bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of the Response Time to Involved-Field Radiotherapy in Primary Gastrointestinal Low-Grade B-Cell Lymphoma
Authors: Choi Kyu Hye , Lee Han Hee , Jung Seung-Eun , Park Kyung-Sin , O Joo-Hyun , Jeon Young-Woo , Choi Byung-Ock , Cho Seok-Goo
Published: July 2020

Background: Early-stage primary gastrointestinal (GI) low-grade B-cell lymphoma shows good therapeutic response to primary radiotherapy. However, there is no clear guideline for the evaluation of response to radiation therapy currently. The aim of this study was to analyze the relationship between the best response time and the clinical course after radiotherapy.Methods: Patients who underwent radiotherapy for treatment of primary GI low-grade B-cell lymphoma from September 2007 to December 2018 at Seoul St. Mary's Hospital were included. Early responders were defined by best response within 6 months after radiotherapy, and delayed responders after 6 months. Clinical and pathological factors associated with delayed response and survival analyses were performed to investigate the recurrence and survival during follow-up.Results: A total of 43 patients were evaluated and the number of gastric mucosa-associated lymphoid tissue and duodenal follicular lymphoma was 36 and 7, respectively. All of 43 patients showed complete remission to radiotherapy and the best response time after radiotherapy was a median of 3 months. There were 8 delayed responders with a median duration of 8.9 months. Early and delayed responders were characterized by a significant difference in depth of invasion beyond the mucosal layer.Conclusions: Delayed responders did not show differences in oncological outcomes compared with early responders. They were allowed to watch and wait for an additional 6 to 12 months without further treatment.
Inhaler devices in asthma and COPD patients – A prospective cross-sectional study on inhaler preferences and error rates
Authors: Schreiber Jens , Sonnenburg Tina , Luecke Eva
Published: July 2020

Background: Inhalation therapy is the backbone of asthma and COPD control. However, inhaler adherence and device mishandling continue to be a problem in real life. Some studies have shown that using a patient-preferred inhaler may reduce device handling errors and improve adherence to prescribed chronic inhaler drug therapy. The aim of this study was to compare the preferences for commonly used inhaler devices in Germany in patients with chronic obstructive respiratory disease. We also pursued the question which properties of an inhaler device are particularly important to the user and what effects age, gender and type of disease (asthma or COPD) may have on device preference and handling errors.Methods: Prospective, open-label cross-sectional study in which 105 patients with asthma (58%) or COPD (42%) participated. Validated checklists were used to objectively assess inhaler technique and errors with 10 different placebo devices. For each device, patients were asked to test the handling, to assess the device properties and to name the device that they would most or least prefer.Results: Across the 10 placebo inhaler devices tested, patients needed an average of 1.22 attempts to error-free use. The device with the lowest mean number of attempts was the Turbohaler® (1.02), followed by the Nexthaler® (1.04), the Diskus® (1.07) and the Spiromax® (1.10). Patients over 60 years vs. younger age (p=0.002) and COPD vs. asthma patients (p=0.016) required more attempts to ensure correct use. 41% of the study participants chose one of the devices they already used as the most preferred inhaler. Overall, 20% opted for the Spiromax®, 15% for the Nexthaler® and 14% for the Turbohaler® or a pMDI. The least preferred device was the Elpenhaler® (0%). From a selection of 7 predefined inhaler attributes, patients stated easy handling as the most important for them. This was followed by short inhalation time and low inhalation resistance.Conclusions: Patient preference may vary between inhaler devices. The lowest number of attempts to error-free use was reported for the Turbohaler® and the Nexthaler®. The Spiromax® and the Nexthaler® achieved the best overall ratings and were the devices most preferred by patients.
Comparative investigation of different telemetric methods for measuring intracranial pressure: a prospective pilot study
Authors: Rot Sergej , Dweek Mamon , Gutowski Pawel , Goelz Leonie , Meier Ullrich , Lemcke Johannes
Published: July 2020

Objectives: Measurement of intracranial pressure (ICP) plays an important role in long-term monitoring and neuro-intensive treatment of patients with a cerebral shunt. Currently, only two complete telemetric implants with different technical features are available worldwide. This prospective pilot study aims to examine patients who had both probes implanted at overlapping times for clinical reasons and represents the first in vivo comparison of both measurement methods.Materials and methods: Patients with a primary subarachnoid hemorrhage or a spontaneous intracerebral hemorrhage with ventricular hemorrhage who had received a telemetric ICP probe (Raumedic® NEUROVENT®-P-tel) were included in the study. Conventional external ventricular drainages (EVD) and ventriculoperitoneal shunts with a telemetric ICP probe (Miethke Sensor Reservoir) were implanted in patients with hydrocephalus who required CSF (cerebrospinal fluid) drainage. ICP values from all systems were obtained. Due to the overlapping implantation time, parallel ICP measurements were performed via two devices simultaneously. ICP measurements via the sensor reservoir were repeated after three, six and twelve months. Differences between the ICP values measured via the NEUROVENT®-P-tel probe, the Miethke sensor reservoir®, and the EVD were analyzed.Results: Sixteen patients were included in the present study between 2016 and 2018. 63% of all patients were male. In 11 patients the ICP measurements were followed up with both devices for 3 months. ICP measurements of the sensor reservoirs showed corresponding trends in 9 cases compared to ICP measurement via the telemetry probe or EVD. Difference in ICP values ranged between 14,5 mmHg and 0,0 mmHg. The average difference of the ICP values in 8 cases was ≤ 3,5 mmHg.Conclusion: ICP measurements with both systems continuously showed synchronous ICP values, however absolute values of ICP measurement with the different systems did not match.
Serum biomarkers of the calcium-deficient rats identified by metabolomics based on UPLC/Q-TOF MS/MS
Authors: Fanyu Meng , Lina Fan , Lin Sun , Qingli Yu , Wang Maoqing , Changhao Sun
Published: July 2020

