bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of the community midwifery model on maternal and newborn health service utilization and outcomes in Busia County of Kenya: A quasi-experimental study
Authors: Shikuku Duncan Ndombi , Tanui Geofrey , Wabomba Mercy , Wanjala Dennis , Friday Josephine , Peru Taphroze , Atamba Evelyne , Sisimwo Kenneth
Published: September 2020

Background: Poor women in hard-to-reach areas are least likely to receive healthcare and carry the burden of maternal and perinatal mortality from complications of childbirth. This study evaluated the effect of an enhanced community midwifery model on skilled attendance during pregnancy/childbirth as well as on maternal and perinatal outcomes against the backdrop of protracted healthcare workers' strikes in rural Kenya. Methods: The study used a quasi-experimental (one-group pretest-posttest) design. The study spanned three time periods (P), including December’2016-February’2017 when medical doctors were on strike (P1), March -May’2017 when no healthcare providers were on strike (P2), and June-October’2017 when nurses/midwives were on strike (P3), which was also the period when the project enhanced the capacity of community midwives (CMs) to provide services at the community level. Analysis entailed comparison of frequencies and means of maternal and newborn health service utilization data across the three time periods. Results: The monthly average number of clients obtaining services from CMs across the three time periods (P1-P2-P3) was as follows: first antenatal care (ANC) (1.8-2.3-9.9), fourth ANC (1.4-1.0-7.1), skilled birth (1.5-1.7-13.1) and the differences in means were statistically significant (p<0.05). Over the period, the monthly average number of clients obtaining services from health facilities was as follows: first ANC (55.7 -70.8-4.0), fourth ANC (29.6-38.1-1.2) and skilled birth (63.1-87.4-5.6), p<0.05. There were no statistically significant differences in the average number of clients obtaining services from CMs or health facilities between P1 and P2 (p>0.05). There was, however, a statistically significant increase in the average number of clients obtaining services from CMs in P3, which was accompanied by a statistically significant decline in the average number of clients of obtaining services from health facilities (p<0.05). First ANC increased by 68, fourth ANC by 75, skilled births by 68, and postnatal care by 33 percentage points in P3 (p<0.0001). There was a non-significant decline in macerated stillbirths and neonatal deaths in P3.Conclusions: The findings underscore the importance of integrating community-level health service providers (CMs and health volunteers) into the primary health care system to complement service delivery according to their level of expertise, especially in low-resource settings.
Discovery of Vanoxerine Dihydrochloride as a CDK2/4/6 Triple-Inhibitor for the Treatment of Human Hepatocellular Carcinoma
Authors: Zhu Ying , Ke Kun-Bin , Xia Zhong-Kun , Li Hong-Jian , Su Rong , Dong Chao , Zhou Feng-Mei , Wang Lin , Chen Rong , Wu Shi-Guo , Zhao Hui , Gu Peng , Leung Kwong-Sak , Wong Man-Hon , Lu Gang , Zhang Jian-Ying , Jiang Bing-Hua , Qiu Jian-Ge , Shi Xi-Nan , Lin Marie Chia-mi
Published: September 2020

Background: Cyclin-dependent kinases 2/4/6 (CDK2/4/6) play critical roles in cell cycle progression, and their deregulations are hallmarks of hepatocellular carcinoma (HCC).Methods: We used the combination of computational and experimental approaches to discover a CDK2/4/6 triple-inhibitor from FDA approved small-molecule drugs for the treatment of HCC. Results: We identified vanoxerine dihydrochloride as a new CDK2/4/6 inhibitor, and a strong cytotoxic drug in human HCC QGY7703 and Huh7 cells (IC50: 3.79 μM for QGY7703 and 4.04 μM for Huh7 cells). In QGY7703 and Huh7 cells, vanoxerine dihydrochloride treatment caused G1‑arrest, induced apoptosis, and reduced the expressions of CDK2/4/6, cyclin D/E, retinoblastoma protein (Rb), as well as the phosphorylation of CDK2/4/6 and Rb. Drug combination study indicated that vanoxerine dihydrochloride and 5-Fu produced synergistic cytotoxicity in vitro in Huh7 cells. Finally, in vivo study in BALB/C nude mice subcutaneously xenografted with Huh7 cells, vanoxerine dihydrochloride (40mg/kg, i.p.) injection for 21 days produced significant anti‑tumor activity (p<0.05), which was comparable to that achieved by 5-Fu (10mg/kg, i.p.), with the combination treatment resulted in synergistic effect. Immunohistochemistry staining of the tumor tissues also revealed significantly reduced expressions of Rb and CDK2/4/6 in vanoxerine dihydrochloride treatment group. Conclusions: The present study is the first report identifying a new CDK2/4/6 triple inhibitor vanoxerine dihydrochloride, and demonstrated that this drug represents a novel therapeutic strategy for HCC treatment.
Causal relationships between genetically determined metabolites and human intelligence: A Mendelian randomization study
Authors: Yang Jian , Zhao Binbin , Qian Li , Gao Fengjie , Fan Yanjuan , He Xiaoyan , Ma Qingyan , Yang Lihong , Yan Bin , Wang Wei , Ma Xiancang
Published: September 2020

