bluuebunny/crossref_metadata_2025 huggingface dataset:
Identification of lncRNA prognostic signature and analysis of their functions for HCV-related hepatocellular carcinoma
Authors: Wang Kun , Li Wenxin , Liu Yefu , Hao Zhiqiang , Hua Xiangdong , Ma Zuohong , Feng Zhaoqiang
Published: August 2020

Background Hepatitis C virus (HCV) infection is a main contribution to the increase in hepatocellular carcinoma (HCC) incidence and patients’ death recently, but prognostic biomarkers for HCV-related HCC remain rarely reported. This study was to identify an lncRNA prognostic signature for HCV-HCC patients and explore their underlying function mechanisms. Methods In total, 102 HCV-HCC samples and 50 normal control samples were obtained from The Cancer Genome Atlas (TCGA) database. Univariate and multivariate Cox regression analysis were conducted to screen an lncRNA signature that could predict overall survival (OS) and then, the risk score was calculated using this signature. The prognostic potential of this risk score was evaluated by drawing Kaplan-Meier, receiver operating characteristic (ROC) curves and performing multivariate Cox regression analyses with clinical variables. Furthermore, a co-expression and competing endogenous RNA (ceRNA) networks were constructed to explore the functional mechanisms of lncRNAs. Results Multivariate Cox regression showed six lncRNAs (SLC16A1-AS1, ZFPM2-AS1, JARID2-AS1, LINC01426, USP3-AS1 and LYPLAL1-AS1) were significantly associated with OS of HCV-HCC patients. These six lncRNAs were used to establish a risk score model, which displayed a higher prognosis prediction accuracy [area under the ROC curve (AUC) = 0.95 for training set; AUC = 0.885 for testing; AUC = 0.907 for entire set]. Also, this was independent of various clinical variables. The crucial co-expression (LINC01426/SLC16A1-AS1-AURKA/SFN/CCNB1, ZFPM2-AS1/LYPLAL1-AS1/JARID2-AS1-TSSK6) or ceRNA (USP3-AS1-hsa-miR-383-SFN) interaction axes were identified. Conclusion Our study identified a novel six-lncRNA prognosis signature for HCV-HCC patients and indicated their underlying mechanisms for HCC progression.
Sex Differences in Stroke Outcome Are Associated With Constitutive Gut Dysbiosis and Stroke-induced Gut Permeability
Authors: El-Hakim Yumna , Mani Kathiresh Kumar , Eldouh Amir , Dabney Alan , Pilla Rachel , Sohrabji Farida
Published: August 2020

Background: Sex differences in experimental stroke are well documented, such that adult males show worse outcomes compared to adult females, including greater infarct volume, increased stroke-induced mortality and more severe sensory-motor impairment. Based on recent evidence that gut dysbiosis may be an early response to stroke, the present study tested the hypothesis that in the acute phase, stroke will result in greater permeability of the gut blood barrier and gut dysbiosis in males as compared to females. Method: Male and female Sprague Dawley rats (5-7 months of age) were subject to endothelin (ET)-1-induced middle cerebral artery occlusion (MCAo). Fecal samples, blood draws and sensory motor tests were conducted pre and 2d after MCAo. Fecal samples were analyzed for 16s sequencing and short chain fatty acids (SCFAs). Gut permeability was assessed in serum samples using biomarkers of gut permeability as well as functional assays using size-graded dextrans. Results: We confirmed stroke-induced sex differences, including greater mortality and sensory motor deficit in males as compared to age-matched female rats. Remarkably, fecal 16s sequencing showed greater bacterial diversity in females at baseline (prior to stroke) while 2 days after stroke, these measures were similar between the sexes. In contrast, fecal levels of short chain fatty acids (SCFAs) which are usually beneficial, were higher in males. MCAo-induced gut permeability was much worse in males as compared to females, as indicated by histological analysis, biochemical markers in serum, and serum measurement of fluorescent-labeled dextrans following oral gavage. Additionally, males had higher serum levels of proinflammatory cytokines IL-17A, MCP-1, IL-5 and EGF compared to females after stroke. Predictive modeling indicated that markers of gut permeability were associated with stroke-induced sensory-motor impairment. Conclusions: Poor stroke outcomes in adult males is mirrored by increased gut permeability in this group. Additionally, these data suggest that constitutive sex differences in the diversity and richness of gut microbial communities may predispose better functional outcomes after stroke in females, and support the idea that preventative modification of the gut microbiome may reduce the risk for stroke in vulnerable populations such as the elderly or those with co-morbid conditions.
Incidence, mortality and survival in children and young people aged 11-25 in Wales with co-occurring mental disorders and problem, hazardous or harmful substance use: estimates derived from linked routine data
Authors: Rees Sarah , Watkins Alan , Keauffling Janet , John Ann
Published: August 2020

