bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploration of interethnic variation in the ibuprofen metabolizing enzyme CYP2C9: a cautionary guide for treatment of COVID-19 symptoms
Authors: Almarzooq Ammar
Published: January 2021

Background: Coronavirus disease 2019 (COVID-19), is a rapidly spreading infectious illness that causes a debilitating respiratory syndrome. Supportive therapy remains the standard for mild-to-moderate cases, including treatments with non-steroidal anti-inflammatory drugs (NSAIDs) e.g. ibuprofen, such medications may increase COVID-19 complications when used in patients with acute viral respiratory infections. Methods: P450 enzyme CYP2C9 are known to be involved in the metabolism of NSAIDs, however, their pharmacogenetic data are limited. This study aims to better understand the genetic landscape of CYP2C9 sequence variation across different ethnic and geographic groups, in correlation with ibuprofen dosing guidelines. A cohort of 101 Jordanian Arab samples were retrospectively recruited and genotyped using Affymetrix DMET Plus Premier Package. Results: This study identified 18 single nucleotide polymorphisms (SNP) within CYP2C9 in 101 Jordanian Arabs, within the context of over 100,000 global subjects in 417 published reports. Genetic structure analysis across populations revealed that Jordanian Arabs share the closest CYP2C9 sequence homology to Near East and European populations. The Jordanian Arab population was also shown to be genetically heterogeneous for CYP2C9, with approximately 33% of individuals sampled exhibiting an ‘at risk’ SNP requiring non-standard ibuprofen dosing that is different from the established guidelines. Conclusions: This is the most comprehensive and up-to-date analysis for CYP2C9 allele frequencies across multi-ethnic populations world-wide. The use of modern genomic tools coupled with a proactive assessment of the most likely gene-drug candidates will lead to a better understanding of the role of pharmacogenetics for COVID-19 and more effective treatments. Trial registration: : The Institutional Review Board (IRB) of the Jordan University of Science and Technology approved this study on 4/7/2013 with approval number 67/2/2013.
Cost Effectiveness of using Faecal Immunochemical Testing (FIT) as an Initial Diagnostic Investigation for Patients with Lower Gastrointestinal Symptoms Suggestive of Malignancy.
Authors: Kearsey Christopher , Graham Catherine , Lobb Harry , Chako Jerry , Weatherburn Rachael , Rooney Paul
Published: January 2021

BackgroundThere has been an increase in the numbers of patients presenting to primary care with suspected colorectal malignancy and subsequently an increase in demand for endoscopy. This study aims to forecast the cost of faecal immunochemical testing (FIT) compared to conventional diagnostic tests as a primary investigation for patients with symptoms suggestive of colorectal malignancy.MethodsRetrospectively, 1950 patients with symptoms suggestive of colorectal malignancy who were referred through primary care and underwent investigations through standard endoscopic evaluation were included. These patients were used to forecast the cost of faecal immunochemical testing creating theoretical data for sensitivity and specificity. Outcome measures included: the number of investigations under current protocol; cost of current investigations; number of predicted false negatives and false positives and positive/negative predictive values using current sensitivity data for FIT; the cost forecast of using FIT as the primary investigation for colorectal malignancy.Results: Median age was 65 (IQR 47-82) with 43.7% male and 56.3% female. A total of 1950 investigations were carried out with a diagnostic yield of 26 cancers (18 colon, 8 rectal), 138 polyps and 29 high risk adenomas (HGD +/- >10mm). In total, £713,948 was spent on the investigations. The commonest investigation was colonoscopy totalling £533,169. The total cost per cancer diagnosis was £27,459. Sensitivity (92.1% CI 86.9-95.3) and specificity (85.8% CI 78.3-90.1) for FIT in colorectal cancer was taken from NICE and was costed via the manufacturer(s). The projected total cost of FIT for the same population using a ≥4μg haemoglobin cut off was £415,680 (£15,554 per cancer). The total cost of high-risk polyps using ≥4μg cut off was £404,427 (sensitivity 71.2% CI 60.5-87.2, specificity 79.8%CI 76.1-83.7) or £13,945 per polyp.Conclusions: FIT is a cheaper and effective alternative test with the potential to replace current expensive methods. The forecast is based on the limited data available for sensitivity/specificity in the current literature. FIT has now been commenced for symptomatic patients in the UK and therefore sensitivity may change in the future.
Improvement of Sperm Morphology After Surgical Varicocele Repair
Authors: Morini Daria , Spaggiari Giorgia , Daolio Jessica , Melli Beatrice , Nicoli Alessia , Feo Gaetano De , Valli Barbara , Viola Domenico , Garganico Simona , Magnani Elena , Pilia Annalisa , Polese Alessandra , Colla Rossana , Simoni Manuela , Aguzzoli Lorenzo , Villani Maria , Santi Daniele
Published: January 2021