Intelligence predicts important life and health outcomes, but the biological mechanisms underlying differences in intelligence are not yet understood. The use of genetically determined metabotypes (GDMs) to understand the role of genetic and environmental factors, and their interactions, in human complex traits has been recently proposed. However, this strategy has not been applied to human intelligence. Here we implemented a two-sample Mendelian randomization (MR) analysis using GDMs to assess the causal relationships between genetically determined metabolites and human intelligence. The standard inverse-variance weighted (IVW) method was used for the primary MR analysis and three additional MR methods (MR-Egger, weighted median, and MR-PRESSO) were used for sensitivity analyses. Using 25 genetic variants as instrumental variables (IVs), our study found that 5-oxoproline was associated with better performance in human intelligence tests (P IVW = 9 · 25×10 -5 ). The causal relationship was robust when sensitivity analyses were applied (P MR-Egger = 0 · 0001, P Weighted median = 6 · 29×10 -6 , P MR-PRESSO = 0 · 0007), and no evidence of horizontal pleiotropy was observed. Similarly, also dihomo-linoleate (20:2n6) and p-acetamidophenylglucuronide showed robust association with intelligence. Our study provides novel insight by integrating genomics and metabolomics to estimate causal effects of genetically determined metabolites on human intelligence, which help to understanding of the biological mechanisms related to human intelligence.
Investigation of availability, demand, targets, and development of Renewable Energy in 2017-2050: A case study in Indonesia
Authors: Erdiwansyah Erdiwansyah , Mahidin Mahidin , Husin Husni , Nasaruddin Nasaruddin , Khairil Khairil , Zaki Muhammad , Jalaluddin Jalaluddin
Published: September 2020

Abundant potential of renewable energy (hereinafter called RE) in Indonesia is predicted to replace conventional energy which continues to experience depletion year by year. However, until now, the use of RE has only reached 2% of the existing potential of 441.7GW. The main overview of this work is to investigate the availability of RE that can be utilized for electricity generation in Indonesia. National energy demand and targets in the long run during the 2017-2050 period are also discussed. Besides, government policies in supporting RE development are considered in this work. The results show that the potential of RE in Indonesia can be utilized and might replace conventional energy for decades. The use of RE for electricity generation can be achieved by employing a government policy that supports the investor as the executor of RE development. The selling price of electricity generated from RE is cheaper than electricity generated from fossils; this makes economy is more affordable for people. Finally, the target set by the government for utilizing RE as the main energy in Indonesia can be done by implementing several policies for the RE development. Thus, greenhouse gas emissions and the use of petroleum fuels can be reduced.
Predictive factors of outcome following nonfermenting gram-negative bacilli peritonitis in peritoneal dialysis
Authors: Santos Ana Claudia Moro Lima dos , Hernandes Rodrigo Travanelli , Montelli Augusto Cezar , Monteiro Aydir Cecília Marinho , Barbosa Thais Alves , Camargo Carlos Henrique , Ferreira Adriano Martison , Mondelli Alessandro Lia , Cunha Maria de Lourdes Ribeiro de Souza da , BARRETTI PASQUAL
Published: September 2020

Background Peritonitis due to gram-negative bacilli (GNB), particularly nonfermenting GNB (NF-GNB), is a serious complication of peritoneal dialysis (PD) with a low resolution rate. Beyond the patient’s condition, microbiological properties such as antimicrobial resistance, biofilms and the production of other virulence factors can explain the bad outcomes. This study aimed to evaluate the influence of the patient’s condition, the microbiological characteristics, including biofilm production, and the treatment of peritonitis on peritonitis resolution.Methods We reviewed the records of 62 new peritonitis episodes caused by NF-GNB that occurred between 1997 and 2015 at a single university center. The influence of microbiological and clinical factors on resolution chance was analyzed by logistic regression.Results The etiologies were species of Pseudomonas (51.6%), Acinetobacter (32.2%), and others (16.1%). There was a high (72.9%) proportion of biofilm producers’ lineages. The in vitro susceptibility rate of Pseudomonas spp. to amikacin, ciprofloxacin, and ceftazidime was significantly greater than that of Acinetobacter spp. and other species; however, there was a similar low resolution rate (<45%) among the episodes attributable to Pseudomonas spp, Acinetobacter spp, and other NF-GNB. Pre-existent exit-site infection was independently associated with nonresolution. No other factor, including biofilm production, was associated with the outcome. Conclusions Peritonitis due to NF-GNB in PD is a severe infection with a reduced resolution rate, and pre-existent exit site infection negatively influences the chance of resolution. The higher in vitro susceptibility of Pseudomonas compared to that of other NF-GNB with a similar resolution rate, suggests bacterial virulence factors beyond biofilm and can act in concert, thereby worsening the outcome.
Development of a superstructure optimization framework for the design of municipal solid waste facilities
Authors: Puchongkawarin Channarong , Mattaraj Supatpong
Published: September 2020