Background Mental disorder (MD) and problem, hazardous or harmful substance use (SUD) are associated with poorer than average health and greater mortality. We analysed routine data to estimate incidence of co-occurring (CC) MD and SUD, and to estimate all-cause mortality and survival with CC, a single MD or SUD diagnosis or neither condition (NC), in young people aged 11-25 in Wales, UK. Methods A retrospective population-based electronic cohort study using data from the Secure Anonymised Information Linkage (SAIL) Databank. Participants were 958,603 individuals aged 11-25 between 2008 and 2017, with a subset for mortality and survival analysis of 465,242 individuals born between 1983 and 1997 and present in the data on 1st January 2008. Incidence was defined as date of first recorded occurrence of a CC code. Incidence and observed unadjusted mortality were reported as rates per 1,000 person-years at risk (PYAR). We plotted Kaplan-Meier survival curves and carried out Cox regression to estimate hazard ratios for risk of death by condition group (CC; MD or SUD only; NC). Results CC incidence in primary care significantly decreased, from 2.5/1,000 PYAR (95% CI 2.3-2.6) in 2008 to 2.1/1,000 (95% CI 2.0-2.2) in 2017 (Incidence rate ratio (IRR) = 0.9, 95% CI 0.8-1.0, p=0.01), and in hospital admissions remained stable, from 2.3/1,000 (95% CI 2.1-2.4) in 2008 to 2.2/1,000 (95% CI 2.0-2.3) in 2017 (IRR = 1.0, 95% CI 0.9-1.1). Higher incidence was associated with male sex, older age and greater deprivation.Observed unadjusted mortality rates for CC (1.4/1,000 PYAR, 95% CI 1.2-1.5) and SUD only (1.1/1,000, 95% CI 0.9-1.4) were significantly higher than for MD only (0.4/1,000, 95% CI 0.3-0.4) and no condition (NC) (0.3/1,000, 95% CI 0.2-0.3). Risk of death was significantly higher for CC (HR = 8.7, 95% CI 7.5-10.0, p<0.001), SUD only (HR = 4.5, 95% CI 3.4-5.9, p<0.001) and MD only (HR = 2.7, 95% CI 2.4-3.1, p<0.001), compared with NC.Conclusions Male sex, older age and greater deprivation were associated with significantly higher CC incidence. CC, and also SUD or MD only, were associated with greater risk of death, compared with individuals with NC.
Stakeholder’s views of adolescent weight management programmes: a qualitative study.
Authors: Jones Helen M , Oyebode Oyinlola , Melendez-Torres G.J. , Al-Khudairy Lena
Published: August 2020

Background Child and adolescent obesity is a significant public health concern. Family-based multi-component weight management programmes are recommended, however recruitment and retention in these programmes are poor. Understanding stakeholders’ views of these programmes may lead to improvements in delivery, and in turn, improve engagement and success in treating adolescents with obesity in the future. The aim of this study is to explore stakeholders’ views on adolescent weight management programmes.Methods A qualitative study of stakeholders (n = 11), recruited by purposive sampling was conducted. Semi-structured interviews were audio recorded, transcribed and analysed using qualitative content analysis. Codes were grouped into sub-categories, which were combined into higher order categories.Results Stakeholders recognised the importance of support for adolescents from experienced professionals, as well as family and peers. There was agreement amongst stakeholders that longer-term support was needed for adolescents with obesity; suggestions included integrating follow-up support with schools and leisure services. The need for the educational side of a programme to be practical and hands on was recognised. Emotional and psychological support must be prioritised. Having a variety of delivery modes, such as group and 1-2-1, particularly in the home environment, were recommended. Stakeholders agreed that weight management programmes for adolescents need to be more proactive at incorporating technology.Conclusions This study identified key categories, which should be considered when developing successful weight management programmes for adolescents with overweight or obesity. By taking on board the views of those that work closely with this group, attrition and dropout rates for weight management programmes may be improved.
The efficacy of mesenchymal stromal cells derived therapies for acute respiratory distress syndrome - a meta-analysis of preclinical trials.
Authors: Wang Fengyun , Fang Bin , Qiang Xinhua , Shao Jingsong , Zhou Lixin
Published: August 2020

Background The investigation of Mesenchymal stromal cells (MSC) conditioned medium or extracellular vesicles (exosomes or microvesicles) for acute lung injury (ALI) or acute respiratory distress syndrome (ARDS) is a fast growing field in recent years. Our purpose is to investigate these MSC’s derived therapies’ (MDT) efficacy for ARDS in animal models by meta-analysis.Methods Meta-analysis of MDT for ALI/ARDS in animal trials. PubMed and EMBASE were searched to screen relevant preclinical trials with a pre-specified search strategy. Results A total of 17 studies were included in our studies. Compared the control group, the pooled result suggested that MDT can reduce lung injury score (mean = -4.02, 95% CI [- 5.28, - 2.23], P <0.0001) and improve survival (OR = -6.45, 95% CI [2.78, 14.97], P <0.0001) significantly. MDT mitigated the infiltration of neutrophils in alveoli (mean = -1.35, 95% CI [-1.69, -1.02], P <0.0001). Also, MDT reduced the wet to dry weight ratio of lung (mean = -2.65, 95% CI [-3.99, -1.31], P= 0.0001) and total protein in BALF (mean = -1.29, 95% CI [-1.63, -0.96], P <0.0001). Furthermore, MDT was found to down-regulate pro-inflammatory mediators such as IL-1, IL-6 and TNF-a, and up-regulate anti-inflammatory mediators such as IL-10.Conclusion MDT reduced lung injury and improved survival in animal ARDS models as it can ameliorate the lungs’ permeability, decrease inflammatory cells infiltration, down-regulate pro-inflammatory mediators and up-regulate anti-inflammatory mediators. However, more animal studies and human trials are needed for further investigation.
Iatrogenic Pneumopericardium after tube thoracostomy: Case Report
Authors: Mindaye Esubalew T. , Arayia Abraham , Tufa Tesfaye H. , Bekele Mahteme
Published: August 2020

