bluuebunny/crossref_metadata_2025 huggingface dataset:
Does electronic consent improve the logistics and uptake of hpv vaccination in adolescent girls? A mixed methods theory informed evaluation of an intervention
Authors: Chantler Tracey , Pringle Ellen , Bell Sadie , Cooper Rosie , Edmundson Emily , Nielsen Heidi , Roberts Sheila , Edelstein Michael , Jack Sandra Mounier
Published: March 2020

Background Technological solutions may improve the logistics of obtaining parental consent in school-based immunisation programmes. In 2018/19 a health care organisation in London, England, piloted an electronic consent intervention in the adolescent girls’ HPV vaccination programme. We conducted a mixed-methods evaluation to examine the usability and acceptability of the intervention and assess its impact on consent form returns and HPV vaccine uptake. Methods The intervention was implemented in 14 secondary schools in seven South London boroughs. Each e-consent school was matched with a school that used standard paper consent. Matching was based on location and the proportion of students: i. with English as a second language, ii. receiving free school meals (socio-economic status proxy). Consent form return rates and HPV vaccine uptake were compared quantitatively between intervention and matched schools. Data from immunisation session observations (n=7), school feedback forms (n=14), individual and group interviews with implementers (n=8), parents and adolescents (n=12) and a focus group discussion with adolescents was analysed thematically to document user’s experiences investigate the implementation of the intervention. Results HPV vaccination uptake did not differ between e-consent and matched paper consent schools, but timely consent form return was significantly lower in the e-consent schools (73.3% (n=11) vs 91.6% (n=11), p=0.008). The transition to using the system was not straightforward, whilst schools and staff understood the potential benefits, they found it difficult to adapt to new ways of working which removed some level of control from schools. Part of the reason for lower consent form return in e-consent schools was that some parents found the intervention difficult to access and use. Adolescents highlighted the potential for e-consent interventions to by-pass their information needs. Conclusions The e-consent intervention did not improve consent form return or vaccine uptake due to challenges encountered in transitioning to a new way of working. New technologies require embedding before they become incorporated in everyday practice. The intervention is undergoing further iterative development to improve its usability, ensure schools are appropriately involved and adolescents receive tailored immunisation information. A re-evaluation once stakeholders are accustomed to e-consent may be required to understand its impact.
A Novel Highway Routing Protocol in Vehicular Ad hoc Networks
Authors: Khezri Edris , Zeinali Esmaeil
Published: March 2020

The Vehicular Ad hoc Networks (VANETs) are an example of mobile networks which utilizes Dedicated Short Range Communication (DSRC) to establish a wireless connection between cars and their primary purpose is to provide more security and comfort for passengers. These networks utilize wireless communications and vehicular technology to collect and disseminate traffic information, and it is required to be delivered to all vehicles on the network reliably and quickly. One of the major challenges raised in VANETs is that the communication path between the source and destination nodes is disconnected due to the dynamic nature of the nodes in this network, and the reconnection process of nodes through the new path reduces the performance of network. This paper presents a highway routing protocol to overcome some of the challenges of these networks including cost, delay, packet delivery rate, and overhead. The NS2 is used for simulation and the performance of the proposed protocol is compared with the VMaSC-LTE and DBA-MAC protocols. The results of the simulation indicated that the proposed protocol performs better than the mentioned protocols.
Respiratory changes during adaptation to stress induced by movement restriction in rabbits
Authors: Villalba-Caloca Jaime , Arreola-Ramírez José Luis , Alquicira-Mireles Jesús , Vargas Mario H. , Carbajal-Salinas Verónica , Segura-Medina Patricia
Published: March 2020