The main objective of this study is to develop a decision-making tool for the design of the optimal municipal solid waste (MSW) facilities based on superstructure optimization. Currently, the disposal of MSW is a major problem due to the lack of awareness of the negative impacts resulting from dumping MSW into the environment. This poses a challenge for the authorities. MSW valorization such as anaerobic digestion (AD), pyrolysis, gasification etc has been increasingly focused on as an approach when handling MSW to enhance both economic and environmental sustainability. However, with an increasing array of processing technologies, the design of MSW facilities involving the integration of these technologies is becoming tedious and unmanageable. To deal with this problem, superstructure optimization is proposed. It is an effective tool for the design of several chemical processes because it is able to consider all potential process alternatives including the optimal solution using mathematical models based on mass and energy balances. Uncertainty is incorporated into the optimization framework to enhance the robustness of the solution. The proposed methodology was applied in the design process of the MSW facility in Ubon Rathathani province, Thailand, with the objective function of maximizing the profit. The optimization problem was developed as Mixed Integer Linear Programming (MILP) and it was solved using an optimization platform, GAMS, with CPLEX as the solver related to obtaining the optimal solution. The results show there to be as positive profit that is economically viable compared to the use of landfill technology.
Adsorptive removal of malachite green dye from aqueous solution onto activated carbon of Catha edulis stem as a low cost bio-adsorbent
Authors: Abate Gietu yirga , Alene Adugna Nigatu , Habte Adere Tarekegne , Getahun Desiew Mekuanint
Published: September 2020

Background: The release of hazardous synthetic dyes into industrial effluents has emerged as an environmental problem requiring remediation. The present study focused on the preparation of a new and environmentally-friendly material (adsorbent) for the remediation of hazardous dyes from aqueous solution. The low cost adsorbent was prepared from locally available khat (Catha edulis) stem which considered as waste and accumulated on waste disposal areas of Woldia town, Ethiopia. Comprehensive characterization studies were carried out on the bio-adsorbent such as proximate analyses, specific surface area, point of zero charge and FT-IR analysis. Results: The proximate analysis shows the prepared adsorbent has very high fixed carbon content (83.65%), which refers to high quality of the adsorbent. The adsorption performance of the prepared activated carbon was optimized by varying operational parameters such as initial dye concentration (10 mg/L), pH (10), dosage (0.5 g), and contact time (60 min). The maximum removal efficiency of the prepared adsorbent at those optimum conditions was 98.8%. The experimental data was tested by most common kinetics and isotherm models. It was observed that the pseudo-second-order kinetic model fits better with good correlation coefficient and the equilibrium data fitted well with the Freundlich isotherm model.Conclusion: In summery this study demonstrated that the waste bio sorbent could be employed as an effective and eco-friendly alternative for the cleanup of dye-polluted aqueous system.
Infra-acetabular screw exited between ischial tuberosity and ischial spine is more suitable for Asian population: A 3D Morphometric study
Authors: Liu Fei , Feng Xiaoreng , Xiao Yang , Xiang Jie , Chen Keyu , Deng Yihang , Lv Jiaxin , Chen Bin
Published: September 2020

Background Recently, the infra-acetabular screw has been proposed for use in treatment of acetabular fractures as a part of a periacetabular fixation frame. Biomechanical studies have shown that an additional infra-acetabular screw placement can enhance the fixation strength of acetabular fracture internal fixation. Currently, the reported exit point of the infra-acetabular screw has been located at the ischial tuberosity (Screw I). However, our significant experience in placement of the infra-acetabular screw has suggested that when the exit point is located between the ischial tuberosity and the ischial spine (Screw II), the placement of a 3.5 mm infra-acetabular screw may be easier for some patients. We conducted this study in order to determine the anatomical differences between the two different IACs. Methods The raw datasets were reconstructed into 3D models using the software MIMICS. Then, the models, in the STL format model, were imported into the software Geomagic Studio to delete the inner triangular patches. Additionally, the STL format image processed by Geomagic Studio was imported again into MIMICS. Finally, we used an axial perspective based on 3D models in order to study the anatomical parameters of the two infra-acetabular screw corridors with different exit points. Hence, we placed the largest diameter virtual screw in the two different screw corridors. The data obtained from this study presents the maximum diameter, length, direction, and distances between the entry point and center of IPE. Results In 65.31% males and 40.54% females, we found a screw I corridor with a diameter of at least 5 mm, while a screw II corridor was present in 77.55% in males and 62.16% in females. Compared to screw I, the length of screw II is reduced, the angle with the coronal plane is significantly reduced, and the angle with the transverse plane is significantly increased.Conclusions For East Asians, changing the exit point of the infra-acetabular screw can increase the scope of infra-acetabular screw use, especially for females.
Genomic characterization of carbapenem resistant Escherichia coli from multiple hospitals in Nanjing, China: focusing on frequent co-occurrence of blaNDM and blaKPC-2 
Authors: Cao Xiaoli , Zheng Jie , Cheng Li , Zhou Wanqing , Zhang Zhifeng , Zhang Kui , Shen Han , Hamprecht Axel
Published: September 2020