Background: Pneumopericardium, the presence of air within the pericardial space, is a rare occurrence which usually follows positive pressure ventilation in infants, or blunt and penetrating thoracoabdominal injuries in adults. The occurrence of iatrogenic pneumopericardium following tube thoracostomy is an extremely rare occurrence.Case presentation: We present a rare case of iatrogenic pneumopericardium in a 1 year and 7 months old female child for whom a left side tube thoracostomy was done using nasogastric tube for an indication of left empyema thoracis. Later, she developed progressive worsening of shortness of breath and imaging revealed iatrogenic pneumopericardium. She was managed conservatively and discharged home in good condition.Discussion: Pneumopericardium can have a range of presentations from being asymptomatic to presenting with features of cardiac tamponade. Treatment can range from conservative observation to pericardiocentesis and insertion of a small chest tube into the pericardium. In the absence of echocardiographic evidence of tamponade, the severe malnutrition our patient had and the already infected pleural cavity which could have increased her postoperative complication we deferred surgical intervention.Conclusion: Iatrogenic pneumopericardium is a rare event but it might lead to death if not diagnosed and treated promptly. Although reporting of complications is not popular, this represents an opportunity to advance the safety during chest drain insertion. The tendency to develop tension pneumopericardium urging surgical intervention is high in pediatric patients but our patient has improved well with conservative management.
Computing the Average Body Mass Index: A Study with Systematic Sampling Using Auxiliary Information
Authors: Vishwakarma Gajendra K. , Singh Neha , Singh Surendra Pal
Published: August 2020

Background: The use of body mass index (BMI) could lead to over/under estimation of fat mass percentage. Systematic sampling is to be applied only if the given population is logically homogeneous, because systematic sample units are uniformly distributed over the population. The method of estimation for mean of the study variable under systematic sampling using auxiliary information has been proposed to estimate the body mass index (BMI).Methods: The measures of different body parts are taken as auxiliary variables. The observation available on different body parts are assumed to be recorded with observational error. Thus we also propose method of estimation for mean in the presence of observational error. Numerical study has been done to reveal the efficacy of the proposed procedure for estimation of mean. Simulation study has also been done to demonstrate the effect of observational error on the estimation of body mass index.Results: The properties of the proposed estimation method have been derived under large sampling approximation and obtained the conditions under which proposed method are more efficient. Conclusions: The study provides an easy approach and simplest way to obtain the BMI estimate with and without observational error. Thus the suggested method may be used by statistician for this problem and for many others similar problem in the estimation of mean.
Three-dimensional Transthoracic Echocardiographic Evaluation of Tricuspid Regurgitation Severity Using Proximal Isovelocity Surface Area: Comparison With Volumetric Method
Authors: Chen Beiqi , Dong Lili , Liu Yu
Published: August 2020

BackgroundThe quantification of tricuspid regurgitation(TR) using three-dimensional(3D) proximal isovelocity surface area (PISA)derived effective regurgitant orifice area (EROA) is feasible in functional TR. The aim of our study was to explore thediagnostic accuracy and utility of 3D PISA EROA in a larger population of different etiologies. MethodsOne hundred and seven patients with confirmed TR underwent 2D and 3D transthoracic echocardiography (TTE). 3D PISA EROA was calculatedand EROA derived from 3D regurgitant volume (Rvol) was used as the reference. Results3D PISA EROA showed better correlation in primary TR than in functional TR(r=0.897, P<0.01). 3D PISA EROA differentiated severe TR with comparable accuracy in patients with primary and functional etiology (Z-value 16.506 vs 21.202), but with different cut-offs (0.49cm2vs. 0.41 cm2). The chi-square value for incorporated clinical symptoms, positive echocardiographic results and 3D PISA EROA to grade severe TR was higher than only included clinical symptoms or incorporated clinical symptoms and posotive echocardiographic results (chi-square value 137.233, P <0.01). ConclusionTR quantification using 3D PISA EROA is feasible and accurate under different etiologies. Ithas incremental diagnostic value for evaluating severeTR.
Comparison of Oral Glucose Tolerance Test and HbA1c in Detection of Disorders of Glucose Metabolism in Patients With Acute Stroke
Authors: Matz Karl , Teuschl Yvonne , Tuomilehto Jaakko , Dachenhausen Alexandra , Brainin Michael
Published: August 2020

Background: Diabetes is an increasingly important risk factor for ischemic stroke and worsens stroke prognosis. Yet a large proportion of stroke patients who are eventually diabetic are undiagnosed. Therefore, it is important to have accurate assessment of glycaemia in stroke patients.Design: Secondary outcome analysis of a randomized controlled trial focussing on parameters of glucose metabolism and detection of diabetes and prediabetes in patients with acute ischemic stroke (AIS).Methods: a total of 130 consecutively admitted patients with AIS without previously known type 2 diabetes mellitus (T2DM) were screened for diabetes or prediabetes as part of secondary outcome analysis of a randomized controlled trial that tested lifestyle intervention to prevent post-stroke cognitive decline. Patients had the oral glucose tolerance test (OGTT) and glycated hemoglobin (HbA1c) measurements in the second week after stroke onset and after one year. The detection rates of diabetes and prediabetes based on the OGTT or HbA1c values were compared.Results: By any of the applied tests at the second week after stroke onset 62 of 130 patients (48%) had prediabetes or T2DM. Seventy-five patients had results from both tests available, the OGTT and HbA1c; according to the OGTT 40 (53.3%) patients had normal glucose metabolism, 33 (44%) had prediabetes, two (2.7%) T2DM. In 50 (66.7%) patients the HbA1c results were normal, 24 (32%) in the prediabetic and one (1.3%) in the diabetic range . The detection rate for disorders of glucose metabolism was 10% higher (absolute difference; relative difference 29%) with the OGTT compared with HbA1c. After one year the detection rate for prediabetes or T2DM was 7% higher with the OGTT (26% relative difference). The study intervention led to a more favourable evolution of glycemic status after one year.Conclusions: Many patients with acute stroke have unrecognised diabetes or prediabetes. The OGTT is a more sensitive screening tool than HbA1c for the detection of previously unrecognised glycemic disorders in patients with acute stroke with an at least 25% relative difference in detection rate. Therefore, an OGTT should be performed in all patients with stroke with no history of diabetes. Measuring HbA1c alone will lead to a false assurance of normal glycemic status in many stroke patients.
A case of a new Lynch Syndrome variant with a deletion, c.1024_1026, in the MSH2 gene in a Chinese family
Authors: Zhao Zhe , Li Lu , Dong Lin , Jia Jia , Su Ke , Bai Hua , Wang Jie
Published: August 2020