Setting: A causative relationship between varicocele and impairment of semen quality has been largely investigated in the context of male infertility, although its clinical benefit remains controversial.Objective: To investigate the effect of varicocele correction on detailed morphologic microscopic semen parameters in a large homogeneous cohort of patients and to evaluate which factors could predict semen improvement after the surgical treatment.Design: An observational, retrospective cohort study was carried out including all patients undergoing surgical treatment for varicocele from September 2011 to March 2020 in the same clinical centre. Enrolled males performed at least one semen analysis before and one after surgical varicocele correction. Primary outcome was the detailed morphologic microscopic sperm evaluation. Secondary outcomes were conventional semen analyses.Results: 121 males (mean age 24.6+6.1 years) were enrolled. Using detailed morphologic microscopic sperm evaluation, a significant morphological improvement was recorded, with a reduction in head and tail abnormalities. Moreover, a significant increase in sperm concentration (p=0.015) and percentage of progressive and total motility (p=0.022 and p=0.039) were observed after surgery. The multivariate logistic analysis identified the ultrasonography varicocele degree before surgery as a main predictor of the sperm concentration improvement (p=0.016), with the highest improvement for varicocele of I and II degree. Conclusion: For the first time, the detailed morphologic microscopic sperm evaluation highlights a relevant reduction in sperm abnormalities after varicocele surgery, showing its potential application in clinical practice.
Sulfonated Pyromellitic Dianhydride-functionalized MCM-41: A Multifunctional Hybrid Catalyst for Melting-assisted Solvent-free Synthesis of Bioactive 3,4-dihydropyrimidin-2-(1H)-ones
Authors: Valiey Ehsan , Dekamin Mohammad , Alirezvani Zahra
Published: January 2021

This study introduces a practical approach to fabricate a novel hybrid catalyst of namely sulfonated pyromellitic dianhydride-aminopropyl silane-functionalized MCM-41 (MCM-41-APS-PMDA-SO3H). Various microscopic, spectroscopic methods and techniques such as FTIR, TGA, XRD, FESEM, and EDX were used to confirm its structural characteristics. The efficiency of the new MCM-41-APS-PMDA-SO3H organosilica nanomaterials, as a heterogenous nanocatalyst, was evaluated in promoting the synthesis of biologically active 3,4-dihydropyrimidin-2-(1H)-one derivatives under solvent-free conditions. It is not only a nano-porous material for enriching reactants with high surface area provided, but also possesses great acidic sites to activate carbonyl groups. Furthermore, favored reusability of the new introduced hybrid organosilica with negligible loss of its activity, easy and quick isolation of the products are the main advantages of this procedure.
A Mesenchymal-like Program of Dormancy controlled by ZFP281 Serves as a Barrier To Metastatic Progression of Early Disseminated Cancer Cells
Authors: Aguirre-Ghiso Julio , Nobre Ana Rita , Dalla Erica , Yang Jihong , Huang Xin , Kenigsberg Ephraim , Wang Jianlong
Published: January 2021

Increasing evidence shows that cancer cells can disseminate from early-evolved primary lesions much earlier than the classical metastasis models predicted. It is thought that a state of early disseminated cancer cell (early DCC) dormancy can precede genetic maturation of DCCs and metastasis initiation. Here we reveal at single cell resolution a previously unrecognized role of mesenchymal- and pluripotency-like programs in coordinating early cancer cell spread and a long-lived dormancy program in early DCCs. Using in vitro and in vivo models of invasion and metastasis, single cell RNA sequencing and human sample analysis, we provide unprecedented insight into how early DCC heterogeneity and plasticity control the timing of reactivation. We identify in early lesions and early DCCs the transcription factor ZFP281 as an inducer of mesenchymal- and primed pluripotency-like programs, which is absent in advanced primary tumors and overt metastasis. ZFP281 not only controls the early spread of cancer cells but also locks early DCCs in a prolonged dormancy state by preventing the acquisition of an epithelial-like proliferative program and consequent metastasis outgrowth. Thus, ZFP281-driven dormancy of early DCCs may be a rate-limiting step in metastatic progression functioning as a first barrier that DCCs must overcome to then undergo genetic maturation.
NCDs-COVID19 Preventions, Environmental – Nutrition Perspective Approach; (The Case of Tanzanian Students)
Authors: Kilimba Ulumbi , Baysen Engine
Published: January 2021

INTRODUCTION; : Non-communicable diseases (NCDs) are serious public diseases. They are affecting a larger a number of young people who are from developing countries. Characterized by been non-transferrable diseases. The main risk factors include unhealthy behaviors and metabolic syndromes. Unhealthy behaviors include excess use of salts, sugar, fats food and alcohol, other are cigarettes, physical inactive and inadequate intake of fruits and vegetable, but also overweight/obesity, hypertension high cholesterol and hyperglygriciride. Common NCDs killers are CVDs, chronic respiratory diseases, diabetes and cancer OBJECTIVES;: main objective of this study was to assess the student knowledge on NCD-COVID-19 prevention; environmental – nutrition perspective approach.. METHOD;: Cross section study design conducted at Dar-es-salaam- Tanzania. Purposive method used to select participants within six secondary schools that are situated at city center. The likert scale questioner used to obtain non-parametric data. The validation and reliability of tool pre-tested before actual data collection. The data were analyzed under ordinal regression analysis under the help of computer with SPSS- 20 version software. The descriptive statistics established frequencies and percentages while statistical measures were median and IQR. RESULTS;: about 600 students were recruited and participated, 54.7% were female and 45.3% male, (SD) mean was 18.3 and SD was 0.64. Students were knowledgeable on nutrition perspective by 81% while on environmental perspective was 50%. CONCLUSION; : the study concluded that, to speed up NCDs–COVID19 prevention, the multipart environmental education, curriculum education review and adoption of new NCDs strategic action (2018-2020) are needed.
The Emergence of Dissociative Experiences as a Function of Perceived Stress Among University Students During the COVID-19 Lockdown
Authors: Garbóczy Szabolcs , Szemán-Nagy Anita , Ahmad Mohamed S. , Harsányi Szilvia , Ocsenás Dorottya , Rekenyi Viktor , Tischler Petra , Al-Tammemi Ala'a B. , Kolozsvári László Robert
Published: January 2021