Background

We previously identified the urinary biomarkers to diagnose calcium deficiency and nutritional rickets by ultra-performance liquid chromatography/quadrupole time-of-flight tandem mass spectrometry (UPLC/Q-TOF MS/MS).To further confirm these biomarkers in vivo, we performed serum metabolomics analysis of calcium deficiency.

Methods

A calcium-deficient rat model was established with a low-calcium diet for 12 weeks. Serum-metabolomics-based UPLC/Q-TOF MS/MS and multivariate statistical analysis was performed to identify the alterations in metabolites associated with calcium deficiency in rats.

Results

Bone mineral density, serum parathyroid hormone and alkaline phosphatase were significantly decreased in the low-calcium diet group (LCG) compared to the normal calcium diet group (NCG). Serum metabolic-profiling analysis could definitively distinguish between the LCG and NCG andidentified25 calcium-deficient biomarkers. Three metabolites (indoxyl sulfate, phosphate, and taurine) of the 25 biomarkers were found in our previous urinary metabolomics study of rats with a calcium deficiency and nutritional rickets. The areas under the curve (AUCs) of these three biomarkers were greater than 0.8, and the combination of any two biomarkers was higher than 0.95.

Conclusion

Dietary calcium deficiency induced the alterations of metabolites in the serum of rats, and the three identified biomarkers had relatively high diagnostic values for calcium deficiency in rats.
Pattern of sucker development in cuttlefishes
Authors: Kimbara Ryosuke , Nakamura Mayuko , Oguchi Kohei , Kohtsuka Hisanori , Miura Toru
Published: July 2020

Background : Morphological novelties have been acquired through evolutionary processes and related to the adaptation of new life-history strategies with new functions of the bodyparts. Cephalopod molluscs such as octopuses, squids and cuttlefishes possess unique morphological characteristics. Among those novel morphologies, in particular, suckers arranged along the oral side of each arm possess multiple functions, such as capturing prey and locomotion, so that the sucker morphology is diversified among species, depending on their ecological niche. However, the detailed developmental process of sucker formation has remained unclear, although it is known that new suckers are formed or added during both embryonic and postembryonic development. In the present study, therefore, focusing on two cuttlefish species, Sepia esculenta and S. lycidas , in which the sucker morphology is relatively simple, morphological and histological observations were carried out during embryonic and postembryonic development to elucidate the developmental process of sucker formation and to compare them among other cephalopod species. Results : The observations in both species clearly showed that the newly formed suckers were added on the oral side of the most distal tip of each arm during embryonic and postembryonic development. On the oral side of the arm tip, the epithelial tissue became swollen to form a ridge along the proximal-distal axis (sucker field ridge). Next to the sucker field ridge, there were small dome-shaped bulges that are presumed to be the sucker buds. Toward the proximal direction, the buds became functional suckers, in which the inner tissues differentiated to form the complex sucker structures. During postembryonic development, on both sides of the sucker field ridge, epithelial tissues extended to form a sheath, covering the ridge for protection of undifferentiated suckers. Conclusions : The developmental process of sucker formation, in which sucker buds are generated from a ridge structure (sucker field ridge) on the oral side at the distal-most arm tip, was shared in both cuttlefish species, although some minor heterochronic shifts of the developmental events were detected between the two species.
Cross-cultural adaptation, validity, and reliability of the Nepali version of the Exercise Adherence Rating Scale: A methodological study
Authors: Adhikari Shambhu Prasad , Dev Rubee , Shrestha Jayana N
Published: July 2020

Background: The Exercise Adherence Rating Scale (EARS) is a commonly used outcome tool, which helps to identify the adherence rate of exercises and reasons for adherence and non-adherence. There is no evidence of the availability of any measurement tools to assess exercise adherence in the Nepalese context and cultural background. Therefore, we conducted a cross-cultural adaptation of the EARS into the Nepali language and investigated its reliability and validity. Methods: Cross-cultural adaptation of the EARS was done based on Beaton guidelines. Psychometric properties were evaluated among 18 participants aged 18 years or older with pre-diabetes or confirmed diagnosis of any disease who were prescribed with home exercises by physiotherapists. Any disease that limited participants from doing exercise and individuals unwilling to participate were excluded. Reliability was evaluated through internal consistency, using Cronbach’s alpha. Exploratory Factor Analysis (EFA) was performed to explore construct validity and confirm its unidimensionality. Receiver Operating Characteristic (ROC) curve was analyzed to identify cut-off score, sensitivity and specificity of the tool.Results: The Cronbach’s alpha was 0.94 for EARS-adherence behavior. The EFA of 6-items adherence behavior revealed the presence of one factor with an eigenvalue exceeding one. The scree-plot suggested for extraction of only one factor with strong loading (75.84%). The Area Under the Curve was 0.91 with 95% confidence interval 0.77 to 1.00 at p = 0.004. The cutoff score was found 17.5 with 89% sensitivity and 78% specificity.Conclusions: The EARS was cross-culturally adapted to the Nepali language. The reliability and construct validity of the Nepali version of the EARS were acceptable to assess exercise adherence in Nepali-speaking individuals. This validated tool might facilitate the evaluation of exercise-related interventions. Future studies could investigate other psychometric properties of the Nepali EARS.
Drug use disorder following early life exposure to tetrachloroethylene (PCE)-contaminated drinking water: a retrospective cohort study
Authors: Aschengrau Ann , Grippo Alexandra , Winter Michael R. , Shea Margaret G. , White Roberta F. , Saitz Richard
Published: July 2020