Background: The increasing emergence of carbapenem resistant Escherichia coli (CREC) poses a potential threat to public health, hence genomic characterization of isolates is needed for a better understanding of its transmission and implementation of infection control measures. Materials and methods：Eleven CREC isolates were collected in 2015 from 6 hospitals in Nanjing, China, and analyzed using whole genome sequencing. Resistance determinants, virulence elements, multi-locus sequence type (MLST), serotypes, phylogeny and fimH types were determined. Results: All of the CREC carried at least one carbapenemase. NDM-5 (n=9) was the most frequent carbapenemase, followed by KPC-2 (n=3) and NDM-1 (n=2); three isolates produced NDM-5 and KPC-2. Ten out of the 11 isolates co-carried blaCTX-M variants. MLST analysis found 7 distinct STs, including ST410 (n=2), ST3489 (n=1), ST156 (n=1), ST683 (n=1), ST297 (n=1), ST167 (n=1), and ST361 (n=1). Six distinct serotypes and 8 Fim types were identified. A great diversity of plasmid profiles was observed with plasmid replicon IncX3 being the most frequent (n=11). Phylogenetic analysis showed great diversity between the 11 CREC isolates and also between 6 additional isolates co-carrying blaNDM and blaKPC which were selected from the strains collection of Nanjing Drum Tower Hospital for comparison. Conjugation assays demonstrated that blaNDM was transferable. Conclusion: NDM is the major carbapenemase among CREC, with NDM-5 being the main variant which can be horizontally disseminated by IncX3 plasmids. These isolates displayed genetic diversity by MLST, Fim typing and serotyping. We herein provided the first report on emergence of NDM-5 producing E. coli ST297, ST683, ST3489, and NDM-1 producing E. coli ST361.
Trends in out of pocket payments and catastrophic health expenditure in the Kyrgyz Republic post “Manas Taalimi” and “Den Sooluk” health reforms, 2012 - 2018
Authors: Iamschikova Mariia , Mogilevskii Roman , Onah Michael N
Published: September 2020

Background: Over the years, the Kyrgyz Republic has implemented health reforms that target health financing with the aim of removing financial barriers to healthcare including out-of-pocket health payments (OOPPs). This study examines the trends in OOPPs and the incidence of catastrophic health expenditure (CHE) post the “Manas Taalimi” and “Den Sooluk” health reforms. Methods: We used data from the Kyrgyzstan Integrated Household Surveys (2012 – 2018). Population-weighted descriptive statistics were used to examine the trends in OOPPs and CHE at three thresholds; 10 percent of total household consumption expenditure (Cata10), 25 percent of total household consumption expenditure (Cata25) and 40 percent of total household non-food consumption expenditure (Cata40). Panel and cross-sectional logistic regression with marginal effects were used to examine the predictors of Cata10 and Cata40. Findings: Between 2012 and 2018, OOPPs increased by about US $6 and inpatient costs placed the highest cost burden on users (US $13.6), followed by self-treatment (US $10.7), and outpatient costs (US $9). Medication continues to predominantly drive inpatient, outpatient, and self-treatment OOPPs. About 0.378 to 2.084 million people (6 – 33 percent) of the population incurred catastrophic health expenditure at the three thresholds between 2012 and 2018. Residing in households headed by a widowed or single head, or residing in rural regions, increases the likelihood of incurring catastrophic health expenditure.Conclusions: The initial gains in the reduction of OOPPs and catastrophic health expenditure appear to gradually erode since costs continue to increase after an initial decline and catastrophic health expenditure continues to rise unabated. This implies that households are increasingly incurring economic hardship from seeking healthcare. Considering that this could result to forgone expenditure on essential items including food and education, efforts should target the sustainability of these health reforms to sustain the reduction of catastrophic health payments and its dire consequences.
State-level needs for social distancing and contact tracing to contain COVID-19 in the United States 
Authors: Chiu Weihsueh A. , Fischer Rebecca , Ndeffo-Mbah Martial L.
Published: September 2020

Starting in mid-May 2020, many US states began relaxing social distancing measures that were put in place to mitigate the spread of COVID-19. To evaluate the impact of relaxation of restrictions on COVID-19 dynamics and control, we developed a transmission dynamic model and calibrated it to US state-level COVID-19 cases and deaths. We used this model to evaluate the impact of social distancing, testing and contact tracing on the COVID-19 epidemic in each state. As of July 22, 2020, we found only three states were on track to curtail their epidemic curve. Thirty-nine states and the District of Columbia may have to double their testing and/or tracing rates and/or rolling back reopening by 25%, while eight states require an even greater measure of combined testing, tracing, and distancing. Increased testing and contact tracing capacity is paramount for mitigating the recent large-scale increases in U.S. cases and deaths.
Comprehensive analysis of immune prognostic‐related genes in the tumor microenvironment of hepatocellular carcinoma
Authors: Gao Weike , Li Luan , Li Chengzhen , Yu Guanying , Zhang Lei , Zhang Dongsheng , Liu Caiyun , Hong Shuai , Wang Dongliang , Guo Peiming , Shi Guangjun
Published: September 2020

Background : The percentage of death resulted from hepatocellular carcinoma (HCC) remains high worldwide, despite surgical and chemotherapy treatment. Immunotherapy offers great promise in the treatment of a rapidly expanding spectrum of HCC. Therefore, further exploration of the immune-related signatures in the tumor microenvironment, which plays a vital role in tumor initiation and progression for immunotherapy is currently needed. Methods: In this present research, 866 immune-related difference expression genes (DEGs) were identified by integrating the DEGs between TCGA HCC and normal tissue and the immune genes from databases (Innate DB; Imm Port), and 144 candidate prognostic genes were defined through weighted gene co-expression network analysis (WGCNA). Results: Seven prognostic immune-related DEGs were determined by LASSO Cox PH model, which were followed by constructing the ImmuneRiskScore model based on the prognostic immune-related DEGs. The prognostic index of the ImmuneRiskScore was validated then in the dependent dataset. Patients were divided into high- and low-risk groups according to ImmuneRiskScore. The difference in ImmuneRiskScore and infiltration of immune cells between groups was detected and the correlation analysis for immunotherapy biomarkers was further explored. Conclusion: The ImmuneRiskScore of HCC could provide a prognostic signature and reflect immune characteristics within tumor microenvironment. Furthermore, it also may provide novel immunotherapy predictive biomarker for HCC patients in the near future.
Age Differences in the Relationships between Risk Factors and Loss of Kidney Function: a General Population Cohort Study
Authors: Toyama Tadashi , Kitagawa Kiyoki , Oshima Megumi , Kitajima Shinji , Hara Akinori , Iwata Yasunori , Sakai Norihiko , Miho Shimizu , Hashiba Atsushi , Furuichi Kengo , Wada Takashi
Published: September 2020