Background: The findings of previous literature showed that epidemics and the associated control measures can increase the level of stress experienced by people. The phenomenon of dissociation has been investigated by many studies, and some have found that stress and trauma may play a central role in its development. In our research study, we examined the effect of COVID-19 lockdown on the mental health of students at the University of Debrecen in Hungary. We investigated whether or not the changes caused by the pandemic induced stress among students and whether or not it was accompanied by an increase in the number of dissociative experiences. Methods: A questionnaire-based cross-sectional study was conducted at the University of Debrecen in Hungary in the period April 30 - May 15, 2020, to assess levels of perceived stress as well as dissociative experiences among students at the time of the official nationwide lockdown. Our survey has adopted the Perceived Stress Scale (PSS) and the Dissociative Experiences Scale (DES). A total of 1320 students have enrolled in our study. Results: Our results showed a high level of perceived stress among the students during the pandemic and lockdown. This elevation was found to have a significant correlation with the emergence of dissociative experiences among both the Hungarian and the international students. Also, these changes were significant among males and females and in all subscales. Female students’ levels of dissociative experiences were higher than of male students on all subscales and in both groups (Hungarian and international). Conclusion: According to our findings, the COVID-19 pandemic, and the quarantine situation increased the perceived stress level which has played a significant role in the development of dissociative experiences among the students. The increased frequency of dissociative experiences entails a higher risk to the appearance of dissociative disorders; thus, it is crucial to create a safety net for university students who are susceptible to high levels of stress.
The Neural Correlates of Product Attachment to Cosmetics: Is It Similar to That of Attachment in Human Relationships?
Authors: Kikuchi Yoshiaki , Noriuchi Madoka , Isobe Hiroko , Shirato Maki , Hirao Naoyasu
Published: January 2021

We used functional magnetic resonance imaging to investigate the similarities in the attachment toward individual's favorite cosmetics and beloved person, both of which are reinforced by touch-driven behaviors. We conducted 2 (visual and visual with tactile) × 2 (preferred and non-preferred cosmetics) experiments. Thereafter, we set regions of interest as per previous studies of human relationship attachment and tested their significance. The hippocampus, posterior cingulate cortex (PCC), putamen, periaqueductal gray (PAG), dorsal raphe nucleus (DRN), and ventral tegmental area were activated in the visual with tactile session, but not in the visual session, revealing that common brain regions are activated in human relationship attachment and attachment to cosmetics, and that tactile cue is important for attachment to cosmetics. Moreover, the PAG showed an interactive effect between tactile cue and preference, and the DRN positively correlated with "security" feeling associated with attachment. Activity in these regions was positively correlated with activity of the PCC and primary somatosensory cortex. This suggests that tactile discriminative cues induce the individual's autobiographical memories of using the cosmetics daily, and the DRN and PAG are activated in association with these memories. These serotonergic and oxytocinergic activities may be critical for the maintenance of attachment to cosmetics.
A case of dermatomyositis in a patient with central core disease: Unusual association with autoimmunity and genetic muscle disease
Authors: Kim Min Jung , Kim Mi Hyeon , Park Sung-Hye , Song Yeong Wook
Published: January 2021

BackgroundDermatomyositis is an inflammatory muscle disease caused by immune-mediated muscle injury, and central core disease (CCD) is a congenital myopathy associated with disturbed intracellular calcium homeostasis and excitation-contraction coupling. To date, CCD has not been reported to have autoantibodies or coexist with inflammatory myopathy.Case presentationHere, we described the case of a 25-year-old woman who had progressive proximal muscle weakness, myalgia, pruritic macular rash, skin ulcers, and calcinosis. Dermatomyositis was initially suspected based on the clinical symptoms accompanied by elevated muscle enzyme levels, electromyography abnormalities, and a positive antinuclear antibody test. However, the patient’s muscle biopsy revealed the characteristic findings of both dermatomyositis and CCD, suggesting that dermatomyositis occurred in this patient with previously asymptomatic CCD. The patient did not have any pathogenic gene mutations associated with congenital myopathy, including RYR1 and SEPN1 in targeted next-generation sequencing. She received high-dose glucocorticoid therapy and azathioprine with a significant improvement in muscle strength.ConclusionsWe present a case of rare coexistence of dermatomyositis and CCD. Clinicians should be aware that patients with CCD may have inflammatory myopathy that responds well to immunosuppressive therapy.
Paranoia and belief updating during a crisis
Authors: Suthaharan Praveen , Reed Erin , Leptourgos Pantelis , Kenney Joshua , Uddenberg Stefan , Mathys Christoph , Litman Leib , Robinson Jonathan , Moss Aaron , Taylor Jane , Groman Stephanie , Corlett Philip
Published: January 2021

The 2019 coronavirus (COVID-19) pandemic has made the world seem unpredictable. During such crises we can experience concerns that others might be against us, culminating perhaps in paranoid conspiracy theories. Here, we investigate paranoia and belief updating in an online sample (N=1,010) in the United States of America (U.S.A). We demonstrate the pandemic increased individuals’ self-rated paranoia and rendered their task-based belief updating more erratic. Local lockdown and reopening policies, as well as culture more broadly, markedly influenced participants’ belief-updating: an early and sustained lockdown rendered people’s belief updating less capricious. Masks are clearly an effective public health measure against COVID-19. However, state-mandated mask wearing increased paranoia and induced more erratic behaviour. Remarkably, this was most evident in those states where adherence to mask wearing rules was poor but where rule following is typically more common. This paranoia may explain the lack of compliance with this simple and effective countermeasure. Computational analyses of participant behaviour suggested that people with higher paranoia expected the task to be more unstable, but at the same time predicted more rewards. In a follow-up study we found people who were more paranoid endorsed conspiracies about mask-wearing and potential vaccines – again, mask attitude and conspiratorial beliefs were associated with erratic task behaviour and changed priors. Future public health responses to the pandemic might leverage these observations, mollifying paranoia and increasing adherence by tempering people’s expectations of other’s behaviour, and the environment more broadly, and reinforcing compliance.
Health Care Providers’ Attitudes Toward and Experiences Delivering Oral PrEP to Adolescent Girls and Young Women in Kenya, South Africa, and Zimbabwe
Authors: Lanham Michele , Ridgeway Kathleen , Mireku Maryline , Nhamo Definate , Pillay Diantha , Murire Mercy , Stankevitz Kayla , Kyongo Jordan , Mullick Saiqa
Published: January 2021