Background: Many studies of adults with occupational exposure to solvents such as tetrachloroethylene (PCE) have shown adverse effects on cognition, mood and behavioral problems. Much less is known about neurotoxic effects in early life at lower exposure levels seen in community settings. We recently reported that illicit drug use was more frequent among adults from Cape Cod, Massachusetts who were exposed to PCE-contaminated drinking water during gestation and early childhood than their unexposed counterparts. Using newly collected data from this population-based retrospective cohort study, the current analysis examines whether early life PCE exposure is also associated with drug use disorder over the life course.Methods: Three-hundred and sixty-three subjects with prenatal and early childhood PCE exposure and 255 unexposed subjects were studied. These individuals (median age: 40-41 years) completed self-administered questionnaires on the eleven established diagnostic criteria for drug use disorder and confounding variables. A validated leaching and transport model was used to estimate exposure to PCE-contaminated water. Results: Overall, 23.3% of subjects reported having at least one criterion for drug use disorder over their lifetime. Early life PCE exposure was associated with a modest increase in the lifetime presence of one or more diagnostic criteria for drug use disorder (adjusted RR: 1.4, 95% CI: 1.0-1.8). Compared to unexposed subjects, PCE-exposed subjects were more likely to report having most diagnostic criteria of drug use disorder, including neglecting major roles due to drug use, physical and psychological problems related to drug use, and giving up activities due to drug use. No dose-response relationships were observed with increasing levels of PCE exposure. Conclusions: These results suggest that exposure to PCE-contaminated drinking water during early life modestly increases the risk of developing diagnostic criteria for drug use disorder later in life. Because this study has several limitations, these findings should be confirmed in follow-up investigations of other exposed populations with more diverse racial and socioeconomic characteristics.
Female northern grass lizards judge mates by body shape to reinforce local adaptation
Authors: Guo Kun , Chen Chen , Liang Xiao-Fang , Qu Yan-Fu , Ji Xiang
Published: July 2020

Background: Identifying the factors that contribute to divergence among populations in mate preferences is important for understanding of the manner in which premating reproductive isolation might arise and how this isolation may in turn contribute to the evolutionary process of population divergence. Here, we offered female northern grass lizards (Takydromus septentrionalis) a choice of males between their own population and another four populations to test whether the preferences that females display in the mating trials correlate with phenotypic adaptation to local environments, or to the neutral genetic distance measured by divergence of mitochondrial DNA sequence loci. Results: Females showed a strong preference for native over foreign males. Females that mated with native versus foreign males did not differ from each other in mating latency, or copulation duration. From results of the structural equation modelling we knew that: 1) geographical distance directly contributed to genetic differentiation and environmental dissimilarity; 2) genetic differentiation and environmental dissimilarity indirectly contributed to female mate preference, largely through their effects on morphological divergence; and 3) females judged mates by body shape (appearance) and discriminated more strongly against morphologically less familiar allopatric males.Conclusions: Local adaptation rather than neutral genetic distance influences female mate preference in T. septentrionalis. The tendency to avoid mating with foreign males may indicate that, in T. septentrionalis, local adaptations are more valuable than genetic novelties. Our results highlight the importance of comprehensive studies integrating ecological, molecular and behavioral approaches to understand population divergence in female mate preferences as the consequence of local adaptations.
Gut Microbiota Characteristics in Mice with Antibiotic-Associated Diarrhea
Authors: Shao Haoqing , Zhang Chenyang , Xiao Nenqun , Tan Zhoujin
Published: July 2020