Background

Multiple genetic variations have been identified in mismatch repair genes for Lynch Syndrome. However, diagnosis of Lynch Syndrome and its subtypes in patients with atypical cancer types still remains challenging. Little is known about Lynch syndrome-related renal carcinoma and related genes. We present a case of renal carcinoma with multiple primary skin tumors, with a new Lynch Syndrome variant with a deletion in a Chinese family.
Case presentation:

The patient was a 60-year-old Chinese male with a history of Lynch Syndrome-related renal carcinoma with repeatedly multiple primary skin tumors. Immunohistochemistry revealed loss of MSH2 and MSH6 proteins. Sequencing of mismatch repair genes revealed a previously unknown germline MSH2 mutation (c.1024_1026 del) resulting in an amino acid deletion (p. V342del). This variant was co-segregated among the carcinoma-affected family members. After 6 cycles of immunotherapy, a marked regression of the skin tumor was obtained.
Conclusions

We clarify the pathogenic significance of this new mutation and suggest immunotherapy for patients with this subtype of Lynch Syndrome.
Developing a scoring tool to estimate the risk of deterioration for normotensive patients with acute pulmonary embolism on admission
Authors: Gao Yizhuo , Ji Chao , Zhao Hongyu , Han Jun , Shen Haitao , Jia Dong
Published: August 2020

Background: It is important to identify deterioration in normotension patients with acute pulmonary embolism (PE). This study aimed to develop a tool for predicting deterioration among normotensive patients with acute PE on admission.Methods: Clinical, laboratory, and computed tomography parameters were retrospective collected for normotension patients with acute PE who were treated at a Chinese center from January 2011 to May 2020 on admission into hospital. The endpoint of the deterioration was any adverse outcome within 30 days. The eligible patients were randomized 2:1 to training and validation datasets. A nomogram was developed and validated by training and validation datasets respectively. The areas under the receiver operating characteristic curves (AUCs) and 95% confidence intervals (CIs) were calculated. A risk-scoring tool for predicting deterioration was applied as a web-based calculator.Results: The 845 eligible patients (420 men, 425 women) had an average age of 60.05±15.43 years. Adverse outcomes were identified for 81 patients (9.6%). The nomogram for adverse outcomes included heart rate, systolic pressure, N-terminal-pro brain natriuretic peptide, and ventricular/atrial diameter ratios at 4-chamber view, which provided AUC values of 0.925 in the training dataset (95% CI: 0.900–0.946, p<0.001) and 0.900 in the validation dataset (95% CI: 0.883–0.948, p<0.001). A risk-scoring tool was published as a web-based calculator (https://gaoyzcmu.shinyapps.io/APE9AD/).Conclusions: We developed a web-based scoring tool that may help predict deterioration in normotensive patients with acute PE.
Obstacle Avoidance and Terrain Identification for a Hexapod Robot
Authors: Zhao Yue , Gao Feng , Yin Yunpeng
Published: August 2020

Legged robots have advanced potential in mobility compared with wheeled or tracked vehicles in harsh environment. In real applications, both environmental perception and terrain identification play an important role in ensuring the safety of the robot. However, few papers involve the obstacle avoidance and terrain identification methods for legged robots. An obstacle avoidance and terrain identification method is proposed in this paper. Firstly, a novel dynamic obstacle avoidance motion planning is proposed which takes full account of the motion ability of the robot. Secondly, a terrain identification method is proposed. The robot can distinguish typical terrains like flat floor, step-on, step-down, ditch and so on. Besides, the ground properties like stiffness are identified to improve the performance of the robot. Finally, the proposed method is integrated on hexapod robots and tested by real experiments which show the method effective. Our methods and experimental results can be a valuable reference for other legged robots.
Reductive dissolution of biogenic magnetite
Authors: Yamazaki Toshitsugu
Published: August 2020