Background: In Kenya, South Africa and Zimbabwe, oral pre-exposure prophylaxis (PrEP) is recommended for adolescent girls and young women (AGYW) at high risk of HIV. Health providers play a critical role in the uptake and effective use of sexual and reproductive health services; however, few published studies have explored providers’ attitudes toward and experiences delivering PrEP to AGYW.Methods: We conducted a cross-sectional qualitative study, interviewing 113 providers at 36 public, private, and nongovernmental health facilities in Kenya, South Africa, and Zimbabwe that were offering PrEP during the research period or were likely to offer PrEP in the future. Data were coded in NVivo 11, and an applied thematic analysis was conducted.Results: Most providers preferred that adolescent girls wait until age 18 to have sex but acknowledged that many girls younger than 18 could benefit from oral PrEP. Their primary concern was whether adolescent girls would be able to take PrEP daily, especially if they do not tell their parents or partners they are using it. Providers reported that it was more challenging to deliver PrEP and other HIV services to girls younger than 18. Those with experience providing PrEP pointed to stigma and lack of PrEP awareness in communities as two primary barriers to PrEP uptake and use.Conclusions: Providers were generally accepting of oral PrEP as an HIV prevention option for AGYW; however, many had negative attitudes about adolescent girls being sexually active and concerns about whether they could take PrEP daily. Results were used to update national PrEP training materials to address negative provider attitudes about PrEP use by AGYW.
Circulating Immune Cell Populations Related to Primary Breast Cancer, Surgical Removal and Radiotherapy Revealed by Flow Cytometry Analysis
Authors: Cattin Sarah , Fellay Benoît , Calderoni Antonello , Christinat Alexandre , Negretti Laura , Biggiogero Maira , Badellino Alberto , Schneider Anne-Lise , Tsoutsou Pelagia , Pellanda Alessandra Franzetti , Rüegg Curzio
Published: January 2021

Background: Advanced breast cancer (BC) impact immune cells in the blood but whether such effects may reflect the presence of early BC and its therapeutic management remains elusive. Methods: To address this question, we used multiparametric flow cytometry to analyse circulating leukocytes in patients with early BC (n=13) at time of diagnosis, after surgery and after adjuvant radiotherapy, compared to healthy individuals. Data were analysed using a minimally supervised approach based on FlowSOM algorithm and validated manually. Results: At time of diagnosis, BC patients have an increased frequency of CD117+ Granulocytic-Myeloid Derived Suppressor Cells (G-MDSC), which was significantly reduced after tumor removal. Adjuvant radiotherapy increased the frequency of CD45RO+ memory CD4+ T cells and CD4+ regulatory T cells. FlowSOM algorithm analysis revealed several unanticipated populations, including cells negative for all markers tested, CD11b+CD15low, CD3+CD4-CD8-, CD3+CD4+CD8+, CD3+CD8+CD127+CD45RO+ cells, associated with BC or radiotherapy. Conclusions: This study revealed changes in blood leukocytes associated with primary BC, surgical removal and adjuvant radiotherapy. Specifically, it identified increased levels of CD117+ G-MDSC, memory and regulatory CD4+ T cells as potential biomarkers of BC and radiotherapy, respectively. Importantly, the study demonstrates the value of unsupervised analysis of complex flow cytometry data to unravel new cell populations of potential clinical relevance.
Prevalence and Factors Predicting Preventable Trauma Induced Mortality
Authors: Hajian Abbas , Davoodabadi Abdoulhossein , Kashi Esmail Abdourrahim , Sehat Mojtaba , Mohammad Shahrzad Ale
Published: January 2021

Introduction: Trauma is one of the most common causes of morbidity and mortality worldwide. Since the definition of preventable death has been described many studies, like current one, were conducted to evaluate this issue.Materials and Methods: This cohort retrospective study investigated archived medical files of trauma victims from 2017 to 2020 in a referral single-center trauma hospital. Registered demographic data, vital signs, Glasgow coma scale (GCS), timing of trauma and death, executed interventions, type and mechanism of trauma in addition to time errors, clinical mismanagements and missed injuries were extracted. Injury severity score (ISS), revised trauma score (RTS) and probability of survival (Ps) based on TRISS method for each case were calculated. Eventually preventable and non-preventable death groups were compared.Results: Finally from the all 413 trauma victims 246(54.9%) files were enrolled. Victims aged from 18 to 95 years. Of all 189(76.8%) were males. Analysis manifested 135(54.9%) of all deaths were potentially and 2(0.08%) were certainly preventable; while the other 49.1% were non-preventable for expiration(p=0.001). Data showed that from all variables systolic blood pressure (SBP) ≥80mmHg, respiratory rate (RR) ≥20 per minute, GCS ≥8, higher RTS, road traffic accidents and control of external bleeding were contribute to prediction of preventable trauma related mortality.Conclusion: This study implied on frequency of trauma related preventable death was regionally high and associated factors that could be lessen the number of these mortalities including of SBP, RR, GCS, RTS, mechanism of trauma and external bleeding of trauma patients should be paid more attention.Trial registration: Retrospectively registered.
Tukey Control Chart for Radon Monitoring in Relation to the Seismic Activity
Authors: Mehmood Tahir
Published: January 2021