Background: Antibiotic-associated diarrhea (AAD), defined as diarrhea that occurs in association with the administration of antibiotics and without another clear etiology, is one of the most commonly adverse drug events of antibiotics therapy. We established a diarrhea model induced by gentamycin and cefradine to investigate the microbiota characteristics in the intestinal lumen of mice with AAD and provide insights into noteworthy bacteria related to gentamicin and cefradine-associated diarrhea.Results: The number of OTUs in the model group and the normal group was 983 and 2107, respectively, and 872 identical OTUs were shared between two groups. Species richness and species diversity of intestinal microbe were altered by antibiotics administration. The dominant phyla of AAD mice were Firmicutes (52.63%) and Proteobacteria (46.37%). The abundance of 8 genera, Ruminococcus, Blautia, Enterococcus, Eubacterium, Clostridium, Coprococcus, Aerococcus, and Pseudomonas, increased significantly, and the abundance of 3 genera, Prevotella, Bacteroides, and Adlercreutzia, decreased significantly in the model group compared to those in the control group (p < 0.05). LEfSe analysis showed that Enterococcus, Eubacterium, Ruminococcus, and Blautia were the key differential genera in the model group.Conclusions: The bacterial diversity of the intestinal lumen was diminished after gentamicin and cefradine administration. The alterations in the abundance and composition of gut microbiota further led to the dysfunction of gut microbiota. More specifically, gentamicin and cefradine significantly increased the abundance of the opportunistic pathogens, of which Enterococcus and Clostridium were the most prominent and most worthy of attention.
Clinical Impact of Hypofractionated Carbon Ion Radiotherapy on Locally Advanced Hepatocellular Carcinoma
Authors: Shiba Shintaro , Shibuya Kei , Okamoto Masahiko , Okazaki Shohei , Komatsu Shuichiro , Kubota Yoshiki , Nakano Takashi , Ohno Tatsuya
Published: July 2020

Background: Hepatocellular carcinoma (HCC) involving a major branch of the portal or hepatic vein is in a locally advanced stage and remains difficult to cure. This study aimed to evaluate the clinical effects of carbon ion radiotherapy (C-ion RT) in locally advanced HCC (LAHCC).
Methods: The data of 11 consecutive patients with LAHCC who received C-ion RT were analyzed. The C-ion RT doses of 52.8 Gy (relative biological effectiveness [RBE]) and 60.0 Gy (RBE) were delivered in 4 fractions for standard cases, and the 60.0 Gy dose was delivered in 12 fractions for close-to-gastrointestinal-tract cases. Survival and local control probabilities were calculated using the Kaplan-Meier method.
Results: The median follow-up duration after C-ion RT was 36.4 months. The median age at the time of registration for C-ion RT was 76 years. The median tumor size was 53 mm. The numbers of treatment-naive and recurrent HCC patients were 1 and 10, respectively. Direct invasion of the major branch of the portal vein, hepatic vein, or both portal and hepatic veins was observed in three, five, and three patients, respectively. The 3-year overall survival, local control, and progression-free survival rates were 64%, 78%, and 18%, respectively. No patient developed radiation-induced liver diseases or grade 3 or higher toxicities in the acute and late phases.
Conclusions: C-ion RT showed favorable clinical outcomes with a high rate of local control and minimal toxicities in LAHCC. Our findings suggest that C-ion RT is a promising multidisciplinary treatment option in LAHCC.
Genome-wide characterization, evolution and expression profiling of UDP-glycosyltransferase family in pomelo (Citrus grandis) fruit
Authors: Wu Boping , Liu Xiaohong , Xu Kai , Zhang Bo
Published: July 2020

Background: Pomelo is one of the three major species of citrus. The fruit accumulates a variety of abundant secondary metabolites that affect the flavor. UDP-glycosyltransferases (UGTs) are involved in the glycosylation of secondary metabolites. Results: In the present study, we performed a genome-wide analysis of pomelo UGT family, a total of 145 UGTs was identified based on the conserved plant secondary product glycosyltransferase (PSPG) motif. These UGT genes were clustered into 16 major groups through phylogenetic analysis of these genes with other plant UGTs (A-P). Pomelo UGTs were distributed unevenly among the chromosomes. At least 10 intron insertion events were observed in these UGT genome sequences, and I-5 was identified to be the highest conserved one. The expression profile analysis of pomelo UGT genes in different fruit tissues during development and ripening was carried out by RNA-seq. Conclusions: We identified 145 UGTs in pomelo fruit through transcriptome data and citrus genome database. Our research provides available information on UGTs studies in pomelo, and provides an important research foundation for screening and identification of functional UGT genes.
Treatment patterns and comorbid burden of patients newly diagnosed with multiple sclerosis in the United States
Authors: Kern David , Cepeda M. Soledad
Published: July 2020

Background: The treatment landscape for multiple sclerosis (MS) is quickly evolving. Understanding real-world treatment patterns of patients is necessary to identifying potential gaps in care.Methods: Patients with incident MS were identified from a large national claims database during 1/1/2014-6/30/2019. Patients had ≥2 diagnoses for MS or an inpatient hospitalization with a primary diagnosis of MS. Patients were required to have enrollment in the database ≥1 year prior to and ≥1 year following their first MS diagnosis. Treatment sequences were captured for all available disease modifying therapies (DMTs) during all available follow-up. Presence of comorbid conditions were captured during the one year prior to and following (and including) the index date; absolute change in prevalence from the pre- to post-index periods was calculated. Results: We identified 5,691 patients with incident MS. Common comorbidities included physical symptoms (e.g., pain, weakness, fatigue), mental health conditions (anxiety, depression), and cardiovascular/metabolic conditions (hypertension, hyperlipidemia, diabetes, obesity). Just 1,994 (35.0%) of patients received a DMT at any time during follow-up. Of those receiving a DMT, 28.2% went on to receive a second line of therapy, 5.8% received a third, and just 0.9% went on to a fourth line. Use of more than one DMT concomitantly occurred in just 1.8% of all treated patients. Glatiramer and dimethyl fumarate were by far the most common first-line treatments received accounting for nearly 62% of patients receiving a DMT. Conclusion: Approximately two-thirds of patients newly diagnosed with MS did not receive a DMT and the disease is accompanied by a significant comorbid burden.
Decompressive Craniectomy Combined With Mild Hypothermia in Patients With Large Hemispheric Infarction: A Randomized Controlled Trial
Authors: Fan Linlin , Su Yingying , Zhang Yan , Ye Hong , Chen Weibi , Liu Gang
Published: July 2020