Background: Annual decline in kidney function is a widely applied surrogate outcome of renal failure. It is important to understand the relationships between known risk factors and the annual decline in estimated glomerular filtration rate (eGFR) according to baseline age; however, these remain unclear.Methods: A community-based retrospective cohort study of adults who underwent annual medical examinations between 1999 and 2013 was conducted. The participants were stratified into different age groups (40–49, 50–59, 60–69, 70–79, and ≥80 years) to assess the risk for loss of kidney function. A mixed-effects model was used to estimate the association between risk factors and annual changes in eGFR.Results: A total of 51,938 participants were included in the analysis. The age group of ≥80 years included 8,127 individuals. The mean annual change in eGFR was -0.39 (95% confidence interval -0.41 to -0.37) mL/min/1.73 m2 per year. Older age was related to faster loss of kidney function. In the older age group, higher systolic blood pressure, proteinuria, and current smoking were related to faster loss of kidney function (p trend <0.01, 0.03, and <0.01, respectively). Conversely, each age group showed similar annual loss of kidney function related to lower hemoglobin levels and diabetes mellitus (p trend 0.47 and 0.17, respectively).Conclusions: Higher systolic blood pressure, proteinuria, and smoking were related to faster loss of kidney function, and greater effect size was observed in the older participants. More risk assessments for older people are required for personalized care.
The Sulfatide/Myb/MEF2C Axis Controls the Malignant Behaviors of Hepatocellular Carcinoma Cells by Modulating lncAY Expression
Authors: Chen Mei Hua , Qi Bing , Cai Qian Qian , Sun Jia Wen , Fu Li Sheng , Kang Chun Lan , Ma Ming Zhe , Wu Xing Zhong
Published: September 2020

The authors have requested that this preprint be removed from Research Square.
Plasma level of lipocalin 2 is increased in neovascular age-related macular degeneration patients, particularly those with macular fibrosis
Authors: Chen Mei , Yang Nan , Lechner Judith , Toth Levente , Hogg Ruth , Silverstri Giuliana , Chakravarthy Usha , Xu Heping
Published: September 2020

Background: Previously, we and others have reported higher populations of circulating neutrophils in patients with neovascular age-related macular degeneration (nAMD). Neutrophil gelatinase-associated lipocalin (NGAL, also known as lipocalin-2, LCN2), an important innate immune mediator, is known to be critically involved in sterile inflammation-mediated organ failure, fibrosis, cancer progression and retinal degeneration. This study investigated the plasma levels of LCN2, matrix metalloproteinase 9 (MMP9) and LCN2/MMP9 complex in different types of nAMD and examined whether the levels were related to patients’ responsiveness to anti-VEGF therapy. Results: One hundred and seventy-four nAMD patients, including 108 with choroidal neovascularisation (CNV), 32 with retinal angiomatous proliferation (RAP), 23 with polypoidal choroidal vasculopathy (PCV) and 11 unclassified patients, and 43 healthy controls were recruited to this case-control study. Fifty-eight nAMD patients had macular fibrosis and 110 patients did not. Out of the 174 nAMD patients, 80 patients responded completely, 90 responded partially, and 4 did not respond to the anti-VEGF therapy. The plasma levels of LCN2 in nAMD patients (181.46 ± 73.62 ng/ml) was significantly higher than that in healthy controls (152.24 ± 49.55 ng/ml, P = 0.047). However, the difference disappeared after adjusting for age. A positive correlation between plasma level of LCN2 and age was observed in nAMD patients (r=0.29, P=0.0002) but not in healthy controls. The plasma level of LCN2 was also positively correlated with circulating neutrophils in nAMD patients (r=0.34, p=0.0007) but not in healthy controls (r=0.057, p=0.77). No correlation was observed between age and circulating neutrophils. Further analysis of nAMD subtypes uncovered a significantly higher level of LCN2 in patients with macular fibrosis even after adjusting for age. No relationship was observed between plasma levels of LCN2 and patients’ responsiveness to anti-VEGF therapy. The plasma levels of MMP9 and LCN2/MMP9 complex were comparable between nAMD and controls. Conclusions: Our results suggest that higher plasma levels of LCN2 in nAMD are related to ageing and increased population of circulating neutrophils. Our results also suggest that higher levels of LCN2 may increase the risk of macular fibrosis in nAMD.
High Throughput Bioinformatics-based Prediction of the targets for BushenjieduDecoction in preventing relapse of acute leukemia
Authors: Sun Weilong , Yang Fujun , Shi Weipeng , Tao Xia , Xi Zhiwei , Liu Yihao , Xu Xinxin , Yang Xiangdong
Published: September 2020