Earthquakes are among the most destructive natural disasters, which cause damage on a huge scale not only to life but to property also. Radon is one of the precursory phenomena that exist in connection to the occurrence of earthquakes and may have potential in forecasting these hazards. The data set in this study contains the observations of radon from August 01, 2014, to January 31, 2015 collected in Sobra city, northern Pakistan. Weibull, Gamma, Log-Normal, Log-Logistic, and Pareto probability distribution were fitted over the radon on its original scale and a log scale. Log-logistic best fits the radon on both scales. Log-logistic based Tukey control charts suggest a central limit of 2465.459 Bq/m3 and upper control limit of 12704.080 Bq/m3 on the original radon data, while they suggest a central limit of 7.759, upper control limit of 11.080 and lower control limit of 4.524 on the log scale. The Tukey control charts reveal several anomalies that were compared with earthquake occurrence. There are five earthquakes that occurred during the same period as the radon monitoring program, having magnitude ranges between 4.9 5.5, with the ratio between strain radius and distance to the epicenter greater than or equal to 1. Among several radon anomalies exceeding the upper control limit, the five are identified as earthquake precursors. The results of this study demonstrate that for earthquakes, seismic events show a correlation with increasing concentrations of radon gas before their occurrence.
Impact of Permissive Hypoxia and Hyperoxia Avoidance on Clinical Outcomes in Septic Patients Receiving Mechanical Ventilation: A Retrospective Single-Center Study
Authors: Nishimoto Kota , Umegaki Takeshi , Ohira Sayaka , Soeda Takehiro , Anada Natsuki , Uba Takeo , Shoji Tomohiro , Kusunoki Munenori , Nakajima Yasufumi , Kamibayashi Takahiko
Published: January 2021

Different ventilatory strategies may affect survival in septic patients requiring mechanical ventilation. In this retrospective before-and-after study, we examined the effects of permissive hypoxia and hyperoxia avoidance on mortality in mechanically ventilated adult (≥18 years) septic patients at a Japanese university hospital. In April 2017, our hospital’s mechanical ventilation policy changed from a conventional oxygenation target (SpO2: ≥96%.) to more conservative targets with permissive hypoxia (SpO2: 88-92% or PaO2: 60 mmHg) and hyperoxia avoidance (reduced oxygenation for PaO2 >110 mmHg). Patients were divided into a pre-change group (April 2015 to March 2017; n=83) or post-change group (April 2017 to March 2019; n=130). Using a multiple logistic regression model, we examined the association of the post-change group with intensive care unit (ICU) mortality. The post-change group did not have a significantly lower adjusted ICU mortality (odds ratio: 0.67, 95% confidence interval: 0.33-1.43; P=0.31) than the pre-change group. However, there were significant differences in mechanical ventilation duration (pre-change: 11.0 days, post-change: 7.0 days; P=0.01) and ICU stay (pre-change: 11.0 days, post-change: 9.0 days; P=0.02). Although the new ventilation policy did not affect ICU mortality, the reductions in mechanical ventilation duration and ICU stay may improve patient turnover and ventilator access.
Percutaneous Endoscopic Lumbar Discectomy for Far Lateral L5/S1 Disc Herniation With High Iliac Crest
Authors: Ding Qirui , Qin Haonan , Ma Cheng , Zhao Feng , Li He , Liu Lijia , Wei Yifan , Ren Yongxin
Published: January 2021

Background: To investigate the effect of percutaneous endoscopic lumbar discectomy (PELD) via a modified posterolateral approach on far lateral lumbar disc herniation (FLLDH) at L5/S1 level with high iliac crest. Methods: This retrospective study recruited the patients diagnosed of FLLDH at L5/S1 level with high iliac crest and accepted PELD in our hospital from March 2016 to November 2019. The visual analogue scale (VAS), Oswestry disability index (ODI), and modified Japanese Orthopaedic Association (M-JOA) scores were recorded before and after surgery. The fractional anisotropy (FA) values were recorded before and after operation. The incision length, operation duration, intraoperative blood loss, hospital stay and complications were observed. The excellent and good rate was calculated at final follow-up. Results: A total of 17 patients, including 10 males and 7 females, were screened and enrolled in this study. The mean incision length, operation duration, blood loss and hospital stays were 0.74±0.058 cm, 55.64±8.635 minutes, 27.42±4.936 ml, and 3.74±1.052 days, respectively. The postoperative VAS scores decreased, the ODI and M-JOA scores, and FA values of nerve root at affected side increased significantly (p＜0.05), compared with those at pre-operation, but no difference was observed among the postoperative scores (p＞0.05). The complications rate was 5.88% (1/17) and overall excellent and good rate was 94.12% (16/17) at the final follow-up. Conclusions: PELD via a modified posterolateral approach was an effective, minimally invasive and safe technique for FLLDH at L5/S1 level with high iliac crest.
In Arthroscopic Rotator Cuff Surgery, Is There a Difference in the Results of Repair Made With Single or Double Rows According to the Shape and Size of the Tear?
Authors: Karakus Ozgun , Karaman Ozgur , Sari Ahmet Sinan , Saygi Baransel
Published: January 2021

