concerning the frequency of market analysis in the group of enterprises.
Conclusion

The issue of adapting the enterprise to the environment is concerning its involvement in the field of research and development (R + D). Depending on the size of the company, there is a difference in the number of companies carrying out research on their own side or by outsourcing. Regulations and the technological environment force innovations of energy companies in the direction of reducing harmful impact on the environment and society. Legal and political factors (both national and EU) determine the activities of power companies (in each group: small, medium and large) and determine the choice of adaptation strategies. The intensity of adaptation to the requirements of the environment changes depends on the size of the company. Power companies apply passive adaptation strategies and as they increase their position on the market, they begin to implement an active adaptation strategy.
"Healthy Akame!" a Community-Government-University collaboration in community-based participatory research (CBPR) with mixed-method to address health issue in rural Japan community
Authors: Haya Marinda Asiah Nuril , Ichikawa Shuhei , Shibagaki Yukino , Board Akame Machijuu Genki Project Community Advisory , Wakabayashi Hideki , Takemura Yousuke
Published: May 2020

Background: Public health programs are commonly designed as one-fit for all, to solve problems with high prevalence or cost. However, differences in community’s values and interest might create gaps between health program’s objectives and its implementation. We hypothesized that implementation of community-based participatory research (CBPR) which involve community in every step, can promote more effective program and empower community. This first step of CBPR aimed to assess community needs and develop tailored program for community in rural Japan.Methods: This study applied sequential exploratory mixed-method study (qualitative followed by quantitative). First, we formed community advisory board (CAB) that represented community organization, city officials, and university researchers. CAB conducted group discussions with community residents to identify community’s health issues and strength. Records of group discussions were analyzed with thematic analysis and developed into questionnaire. Questionnaire was sent to all households in community to get priority score of health issues and proposed action, also to assess the willingness to participate in community health program. CAB designed program based on overall results.Results: Ten group discussions with 68 participants generated the following health issues: 1) Diseases, 2) Unhealthy behavior, and 3) Unsupportive environment. Nature, vacant lot, and local farms were considered as local strength. From 1470 households, 773 questionnaires were collected. Cancer, lifestyle-related diseases, and cerebrovascular diseases were ranked highest as health problems. Improving services and access for medical checkup were considered most important. Utilization of public space, local farm, and collaboration with community health office came next for proposed action. Female, people who practice preventive behavior and have high commitment to community were more likely to attend community health program. Almost half participants were unwilling to attend, with majority were work-related reasons. Taking consideration of feasibility and target coverage, CAB decided to develop community program to tackle lifestyle-related diseases. To make advantage of local resources, the main activities centered on health education classes, cooking classes, healthy cafeteria, local farmers market, exercise classes and sports events.Conclusions: CBPR approach was useful to identify community’s needs and to develop a community-based health program that address the needs by utilizing local strength.
Open secret, or imagined problem: Drug and alcohol use in Tanzanian road traffic accident drivers
Authors: Dozois Adeline Rose , Nkondora Paulina , Noste Erin E , Mfinanga Juma , Sawe Hendry R , Runyon Michael S.
Published: May 2020

Background

Road traffic accidents (RTAs) have emerged as an important public health problem in low and middle-income countries, where 90% of RTA deaths occur. The World Health Organization has suggested strategies to address excess mortality from RTAs including efforts to combat driving while intoxicated. The association between substance use and RTAs is well known in high-income countries, but data is more limited in low-resource settings including Tanzania. The objective of this study is to examine the prevalence of drug use, alcohol use, and substance use disorders in Tanzanian RTA drivers.
Methods

This prospective observational study was conducted in the Emergency Department of Muhimbili National Hospital, a national referral hospital in Dar es Salaam, Tanzania. Research assistants available 24 hours per day enrolled adult drivers who presented within 24 hours of an RTA. In eligible patients, research assistants collected a saliva test of blood alcohol content (BAC) and a urine drug screen (UDS), and administered a validated substance abuse screening tool, the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), Patients were excluded from individual analyses if they could not produce a saliva or urine test or answer questions. Primary outcomes were rates of positive BAC, UDS and self-reported high-risk alcohol and drug use patterns. Descriptive statistics were calculated using Excel.
Results

We screened 5264 trauma patients and enrolled 538, in whom 191 had a BAC, 362 had a UDS, and 417 had a complete ASSIST. Fifteen of 191 patients (7.8%) had a positive BAC, and 68/362 (18.7%) patients had a UDS that was positive for at least one drug. Based on the ASSIST, 104/417 (24.5%) of patients were at moderate or high risk for alcohol use disorder. Few were at risk for disordered use of other non-tobacco substances.
Conclusion

In our population of drivers presenting within 24 hours of an RTA, positive BAC and UDS tests were rare. A substantial portion of the population was at moderate to high risk for an alcohol use disorder. Ideal screening for substance use in trauma populations may involve a verbal screening tool, particularly when the time between injury and hospital arrival is delayed.
The Construction and Grade Development of the Evaluation System of the Physical Ability Index of Preschooler
Authors: WANG Tingting , YAN Zhili
Published: May 2020