BackgroundTo investigate the effects of decompressive craniectomy (DC) combined with hypothermia treatment on mortality and neurological outcomes in patients with large hemispheric infarction (LHI).MethodsPatients within 48 hours of symptom onset were randomized to the following three groups: the DC group, the DC plus head surface cooling (DCSC) group and the DC plus endovascular hypothermia (DCEH) group. Patients in the DC group were given standard medical treatment with a normothermic target temperature. Patients in the DCSC group received standard medical treatment plus 24-hour ice cap on the head for 7 days. Patients in the DCEH group were given standard medical treatment plus endovascular hypothermia with a target temperature of 34 °C. The primary end-points were mortality and modified Rankin Scale (mRS) score at 6 months.ResultsThere were 9 patients in the DC group, 14 patients in the DCSC group and 11 patients in the DCEH group. The mortality rates of the DC, DCSC and DCEH groups at the time of discharge were 22.2% (2/9), 0% (0/14) and 9.1% (1/11), respectively. At 6 months, the mortality rates in the DC, DCSC and DCEH groups increased to 44.4% (4/9), 21.4% (3/14) and 45.5% (5/11), respectively (P = 0.367). The most common cause of death after discharge was pneumonia (8 cases). Twelve cases (35.3%) achieved good neurological outcome (mRS 0–3) at 6 months. The proportions of good neurological outcome in the DC, DCSC and DCEH groups were 22.2% (2/9 cases), 42.9% (6/14 cases) and 36.4% (4/11), respectively. The DCSC group seemed to have higher proportion of good outcomes, but there was no significant difference between groups (p = 0.598). Among survivors, endovascular hypothermia had a higher proportion of good outcome, still without significant difference (DC group, 2/5 cases, 40.0%; DCSC group, 6/11 cases, 54.5%; DCEH group, 4/6 cases, 66.7%; p = 0.696). The incidence of complications in the DCEH group was higher than those of the DC and DCSC groups (18.9%, 12.0%, and 12.1%, respectively; P = 0.025).ConclusionsThere is still no evidence to confirm that hypothermia further reduces long-term mortality and improves neurological outcomes in LHI patients with DC. However, there is a trend to benefit survivors from hypothermia. A local cooling method may be a better option for DC patients, which has little impact on systematic complications.Clinical Trial Registration-Decompressive Hemicraniectomy Combined Hypothermia in Malignant Middle Cerebral Artery Infarct, ChiCTR-TRC-12002698. Registered 11 Oct 2012- Retrospectively registered,URL: http://www.chictr.org.cn.
Users’ Responses to a Machine-Learning Decision Support Model: A Randomized Controlled Trial for Prostate-Specific Antigen Screening
Authors: Lin Yi-Ting , Chiang Han-Sun , Liu Chih-Kuang , Huang Yen-Chun , Chen Mingchih
Published: July 2020

Background: Although a shared decision-making (SDM) process integrates patient values and evidence-based medicine, patients’ anxiety and decision conflicts remain. Thus, we propose a new decision-making model integrating a machine-learning algorithm to investigate its feasibility for reducing anxiety, decision conflicts, and increasing satisfaction after making a decision.Methods: We enrolled participants willing to undergo the SDM process for a prostate-specific antigen (PSA) blood test and obtained data including age, PSA knowledge, if they have a friend with prostate cancer, perceptive risk of prostate cancer, International Prostate Symptom Score and Importance for Physiological and Psychological Impact in PSA Testing scores, personal values, and their final decisions, including “Accept” PSA blood test or “Not now,” to build the dataset for training the following machine-learning models: multilayer perceptron neural network, random forest (RF), extreme gradient boosting, support vector machine, and deep learning neural network. Uniform parameter tuning and model comparison were implemented. The best model was used for a randomized controlled trial (RCT), in which we measured the effects of personalized suggestions generated by the machine-learning model on anxiety, decision satisfaction, and decision conflicts.Results: RF was the best algorithm for building models with our dataset from 507 subjects (mean AUC: 0.8801, mean ACC: 0.8313, Max ACC: 0.8933). Therefore, we used the RF model for RCT with 185 and 182 subjects in the machine-learning suggestion group (MLSG) and control group (CG), respectively. The MLSG patients were calmer, more content, and less worrisome than those in the CG. They also experienced higher decision satisfaction and less decision conflict, including more decision support, advice, assurance of decision, ease of decision-making, and adherence to decision. Moreover, participants who were suggested “Accept” by the model were more likely to make “Accept” their final decision than the CG participants (50.75% vs 24.18%, χ2 = 16.07, p < 0.000). The “Not now” suggestion followed a similar trend.Conclusions: A highly accurate machine-learning model was constructed using our methods. Personalized suggestions generated from this model yielded increased satisfaction and reduced anxiety and decision conflict. Patients tended to take machine-learning suggestions as their final decision.Trial name: Shared Decision Making: Decision Tree and Artificial Neural Network Assisted Decision Aid for PSA ScreeningTrial registration: ChiCTR, ChiCTR2000034126. Registered 25 June 2020 – Retrospectively registered, http://www.chictr.org.cn/ChiCTR2000034126
Association of the genetic variants in the Endoplasmic reticulum aminopeptidase 2 gene with ankylosing spondylitis susceptibility
Authors: Ebrazeh Mehrdad , Ezzatifar Fatemeh , Torkamandi Shahram , Mohammadi Fatemeh Sadat , Salimifard Sevda , Hemmatzadeh Maryam , Aslani Saeed , Babaie Farhad , Azizi Gholamreza , Jadidi-Niaragh Farhad , Mohammadi Hamed
Published: July 2020

