bluuebunny/crossref_metadata_2025 huggingface dataset:
Ethnobotany study of banana plant sap (Musa sp.) as an incision remedy (Vulnus scissum)
Authors: Cahyanto Tri , Anugrah Restu , Nisa Nisrina Khairun , Rosma Triska , Islamiati Yuna
Published: June 2020

The use of banana plant sap as an incision remedy has been carried out through generations in Citatah Village, Cipatat District, West Bandung Regency, Indonesia. This study aimed to examine the ethnobotanical utilization of banana plant sap as an incision remedy. The research was conducted using the snowball sampling technique by the method of structured observation and interviews with 30 respondents. The followings were tools and materials used for the research, a set of stationery, cameras, voice recorders, and laptops. The data obtained were analyzed using qualitative and quantitative descriptive analysis. The results showed that of the thirty respondents who knew the utilization of banana plant sap as wound remedy, only 60% were still using it. Parts of banana plants that were often used by the community was the banana plant shoots by 87% of the total respondents and banana leaf fronds by 13%. There was no specific type of banana used for this wound remedy. However, the type of banana most widely used by the community was ambon Banana (Musa paradisiaca var. sapientum) with a percentage of 20%, kulutuk/manggala banana (Musa balbisiana) 60%, and kepok Banana (Musa paradisiaca formatypica) 20%. Based on the results of the observation and interview, there were at least four benefits of using banana sap, namely preventing infection, sticking wounds, stopping bleeding, and drying the wound. While scientifically, this banana sap can be used as the wound remedy because it contains flavonoid compounds, saponins, triterpenoids, steroids, alkaloids, ascorbic acid, and tannins.
Immunohistochemical Expression of P16 Protein and TGF β1 in Mice Liver Exposed to Fumonisin B1
Authors: Mohammed et al. Sinai
Published: June 2020

Fumonisin B1 (FB1) is a mycotoxin produced in some grains (mainly corn) by Fusarium species. Due to a structural similarity between FB1 and sphinganine, sphingolipids metabolism is inhibited. Such inhibition plays a critical role in cell to cell singling and structure of lipoprotein; therefore FB1 has been suggested to have a relationship with human and animal cancer. This research is planned to study the effect of FB1 on male mice at two doses (20 and 30 µg/ ml) on the expression of TGF-β1 and p16 in liver cells. Three groups of Swiss albino male mice; each group was orally administrated with FB1 toxin as the following: normal saline (control group); 20 and 30 µg/ ml. All groups were sacrificed after two weeks of oral management. Liver samples were collected and prepared for immunohistochemistry technique (IHC) using anti-TGF-β1 and anti-p16 antibodies. The results showed that exposure to FB1 caused significant elevation of TGF-β1 in both doses (76.74 ± 2.387% and 80.62 ± 7.277%, respectively) in comparison with the control group (46.79 ± 2.404%). The level of p16 protein was decreased at 20 µg/ml (76.63 ± 2.349%) and then increased at 30 µg/ml (81.25 ± 6.263%) but the expression was lower than that of control (90.00 ± 0.805%). In conclusion, FB1 has a significant effect on TGF-β1 and p16 protein expression at both doses (20 and 30 µg/ml), and therefore, its role in cancer development is suggested.
Investigation of the Biochemical and Ultrastructural Mechanisms Underlying the Antimicrobial Activity of Mimusops spp. Extracts
Authors: Mohamed Mahmoud S.M. , Abdelmohsen Gehad , Dawoud Gouda T. M.
Published: June 2020

Antibiotic resistance is the major growing threat facing the pharmacological treatment of bacterial infections. Therefore, bioprospecting the medicinal plants could provide potential sources for antimicrobial agents. Mimusops, the biggest and widely distributed plant genus of family Sapotaceae, is used in traditional medicines due to its promising pharmacological activities. This study was conducted to elucidate the antimicrobial effect of three unexplored Mimusops spp. (M. kummel, M. laurifolia and M. zeyheri). Furthermore, the mechanisms underlying such antibacterial activity were studied. The Mimusops leaf extracts revealed significant antibacterial activities against the five tested bacterial strains with a maximum inhibition zone diameter of 22.0 mm against B. subtilis compared with standard antibiotic ciprofloxacin. The minimal inhibitory and bactericidal concentration values against tested Gram-positive and Gram-negative bacterial strains ranged from 3.15-12.5 µg/ml. However, weak antifungal effect was recorded against Candida albicans with MIC value ˃25 µg/ml. The 1, 1-diphenyl-2-picrylhydrazyl (DPPH) assay showed that M. caffra was the best antioxidant (IC50=14.75±0.028 µg/ml), while M. laurifolia was the least one (IC50=34.22±0.014 µg/ml). The phenolics in plant leaves extracts were identified and quantified by high performance liquid chromatography (HPLC) which revealed the presence of seven phenolic acids and four flavonoids. The abundant phenolic compounds were rutin (5.216±0.067 mg/g dried wt.) and gallic acid (0.296±0.068 mg/g) followed by myricetin (0.317±0.091 mg/g) then kaempferol (0.113±0.049 mg/g) as flavonoids. The antibacterial mechanism of M. laurifolia extract, as a representative species, induces ultrastructural changes in the model bacterium Staphylococcus aureus with cell wall and plasma membrane lysis as revealed by transmission electron microscopy. Overall, Mimusops species (M. laurifolia, M. kummel and M. zeyheri) are promising natural alternative sources for antimicrobial agents.
Moving Objects Detection Based on Frequency Domain
Authors: Awad Jalal hameed , Majeed Balsam Dhyia
Published: June 2020