Purpose

Motor skills(MS), physical activity(PA) and physical fitness(PF) are important factors in preschooler's healthy growth. Thus, the aim of this study was to integrate the level of MS、PA and PF,so as to build an evaluation system of preschooler's physical activity index (PAIP). Method: Preschooler (n = 600) from kindergarten in Changsha, the capital city of Hunan Province in Central China were recruited, and a three-axis accelerometer (ActiGraph GT3X-BT) was used to the PA status of them, and the test of gross motor development three edition (TGMD-3) was used to the MS status of them, and national fitness test standard of China was used to PF status of them. We conducted simultaneous path modeling in AMOS to test moderation effects.
Results

Based on the measurements of MS、PA and PF༌a PAIP model was built using a structural equation modeling (SEM) approach. This model combined physical fitness, physical activity and motor skills together and to reveals that the promotion of motor skills to the physical health of preschoolers has greater benefits than physical fitness and physical activity. At the same time, the evaluation index system and reference level of physical movement ability index of preschool children are developed, which provides an operational way to look forward to the development of physical health of preschool children.
Conclusions

The theoretical structure model of PAIP suggests that kindergarten administrators and physical education teachers should put the multi-directional development and types of motor skills of preschool children in the first place.
Modulation of mechanosensory vibrissal responses in the trigeminocervical complex by stimulation of the greater occipital nerve in a rat model of trigeminal neuropathic pain
Authors: García-Magro Nuria , Negredo Pilar , Martin Yasmina B. , Nuñez Angel , Avendaño Carlos
Published: May 2020

Background: Stimulation of occipital or trigeminal nerves has been successfully used to treat chronic refractory neurovascular headaches such as migraine or cluster headache, and painful neuropathies. Convergence of trigeminal and occipital sensory afferents in the "trigeminocervical complex" (TCC) from cutaneous, muscular, dural, and visceral sources is a key mechanism for the input-induced central sensitization that may underlie the altered nociception. Both excitatory (glutamatergic) and inhibitory (GABAergic and glycinergic) mechanisms are involved in modulating nociception in spinal and medullary dorsal horn neurons, but the mechanisms by which nerve stimulation effects occur are unclear. This study was aimed at investigating the acute effects of electrical stimulation of the greater occipital nerve (GON) on the responses of neurons in the TCC to the mechanical stimulation of the vibrissal pad.Methods: Adult male Wistar rats were used. Neuronal recordings were obtained in laminae II-IV in the TCC in control, sham and infraorbital chronic constriction injury (CCI-IoN) animals. GON was isolated and electrically stimulated. Responses to stimulation of vibrissae by brief air pulses were analyzed before and after GON stimulation. In order to understand the role of neurotransmitters involved, specific receptor blockers of NMDA (AP-5), GABAA (bicuculline, Bic) and Glycine (strychnine, Str) were locally applied.Results: GON stimulation produced a facilitation of the response to light facial mechanical stimuli in controls, and an inhibition in CCI-IoN cases. AP-5 reduced responses to GON and vibrissal stimulation and blocked the facilitation of GON on vibrissal responses found in controls. The application of Bic or Str reduced significantly the facilitatory effect of GON stimulation on the response to vibrissal stimulation in controls. However, the opposite effect was found when GABAergic or Glycinergic transmission was prevented in CCI-IoN cases.Conclusions: GON stimulation modulates the responses of TCC neurons to light mechanical input from the face in opposite directions in controls and under CCI-IoN. This modulation is mediated by GABAergic and Glycinergic mechanisms. These results will help to elucidate the neural mechanisms underlying the effectiveness of nerve stimulation in controlling painful craniofacial disorders, and may be instrumental for identifying new therapeutic targets for their prevention and treatment.
Type of the Paper: Article Homogenous Gamma-Irradiation by a Linear Accelerator for Inactivation of viruses in Plasma Samples, a Pilot Study with HIV-1-Infected Plasma
Authors: Tonino Rik , Franken Eric , Elzakker Erika van , Gescher Frank , Schipperus Martin
Published: May 2020