Leukemia is a lethal myeloproliferative disorder, its’ relapse following chemotherapy is the major concern in clinical practice. For a long time, we found that traditional Chinese medicines such as Bushenjiedudecoction (BSJD) have significant effects on delaying relapse. However, the underlying mechanisms are not clear, which limits the clinical application of BSJD decoction. Therefore, we tried to make some explorations in this study. We isolated mesenchymal stem cells (MSC) after treated them with BSJD for proteomic analysis. And then 109 targets were screened out through analysis of the shared proteins of that affected by BSJD and those related to leukemia. Subsequently, the data were analyzed by GO functions, KEGG pathways, PPI network and topological analysis, and then some nodes were selected for animal experiment. As a result, we demonstrated the effective targets of BSJD on MSC through bioinformatics analysis and explored the potential mechanism of BSJD from its influence on niches.
Quad test for fetal aneuploidy screening as a predictor of small-for-gestational age fetuses: A population-based study
Authors: Boonpiam Rakchanok , Wanapirak Chanane , Sirichotiyakul Supatra , Sekararithi Ratanaporn , Traisrisilp Kuntharee , Tongsong Theera
Published: September 2020

Background: To identify the relationship between quadruple test for aneuploidy screening (alpha-fetoprotein: AFP; free beta-human chorionic gonadotropin: b-hCG; unconjugated estriol: uE3 and inhibin-A: IHA) and fetal growth restriction and to construct predictive models for small-for-gestational-age (SGA) fetuses.Methods: Women who underwent quadruple test for aneuploidy were followed-up for final outcomes. The multiples of the median (MoMs) of the four biochemical markers for the SGA group and those of normal fetuses were compared. The models for predicting SGA by the individual biomarkers and their combination were constructed using binary logistic regression analysis, and their diagnostic performances in predicting SGA were determined.Results: Of 10,155 eligible pregnant women, 578 (5.7%) and 9,577 (94.3%) had SGA and normal growth, respectively. High levels of AFP, b-hCG and IHA but low levels of uE3 significantly increased the risk of SGA. The constructed predictive equations had predictive performance for SGA, with areas under the receiver-operated characteristic curve of 0.724, 0.655, 0.597, 0.664 and 0.754 for AFP, b-hCG, uE3, IHA, and the combination, respectively.Conclusion: The quad test for aneuploidy screening could also be used as a predictor of SGA, without extra-effort and extra-cost.
Investigating effects of preoperative inflammatory biomarkers on predicting survival outcomes of peripheral intrahepatic cholangiocarcinoma after curative resection.
Authors: Zhang Zeyu , Zhou Yufan , Hu Kuan , Huang Yun
Published: September 2020

Introduction: Intrahepatic cholangiocarcinoma (ICC) stands as the second most common malignant tumor in liver with poor patient prognosis. Increasing evidences have shown that inflammation plays a significant role in tumor progression, angiogenesis and metastasis. However, the prognosis significance of inflammatory biomarkers on recurrence-free survival (RFS) and overall survival (OS) in peripheral ICC patients is poorly recognized. Methods: Peripheral ICC patients who underwent curative hepatectomy and diagnosed pathologically were retrospectively analyzed. Inflammatory biomarkers, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), systemic immune-inflammation index (SII), were investigated. Results: Receiver operating characteristic (ROC) curves showed no significance in NLR, PLR and LMR in RFS and OS, while significant results were shown on SII in both RFS (P=0.035) and OS (P=0.034) with areas under ROC curve as 0.63 (95%CI: 0.52-0.74) and 0.62 (95%CI: 0.51-0.72), respectively. Kaplan-Meier curves revealed statistically significant better survival data in SII-low groups on both RFS (P<0.001) and OS (P<0.001). The univariate and multivariate analyses revealed that higher level of SII was independently associated with both poorer RFS time and OS time. However, no significant result was shown on NLR, PLR or LMR. Conclusion: SII is an effective prognostic factor for predicting the prognosis of peripheral ICC patient undergone curative hepatectomy, while NLR, PLR and LMR are not associated with clinical outcomes of these patients.
Mainz Foot-school: a course concept for prevention and treatment of foot disorders
Authors: Betz Martin , Konradi Jürgen , Betz Ulrich , Drees Philipp
Published: September 2020

Background: Physiotherapy offers an active approach to prevent and treat foot dysfunction, but it is currently rarely used. A Spiraldynamik®-inspired 6‒8-h educational program, called “Mainzer Fußschule” (Mainz Foot-school, MFS), was established to offer a framework for effective implementation. Elements of the courses are: knowledge transfer about anatomy and function, perception training, mobilization, as well as strengthening and coordination. In order to evaluate opinions of former participants about the course format and their subjective effects of course participation, we collected patient-reported outcomes (PROs).Methods: In mid-2018, we conducted a retrospective, monocentric, questionnaire-based cohort study. The online-questionnaire comprised 23-items. All MFS attendees in 2015‒2017 who were contactable via e-mail (522; 90.3%) were approached. Finally, 350 completed questionnaires (67%) were returned.Results: The overall framework of the course was evaluated very positively by most participants, with 94.8% expressing a positive opinion about the course format, 97.2 % about the theory vs. practice ratio, and 97.2% about the information content. PROs regarding the offering were equally positive, with 84.3 % stating that their feet are now used and treated differently, and 63,9 % that they still perform exercises learned in the MFS. Furthermore, the majority (67.9 %) believes that the procedure had a positive effect on their existing foot problem. Feedback on the various other examined aspects was similarly positive.Conclusions: The courses were rated positively by the majority of former participants, both in terms of format and subjective effects. Thus the MFS is a promising therapy option that should be included in an extended treatment concept with individual orthopedic examination and therapy options. Our results should be verified in a multicenter, randomized controlled study.Trial registration: The Trial was approved by the ethical review committee of the Rhineland-Palatinate state chamber of physicians (18.04.2018). International Clinical Trials Registry Platform (ICTRP), DRKS00013890. Registered 11 May 2018, http://apps.who.int/trialsearch/Trial2.aspx?TrialID=DRKS00013890.
Maternal and Perinatal Outcomes in Women with Eclampsia by Mode of delivery at Riley Mother Baby Hospital: A longitudinal case-series study
Authors: Poli Philippe Amubuomombe , Irene Koech MMED , Mogeni Richard , Mwangi Ann , Cheruiyot Andrew , Omenge Orang'o Elkanah
Published: September 2020