Background: Single nucleotide polymorphisms (SNPs) in the Endoplasmic reticulum aminopeptidase (ERAP) 2 gene has been attributed in the pathogenesis of Ankylosing spondylitis (AS). Here we assessed the ERAP2 gene SNPs association with AS predisposition in Iranian patients and determined their effect on the inflammatory state of the patients.Methods: For genotyping of rs2548538, rs2287988, and rs17408150 SNPs using Real-time allelic discrimination approach, DNA was extracted from the whole blood of 250 AS patients and 250 healthy subjects. RNA of the peripheral blood mononuclear cells (PBMCs) was separated, cDNA was synthesized, and transcriptional levels of cytokines, including interleukin (IL)-17A, IL-23, IL-10, and transforming growth factor (TGF)-β were measured. Enzyme-linked immunosorbent assay (ELISA) was used to measure the serum concentration on the cytokines.Results: It was observed that three ERAP2 gene SNPs had no significant association with risk of AS in the total patients. Nonetheless, rs2287988 and rs17408150 SNPs showed statistically significant association with susceptibility to the disease in the Human leukocyte antigen (HLA)-B27 positive AS subjects. Transcriptional level and serum concentration of IL-17A and IL-23 were higher, while those of IL-10 were lower in both AS patients and HLA-B27 positive AS patients relative to controls. Nevertheless, ERAP2 gene SNPs in the HLA-B27 positive AS patients did not affect the transcriptional level and serum concentration of cytokines.Conclusions: ERAP2 gene rs2287988 and rs17408150 SNP are associated with susceptibility to AS, but they probably are not determining the levels of IL-17A, IL-23, and IL-10 in this disease.
The whirlpool sign predicts cases of testicular torsion with the preserved flow: a case series
Authors: Xu Zhihua , Ni Shuangshuang , Wu Senmin , Zhu Hui , Chen Kai , Luo Hongxia
Published: July 2020

Background To investigate the diagnostic characteristics of high-frequency ultrasound with color doppler flow signal in pediatric testicular torsion to increase the diagnostic accuracy.Methods Seven pediatric patients from October 2017 to August 2019 with preserved blood flow signal but surgically diagnosed as testicular torsion were retrospectively included into the study. The imaging manifestations of high-frequency ultrasonography were evaluated.Results Seven cases of testicular torsion with preserved blood flow aging from 49 days to 15 years old were included in the study. All the cases had preserved blood flow in testis, but the surgical findings showed various twist degrees from 90° to 540°. Preoperative ultrasound showed spermatic cord distortion in all cases, and the testicular long axis tilted in four cases.Conclusion In some testicular torsion cases, color doppler may show normal or increased blood flow signals in the testis. The “whirlpool sign” in the spermatic cord is an important indicator suggestive of testicular torsion.
Costs and Its Drivers for Diabetes Mellitus Type 2 Patients in France and Germany: A Systematic Review of Economic Studies
Authors: Stegbauer Constance , Falivena Camilla , Moreno Ariadna , Hentschel Anna , Rosenmöller Magda , Heise Tim , Szecsenyi Joachim , Schliess Freimut
Published: July 2020

Background
Type 2 diabetes represents an increasingly critical challenge for health policy worldwide. It absorbs massive resources for both patients and national economies to sustain direct and associated costs of treatment and indirect costs related to loss of work and wages. Last years are fuelling of innovations grounded on the remote control and personalised programs which are significantly improving the management of diabetes and the reduction of its related complications. In this view, this work attempts to update cost analysis reviews on type 2 diabetes, focusing on France and Germany, in order to explore most significant cost drivers and rooms for cost savings by technology advancement. Although characterized by different approaches in delivering care, France and Germany represent the primary European markets for diabetes technologies.
Methods
A systematic review of the literature was carried out in MEDLINE, Embase and EconLit for interventional, observational, and modelling studies on expenditures for type 2 diabetes management in France or Germany published since 2012. Included articles were analysed for annual direct, associated, and indirect costs of type 2 diabetes patients. An appraisal of study quality was performed. Results are summarised narratively.
Results
From 1.260 records, the final sample was composed of 24 papers selected according to predefined inclusion/exclusion criteria. Both France and Germany revealed a predominant focus on direct cost. Comparability was limited due to different study populations and cost categories used. Nevertheless, France seems to reimburse higher direct costs than Germany. Indirect costs were only available for Germany. According to prior literature, reported cost drivers are hospitalisation and prescriptions as well as higher HbA1c and BMI, treatment with insulin and complications all indicating the severity of the disease. Diversity in available data and in included costs limit the results and may explain differences found.
Conclusions
Preventing complications and glycaemic control are widely recognized as the most effective ways to govern the expenditure for the treatment of diabetes. The implementation of self-based supports, such as hybrid closed-loop metabolic, already implemented for type 1 diabetes management, are the key pillars for further debates and policymaking, involving the perspectives of both caregivers and patients.
Measuring capabilities in health and physical activity promotion: a systematic review.
Authors: Till Maike , Abu-Omar Karim , Ferschl Susanne , Reimers Anne Kerstin , Gelius Peter
Published: July 2020