IntroductionThe aim of this study was to evaluate the effect on the results of patients applied with arthroscopic full layer total layer rotator cuff repair made according to the shape and size of the tear.Materials and MethodsThe study included a total of 120 patients applied with arthroscopic full layer rotator cuff repair as single or double row repair, comprising 69 (57.5%) females and 51 (42.5%) males. The patients were separated into 3 groups of 40 according to the shape of the tear, as Group A (crescent type), Group B (U type), and Group C (L type). Within each group, classification was made according to the size of the tear. The long-term postoperative functional results were compared between the groups. ResultsThe mean age of the whole sample was 66.68±6.86 years (range, 50-81 years). A statistically significant difference was determined between the groups in respect of Constant Murley (CM), ASES, and UCLA scores (p<0.05). The scores of Group A of all the scales were found to be higher than those of Group C (p<0.05). In single row and double row repair of small and medium-sized tears of all shapes, no significant difference was determined in respect of the CM and UCLA scores (p>0.05). In the large tears, no significant difference was determined between crescent and U-shaped tears in respect of the CM and UCLA scores (p>0.05).ConclusionsNo significant difference was determined between single and double row repair of crescent type tears of all sizes. In the repair of small and medium-sized U type tears, no significant difference was determined between single and double row repair in respect of the CM and UCLA scores. In large U-shaped tears, the CM, ASES, and UCLA scores were determined to be high in double row repair. No significant difference was determined between single and double row repair of L type small and medium-sized tears. In the large L -shaped tears, the results of the single row repair were found to be higher than those of the cases with double row repair.
Breastfeeding in Neonates During the Coronavirus Disease 2019 Pandemic in China: A Cross-Sectional Survey
Authors: Fang Xu , Zhuxiao Ren , Dongchi Zhao , Ming Yi , Jiayu Miao , Yang Jie , Zhichun Feng
Published: January 2021

ObjectiveTo elucidate the current situation of breastfeeding in neonates in China and to investigate whether SARS-CoV-2 is transmitted through the mother’s milk.DesignA nationwide cross-sectional surveySettingThree hundred and forty-four member hospitals of the Chinese Neonatologist Association network from 31 provinces in China.SampleNine hundred and fourteen neonatologistsMain outcome measuresThese included (1) breastfeeding practices in the obstetrics ward; (2) breastfeeding implementation for neonates admitted to neonatal intensive care unit (NICU); (3) presence of SARS-CoV-2 in the breast milk of COVID-19 positive mothers based on the real-time reverse transcriptase-polymerase chain reaction (RT-PCT) test results.ResultsBreastfeeding was undermined during the COVID-19 pandemic. Of the 344 hospitals, 153 (44.48%) centers received breast milk from milk banks to feed babies in NICU. Eight (2.33%) Level III centers performed SARS-CoV-2 PCR tests on breast milk from 15 mothers with COVID-19 and found no SARS-CoV-2 RNA presence in breast milk. Moreover, none of the mothers engaged in breastfeeding. Further, only 52 (5.69%) neonatologists supported breastfeeding in mothers with COVID-19.ConclusionsBased on the available evidence, the benefits of breastfeeding for both infants and mothers outweigh the potential risk of SARS-CoV-2 transmission through breast milk. Amidst the COVID-19 pandemic, medical staff should encourage breastfeeding, in keeping with normal infant feeding guidelines, and provide skilled support to all mothers who choose to breastfeed.
Step-By-Step Instructions For The Innovative Three-Port-Technique of Laparoscopic Sleeve Gastrectomy: How I Do It ？
Authors: dong zhiyong , Stier Christine , Chen Wenhui , Chong Tsz Hong , Yang Jingge , Parmar Chetan , Wang Cunchuan
Published: January 2021

Background Laparoscopic sleeve gastrectomy (LSG) is considered a standard bariatric procedure, which is easy to perform. However, there are pitfalls to be aware of, because complications from the operation, on the other hand, pose great challenges. Methods We describe our innovative three-port-technique of LSG in a step-by-step instruction. To investigate the safety and efficacy, a retrospective evaluation and analysis was performed on consecutive 116 patients. For this purpose, the operation time, complication rates and weight loss were recorded.Results Mean BMI was 35.47 ± 4.53 kg Mean procedure duration was 90.13 ± 5.68 mins. Mean weight loss achieved was 11.57 ± 5.09 kg at first month; 19.75 ± 6.57 kg at third month; 26.85 ± 7.60 kg at sixth month, and 28.86 ± 11.23 kg at one year. According to the Clavien-Dindo classification, no seriously complications were observed after 1, 3, 6 12 months follow-up. Conclusion LSG in this innovative three-port technique can be performed safely with a convincing outcome.
Exosomal miR-218-5p/miR-363-3p from Endothelial Progenitor Cells Ameliorate Myocardial Infarction by Targeting the P53/JMY Signaling Pathway
Authors: Ke Xiao , Yang Rongfeng , Wu Fang , Wang Xing , Liang Jiawen , Hu Xun , Hu Chengheng
Published: January 2021