In this research a proposed technique is used to enhance the frame difference technique performance for extracting moving objects in video file. One of the most effective factors in performance dropping is noise existence, which may cause incorrect moving objects identification. Therefore it was necessary to find a way to diminish this noise effect. Traditional Average and Median spatial filters can be used to handle such situations. But here in this work the focus is on utilizing spectral domain through using Fourier and Wavelet transformations in order to decrease this noise effect. Experiments and statistical features (Entropy, Standard deviation) proved that these transformations can stand to overcome such problems in an elegant way.
A Cryptosystem for Database Security Based on TSFS Algorithm
Authors: Abdulameer Saad Abdulkareem , Kashmar Ali Habeeb , Shihab Ammar Ibraheem
Published: June 2020

Implementation of TSFS (Transposition, Substitution, Folding, and Shifting) algorithm as an encryption algorithm in database security had limitations in character set and the number of keys used. The proposed cryptosystem is based on making some enhancements on the phases of TSFS encryption algorithm by computing the determinant of the keys matrices which affects the implementation of the algorithm phases. These changes showed high security to the database against different types of security attacks by achieving both goals of confusion and diffusion.
Towards Accurate Pupil Detection Based on Morphology and Hough Transform
Authors: AlShemmary et al. Ebtesam
Published: June 2020

Automatic recognition of individuals is very important in modern eras. Biometric techniques have emerged as an answer to the matter of automatic individual recognition. This paper tends to give a technique to detect pupil which is a mixture of easy morphological operations and Hough Transform (HT) is presented in this paper. The circular area of the eye and pupil is divided by the morphological filter as well as the Hough Transform (HT) where the local Iris area has been converted into a rectangular block for the purpose of calculating inconsistencies in the image. This method is implemented and tested on the Chinese Academy of Sciences (CASIA V4) iris image database 249 person and the IIT Delhi (IITD) iris database v1 using MATLAB 2017a. This method has high accuracy in the center and radius finding reaches 97% for 2268 iris on CASIA V4 image and 99.77% for 2240 iris images on IITD, the speed is acceptable compared to the real-time detection speed and stable performance.
The limited value of ‘employability’ as an objective in the training of Psychologists: Evidence from Chile
Authors: González Luis , Espinoza Oscar , Sandoval Luis , McGinn Noel , Castillo Dante
Published: June 2020

This study, carried out in Chile, describes difficulties in the incorporation of employability as an objective in the training of psychologists. Prior research emphasized confusion of key actors about how to train and measure employability. To illustrate that confusion, we compared perspectives of university Psychology department heads and employers of their graduates. Semi-structured interviews revealed understandings of various elements in the employment process. The department heads began by describing the process and criteria they follow to design, operate and assess their programs. Employers described the skills they have looked for when hiring graduates. Where possible the study notes the match between university training objectives and employer preferences. The skills promoted by universities and employers match on only some dimensions. ‘Employability’ varies in meaning across actors, occupations, and contexts. At present, universities and employers have little understanding of what the other seeks to accomplish.
Risk factors for parastomal hernia of loop stoma and relationships with other stoma complications in laparoscopic surgery era
Authors: Shiraishi Takuya , Nishizawa Yuji , Ikeda Koji , Tsukada Yuichiro , Sasaki Takeshi , Ito Masaaki
Published: June 2020

Background: Laparoscopic approach is now a widespread technique used worldwide, but there are few recent studies on risk factors for parastomal hernia. Therefore, this study was performed to analyze the incidence of parastomal hernia in laparoscopic and open surgery in which a loop stoma was created and was intended to be temporary, and to determine risk factors for parastomal hernia formation. Associations between parastomal hernia and other stoma-related complications were also analyzed.Methods: A retrospective analysis of patient and surgical characteristics was performed in 153 consecutive patients who underwent a temporary diverting loop ileostomy or colostomy after surgery related to malignant diseases at our hospital from January to December 2016.Results: Parastomal hernia developed in 77 cases (50.3%), including 39 (25.5%) diagnosed by physical examination and 38 (24.8%) detected by CT alone. On multivariate analysis, a stoma not passing through the middle of the rectus abdominis muscle was the only independent risk factor for parastomal hernia formation (p=0.005) during the median follow-up of 245.0 days. When we analyzed the factors that were associated with a stoma not passing through the middle of the rectus abdominis muscle, the only independent factor associated with this misplacement of the stoma was a laparoscopic approach (p=0.012). An analysis of stoma-related complications showed that peristomal skin disorders were significantly associated with parastomal hernia (p=0.049).Conclusions: This study showed that a stoma that is not formed through the middle of the rectus abdominis muscle is a risk factor for parastomal hernia formation, and that a laparoscopic approach is associated with this risk factor. Moreover, parastomal hernia is significantly associated with peristomal skin disorders.
Leukocyte Telomere Length in Patients with Transfusion-Dependent Thalassemia
Authors: Nanthatanti Nithita , Tantiworawit Adisak , Piriyakhuntorn Pokpong , Rattanathammethee Thanawat , Hantrakool Sasinee , Chai-Adisaksopha Chatree , Rattarittamrong Eakarat , Norasetthada Lalita , Tuntiwechapikul Wirote , Fanhchaksai Kanda , Charoenkwan Pimlak , Kumfu Sirinart , Chattipakorn Nipon
Published: June 2020