Reductive dissolution of magnetites is known to occur below the Fe-redox boundary in sediment columns. This study aims to document the detailed processes of biogenic magnetite dissolution. A sediment core taken from the Japan Sea was used for this purpose, in which reductive dissolution of magnetic minerals are known to start at about 1.3 m in depth and mostly complete within an interval of about 0.3 m. Using first-order reversal curve diagrams, preferential dissolution of biogenic magnetites within this interval is estimated from the observation that a narrow peak extending along the coercivity axis (the central ridge), which is indicative of biogenic magnetite, diminishes downcore. Transmission electron microscopy shows that the sediments contain the three morpho-types of magnetofossils: octahedron, hexagonal prism, and bullet shaped. With the progress of reductive dissolution, the proportion of bullet-shaped magnetofossils decreases, whereas that of hexagonal prisms increases. For hexagonal prisms, {111} caps are often etched while {110} side faces are almost intact. These observations can be explained by the differences in resistivity against dissolution among crystal planes of magnetite. A previous study reported that the dissolution rate of (111) planes is higher than that of (110) planes. Hexagonal prisms elongate in the [111] direction and are wrapped with {110} side faces, whereas octahedral and bullet-shaped magnetofossils have larger proportions of surface areas with {111} faces. Magnetosome morphology may reflect preference of inhabiting magnetotactic bacterial lineage for chemical conditions in sediments. One should, however, be cautious for possible alteration of original morphological composition during reductive diagenesis when magnetofossil morphology is used as a paleoenvironmental proxy.
Identification and characterization of a Babesia bigemina thrombospondin-related superfamily member, TRAP-1: a novel antigen containing neutralizing epitopes involved in merozoite invasion
Authors: Montenegro Valeria N , Paoletta Martina S , Ortiz Jose Jaramillo , Suarez Carlos E , Wilkowsky Silvina E
Published: August 2020

Background The Thrombospondin-Related Anonymous Protein (TRAP) has been described as a potential vaccine candidate in several apicomplexan parasites. However, this protein and members of this family have not been characterized yet in Babesia bigemina, one of the most prevalent species causing bovine babesiosis.Methods The Babesia bigemina TRAP-1 (BbiTRAP-1) gene was identified by a bioinformatics search using the B. bovis TRAP-1 sequence. Members of the TRAP and TRAP-related protein family (TRP) families were identified in Babesia and Theileria through the search of the TSP-1 adhesive domain, the hallmark motif of TRAP proteins. Structural modelling and phylogenetic analysis were performed with the identified TRAP proteins. A truncated recombinant BbiTRAP-1 and specific antisera were produced, and used in Western blot analysis and indirect fluorescent antibody test (IFAT). B-cell epitopes with neutralizing activity in BbiTRAP-1 were defined by ELISA and invasion assays.Results TRAP family has 3 members in B. bigemina (BbiTRAP-1-3). All are type 1 transmembrane proteins containing the von Willebrand factor A (vWFA), thrombospondin type 1 (TSP-1) and cytoplasmic C-terminus domains along with transmembrane regions. The BbiTRAP-1 predicted structure also contains a metal ion-dependent adhesion site (MIDAS) for interaction with the host cell. The TRP family in Babesia and Theileria species contains the canonical TSP-1 domain but lack the vWFA domain,and together with TRAP define a novel gene superfamily. A variable number of tandem repeat units is present in BbiTRAP-1 and could be used for strain genotyping. Western blot and IFAT analysis confirmed expression of BbiTRAP-1 by blood stage parasites. Partial recognition by a panel of sera from B. bigemina infected cattle in ELISA using truncated BbiTRAP-1 suggests that this protein is not an immunodominant antigen. Additionally, bovine anti- recombinant BbiTRAP-1 antibodies were capable of neutralize merozoite invasion in vitro. Conclusions We identified the TRAP and TRP gene families in several Babesia and Theileria species, and characterized BbiTRAP-1 as a novel antigen of B. bigemina. The functional relevance and presence of neutralization-sensitive B-cell epitopes suggest that BbiTRAP-1 could be included in future vaccine candidates against B. bigemina.
The Dysregulation of the Hypothalamic-pituitary-adrenal Axis in Diet-induced Prediabetic Male Sprague Dawley Rats
Authors: Mosili Palesa , Mkhize Bongeka Cassandra , Ngubane Phikelelani , Sibiya Ntethelelo , Khathi Andile
Published: August 2020

Background: Altered function of the hypothalamic-pituitary-adrenal (HPA) axis in type 2 diabetic patients, a condition preceded by pre-diabetes, has been shown to increase the risk of depression as well as cause downstream effects resulting in upregulation of gluconeogenesis and dyslipidemia. In addition, stress, either psychological from managing diabetes or lifestyle related, further activates the HPA axis causing an exaggerated stress response. This study investigated the activity of the HPA axis in selected markers of glucose handling, and the stress response relative to components of the HPA axis in a diet-induced pre-diabetic rat model. Methods: Sprague Dawley Rats were randomly divided into non-prediabetic group (NPD) and pre-diabetic group (PD) (n=6, per group) over a 20-week induction period and a further 12-week experimental period to get 32 weeks. At the end of the 20 and 32-week periods, insulin resistance using the HOMA-IR index, adrenocorticotropic (ACTH) and corticosterone (CORT) concentrations were measured. Stress was induced and the forced swim test (FST) were performed in the 12-week experimental week. At the end of 32 weeks glucocorticoid and mineralocorticoid hippocampal receptors were measured too. Results: Impaired glucose handling in the PD group as well as increase in corticosterone (CORT) was observed at the end of both 20 and 32-week periods by comparison to NPD groups. No changes were observed in ACTH concentration at week 20 while, at week 32, a decrease in plasma ACTH concentration was observed in the PD group by comparison to the NPD group. The stressed-induced animals were stressed underwent the forced swim test: the behaviour observed showed an increase in immobility time in the PD stressed group by comparison to the NPD group. This was followed by the observation of a decrease in ACTH and CORT concentration in the PD stressed group by comparison to the NPD stressed group. Mineralocorticoid and glucocorticoid receptors gene expression were elevated in the stressed PD group relative to the stressed NPD group. Conclusion: These observations, together, suggest that diet-induced pre-diabetes is associated with impaired HPA axis activity and deteriorating response to stress.
Using Audit and Feedback and the Benchmark to Enhance Infection Prevention and Control of Multidrug Resistant Organisms: a Quasi-experiment Study
Authors: Zhou Qian , Lai Xiaoquan , Zhang Xinping
Published: August 2020