BACKGROUNDThe risk of the transmission of (emerging) infectious diseases via blood products is a major public health concern. Therefore, it has been a long-sought goal to find a cost-effective way to sterilise blood after collection. No pathogen inactivation (PI) techniques are available for red blood cells on the market yet, though phase III trials are currently performed. γ-irradiation could theoretically inactivate viruses in red blood cells (RBCs). The dose of γ-irradiation needed to achieve sterility causes irreversible damage to the red blood cells and is therefore not suitable for PI of RBC concentrates. Inhomogeneous irradiation has always been used in the past, but leads to inconsistent measurements and uncertainty of results. By contrast, homogeneous irradiation may achieve the sterility assurance level (SAL) at much lower doses. If a maximum of 25 Gy of homogeneous γ-irradiation is able to sterilise blood products, this would be a very attractive PI method for RBC products. METHODSThis proof-of-concept study aims to sterilise HIV-1 infected plasma using homogeneous γ-irradiation. Six HIV-1 infected plasma samples were irradiated with 25 Gy of homogeneous γ-irradiation. HIV-1 RNA-loads before and after were compared.RESULTSNo difference was found in the HIV-1 RNA loads within the limitations of the test used before and after the irradiation. Therefore, homogeneous γ-irradiation appears not to be feasible as a PI-technique for HIV-1 in RBC products. CONCLUSIONThis inevitably means SAL will not be achieved for all viruses with up to 25 Gy of homogeneous γ-irradiation.
Outcomes After Transcatheter Aortic Valve Replacement in Cancer Survivors with Prior Chest Radiation Therapy: A Systematic Review and Meta-Analysis
Authors: Zafar Meer Rabeel , Mustafa Syed Farrukh , Miller Timothy W , Alkhawlani Talal , Sharma Umesh C
Published: May 2020

Background: Cancer survivors with prior chest radiation therapy (C-XRT) frequently present with aortic stenosis (AS) as the first manifestation of radiation-induced heart disease. They are considered high-risk for surgical valve replacement. Transcatheter aortic valve replacement (TAVR) appears as an attractive option for this patient population but the outcomes are not well established in major clinical trails. The authors performed a systemic review and meta-analysis of clinical studies for the outcomes after TAVR in cancer survivors with prior C-XRT.Methods: Online databases were searched from inception to April 2020 for studies evaluating the outcomes of TAVR in patients with and without C-XRT. We analyzed the pooled estimates (with their 95% confidence intervals) of the odds ratio (OR) for the all-cause mortality at 30-day and 1-year follow-ups, 4-point safety outcomes (stroke, major bleed, access-related vascular complications and need for a pacemaker), a 2-point efficacy outcome (mean aortic valve gradient and left ventricular ejection fraction) and worsening of congestive heart failure (CHF). Four studies were included following 2054 patients with and without prior C-XRT exposure (164 patients and 1890 patients respectively).Results: The C-XRT group had similar 30-day mortality compared to the control group (OR 1.29, 95% CI 0.64 to 2.58, p=0.48). The 1-year mortality was higher in the C-XRT group (OR 1.97, CI 1.15 to 3.39, p=0.01). Apart from higher congestive heart failure (CHF) exacerbation in the C-XRT group (OR 2.03, CI 1.36 to 3.04, p=0.0006), TAVR resulted in similar safety and efficacy outcomes in both groups.Conclusion: TAVR in the C-XRT group has similar 30-day mortality, safety, and efficacy outcomes compared to the control group; however, they have higher 1-year mortality and CHF exacerbation. The quality of analyzed data is low, warranting randomized trials to assess the true benefits of TAVR in these patients.
Development and validation of a novel stem cell subtype for bladder cancer based on stem genomic profiling
Authors: Tang Chaozhi , Ma Jiakang , Liu Xiuli , Liu Zhengchun
Published: May 2020

Background

Bladder cancer is the fifth most common type of cancer worldwide, with high recurrence and progression rates. Although considerable progress has been made in the treatment of bladder cancer through accurate typing of molecular characteristics, little is known about the various genetic and epigenetic changes that have evolved in stem and progenitor cells. Thus, we developed a novel stem cell typing method to fill this gap.

Methods

Based on six published genomic data sets, we used 26 stem cell gene sets to classify each data set. Unsupervised and supervised machine learning methods were used to perform the classification.

Results

We classified BLCA into three subtypes—high stem cell enrichment (SCE_H), medium stem cell enrichment (SCE_M), and low stem cell enrichment (SCE_L)—based on multiple cross-platform data sets. The stability and reliability of the classification were verified. The stemness index obtained from the one-class logistic regression machine learning method showed that the degree of tumor stem cell enrichment was not proportional to the stemness index. Compared with the other subtypes, SCE_H showed the highest degree of cancer stem cell concentration, lowest stemness index, and highest level of immune cell infiltration and was the most sensitive to predicted immune checkpoint inhibitor treatment. However, this group showed the worst prognosis. Comparison of gene set enrichment analysis results for pathway enrichment of various subtypes revealed that the SCE_H subtype activates some important pathways regulating cancer occurrence, development, and even poor prognosis, including epithelial mesenchymal transition, hypoxia, angiogenesis, KRAS signal up-regulation, the interleukin 6-mediated Jak-STAT signaling pathway, and inflammatory response. Two identified pairs of transcription factors, GRHL2 and GATA6 and IRF5 and GATA3 , likely have opposite regulatory effects on SCE_H and SCE_L, respectively.

Conclusions

The identification of BLCA subtypes based on cancer stem cell gene sets revealed the complex mechanism of carcinogenesis causing BLCA and provides a new direction for the diagnosis and treatment of BLCA.