Background: Thalassemia is a hereditary hemolytic anemia with a severity ranging from mild, non-transfusion dependent to severe chronic anemia requiring lifelong transfusion. Transfusional iron overload is a major complication in patients with transfusion-dependent thalassemia (TDT). Telomeres are sequences of nucleotides forming the end caps of chromosomes that act as a DNA repair system. Iron overload in thalassemia can cause increased oxidative stress which leads to cellular damage and senescence. This may result in telomere length shortening. The degree of telomere length shortening may reflect the severity of thalassemia. Methods: This research aimed to study the leukocyte telomere length in patients with TDT in comparison to non-thalassemic individuals and to identify the clinical and laboratory parameters that are associated with telomere length. We conducted a cross-sectional study in patients with TDT aged ³18 years. Leukocyte telomere length was measured by real-time quantitative PCR. Results: Sixty-five patients with TDT were enrolled onto the study. There were 37 female patients (54.4%). The median age was 27 (18-57) years, and mean pre-transfusion hemoglobin level was 7.1 (± 1.07) g/dL. The mean telomere to single copy gene (T/S) ratios of patients with TDT and the controls were 0.72±0.18 and 0.99±0.25, respectively (p <0.0001). There was a significant correlation between the T/S ratio and age (p = 0.0002), and hemoglobin level (p = 0.044). There was no correlation between telomere length and other factors. Conclusions: Our study showed that TDT patients had shorter leukocyte telomere length compared with controls. Leukocyte telomere shortening in TDT was an aging-dependent process and associated with lower hemoglobin level.
Immune response of horses to inactivated African horse sickness vaccines
Authors: Rodriguez Marina , Joseph Sunitha , Pfeffer Martin , Raghavan Rekha , Wernery Ulrich
Published: June 2020

The authors have withdrawn this preprint due to author disagreement.
Spinal cord stimulation for chronic intractable trunk or limb pain: study protocol for a Chinese multicenter randomized withdrawal trial (CITRIP study)
Authors: Lu Yang , Mao Peng , Wang Guihuai , Tao Wei , Xiong Donglin , Ma Ke , Li Rongchun , Feng Dan , Duan Wanru , Li Shun , Fu Zhijian , Feng Zhiying , Jin Yi , Wan Li , Lu Yan , Fan Bifa , Wang James Jin , Li Luming
Published: June 2020

Background Although effective results of many studies support the use of spinal cord stimulation in the chronic pain patients, no randomized controlled trial has been undertaken in China to date. CITRIP is a multicenter, prospective, randomized, withdrawal study designed to evaluate the clinical effectiveness and safety of spinal cord stimulation plus remote programming management in patients with intractable trunk or limb pain. Method Participants will be recruited in approximately 10 centers across China. Eligible participants with intractable trunk or limb and an average Visual Analog Scale (VAS) score ≥ 5 will undergo spinal cord stimulation test. Participants with VAS score reduction ≥ 50% could move forward to receive implantation of an implanted pulse generator. In the withdrawal period at 3-months follow-up visit, participants randomized to the experimental group (EG) will undergo continuous stimulation while ceasing the stimulation in the control group (CG). The outcome assessment will occur at baseline and at 1, 3 (pre and post randomization) and 6 months. The primary outcome is the difference of maximal visual analog scale (VAS) score between EG and CG in the withdrawal period compared with baseline before the withdrawal period. Additional outcomes include VAS score change at 1, 3 and 6-month follow-ups, responder rate (VAS score improving by 50%), achievement rate of a desirable pain state (VAS score ≤ 4), awake times during sleep, Beck Depression Inventory for depression evaluation, short-form 36 for quality of life evaluation, drug usage, satisfaction rating of the device. Adverse events will be collected. The primary analysis will follow the intention-to-treat principle. Discussion The CITRIP study seeks to evaluate the effectiveness and safety of a randomized withdrawal trial of spinal cord stimulation for patients with intractable trunk or limb pain.
Determinants of Long Acting Contraceptive Utilization Among HIV Positive Reproductive Age Women Attending Care at Art Clinics of Public Health Facilities in Arba Minch Town, Southern Ethiopia, 2019. A Case Control Study
Authors: Yirsaw Betselot , Meskel Feleke G , Michael G-kiros G , Shitemaw Tewoderos
Published: June 2020

Background: Long acting and permanent contraceptive methods by far are the most effective, very safe and convenient methods than short acting contraceptive methods. But in less developed countries, use of long acting reversible contraceptive or permanent methods (LARCs/PMs) is very low. Therefore the aim of this study was to identify determinants of long acting contraceptive method utilization among HIV positive reproductive age women. Methods: An institutional based case control study was conducted among random sample of 354 HIV positive reproductive age women (total of 97.8% response rate) at Anti-Retroviral Therapy clinics from February 20 to March 20, 2019. Case to control ratio was 1:2. A structured questionnaire and information recorded from ART card review were used to collect the data. Each variable was entered in Bivariate analysis with dependent variables and those variables with P-value of ≤ 0.25 were included in the Multivariate analysis. Significance was determined at the level of P-value <0.05 with 95% CI of AOR. Results: A total of 354 (33.3% cases and 66.7% controls) HIV positive reproductive age women were interviewed with response rate of 97.8%. The study revealed being in age group of 39 and above [AOR=0.17, 95% CI (0.06, 0.48)], being divorced/separated and widowed [AOR=0.05, 95% CI (0.003, 0.61)], having supportive opinion and strongly supportive opinion regarding family planning service availability in ART clinic [AOR= 5.01, 95% CI (1.79, 14.07)], [AOR= 7.81, 95% CI (2.54, 24.01)] and having no future fertility intention [AOR= 7.03, 95% CI (2.73, 18.06)] were statistically significant determinants for long acting contraceptive method utilization. Conclusion: Woman in age group of 39 and above, having no future fertility intention and being divorced/separated and widowed was found to be determinants of long acting contraceptive method utilization among HIV positive reproductive age women. In addition our study support the WHO Strategic Considerations for Strengthening the Linkages between Family Planning and HIV/AIDS Policies, Programs, and Services.
Weight management barriers and facilitators after breast cancer in Australian women: a national survey
Authors: Ee Carolyn , Cave Adele Elizabeth , Naidoo Dhevaksha , Bilinski Kellie , Boyages John
Published: June 2020