Background Confinement inside a restricted space causing movement restriction is a stressful condition, potentially leading to spontaneous changes of respiratory parameters that are expected to return to normal values as the stress subsides. Barometric plethysmography is a non-invasive method to study surrogates of pulmonary mechanics in conscious animals enclosed into a plexiglass chamber. This chamber greatly restricts the animal movements but does not cause its immobilization. Methods Respiratory parameters from six rabbits were recorded during 90 min/day for 5 days while the animal was confined inside a plethysmographic chamber. Modifications of respiratory parameters were evaluated by dividing the total length of the recording in three 30-min periods. Results During the 90-min recording, enhanced pause (Penh, a lung resistance surrogate) showed a decreasing trend, coinciding with a decline of the mid-expiratory flow (an airway obstruction surrogate), and time of braking (an end-inspiratory glottis closure surrogate). Respiratory frequency increased from 346 to 363 breaths/min, coinciding with a progressive decline of tidal volume and minute ventilation. Because rabbit responses to stressful situations are predominantly parasympathetic in nature, an increased parasympathetic tone during the first minutes of confinement might explain the initially augmented lung, airways and glottis resistances, and these, in turn, could be responsible for the low initial respiratory frequency. Subsequent changes of these variables probably reflect progressively lower level of stress due to adaptation to the new environment. This pattern did not change in the 5 days studied. Conclusions We concluded that respiratory parameters in rabbits display subtle changes during the first 90 min of movement restriction, probably driven by an initially augmented parasympathetic tone due to stress, with subsequent normalization as stress diminished due to adaptation to the new environment.
Micromorphology analysis and compare bond strength of two adhesives to different degrees of dental fluorosis
Authors: Liu Shuangfeng , Zhu Yanxia , Gegen Tana
Published: March 2020

Objectives: To evaluate the effects of two adhesives on the bond strength of different degrees of dental fluorosis (DF). Methods: Teeth which were indicated for extractions for orthodontic or periodontal problems were selected. 180 extracted teeth were selected with varying degrees of DF based on modified Dean's fluorosis index, including 60 teeth with mild fluorosis, 60 teeth with moderate fluorosis, and 60 teeth with severe fluorosis. The teeth in each group were randomly divided into 2 subgroups (n=30) that were subjected to the all-etching bonding system (Prime & Bond NT) and self-etching bonding system (SE-Bond). Each group of adhesives was used to bond Z350 universal resin (3M) to the etched dental enamel. Tensile and shear testing were used to determine the bond strength. After the tensile testing, the fractured specimens were examined under scanning electron microscopy (SEM) and laser scanning confocal microscope. (LSCM). Results: The Prime & Bond NT had statistically significant on tensile and shear strength for mild fluorosis enamel (P<0.05), but it had no significant difference for moderate and severe dental fluorosis (P>0.05). Self-etching bonding system (SE-Bond) had no statistical significance on the tensile and shear strength for mild, moderate and severe dental fluorosis (P>0.05). SEM and LSCM showed that the mild fluorosis enamel crystals were relatively dense and a small amount of resin remained. The moderate fluorosis enamel crystals were loosely arranged and the gaps were widened. The severe fluorosis enamel crystals were irregularly arranged. The disorder was aggravated, and the dentinal orifice exposed by partial enamel exfoliation can be seen. Conclusions: The bonding strength of mild fluorosis enamel to Prime & Bond NT was better than that of SE-Bond . And there is no difference in the bonding strength of SE-Bond to different degrees of DF.
Training leads to improved performance of Health Unit Management Committees in south western Uganda manuscript
Authors: Kyomuhangi Teddy , Manalili Kimberly , Kabakyenga Jerome , Maling Samuel , Muganga George , Brenner Jennifer Lynn
Published: March 2020

Background: A quality health workforce is critical for the development of health systems and effective delivery of health services. In southwestern Uganda, Health Unit Management Committees (HUMCs) are central to the delivery of health care. They also play a key role in facilitating links between health centres and the community, as they comprised of community members. While these teams took part in planning and management training between 2012-2015, no analysis had been done with regards to the outcomes of these training. This study sought, therefore, to determine whether HUMC members saw increased performance outcomes as a result of their training. Methods: The study followed a cross sectional evaluation design and adopted qualitative methods, including Focus Group Discussions (FGDs), Key Informant Interviews (KIIs) and In-Depth Interviews with health unit In-charges (managers), district health team members and project intervention staff. Evaluation was conducted in July 2016 in Bushenyi district in southwestern Uganda. Evaluation was completed in all levels of health care centers and in both urban and rural settings. Data was collected by members of the research team in both Runyankole and English, and translated into English. Results: Findings revealed that HUMCs reported to be more capable of handling issues at the facility as a result of knowledge and skills acquired during trainings. HUMCs identified several key learning themes, including: conflict resolution, strengthened relationships between members and increased community engagement. The training also resulted in several initiatives for increased health care outcomes, including saving schemes for emergency transportation of referrals, construction of placenta pit and canteen, and beautification projects. Overall there were positive feelings towards the training and its relevance for HUMCs’ job performance. Discussion: In examining the results of the study, conclusions can be drawn that training for HUMCs, which had been the first of their kind in this area, increased performance outcomes in health centers. This aligns with similar research, which identified management training for health care management teams as an important factor for improving the delivery of health services.
Molecular Characteristics and Antimicrobial Susceptibility Profile of Pseudomonas aeruginosa isolated from patients attending Healthcare Facilities in Mthatha, South Africa
Authors: Hosu Mojisola C. , Vasaikar Sandeep D. , Okuthe Grace E. , apalata teke
Published: March 2020