BackgroundInfection prevention and control (IPC) is important to prevent the spread of multidrug resistant organisms (MDROs). We aimed to enhance and explore the implementation of preventing and controlling MDROs using audit and feedback and the benchmark. MethodsThis quasi-experimental design was conducted in three hospitals from 1st March 2018 to 30th September 2019. A multimodal intervention treated audit and feedback and benchmark as key components for MDROs IPC was conducted in Wuhan, China. A checklist of 40 implementation indicators based on IPC measures was formed to guide the audit twice a week. Immediate feedback was verbally given after each audit on the spot, and written feedbacks containing benchmark and individual implementation levels were delivered monthly or quarterly in three hospitals. The intervention effect was evaluated by Chi-square and Poisson segmented linear regression. Impacts of implementation of indicators on the incidence were modeled by mixed-effect regressions. ResultsThe incidence of nosocomial MDROs decreased by 19.39%, 20.55%, and 24.03% in A, B, and C hospital, respectively. The lowest implementation compliance of indicators was the use of personal protective equipment of doctors (50.24%). The highest was isolated warning signs of nurses (96.46%). The implementation on hand hygiene of doctors (Coef. = -27.87, p=0.001) and nurses (Coef. = -35.44, p=0.001), clean of surrounding instruments and bed unit (Coef. = -4.84, p=0.030), education to patients and relatives (Coef. = -59.51, p=0.031), and sending of specimen inspection timely (Coef. = -9.95, p<0.001) were negatively associated with the incidence of nosocomial MDROs infection. Conclusions The multimodal intervention by strengthening the implementation of audit and feedback and the benchmark is feasible and effective in China. The checklist is an effective and practical tool to measure the level of implementation. Education to patients and relatives, hand hygiene, clean of surrounding instruments and bed unit, and sending of specimen inspection timely are especially crucial.
The Association Between Adherence to The Dietary Approaches to Stop Hypertension (DASH) Diet and Neuro-Psychological Function in Young Women
Authors: Saharkhiz Mansoore , Ayadilord Malaksima , karbasi samira , Naseri Mohsen , Abad Mahin Siami Ali , Ferns Gordon A. , Bahrami Afsane
Published: August 2020

Background: The beneficial impact of adherence to a DASH diet may have a bidirectional relationship with mental wellbeing. The aim of the present study was to evaluate the relationship between the DASH diet and neuro-psychological function in young women.Methods: In this cross-sectional study, a total of 181 adolescent girls aged between 18-25 years were recruited. The dietary intakes of study participants were collected using a valid and reliable food frequency questionnaire (FFQ) containing 65 food items. Neuropsychological function of participants was evaluated using standard questionnaires.Results: As may be expected, individuals in the highest tertile of adherence to DASH diet (high adherence) consumed more folate, fruits, vegetables, low fat dairy, nuts, legume, and seed , and less sweetened beverage and sodium, compared to the participants in the lowest tertile (lower adherence). There was a significant negative relationship between cognitive function and consumption of red and processed meat (r=-0.168; p<0.05), quality of life score with dietary sodium (r=-0.151; p<0.01) and depression score with vegetables (r=-0.174; p<0.05). In multivariate multinomial logistic regression analyses adjusted for age, BMI and energy intake, adherence to a DASH style-pattern was protective against stress score (OR=0.32; 95%CI: 0.14-0.71) and difficulty with sleep initiating (OR=0.46; 95%CI: 0.21-1.00).Conclusion: Adherence to a DASH diet may be a protective against a high stress score and difficulty with sleep initiating.
Automatic Arrhythmia Detection Using One-Dimensional Convolutional Neural Network
Authors: Liu Zhong , Wang Xin’an
Published: August 2020

Background: Cardiovascular diseases (CVDs) are common diseases that pose significant threats to human health. Statistics have demonstrated that a large number of individuals die unexpectedly from sudden CVDs. Therefore, real-time monitoring and diagnosis of abnormal changes in cardiac activity are critical, as they can help the elderly and patients handle emergencies in a timely manner. To this end, a round-the-clock electrocardiogram (ECG) monitoring system can be developed with the quick detection of an ECG signal, segmentation of the detected ECG signal, and rapid diagnosis of a single segmented ECG beat. In this paper, to achieve the automatic detection and diagnosis of an ECG signal, five common types of ECG signals are used for recognition. For pre-processing the original ECG signal, the dual-slope detection algorithm is proposed and developed. Then, with the pre-processed ECG data, a five-layer one-dimensional convolutional neural network is constructed to classify five categories of heartbeats, namely, a normal heartbeat and four types of abnormal heartbeats. Results: To be able to compare the results of the experiment, the experimental data used in this study are obtained from the open-source MIT-BIH arrhythmia database. This database is authoritative, as each ECG signal cycle is annotated by at least two cardiologists, and abnormal ECG signals are classified into different categories. By comparing the detection and recognition results in this study with the results annotated in the MIT-BIH arrhythmia database, an overall accuracy of 96.20% is achieved in the classification of normal ECG signals and four categories of abnormal ECG signals.Conclusions: This paper provides an accurate method with low computational complexity for 24-hour dynamic monitoring and automated diagnosis of heartbeat conditions. With wearable devices, this method can be used at home for the initial screening of CVDs. In addition, it can perform diagnosis and warning for postoperative patients or patients with chronic CVDs.
Current Laboratory and Clinical Practices in Reporting and Interpreting Anti-nuclear Antibody Indirect Immunofluorescence (ANA IIF) Patterns: Results of an International Survey
Authors: Hoovels Lieve Van , Broeders Sylvia , Chan Edward K.L. , Andrade Luis , Cruvinel Wilson de Melo , Damoiseaux Jan , Viander Markku , Herold Manfred , Coucke Wim , Heijnen Ingmar , Bogdanos Dimitrios , Calvo-Alén Jaime , Eriksson Catharina , Kozmar Ana , Kuhi Liisa , Bonroy Carolien , Lauwerys Bernard , Schouwers Sofie , Lutteri Laurence , Vercammen Martine , Mayer Miroslav , Patel Dina , Egner William , Puolakka Kari , Tesija-Kuna Andrea , Shoenfeld Yehuda , de Sousa Maria José Rego , Hoyos Marcos Lopez , Radice Antonella , Bossuyt Xavier
Published: August 2020