Background: Breast cancer is the most common cancer in women worldwide. Weight gain after breast cancer is associated with poorer health outcomes. The aim of this study was to describe how Australian breast cancer survivors are currently managing their weight. Methods: Online cross-sectional survey open to any woman living in Australia who self-identified as having breast cancer, between November 2017 and January 2018. Results: We received 309 responses. Most respondents described their diet as good/excellent and reported moderate-high levels of weight self-efficacy. Despite this, the proportion of overweight/obesity increased from 47% at time of diagnosis to 67% at time of survey. More than three quarters of respondents did not receive any advice on weight gain prevention at the time of diagnosis. 39% of women reported being less active after cancer diagnosis, and and few weight loss interventions were perceived to be effective. Facilitators were structured exercise programs, prescribed diets, and accountability to someone else, while commonly cited barriers were lack of motivation/willpower, fatigue, and difficulty maintaining weight. Women who cited fatigue as a barrier were almost twice as likely to be doing low levels of physical activity (PA) or no PA than women who did not cite fatigue as a barrier. Conclusions: We report high levels of concern about weight gain after BC and significant gaps in service provision around weight gain prevention and weight management. Women with BC should be provided with support for weight gain prevention in the early survivorship phase, which should include structured PA and dietary changes in combination with behavioural change and social support. Weight gain prevention or weight loss programs should address barriers such as fatigue. More research is required on the effectiveness of diet and exercise interventions in BC survivors, particularly with regard to weight gain prevention.
A Comparison of Cylindrical and Tapered Stem Designs in Femoral Revision Hip Arthroplasty
Authors: Zhang Yu , Zhang Ye , Sun Jian-Ning , Hua Zi-Jian , Chen Xiang-Yang , Feng Shuo
Published: June 2020

Background Both cylindrical and tapered stems are commonly used in revision total hip arthroplasty, it is unclear whether the geometry of prosthesis stem has an effect on the patient's efficacy and prognosis. we assume the tapered stem is superior to the cylindrical stem for better clinical outcome. Methods A multicenter review of 120 femoral revisions with Paprosky I, II and III defects using cobalt cylindrical stem (54 hips) or titanium tapered stem (66 hips) was performed with an average follow-up of 6 years. Demographic data was comparable between groups. Results There were no significant group differences were found in surgery time, bleeding volume and the postoperative Harris Hip Score, the level of overall satisfaction, 8-year cumulative survival. However, intraoperative fractures in the tapered group (4.5%) occurred significantly less than in the cylindrical group (14.8%), and stem subsidence was significantly less in the tapered group (2.17mm) than in the cylindrical group (4.17 mm). There was a higher ratio of bone repair and lower bone loss in the tapered group compared to the cylindrical group. The postoperative thigh pain rate was higher in the cylindrical group (12.9%) than in the tapered group (4.5%). Conclusion Both cylindrical stem and tapered stem can achieve satisfactory mid-term clinical results in revision THA; The tapered stem has better bone restoration of proximal femur, low incidence of intraoperative fracture, and low postoperative thigh pain rate compared with the cylindrical stem.
Self-Assessed Life Expectancy Among Older Adults In Côte D’ivoire
Authors: Moussa Richard K , Diaby Vakaramoko
Published: June 2020

Background The purpose of this study was to estimate individuals’ expected longevity based on self-assessed survival probabilities and determine the predictors of such subjective life expectancy in a sample of elderly people (50 years and older) in Côte d’Ivoire.Methods Paper-based questionnaires were administered to a sample (n=267) of older adults residing in the city of Dabou, Côte d’Ivoire in May 2017. Information on subjective expectations regarding health, comorbidities, and self-assessed survival probabilities was collected. We estimated self-assessed life expectancy and its determinants using a two-pronged approach by: (i) estimating individuals’ life expectancy using the self-assessed survival probabilities (SSPs), and (ii) applying a finite mixture of regression models to form homogenous groups of individuals (clusters/components) and investigate the determinants. A spline-based approach was used to estimate the overall distribution of life expectancy for each individual using two to four points of self-assessed survival probabilities. A finite mixture of regression models was used to identify homogeneous groups of individuals (i.e. clusters/components) of the overall subjective life expectancy distribution of the study participants. Results The mean subjective life expectancy in older people varied according to four components/clusters. The average subjective life expectancy among the elderly was 79.51, 78.89, 80.02, and 77.79 years in the first, second, third, and fourth component of the subjects' overall subjective life expectancy, respectively. The effect of sociodemographic characteristics, comorbidities, and lifestyle on subjective life expectancy varied across components. For instance, a U-shape relationship between household per capita income and subjective life expectancy was found for individuals classified into the third component, and an inverse U-shape relationship was found for individuals classified into the fourth component.Conclusions We extended the estimation of subjective life expectancy by accounting for heterogeneity in the distribution of the estimated subjective life expectancy. This approach improved the usual methods for estimating individual subjective life expectancies and may provide insight into the elderly’s perception of aging, which could be used to forecast the demand for health services and long-term care needs.
KIAA0101 and UbcH10 interact to regulate non-small cell lung cancer cell proliferation by disrupting the function of the spindle assembly checkpoint
Authors: Lei Han , Wang Kun , Jiang Tongying , Lu Jingjing , Dong Xue , Wang Feilong , Li Qiang , Zhao Liming
Published: June 2020