BackgroundAccumulating evidence has shown that endothelial progenitor cell-derived exosomes (EPC-Exos) can ameliorate myocardial fibrosis. The purpose of the present study was to investigate the effects of EPC-Exos-derived microRNAs (miRNAs) on myocardial infarction (MI). MethodsA miRNA-Seq dataset of miRNAs differentially expressed between EPCs and exosomes was collected. Quantitative real-time polymerase chain reaction (qRT-PCR) was used to validate the miRNA expression indicated by miRNA-Seq. Immunofluorescence, cell proliferation and angiogenesis assays were employed to investigate the effects of miRNAs on cardiac fibroblasts (CFs) in vitro. Interactions between miRNAs and their respective targets were examined via immunoblotting, qRT-PCR and luciferase reporter assays. An MI rat model was constructed, and various staining and immunohistochemical assays were performed to explore the mechanisms underlying the miRNA-mediated effects on MI. ResultsmiR-363-3p and miR-218-5p were enriched in EPC-Exos, and miR-218-5p and miR-363-3p mimic or inhibitor enhanced or suppressed CF proliferation and angiogenesis, respectively. miR-218-5p and miR-363-3p regulated P53 and junction-mediating and regulatory protein (JMY) by binding to the promoter region of P53 and the 3’ untranslated region of JMY. Additionally, treatment of CFs with exo-miR-218-5p or miR-363-3p mimic upregulated P53 and down-regulated JMY expression, promoted mesenchymal-endothelial transition and inhibited myocardial fibrosis. Administration of exosomes containing miR-218-5p mimic or miR-363-3p mimic ameliorated left coronary artery ligation-induced MI and restored myocardial tissue integrity in the MI model rats. ConclusionsIn summary, these results show that the protective ability of EPC-Exos against MI was mediated by the shuttled miR-218-5p or miR-363-3p via targeting of the P53/JMY signaling pathway.
Early Discrimination of Refractory Mycoplasma Pneumoniae Pneumonia in Children: A Multicenter Prospective Study in Zhejiang, China
Authors: Xu Dan , Zhang Yuanyuan , Zhang Ailian , Zheng Jishan , Ye Mingwei , Li Fan , Qian Gencai , Shi Hongbo , Jin Xiaohong , Huang Lieping , Mei Jiangang , Mei Guohua , Xu Zhen , Fu Hong , Lin Jianjun , Ye Hongzhou , Zheng Yan , Hua Lingling , Yang Min , Tong Jiangmin , Chen Lingling , Yang Dehua , Zhou Yunlian , Li Huiwen , Lan Yinle , Xu Yulan , Feng Jinyan , Chen Xing , Gong Min , Chen Zhimin , Wang Yingshuo
Published: January 2021

Objective: To explore potential predictors of RMPP in early stage.Study design: The prospective study, multicenter study was conducted in Zhejiang, China from May 1st, 2019 to January 31st, 2020. Children aged 29 days to 14 years old, with fever time during 48 to 120 hours were included. A total of 1428 children completed the study. A questionnaire was designed to collect patients’ information. Pharyngeal swab samples were collected. M. pneumoniae DNA in pharyngeal swab specimens were detected. Whether the patients develop to RMPP were assessed. Logistic regression analyses were used to examine associations between clinical data and RMPP.Results: The ages of the patients ranged from 34 days to 13.9 years with a median 4.3 years. The positive rate of M. pneumoniae -DNA was 37.4% (534/1428), and 446 cases were Mycoplasma pneumoniae pneumonia (MPP). In MPP patients, 55 cases were RMPP (12.3%), others were general MPP (GMPP) patients (n=391, 87.7%). Only the peak body temperature before the first visit and LDH level in RMPP patients were higher than that in GMPP [39.6 (39.1-40.0) °C vs. 39.2 (38.9-39.7) °C, p=0.003, and 332.5 (278.8-392.1) U/L vs. 310.5 (259.0-358.8) U/L, p=0.024]. Logistic regression also only included the above two parameters in the prediction probability. The area under ROC curve of the prediction probability π of RMPP was 0.682 (95% CI, 0.593-0.771), P<0.01. The cut-off value was 0.12. Sensitivity and specificity of the prediction probability π in cut-off value was 0.64 and 0.70, respectively.Conclusions: AND RELEVANCE A prediction probability, calculating from the peak body temperature before the first visit and LDH level for early identifying RMPP from other MPP within 2-5 days of fever duration, with a cut-off value of 0.12 may be helpful in clinical practice.
Impact of Pre-Operative Breast Magnetic Resonance Imaging (MRI) on Contralateral Synchronous and Metachronous Breast Cancer Detection- A Case Control Comparison Study With Mean Follow-Up of 102 Months.
Authors: Wu Wen-Pei , Chen Chih-Yu , Lee Chih-Wei , Wu Hwa-Koon , Chen Shou-Tung , Wu Yu-Ting , Lin Ying-Jen , Chen Dar-Ren , Kuo Shou-Jen , Lai Hung-Wen
Published: January 2021

Background: Women with unilateral breast cancer are at an increased risk for the development of contralateral breast cancers. We hypothesis that combined breast MRI would detect more contralateral synchronous breast cancer than conventional imaging alone, and resulted in less contralateral metachronous breast cancer during follow-up. Methods: In this case control analysis, we retrospectively collected two groups of patients for evaluating the effectiveness and value of adding pre-operative breast MRI to conventional breast images (mammography and sonography) for detection of contralateral synchronous breast cancer. The new metachronous contralateral breast cancer diagnosed during follow-up was prospectively evaluated and compared. Results: Group A (n=733) comprised patients who underwent conventional preoperative imaging and group B (n=735) combined with MRI were enrolled and compared. Seventy (9.5%) of the group B patients were found to have contralateral lesions detected by breast MRI, and 65.7% of these lesions only visible with MRI. The positive predictive value of breast MRI detected contralateral lesions was 48.8%. With the addition of breast MRI to conventional imaging studies, more surgical excisions were performed in contralateral breasts (6% (44/735) versus 1.4% (10/733), P< 0.01), more synchronous contralateral breast cancer detected (2.9% (21/735) versus 1.1% (8/733), P=0.02), and resulted in numerical less (2.2% (16/714) versus 3% (22/725), p=0.3) metachronous contralateral breast cancer during a mean follow-up of 102 months. Conclusions: Combining pre-operative breast MRI evaluation resulted in an increase of contralateral synchronous breast cancer detection, and a numerical less subsequent contralateral metachronous breast cancer occurrence compared to conventional imaging alone.
Association Between Socio-Environmental Factors, Coverage by Family Health Teams, and Rainfall in the Spatial Distribution of Zika Virus Infection in the City of Rio de Janeiro, Brazil, in 2015 and 2016
Authors: Raymundo Carlos Eduardo , Medronho Roberto de Andrade
Published: January 2021