Background

Eclampsia, considered a serious complication of preeclampsia, remains a life-threatening condition among pregnant women. It accounts for 12% of maternal deaths and 16–31% of perinatal deaths worldwide. Most deaths from eclampsia occurred in resource-limited settings of sub-Saharan Africa. This study was performed to determine the optimum mode of delivery, as well as factors associated with the mode of delivery, in women admitted with eclampsia at Riley Mother and Baby Hospital.
Methods

This was a hospital-based longitudinal case-series study conducted at the largest and busiest obstetric unit of the tertiary hospital of western Kenya. Maternal and perinatal variables, such as age, parity, medications, initiation of labour, mode of delivery, admission to the intensive care unit, admission to the newborn care unit, organ injuries, and mortality, were analysed using the Statistical Package for the Social Sciences software version 20.0. Quantitative data were described using frequencies and percentages. The significance of the obtained results was judged at the 5% level. The chi-square test was used for categorical variables, and Fisher’s exact test or the Monte Carlo correction was used for correction of the chi-square test when more than 20% of the cells had an expected count of less than 5.
Results

During the study period, 53 patients diagnosed with eclampsia were treated and followed up to 6 weeks postpartum. There was zero maternal mortality; however, perinatal mortality was reported in 9.4%. Parity was statistically associated with an increased odds of adverse perinatal outcomes (p = 0.004, OR = 9.1, 95% CI = 2.0-40.8) and caesarean delivery (p = 0.020, OR = 4.7, 95% CI = 1.3–17.1). In addition, the induction of labour decreased the risk of adverse outcomes (p = 0.232, OR = 0.3, 95% CI = 0.1-2.0).
Conclusion

There is no benefit of emergency caesarean section for women with eclampsia. Instead, it increases the risk of perinatal adverse outcomes, including the risk of admission to the newborn unit and perinatal death.
The Effects of Contralateral Throwing Practice on Throwing Parameters, Isometric Strength, Grip Strength, and Shoulder Range of Motion in High School Baseball Athletes
Authors: Gheith Raad , Sharp Matthew H. , Stefan Matthew W. , Reber Dallen D. , LoDuca Salvatore , Lowery Ryan P. , Wilson Jacob M.
Published: September 2020

Background

Baseball throwing is typically done with one dominant arm and after years of throwing the skills becomes autonomous and improvement is slowed. Incorporating training of the non-dominant arm could induce a cross-education effect and assist in improving the dominant throwing arm. Therefore, the purpose of this study was to determine the effect of contralateral (CL) throwing practice on dominant arm throwing accuracy and other parameters in experienced baseball players.
Methods

16 male high school baseball players participated in contralateral throwing practice. Each participant was randomly assigned to either contralateral (CL) or control (CON) following a pre-test. Sessions consisted of 30 non-dominant arm throws from a randomized location to a standard catch net, twice a week for 4 weeks. Following the 4 weeks of training, participants were post-tested to determine the effects of the contralateral throwing program. Accuracy percentage, throwing velocity, Accuracy:Velocity ratio, and non-specific throwing parameters were collected to determine the effect of the contralateral throwing program.
Results

For dominant side throwing accuracy %, significant pre- to post-testing differences were demonstrated in the CL condition (p < 0.05, Pre = 47.4, Post = 54.9). Accuracy:Velocity ratio was statistically significant in the CL condition in pre- to post-test (p < 0.05, Pre = 0.71, Post = 0.86). There were no significant differences detected in non-throwing specific parameters.
Conclusion

Contralateral throwing practice improved accuracy and Accuracy:Velocity ratio in the dominant arm of the CL group. Use of a contralateral throwing program can be used to improve performance in a well learned, complex, open skill such as baseball throwing.
A new hybrid record linkage process to render epidemiological databases interoperable: application to the GEMO and GENEPSO studies involving BRCA1 and BRCA2 mutation carriers
Authors: JIAO YUE , Lesueur Fabienne , Azencott Chloé-Agathe , Laurent Maïté , Mebirouk Noura , Laborde Lilian , Beauvallet Juana , Dondon Marie-Gabrielle , Eon-Marchais Séverine , Laugé Anthony , Collaborators GEMO Study , Collaborators GENEPSO Study , Noguès Catherine , Andrieu Nadine , Stoppa-Lyonnet Dominique , Caputo Sandrine M.
Published: September 2020