Background Chromosome mis-segregation caused by spindle assembly checkpoint (SAC) dysfunction during mitosis is an important pathogenic factor in cancer, and modulating SAC function has emerged as a potential novel therapy for non-small cell lung cancer (NSCLC). UbcH10 is considered to be associated with SAC function and the pathological types and clinical grades of NSCLC. KIAA0101, which contains a highly conserved proliferating cell nuclear antigen (PCNA)-binding motif that is involved in DNA repair in cancer cells, plays an important role in the regulation of SAC function in NSCLC cells, and bioinformatics predictions showed that this regulatory role is related to UbcH10. We hypothesized KIAA0101 and UbcH10 interact to mediate SAC dysfunction and neoplastic transformation during the development of USCLC. Methods NSCLC cell lines were used to investigate the spatial-temporal correlation between UbcH10 and KIAA0101 expression and the downstream effects of modulating their expression were evaluated. Further immunoprecipitation assays were used to investigate the possible mechanism underlying the correlation between UbcH10 and KIAA0101. Eventually, the effect of modulating UbcH10 and KIAA010 on tumor growth and its possible mechanisms were explored through in vivo tumor-bearing models. Results In this study, we demonstrated that both UbcH10 and KIAA0101 were upregulated in NSCLC tissues and cells and that their expression levels were correlated in a spatial and temporal manner. Importantly, UbcH10 and KIAA0101 coordinated to mediate the premature degradation of various SAC components to cause further SAC dysfunction and neoplastic proliferation. Moreover, tumor growth in vivo was significantly inhibited by silencing UbcH10 and KIAA0101 expression. Conclusions KIAA0101 and UbcH10 interact to cause SAC dysfunction, chromosomal instability and malignant proliferation in NSCLC, suggesting that UbcH10 and KIAA0101 are potential therapeutic targets for the treatment of NSCLC by ameliorating SAC function.
Assessing Accuracy and Precision of 3D Augmented Reality Holographic models derived from DICOM data
Authors: Uribe Jesus , Vu Lan , Laguna Benjamin , Courtier Jesse
Published: June 2020

Objective: Assess accuracy and precision of measurements on 3D Augmented reality (AR) models derived from CT DICOM data, and compare AR model measurements with PACS measurements. Materials/Methods: 5 individual 3D hologram models were produced using a CT phantom with fiducial markers set at varying distances. DICOM files were translated into 3D AR models using open source software. AR models were adapted for display on an AR device using a novel application. AR models were projected and distances between the projected fiducial markers were measured. Finally, 5 measurements each were obtained of the holographic projected distances between fiducials in the x1, y1, and z1 labeled planes respectively for precision assessment. Mann-Whitney U test was performed to compare measured distances on AGFA-PACS, AR models, and actual measured distances on phantom models. Results: No significant difference was found between gold standard measurements and either PACS measurements (p=0.9124) or AR measurements (p=0.8966). AR model measurements had a standard error of 0.24mm, 0.24mm, and 0.38mm in the x,y, and z planes respectively. Furthermore, measurements on AR models demonstrated a high degree of accuracy in comparison to gold standard measurements. Conclusion: Current AR technology is can produce reliable 3D AR models from CT DICOM data
EBV-positive intravascular large B-cell lymphoma of the liver: a case report and literature review
Authors: Li Qingjiao , Li Jinghe , Yang Keda , Peng Ying , Xiang Yao , Sun Shuyuan , Zeng Jian , Zhang Xin , Wang Junpu
Published: June 2020

Background Intravascular large B-cell lymphoma (IVLBCL) is an extremely rare subtype of diffuse large B-cell lymphoma that most commonly involves the central nervous system, skin, and bone marrow. To our knowledge, Epstein-Barr virus (EBV)-positive IVLBCL in the liver has never been reported in the literature. Case presentation We report a case of a 65-year-old Chinese man with complaint of fever for 18 days. No obvious abnormality was found by physical examination. Laboratory findings were notable for anemia, thrombocytopenia, and elevated level of serum lactate dehydrogenase. Bone marrow on smear, biopsy, and flow cytometry revealed no lymphoma. Imaging studies showed a slightly lower density lesion in the liver with high fluorodeoxyglucose uptake and hepatosplenomegaly. Percutaneous liver biopsy revealed clustering of large atypical lymphocytes within the hepatic sinusoids. Immunohistochemically, these lymphoma cells were positive for CD20, PAX-5, MUM-1, BCL-6 and CD5, but negative for CD3 and CD10. Besides, Epstein-Barr virus-encoded RNA was detected in tumor cells by in situ hybridization. BCL-2 , BCL-6 and MYC genes were intact tested by fluorescence in situ hybridization analysis. The patient was diagnosed as IVLBCL and died after 1 month of hospitalization without receiving immunochemotherapy. Conclusions IVLBCL of the liver is a highly rare lymphoma with nonspecific manifestations and dismal prognosis. Full recognition of its clinicopathological features will help to better diagnose this disease.
Professional advice for primary healthcare workers in Ethiopia: a social network analysis
Authors: Sabot Kate , Blanchet Karl , Berhanu Della , Spicer Neil , Schellenberg Joanna
Published: June 2020