Background: The capability approach by Amartya Sen and Martha Nussbaum has gained increasing attention in the field of public health. As it combines individual, social and structural factors and shifts the focus of attention from the actual behavior towards available options for health behaviors that people can actually choose from, it may help advance our understanding of complex health issues. Objectives: The aim of this article is to identify and describe tools available to measure capabilities within the context of health, with a specific focus on capabilities for health-enhancing physical activity. Method: We conducted a systematic literature review using 11 databases covering scientific journal articles published in English or German between the years 2000 and 2019 with a focus on capabilities for health or physical activity.Results: We found a total of 44 articles meeting our inclusion criteria. Four articles measured capabilities using qualitative methods, one combined qualitative and quantitative methods, while the rest used quantitative methods. We identified a total 11 different capability questionnaires, all showing moderate to good validity/reliability. Only one questionnaire and one interview-based tool specifically dealt with capabilities for health enhancing physical activity.Conclusion: Although we were able to identify measurement tools for capabilities in health, this review has shown that there is no generic tool available for the measurement across all population- and age-groups, and tools focusing on physical activity are scarce. However, our results can be used as guide for future projects that aim at measuring capabilities.
A Novel Methodology For Isolation and Primary Culture of Swine Gastric Epithelial Cells.
Authors: Bautista-Amorocho Henry , Silva-Sayago Jorge Alexander , Goyeneche-Patino Diego A. , Pérez-Cala Tania Liseth , Macías-Gómez Fabio , Arango-Viana Juan Carlos , Martínez Alonso
Published: July 2020

Background: Culture of primary epithelial cells has a great advantage over tumor-derived or immortal cells lines since functional phenotype and genetic makeup are preserved. Swine model has proved to be helpful and reliable as a surrogate model in human diseases. Several porcine cell lines have been established from a variety of tissues and shown to extensively contribute to the current understanding of several pathologies, including cancer. However, few protocols for the isolation and culture swine gastric epithelial cells with phenotype preservation have been described. Therefore, the objective of this research was to develop a new methodology for establishing a primary cell culture from the fundic gland area of the porcine stomach.Results: Enzymatic disaggregation of gastric tissue by using a combination of collagenase type I and dispase II, protease inhibitors (soybean trypsin inhibitor and bovine serum albumin), and antioxidants (Dithiothreitol) allowed the isolation of gastric epithelial cells from the fundic gland area with viability > 90% during the incubation period. Gastric epithelial cells cultured in RPMI 1640, DMEM HG, and DMEM/F12 media did not lead to cell adhesion, cluster formation and cell proliferation. By contrast, Williams’ medium supplemented with growth factors supports the confluence and proliferation of a pure epithelial cell monolayer after 10 days of incubation at 37oC in a 5% CO2 incubator. Mucin-producing cell phenotype of primary isolates was confirmed by PAS staining as well as the expression of MUC1 and MUC20 genes by RT-PCR and DNAc sequencing. Swine Gastric epithelial cells also showed origin-specific markers such as epithelial membrane antigen (EMA), cytokeratin cocktail (AE1/AE3) and cytokeratin 18 (CK-18) detected by immunohistochemistry and immunofluorescence, respectively. Conclusions: A new methodology was successfully established for the isolation of primary gastric epithelial cells from the fundic gland area in a swine model, based on a combination of tissue specific proteases, protease inhibitors, and antioxidants. The formulation of Williams’ medium with growth factors for epithelial cells supports the adherence and maintains the functional phenotype of primary cells, which was confirmed by mucin production and expression of typical epithelial markers in the long term.
Prevalence of Musculoskeletal Symptoms Among Dental Students in United Arab Emirates
Authors: Hashim Raghad , Salah Afraa , Mayahi Fatemeh , Haidary Saeedeh
Published: July 2020