Background: Zika virus (ZIKV) infection caused outbreak in Brazil, in 2015 and 2016. Disorganized urban growth, facilitates the concentration of numerous susceptible and infected individuals. It is useful to understand the mechanisms that can favor the increase in ZIKV incidence, such as areas with wide socioeconomic and environmental diversity. Therefore, the study analyzed the spatial distribution of ZIKV in the city of Rio de Janeiro, Brazil, in 2015 and 2016, and associations between the incidence per 1,000 inhabitants and socio-environmental factors. Methods: The census tracts were used as the analytical units reported ZIKV cases among the city’s inhabitants. Local Empirical Bayesian method was used to control the incidence rates’ instability effect. The spatial autocorrelation was verified with Moran’s Index and local indicators of spatial association (LISA). Spearman correlation matrix was used to indicate possible collinearity. The Ordinary Least Squares (OLS), Spatial Lag Model (SAR), and Spatial Error Model (CAR) were used to analyze the relationship between ZIKV and socio-environmental factors.Results: The SAR model exhibited the best parameters: R2 = 0.44, Log-likelihood= -7482, Akaike Information Criterion (AIC) = 14980. In this model, mean income between 1 and 2 minimum wages was possible risk factors for Zika occurrence in the localities. Household conditions related to adequate water supply and the existence of public sewage disposal were associated with lower ZIKV incidence rates, suggesting possible protective factors against the occurrence of ZIKV in the localities. The presence of the Family Health Strategy in the census tracts was positively associated with the ZIKV incidence rate. However, the results show that mean income less than 1 minimum wage were negatively associated with higher ZIKV incidence rates. Discussion: The results demonstrate the importance of socio-environmental variables in the dynamics of ZIKV transmission and the relevance for the development of control strategies.
Development and evaluation of a handheld type 6 DoF midair haptic device using asymmetric vibration and a presentation force vectoring mechanism
Authors: Okuda Yuto , Komizunai Shunsuke , Konno Atsushi
Published: January 2021

This paper describes a handheld type aerial haptic device with 6 DoF (degree of freedom) using pseudo-haptics by asymmetric vibration. By introducing a original presentation force vectoring mechanism, 6 DoF force sense presentation and compactness suitable for handheld use with a small number of vibrators are realized together. In addition, a relationship between the drive input and output (presentation force sense) of the developed device is formulated, and its inverse problem solving method for obtaining the drive input that realizes a desired presentation force sense is derived. Furthermore, a user test clarified the direction in which this device can / cannot effectively exert force.
Barriers and Facilitators to Implementing a Stepped Care Cognitive-behavioral Therapy for Insomnia in Cancer Patients: a Qualitative Study.
Authors: Savard Josée , Filion Catherine , Gagnon Marie-Pierre , Caplette-Gingras Aude , Bélanger Lynda , Morin Charles M.
Published: January 2021

Background: Insomnia affects between 30 to 60% of cancer patients and tends to become chronic when left untreated. Cognitive-behavioral therapy for insomnia (CBT-I) is the recommended first-line treatment for cancer-related insomnia. Yet, this treatment is not readily accessible. A stepped care intervention beginning with a self-administered (web-based) intervention appears to be a promising cost-effective approach to offer CBT-I in routine cancer care as compared to a standard face-to-face therapy. This qualitative study investigated current practices in the assessment and management of insomnia in five hospitals offering cancer care and identified the barriers and facilitators to the implementation of a stepped care CBT-I in these clinical settings. Methods: Nine focus groups composed of a total of 43 clinicians (e.g., physicians, nurses, nurse navigators, technologists, psychologists) and administrators, as well as 10 cancer patients were held. The Consolidated Framework for Implementing Research was used to develop the semi-structured interview and analyze the data. Results: Sleep difficulties are not systematically discussed in clinical practice and when a treatment is offered, most often, it is a pharmacological one. Based on the Consolidated Framework for Implementing Research, barriers to the implementation of a stepped care CBT-I included individual characteristics (e.g. lack of knowledge about CBT-I among cancer care providers, patients’ comorbidities and preferences); intervention characteristics (e.g., lack of internet access); inner setting characteristics (e.g., lack of time and resources, resistance to change); and process factors (e.g., need for prior training and engagement of all stakeholders). Facilitators were related to individual characteristics (e.g. strong beliefs in the efficacy of CBT-I); intervention characteristics (e.g. web-based format that increases accessibility at a lower cost, short- and long-term effects of CBT-I); and process factors (e.g. high motivation and commitment to offer a new service to patients). Conclusions: This qualitative study confirms the need to better address insomnia in routine cancer care and suggests that, while some barriers were mentioned, the implementation of a stepped care CBT-I is feasible provided that some conditions are met such as prior training and engagement of all stakeholders from the outset.