BackgroundThe International Consensus on Antinuclear Antibody (ANA) Patterns (ICAP) has recently proposed nomenclature in order to harmonize ANA indirect immunofluorescence (IIF) pattern reporting. ICAP distinguishes competent-levelfrom expert-level patterns. A survey was organized to evaluate reporting, familiarity, and considered clinical value of ANA IIF patterns. MethodsTwo surveys were distributed by European Autoimmunity Standardization Initiative (EASI) working groups, the International Consensus on ANA Patterns (ICAP) and UKNEQASto laboratory specialists and clinicians. Results438 laboratory specialists and 248 clinicians from 67 countries responded. Except for dense fine speckled (DFS), the nuclear competent patterns were reported by >85% of the laboratories. Except for rods and rings, the cytoplasmic competent patterns were reported by >72% of laboratories. Cytoplasmic IIF staining was considered ANA positive by 55% of clinicians and 62% of laboratory specialists, with geographical and expertise-related differences. Quantification of fluorescence intensity was considered clinically relevant for nuclear patterns, but less so for cytoplasmic and mitotic patterns.Combining IIF with specific extractable nuclear antigens (ENA)/dsDNA antibody testing was considered most informative. Of the nuclear competent patterns, the centromere and homogeneous pattern obtained the highest scores for clinical relevance and the DFS pattern the lowest. Of the cytoplasmic patterns, the reticular/mitochondria-like pattern obtained the highest scores for clinical relevance and the polar/Golgi-like and rods and rings patterns the lowest. ConclusionThis survey confirms that the major nuclear and cytoplasmic ANA IIF patterns are considered clinically important. There is no unanimity on classifying DFS, rods and rings and polar/Golgi-like as a competent pattern and on reporting cytoplasmic patterns as ANA IIF positive.
PUMCH-SLN nomogram for the preoperative prediction of sentinel lymph node metastasis in breast cancer
Authors: Wang Xue-fei , Zhang Guo-chao , Zuo Zhi-chao , Zhu Qing-li , Liu Zhen-zhen , Wu Sha-fei , Li Jia-xin , Du Jian-hua , Yan Cun-li , Ma Xiao-ying , Shi Yue , Shi He , Zhou Yi-dong , Mao Feng , Lin Yan , Shen Song-jie , Zhang Xiao-hui , Sun Qiang
Published: August 2020

Background: To investigate associations between clinicopathological features and sentinel lymph node (SLN) status of breast cancer, then constructed a nomogram to predict SLN metastasis.Methods: Patients treated with SLN dissection from 2014 to 2019 at Peking Union Medical College and Hospital (PUMCH), were retrospectively analyzed as the training set (n = 472). Lymph node ultrasound and pathological characteristics were compared using chi-squared and t-tests. To verify the accuracy of the model, internal (n = 175) and external (3 centers, n = 81) validation groups were established for patients in 2019. A nomogram predicting SLN metastasis was constructed using multivariable logistic regression models; discrimination and calibration of the nomogram were assessed by C statistics and calibration curve. Clinical use by decision curve analysis.Results: In the training set the SLN+ rate was 23.73%. Statistically significant factors associated with SLN positivity were: histology type (P < 0.001); PR (P = 0.003); Her-2 status (P = 0.049); and ultrasound lymph node (ALN-US) shape (P = 0.034), corticomedullary demarcation (P < 0.001), and blood flow (P = 0.001). Five independent variables were integrated into the nomogram (C-statistic 0.714 [95% CI: 0.688-0.740], validated internally (0.816 [(95% CI: 0.784-0.849]) and externally (0.942 [95% CI: 0.918-0.966]). Thus, the model had good predictive accuracy and clinical applicability.Conclusions: The PUMCH-SLN nomogram provides a direct and reliable tool for prediction and individual evaluation of SLN status preoperatively, emphasizing the role of ALN-ultrasound morphology for predicting SLN metastasis. This nomogram should aid decisions concerning ALN dissection and adjuvant treatment.
Detection of somatic mutations in circulating cell-free DNA from patients with esophageal squamous cell carcinoma
Authors: Yuan Zuyang , Wang Xinfeng , Geng Xiao , Li Yin , Mu Juwei , Tan Fengwei , Xue Qi , Gao Shugeng , He Jie
Published: August 2020