Background: In an era of increasingly competitive funding, governments and donors will be looking for creative ways to extend and maximise resources. One such means can include building upon professional advice networks to more efficiently introduce, scale up, or change programmes and healthcare provider practices. This cross-sectional, mixed-methods, observational study compared professional advice networks of healthcare workers in eight primary healthcare units across four regions of Ethiopia. Primary healthcare units include a health centre and typically five satellite health posts.Methods: 160 staff at eight primary healthcare units were interviewed using a structured tool. Quantitative data captured the frequency of healthcare worker advice seeking and giving on providing antenatal, childbirth, postnatal and newborn care. Network and actor-level metrics were calculated including density (ratio of ties between actors to all possible ties), centrality (number of ties incident to an actor), distance (average number of steps between actors) and size (number of actors within the network). Following quantitative network analyses, 20 qualitative interviews were conducted with network study participants from four primary healthcare units. Qualitative interviews aimed to interpret and explain network properties observed. Data were entered, analysed or visualised using Excel 6.0, UCINET 6.0, Netdraw, Adobe InDesign and MaxQDA10 software packages.Results: The following average network level metrics were observed: density .26 (SD.11), degree centrality .45 (SD.08), distance 1.94 (SD.26), number of ties 95.63 (SD 35.46), size of network 20.25 (SD 3.65). Advice networks for antenatal or maternity care were more utilised than advice networks for post-natal or newborn care. Advice networks were typically limited to primary healthcare unit staff, but not necessarily to supervisors. In seeking advice, a colleague’s level of training and knowledge were valued over experience. Advice exchange primarily took place in person or over the phone rather than over email or online fora. There were few barriers to seeking advice.Conclusion: Informal, inter-and intra-cadre advice networks existed. Fellow primary healthcare unit staff were preferred, particularly midwives, but networks were not limited to the primary healthcare unit. Additional research is needed to associate network properties with outcomes and pilot network interventions with central actors.
Biofilm formation on three different endotracheal tubes: a prospective clinical trial
Authors: Thorarinsdottir Hulda Rosa , Kander Thomas , Holmberg Anna , Petronis Sarunas , Klarin Bengt
Published: June 2020

Background: Biofilm formation on endotracheal tubes (ETTs) is an early and frequent event in mechanically ventilated patients. The biofilm is believed to act as a reservoir for infecting microorganisms and thereby contribute to development and relapses of ventilator-associated pneumonia (VAP). Once a biofilm has formed on an ETT surface, it is difficult to eradicate. This clinical study aimed to compare biofilm formation on three widely used ETTs with different surface properties and to explore factors potentially predictive of biofilm formation.Methods: We compared the grade of biofilm formation on ETTs made of uncoated polyvinyl chloride (PVC), silicone-coated PVC, and PVC coated with noble metals after > 24 hours of mechanical ventilation in critically ill patients. The comparison was based on scanning electron microscopy of ETT surfaces, biofilm grading, surveillance and biofilm cultures, and occurrence of VAP.Results: High-grade (score ≥ 7) biofilm formation on the ETTs was associated with development of VAP (OR 4.17 [95% CI 1.14–15.3], p = 0.031). Compared to uncoated PVC ETTs, the silicone-coated and noble-metal-coated PVC ETTs were independently associated with reduced high-grade biofilm formation (OR 0.18 [95% CI 0.06–0.59], p = 0.005, and OR 0.34 [95% CI 0.13–0.93], p = 0.036, respectively). No significant difference was observed between silicon-coated ETTs and noble-metal-coated ETTs (OR 0.54 [95% CI 0.17–1.65], p = 0.278). In 60% of the oropharyngeal cultures and 58% of the endotracheal cultures collected at intubation, the same microorganism was found in the ETT biofilm at extubation. In patients who developed VAP, the causative microbe remained in the biofilm in 56% of cases, despite appropriate antibiotic therapy. High-grade biofilm formation on ETTs was not predicted by either colonization with common VAP pathogens in surveillance cultures or duration of invasive ventilation.Conclusion: High-grade biofilm formation on ETTs was associated with development of VAP. Compared to the uncoated PVC ETTs, the silicone-coated and noble-metal-coated PVC ETTs were independently associated with reduced high-grade biofilm formation. Further research on methods to prevent, monitor, and manage biofilm occurrence is needed.Trial registration: ClinicalTrials.gov, NCT02284438. Retrospectively registered on 21 October 2014, URL: https://clinicaltrials.gov/ct2/show/NCT02284438.
Levels of knowledge regarding malaria causes, symptoms, and prevention measures among Malawian women of reproductive age.
Authors: Sixpence Alick , Nkoka Owen , Chirwa Gowokani C. , Milanzi Edith B. , Mangani Charles , Mathanga Don P. , Ntenda Peter A. M.
Published: June 2020