Background
The main purpose of this study was to assess the prevalence of neck, shoulder, and low-back pains and to explore factors associated with musculoskeletal pain (MSP) among dental students at Ajman University and Ras Al Khaimah College of Dental Sciences in United Arab Emirates (UAE).
Method
This cross-sectional study was conducted among dental students using an online questionnaire; which was a modified version of the Standardized Nordic questionnaire, focused on neck, shoulder and low-back pain in the past week and the past year.
Results
Two hundred and two students responded to the questionnaire out of 368. The prevalence of MSP in at least one body site in the past week, and in the past year was 48.5% and 68.3% respectively. Factors significantly associated with MSP in at least one body site at any time were having history of trauma (P = 0.009), exercise (P = 0.001), being in the clinic for longer time (P = 0.000), and BMI (P = 0.010).
Conclusion
MSP among dental students in the UAE is high, particularly among those with history of trauma, not physically active, spending longer hours in the clinic, and those with higher Body Mass Index (BMI). Careful attention is required by the dental colleges to increase students’ awareness towards this problem.
Non-Timber Forest Products and Climate Change Adaptation / Forest Dependent Communities In Bamboko Forest Reserve, South West Region Of Cameroon
Authors: Nghogekeh Tieminie Robinson , Loh Chia Eugene , Chupezi Tieguhong Julius , Mayiadieh Nghobuoche Frankline , Mandiefe Piabuo Serge , Tieguhong Mamboh Rolland
Published: July 2020

Background: This study to assess the role of Non-timber forest products was conducted to forest dependent communities around Bamkoko Forest Reserve in the South West Region of Cameroon as a strategy to cope with the impacts of climate change. Methods: Data were collected through household questionnaires, participatory rural appraisal techniques, transect walk and direct field observations. Results: A total of 16 plants species were identified to be harvested by residents around Bamkoko Forest Reserve as None Timber Forest Products. The majority of the respondents (88%) perceived that there has been a change in the climate patterns due to increased temperatures and unpredictable rainfalls. Eru was found to be the most affected livelihood activity (55%) by climate change around Bamboko Forest Reserve. Communities living around Bamboko Forest Reserve were found to use more than one strategy to cope with the adverse effects of climate change. Conclusion: The study concluded that NTFPs still play a safety net role to assist communities in adverse situation such as crop failure under the current change in climate. The need to emphasis sustainable harvesting, improve processing and access to NTFPs markets is crucial.
Genome-wide analysis of CrRLK1L genes and their expression profiling during fiber development in cotton
Authors: Zuo Dongyun , Ashraf Javaria , Cheng Hailiang , Liu Shang , Zhang Youping , Wang Qiaolian , Lv Limin , Xiaoxu Feng , Song Linlin , Liu Yuanyuan , Song Guoli
Published: July 2020

Background: Catharanthus roseus receptor-like kinase 1-like (CrRLK1Ls) proteins play important roles in cell growth, plant morphogenesis, reproduction, hormone signaling, plant immunity and stress responses in Arabidopsis. However, not much information is available about their functions during cotton fiber development.Results: We identified a total of 125, 73 and 71 full-length putative CrRLK1L genes in G. hirsutum, G. arboreum and G. raimondii, which are much greater than that of the other plants. The phylogenetic and gene structure analysis divided the cotton CrRLK1L genes into six major groups, among which only group I and II contained AtCrRLK1Ls of Arabidopsis, suggesting that other groups (group III-VI) were expanded by gene duplication during cotton evolution. Genome collinearity analysis revealed that half of the At02 genes in G. hirsutum derived from A02 of G. arboreum, while the other half (GhCrRLK1L6 and GhCrRLK1L7) originated from Dt03 and Dt02 of G. raimondii, indicating segmental duplication between noncorresponding chromosomes during polyploidization of G. hirsutum. In addition, expression and cis-element analysis revealed that only 22 GhCrRLK1Ls showed specific expression pattern during fiber development which are mainly due to the presence of binding sites for NAC, MYB and WRKY transcription factors.Conclusions: This study provides a strong foundation to further explore the molecular mechanism of CrRLK1L genes during fiber development in upland cotton.
Early incidence of deep venous thrombosis and its risk factors after knee arthroscopic surgery in patients with anticoagulant and non-anticoagulant
Authors: Shu Lei , Ni Qubo , Chen Biao , He Hangyuan , Chen Liaobin , Yang Xu
Published: July 2020

Purpose: To investigated the early incidence of deep venous thrombosis (DVT) and its risk factors after knee arthroscopic surgery in patients with anticoagulant and non-anticoagulant.Methods: 272 patients were reviewed who have undergone knee arthroscopic surgery in our hospital from January 2018 to October 2019. Color doppler ultrasound was performed for every patient at 24h preoperatively and three days after operation. On the first day after surgery, low molecular weight heparin (LMWH) was randomly administered to some patients and not in others. The following factors were recorded: gender, age, body mass index (BMI), preoperative platelet and D-dimer level, D-dimer level three days after surgery, anesthetic technique, tourniquet time, whether to use LMWH after operation, and type of surgical procedures. Chi-square test or Student t test was used to preliminarily screen out suspected risk factors. Then, multiple logistic regression analysis was utilized to further determine the risk factors of DVT after knee arthroscopic surgery.Results: The incidence of DVT in the postoperative anticoagulant group was 7.5%, and 7.4% in the non-anticoagulant group. An increased incidence was found among higher D-dimer level postoperatively. There was no significant difference in the incidence of DVT between use of LMWH and non-use of LMWH in three days after surgery.Conclusion: The early incidence of DVT in the group of patients without LMWH was 7.4%. The incidence of DVT in patients with knee arthroscopy surgery could not be reduced by using LMWH within three days, and high D-dimer level was a risk factor for DVT after knee arthroscopic surgery.