Background: The aim of this study was to assess whether both ubiquitous and heterogeneous somatic mutations could be detected in circulating cell-free DNA (cfDNA) from patients with esophageal squamous cell carcinoma (ESCC). Methods: Paired multi-regional tumor tissues, cfDNA and white blood cells (WBCs) collected from five ESCC patients before treatment from a prospective study (NCT02395705). Of them, samples from Cohort 1 (E102 and E110) were sequenced by whole-exome sequencing (WES) and those from Cohort 2 (E104, E111 and E121) were sequenced by targeted captured sequencing with a panel of 560 cancer-related genes respectively. To call somatic single nucleotide variations (SNVs) by comparing the solid tumor or cfDNA with matched WBCs, the minimal variant allele frequency (VAFmin) as 0.1% and P value <0.05 were allowed. Results: Genomic DNA (gDNA) and plasma-derived cfDNA from 26 samples were successfully sequenced. In Cohort 1, 596 (596/712, 83%) and 562 (562/796, 71%) were heterogeneous SNVs in E102 and E110 respectively. There was a statistically significant linear relationship between the VAFs for tumor and cfDNA (R2 = 0.78, P <0.0001). In Cohort 2, 296 (296/323, 92%), 384 (384/423, 91%) and 331 (331/357, 93%) were heterogeneous SNVs in E104, E111 and E121respectively. cfDNA could recover an average of 60.7% (31/51; range, 35.7%-76.2%) of somatic mutations present in matched solid tumors. The correlation of VAFs between cfDNA and matched solid tumor was significantly positive (r2 =0.92, P <0.0001).Conclusions: Both sequencing approaches revealed the highly intratumoral heterogeneity in ESCC and enabled the detection of both ubiquitous and heterogeneous mutations in cfDNA. Further validation in cfDNA is required to define its potential utility for ESCC in clinical practice. Trial registrationAll patients selected in this study were from the registered clinical trial from ClinicalTrials.gov (NCT02395705). Date of registration: March 24, 2015.
A Cross-country Investigation of Perceived Stress During COVID-19 Pandemic: The Impact of Situational Factors and Personality Traits
Authors: Do Ngoc Minh
Published: August 2020

The study investigates the public mental health cross-national during the global COVID-19 pandemic. Analysis of data collected from people across different countries shows that people are experiencing moderate stress level and demonstrates that stress level is affected by internal genetic factor and external conditions. Specifically, perceived stress is affected by personality traits and contextual settings namely residence location, personal finance situation, and usage of social media during the pandemic.
Rescue operations lead to increased cardiovascular stress in HEMS Crew Members - A prospective pilot study of a German HEMS cohort
Authors: Strauss Markus , Dahmen Janosch , Hutter Sophia , Brade Marko , Leischik Roman
Published: August 2020

BackgroundHelicopter emergency medical service (HEMS) is an important part of prehospital emergency medicine. The working conditions lead to high physical stress, especially in rescue operations. To date, little is known about the cardiovascular stress of HEMS crew members in the rescue service. Examinations of professional groups in public security have shown a significant risk in these. The present study aims to determine the cardiovascular stress profile during rescue situations in HEMS crew members.MethodsA total number of 21 (male n=20) HEMS crew members (11 emergency physicians and 10 paramedics) participated in the prospective study. Heart rate (HR), blood pressure (BP) and long-term ECG measurements were recorded at the whole operation day. The changes of measurements during rescue operation (in total 52 operations) were compared to these of standby time.ResultsRescue operations lead to increased load on the cardiovascular system. Expression of this is significantly higher BP, HR values and rate of cardiac events compared to standby time. Significantly higher of both, mean and maximal, diastolic and systolic blood pressure were measured on duty. Especially the difference in BP sys mean is 7.4 ± 9.0 mmHg (7.4, CI [5.1; 9.7], p <0.001). HR minimal, mean and maximal were also significantly higher during rescue operations. HR max was 33.7 bpm higher on average than in the standby time (CI [26.2; 40.8], p <0.001). Cardiac events occurred significantly more frequently during the period of rescue operation than in standby time hours (time volume of 1 hour, p = 0.02).ConclusionsThe results show a significant load on the cardiovascular system during rescue operations in HEMS crew members. This is expressed in a higher occurrence of extrasystoles, HR and BP values during rescue operation than on standby time. Therefore, it is important to carry out a risk stratification of the personnel deployed in the HEMS crew members to prevent cardiovascular risk and events.
Equivalency between the shock index and subtracting the systolic blood pressure from the heart rate: An observational cohort study
Authors: Kamikawa Yohei , Hayashi Hiroyuki
Published: August 2020

Background: Although the shock index is known to predict mortality and other severe outcomes, deriving it requires complex calculations. Subtracting the systolic blood pressure from the heart rate may produce a simple shock index that would be a clinically useful substitute for the shock index. In this study, we investigated whether the simple shock index was equivalent to the shock index.Methods: This observational cohort study was conducted at 2 tertiary care hospitals. Patients who were transported by ambulance were recruited for this study and were excluded if they were aged < 15 years, had experienced prehospital cardiopulmonary arrest, or had undergone inter-hospital transfer. Pearson’s product-moment correlation coefficient and regression equation were calculated, and two one-sided tests were performed to examine their equivalency.Results: Among 5,429 eligible patients, the correlation coefficient between the shock index and simple shock index was extremely high (0.917, 95% confidence interval 0.912 to 0.921, P < .001). The regression equation was estimated as sSI = 258.55 log SI. The two one-sided tests revealed a very strong equivalency between the shock index and the index estimated by the above equation using the simple shock index (mean difference was 0.004, 90% confidence interval 0.003 to 0.005).Conclusion: The simple shock index strongly correlated with the shock index.