Background: Malawi is a malaria-endemic country and approximately 6 million cases are reported annually. Improving knowledge of malaria causes and symptoms, and the overall perception towards malaria and its preventive measures is vital for malaria control. Thus, the current study investigated the levels of knowledge of the causes, symptoms, and prevention of Malaria among Malawian women. Methods: We analyzed data from the 2017 wave of the Malawi Malaria Indicator Survey (MIS). In total, 3,422 women of reproductive age (15–49 years) were sampled and analyzed. We assessed the levels of women’s knowledge about 1), causes of malaria 2) symptoms of malaria and 3) preventive measures. The tertiles of the composite score were used as the cut-offs to categorize the levels of knowledge as ‘‘low”, ‘‘medium” and ‘‘high”. Multinomial logistic regression models were constructed to assess the independent factors while taking into account the complex survey design. Results : All in all, 49.74% of all respondents had high levels of knowledge of causes, symptoms, and preventive measures. The high level of knowledge was 45% for rural women and 55% for urban dwellers. After adjustment for independent factors, women of age group 15–19 years adjusted odds ratio ([aOR]: 2.58; 95% Confidence Interval [CI]: 1.69–3.92), women with no formal education (aOR: 3.73; 95% CI: 2.20–6.33), women whose household had no television (aOR: 1.50; 95% CI: 1.02–2.22), women who had not seen/heard malaria message (aOR: 1.53; 95% CI: 1.20–1.95), women of Yao tribe (aOR: 1.95; 95% CI: 1.10–3.46) and women from rural areas had low levels of knowledge about the causes of malaria, symptoms of malaria, and preventive measures. Additionally, the results also showed that women aged 15–19 years (beta [β] = -0.73, standard error [SE] = 0.12); P <.0001, women with no formal education (β = -1.17, SE = 0.15); P <.0001, women whose household had no radio (β = -0.15, SE = 0.0816); P =0.0715 and women who had not seen or heard malaria message (β = -0.41, SE = 0.07); P <.0001 were likely to have a lower knowledge score. Conclusions: The levels of malaria knowledge were reported to be unsatisfactory among adult women, underscoring the need to scale up efforts on malaria education. Beside insecticide-treated bed nets (ITNs) and prompt diagnosis, malaria can be best managed in Malawi by increasing knowledge of malaria causes, and symptoms especially for younger women, women with no formal education, women whose households have no media, women from Yao tribes and rural dwellers.
Growth hormone alleviates oxidative stress and improves the IVF outcomes of poor ovarian responders: A randomized controlled trial
Authors: Gong Yan , Zhang Kun , Xiong Dongsheng , Wei Jiajing , Tan Hao , Qin Shengfang
Published: June 2020

Background: Oxidative stress (OS), defined as an imbalance between excessive reactive oxygen species (ROS) and/or reactive nitrogen species (RNS) production and antioxidant insufficiency, has been suggested to be involved in the pathogenesis of poor ovarian response (POR). Growth hormone (GH) can reduce OS in some cell types. This study investigated whether GH could improve OS in and in vitro fertilization and embryo transfer (IVF-ET) outcomes of poor ovarian responders.Methods: This study enrolled 105 patients with POR and 58 patients without POR (controls) who were diagnosed according to the Bologna criteria and underwent conventional IVF-ET. Poor ovarian responders were randomly assigned to two groups: the POR-GH group, which received pretreatment with GH 4 IU/d on day 2 of the previous menstrual cycle before IVF until the trigger day, and the POR-C group, which received no pretreatment. The OS markers in follicular fluid (FF), ROS levels in granulosa cells (GCs), and IVF outcomes of the groups were compared.Result(s): The endometrial thickness on trigger day, number of cleaved embryos, number of higher quality embryos, and rates of implantation and clinical pregnancy were significantly increased in the POR-GH group compared with the POR-C group (P < 0.05). Moreover, compared to those in the non-POR group, the FF malondialdehyde (MDA), total oxidant status (TOS), oxidative stress index (OSI) and ROS levels in GCs were significantly higher, whereas superoxide dismutase (SOD) and total antioxidant capacity (TAC) were significantly lower in the POR-C group (P < 0.05). Furthermore, compared with those in the POR-C group, the FF TAC was significantly increased in the POR-GH group, and the TOS, OSI and intracellular ROS levels were significantly reduced (P < 0.05).Conclusion(s): Pretreatment with GH alleviates OS and improves oocyte quality in and IVF outcomes of poor ovarian responders.Clinical Trial Registration: Chinese Clinical Trial Registry. ChiCTR1900021269. Registered 8 February 2019, http://www.chictr.org.cn/edit.aspx?pid=35837&htm=4.
Differentiation of soft tissue and bone sarcomas from benign lesions utilizing 18F- FDG PET/CT-derived parameters
Authors: Chen Bo , Feng Hongbo , Xie Jinghui , Li Chun , Zhang Yu , Wang Shaowu
Published: June 2020