BackgroundLinking independent sources of data related to same individuals enable innovative epidemiological and health studies but requires a robust record linkage approach. We describe a hybrid record linkage process to link databases from two independent ongoing national studies, GEMO (Genetic Modifiers of BRCA1 and BRCA2), which focuses on the identification of genetic factors modifying cancer risk of BRCA1 and BRCA2 mutation carriers, and GENEPSO (prospective cohort of BRCAx mutation carriers), which focuses on environmental and lifestyle risk factors.MethodsTo identify the maximum individuals participating in the two studies but may not be registered by a common number, we combined Probabilistic Record Linkage (PRL) and supervised Machine Learning (ML). This combined linkage was named “PRL+ML”. We built the ML model using a first version of the two databases as a training dataset on which matching status was assigned by PRL followed manual review. ResultsThe Random Forest (RF) algorithm showed a highest sensitivity (0.985) among six widely used ML algorithms: RF, Bagged trees, AdaBoost, Support Vector Machine, Neural Network.Therefore, RF was selected to build the ML model since our goal was to identify the maximum of true matches. Our combined linkage PRL+ML showed a higher sensitivity (range 0.988-0.992) than either PRL (range 0.916-0.991) or ML (0.981) alone. It identified 2,068 individuals participating in both GEMO (6,375 participants) and GENEPSO (4,925 participants).ConclusionsOur hybrid linkage process represents an efficient tool for linking GEMO and GENEPSO. It may be generalizable to other epidemiological studies involving other databases and registries.
Quantification and Confirmation of Zearalenone Using a LC-MS/MS QTRAP System in Multiple Reaction Monitoring and Enhanced Product Ion Scan Modes.
Authors: lv Shencong , Wu Xiaoqiong , Zhu Guoying , Guan Jian , Yan Yong , Ge Miaohua
Published: September 2020

Background: A simple, rapid, and efficient liquid chromatography tandem mass spectrometry (LC–MS/MS) method, operated in electrospray ionization (ESI) and quadrupole linear ion trap modes, has been developed for the identification and structural characterization of zearalenone (ZEN) in corn oil. Methods: Samples (5 g) were extracted with acetonitrile/water (80:20, v/v). After centrifugation and dilution, the extracts were separated on a C18 analytical column by gradient elution (acetonitrile/water) and analyzed by UPLC–MS/MS. Enhanced product ion mode was used for qualitative analysis, while multiple reaction monitoring mode was used for quantitative analysis. Results: Calibration curve showed good linearity with correlation coefficients (r) higher than 0.995. Limit of detection was determined to be below 0.20 μg kg-1 for ZEN. The recovery for ZEN was in the acceptable range of 86.6% to 97.2%. 82.4 % of the samples were found to contain ZEN among the 51 samples.Conclusion: The sample pretreatment and LC–MS methods developed in this research, from a convenience and analysis time perspective, are simple, efficient, cheaper, and less time-consuming than existing methods.
A Tablet ‐ Based Intervention for Activating Nursing Home Residents with Dementia: Results from a Cluster-Randomised Controlled Trial
Authors: O'Sullivan Julie Lorraine , Lech Sonia , Gellert Paul , Grittner Ulrike , Voigt-Antons Jan-Niklas , Möller Sebastian , Kuhlmey Adelheid , Nordheim Johanna
Published: September 2020

Background: Non-pharmacological interventions (NPI) can improve cognitive and non-cognitive symptoms in nursing home residents living with dementia. However, delivery of suitable NPI can be challenging in everyday nursing home settings. Internet and communication technologies (ICT) may be promising tools for supporting NPI delivery in nursing homes. Methods: A two-arm cluster-randomised controlled trial was conducted to investigate global and momentary effects of a novel ICT-based NPI for nursing home residents with dementia. Ten nursing homes were randomly allocated to the tablet-based intervention (TBI) or conventional activity sessions (CAS) group (each with five nursing homes) between April 2016 and May 2017. A total of N = 162 participants received either regular TBI (n = 80) or CAS (n = 82) over a period of eight weeks. Linear mixed models were used to analyse group differences regarding the primary outcome apathy (AES-I), and secondary outcomes quality of life (QOL-AD, QUALIDEM), neuropsychiatric (NPI-NH, psychotropic medication) and depressive symptoms (GDS). Ecological Momentary Assessments (EMA) of quality of life were also conducted in both groups before and after each activity session.Results: No significant group difference in the change of apathy (AES-I score, primary outcome) was found post intervention (mean group difference: B = .19; 95% CI: -3.90 to 4.28, p = .93). Regarding secondary outcomes, a reduction of psychotropic medication was found for TBI compared to CAS (B = .42; 95% CI: .15 to .69, p < .01). Further analyses revealed a post-intervention improvement of informant-rated quality of life across both groups (B = 3.69; 95% CI: .68 to 6.69, p = .02). Analysis of EMA also rendered short-term post-session improvements of quality of life in the CAS group (B = .43; 95% CI: .30 to .57, p < .001). Conclusions: These findings suggest that NPI involving individually tailored activities have a beneficial impact on quality of life in nursing home residents with dementia. Although we found no clear advantage of TBI compared to CAS, ICT have the potential to support NPI delivery and facilitate regular assessments of fluctuating momentary states in nursing home residents with dementia. Trial registration: The trial was retrospectively registered with the ISRCTN registry (Trial registration number: ISRCTN98947160) on 01/09/2016 http://www.isrctn.com/ISRCTN98947160.