Background: Pseudomonas aeruginosa is a common pathogen causing healthcare-associated infections most especially in critically ill and immunocompromised patients. This pathogen poses a public health threat due to its innate resistance to many antimicrobial agents and its ability to acquire new resistance mechanisms under pressure. Infections with Extended spectrum β-lactamases (ESBL)‑producing isolates result into outbreaks that lead to serious antibiotic management concerns with higher mortality and morbidity and significant economic causatives. In this study, we evaluated the antimicrobial resistance patterns and characterized genetically the ESBLs and Metallo- β-lactamases (MBL) produced by this pathogen. Methods: Isolates of P. aeruginosa cultured from patients who attended Nelson Mandela Academic Hospital and other clinics in the four district municipalities of the Eastern Cape between August 2017 and May 2019 were identified; and their antibiotic resistance patterns were tested against amikacin, aztreonam, cefepime, ceftazidime, ciprofloxacin, doripenem, gentamicin, imipenem, levofloxacin, meropenem, piperacillin, piperacillin/tazobactam and tobramycin using the bioMérieux VITEK® 2 and confirmed by Beckman autoSCAN-4 System. Real-time PCR was done using Roche Light Cycler 2.0 to detect the presence of ESBLs; blaSHV, blaTEM and blaCTX-M genes; and MBLs; blaIMP, blaVIM. Results: High antibiotic resistance in decreasing order was observed in piperacillin (64.2%), aztreonam (57.8%), cefepime (51.5%), ceftazidime (51.0%), piperacillin/tazobactam (50.5%), and imipenem (46.6%). A total of 75 (36.8%) multidrug resistant (MDR) isolates were observed of the total pool of isolates. The blaTEM, blaSHV and blaCTX-M was detected in 79.3%, 69.5% and 31.7% isolates (n=82), respectively. The blaIMP was detected in 1.25% while no blaVIM was detected in any of the isolates tested. Conclusions: The study showed a high rate of MDR P. aeruginosa in our setting. The vast majority of these resistant isolates carried blaTEM and blaSHV genes. Continuous monitoring of antimicrobial resistance and strict compliance towards infection prevention and control practices are the best defence against spread of MDR P. aeruginosa.
Efficacy of Indirect Decompression in Lumbar Spinal Stenosis with Stand-alone Oblique Lateral Interbody Fusion
Authors: Liu Chen , Zhao Quanlai , Zhang Yu , Xiao Liang , Ge Xin , Xu Hongguang
Published: March 2020

Background Oblique lateral interbody fusion (OLIF) has been gained more and more attention in the treatment of degenerative lumbar disease. The goal of this study was to evaluate the effect of indirect decompression in lumbar spinal stenosis with stand-alone OLIF. Methods Sixty-three patients with lumbar spinal stenosis who underwent stand-alone OLIF between July 2017 and May 2018 our department were included. Clinical outcomes including visual analogue scale (VAS) and Oswestry Disability Index (ODI) were recorded. Radiographic outcomes comprising of disc height (DH), foraminal height (FH) and lumbar lordosis (LL) were measured. Intraoperative data and complications were collected. All the data were compared preoperatively and postoperatively. Results Eighty-two segments were fused in sixty-three patients using stand-alone OLIF. The average follow-up time was 21.9±3.5 months (range from 16 to 28 months). The DH increased from 0.9±0.3 cm preoperatively to 1.3±0.2 cm postoperatively, and the final follow-up was 1.1±0.2 cm (P < 0.01). The FH increased from 1.7±0.3 cm before surgery to 2.3±0.3 cm after surgery, but decreased to 2.1±0.3 cm at final follow-up (P < 0.01). The LL increased from 38.0°±15.6° before surgery to 42.7°±13.0° at the final follow-up (p<0.01). The VAS and ODI scores of all patients significantly improved at the final follow-up (p<0.01). The total complication rate was 30.2%. Only three patients received revision of posterior decompression and pedicle screw fixation. Conclusions Stand-alone OLIF is an effective option in selected patients with lumbar spinal stenosis.
Improving the energy conversion efficiency of a laser-driven flyer by an in-situ fabricated nano-absorption layer
Authors: Wang Liang , Yan Yichao , Ji Xiangbo , Zhang Wanli , Jiang Hongchuan , Qin Wenzhi , Wang Yao , Tang Duo
Published: March 2020