Background: Accurate differentiation between malignant and benign changes in soft tissue and bone lesions is essential for the prevention of unnecessary biopsies and surgical resection. Nevertheless, it remains a challenge and a standard diagnosis modality is urgently needed. The objective of this study was to evaluate the usefulness of 18F-fluorodeoxyglucose (18F-FDG) PET/CT-derived parameters to differentiate soft tissue sarcoma (STS) and bone sarcoma (BS) from benign lesions. Methods: Patients who had undergone pre-treatment 18F-FDG PET/CT imaging and subsequent pathological diagnoses to confirm malignant (STS and BS, n = 37) and benign (n = 33) soft tissue and bone lesions were retrospectively reviewed. The tumor size, PET and low-dose CT visual characteristics, maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and heterogeneous factor (HF) of each lesion were measured. Univariate and multivariate logistic regression analyses were conducted to determine the significant risk factors to distinguish sarcoma from benign lesions. To establish a regression model based on independent risk factors, and the receiver operating characteristic curves (ROCs)of individual parameters and their combination were plotted and compared. Conventional imaging scans were re-analyzed, and the diagnostic performance compared with the regression model.Results: Univariate analysis results revealed that tumor size, SUVmax, MTV, TLG, and HF of 18F-FDG PET/CT imaging in the STS and BS group were all higher than in the benign lesions group (all P values were <0.01). The differences in the visual characteristics between the two groups were also all statistically significant (P <0.05). However, the multivariate regression model only included SUVmax and HF as independent risk factors, for which the odds ratios were 1.135 (95%CI: 1.026~1.256, P = 0.014) and 7.869 (95%CI: 2.119~29.230, P = 0.002), respectively. The regression model was constructed using the following expression: Logit (P) = -2.461+0.127SUVmax+2.063HF. The area under the ROC was 0.860, which was higher than SUVmax (0.744) and HF (0.790). The diagnostic performance of the regression model was superior to those of individual parameters and conventional imaging.Conclusion: The regression model including SUVmax and HF based on 18F-FDG PET/CT imaging may be useful for differentiating STS and BS from benign lesions.
Effect of Intraoperative Goal-directed Balanced Crystalloid versus Colloid Administration on Postoperative Cardiac Outcome
Authors: Reiterer Christian , Kabon Barbara , Taschner Alexander , Zotti Oliver , Kurz Andrea , Fleischmann Edith
Published: June 2020

Background: N-terminal pro brain natriuretic peptide (NT-proBNP) and troponin T are released during myocardial wall stress and/or ischemia and are strong predictors for postoperative cardiovascular complications. However, the effect of goal-directed crystalloid versus colloid administration on NT-proBNP and troponin T, especially in relatively healthy patients undergoing moderate- to high risk abdominal surgery, still remains unclear. Thus, we evaluated in this sub-study the effect of a goal-directed crystalloid versus a goal-directed colloid fluid regimen on postoperative maximum NT-proBNP concentration. We further evaluated the incidence of MINS between both study groups. Methods: 30 patients were randomly assigned to receive additional fluid boluses of 6% hydroxyethyl starch 130/0.4 and 30 patients to receive lactated Ringer´s solution. Intraoperative fluid management was guided by oesophageal Doppler-according to a previously published algorithm. The primary outcome were differences in postoperative maximum NT-proBNP (maxNT-proBNP) between both groups. As our secondary outcome we evaluated the incidence of MINS between both study groups. We defined maxNT-proBNP as the maximum value measured within 2 hours after surgery and on the first and second postoperative day. Results: In total 56 patients were analysed. There was no significant difference in postoperative maximum NT-proBNP between the colloid group (258.7 ng/L (IQR 199.4 to 782.1)) and the crystalloid group (440.3 ng/L (IQR 177.9 to 691.2)) during the first 2 postoperative days (P = 0.29). 5 patients in the colloid group and 7 patients in the crystalloid group developed MINS (P = 0.75).Conclusions: Based on this relatively small study goal-directed colloid administration did not decrease postoperative maxNT-proBNP concentration as compared to goal-directed crystalloid administration. Nevertheless, there was a tendency of lower postoperative maximum NT-proBNP concentrations in patients receiving colloids.Trial registration: ClinicalTrials.gov (NCT01195883)
Stuck-moving Needle acupuncture the Myofascial Triggers Point to treat Idiopathic Frozen Shoulders: study protocol for a randomized controlled trial
Authors: BAI YANG , Wang Ying , Chen Bo , Lei Qianqian , Zhao Hailong , Lu Jingbao , Fan Qian , Wang Yali , Song HongBo , Cheng Maomao , Wang Wei , Hu Shengen , Du YuanHao , Xia Tian
Published: June 2020

Background
There are evidences for the efficacy of acupuncture treatment for chronic shoulder pain, however it remains unclear the best acupuncture modes for effective treatment. We compared the effect of myofascial trigger point (MTrp) Stuck-moving Needle acupuncture with that of common acupuncture treatments. Further, we evaluated the efficacy and safety of stuck-moving needle acupuncture for the MTrp in improving pain and range of motions in patients with idiopathic frozen shoulder. The ultimate aim of the study is to select an effective therapy for patients with idiopathic frozen shoulder.
Methods
Randomized controlled trial will be conducted in the 3 clinical centers of Qingyang Traditional Chinese Medicine Hospital, Qingyang Xifeng district People's Hospital and Qingyang Second People's Hospital in China from February 2020 to January 2021. One-hundred and eight frozen shoulder patient will be recruited and randomized into one of three groups in a 1:1:1 ratio of the Stuck-moving Needle acupuncture group, Common acupuncture control group and physical exercise control group. This trial will include a 1-week baseline period, a 3-weeks of treatment period, and a 12-weeks of follow-up period. During the 3-weeks of treatment period, patients will receive 9 sessions of acupuncture. The primary outcome will be related to change in the Visual Analogue Scale (VAS) and Measurement of range of joint motion (ROM) from baseline period to the 12-week follow-up period. Secondary outcome measures will include, measurement of Pressure Pain Threshold (PPT), Pressure Pain Tolerance (PTT) Oxford Shoulder Score (OSS), 36-item Short Form survey and Patient satisfaction evaluation. Adverse events also will be recorded for safety assessment.
Discussion
The results of this trial will allow us to compare the difference in efficacy between Stuck-moving Needle acupuncture MTrP with that of common acupuncture treatments. The findings from this trial will be published in the peer-reviewed journals.
Trial registration:
Acupuncture-Moxibustion Clinical Trial Registry (ChiMCTR1900002862) and Chinese Clinical Trial Registry (ChiCTR1900028452). registered on 22, Dec. 2019