Three kinds of Al flyer plates with different nanostructured absorption layers were in-situ prepared by a direct laser writing technology to improve the energy conversion efficiency in a laser-driven flyer assembly. Microstructures, light absorption, flyer velocity in the acceleration chamber were investigated. The reflectance for the flyers at 1064 nm wavelength can be reduced from about 80% to 9.6% by the nanostructured absorption layer. The terminal velocity of a 50 μm thick Al flyer irradiated by a 60mJ laser pulse is 831 m/s, while the velocity of the flyer with an in-situ fabricated nano-absorption layer reaches up to 1113 m/s at the same condition. Resultantly, the energy conversion efficiency of the flyer with nanostructure absorption layer can reach as high as 1.99 times that of the Al flyer. Therefore, the nanostructured absorption layer in-situ prepared on the surface of a flyer provides a new method to significantly improve the energy conversion efficiency of a laser-driven flyer.
Correlates of mental health in occupations at risk for traumatization: A cross-sectional study
Authors: Schäfer Sarah K. , Sopp Marie Roxanne , Staginnus Marlene , Lass-Hennemann Johanna , Michael Tanja
Published: March 2020

Background Hospitals, police stations, and fire departments are highly demanding work places. Staff members are regularly exposed to various stressors including traumatic events. Correspondingly, several studies report high rates of mental health issues among these occupations. Nevertheless, despite these challenging circumstances, some staff members manage to sustain their mental health. The current study is the first to investigate correlates of mental health among three different highly demanding occupations. Methods The present cross-sectional survey investigated health-benefitting factors (sense of coherence – SOC, trait resilience, locus of control – LOC) and psychopathological symptoms (general mental health problems, posttraumatic stress, burnout) in medical staff ( n = 223), police officers ( n = 257), and firefighters ( n = 100). Results Among all occupations, SOC, trait resilience, and an internal LOC were negatively associated with general mental health problems, posttraumatic stress, and burnout symptoms. By contrast, all these outcome measures were positively correlated with an external LOC. Multiple regression models including all health-benefitting factors as predictors explained 56% of the variance in general mental health problems and 27% in posttraumatic stress symptoms. Among all occupations, SOC was the strongest predictor of both general mental health problems and posttraumatic stress symptoms. Multigroup path analyses revealed minor differences across occupations, mainly driven by a stronger influence of LOC in police officers. Conclusion Across all occupations, SOC was identified as the most important health-benefitting factor. Future longitudinal studies should further examine the causal link between health-benefitting factors and mental distress in different work places. Such studies will also allow for further development and evaluation of resilience promoting programs.
Prevalence and factors associated with severe depressive symptoms in older West African people living with HIV: the West Africa IeDEA collaboration
Authors: Bernard Charlotte , Font Hélène , Diallo Zélica , Ahonon Richard , Tine Judicaël Malick , Abouo Franklin N'guessan , Tanon Aristophane , Messou Eugène , Seydi Moussa , Dabis François , de Rekeneire Nathalie
Published: March 2020

Background To encourage successful aging, the psychological domain must not be neglected. As depression, one of the most common psychiatric disorders in PLHIV, has negative impact on both mental and physical health, the prevalence and the factors associated with the presence of severe depressive symptoms in older PLHIV living in West Africa need to be well understood. Methods Data from PLHIV aged ≥50 years old and on ART since ≥6 months were collected in three clinics (two in Côte d’Ivoire, one in Senegal) participating to the West Africa International epidemiological Databases to Evaluate AIDS (IeDEA) collaboration. The severity of the depressive symptoms was measured using the Center for Epidemiological Studies Depression scale (CES-D) and associated factors were identified using logistic regression. Results The median age of the 334 PLHIV included in the study was 56.7 (53.5-61.1) years old, 57.8% were female and 87.1% had an undetectable viral load. The prevalence of severe depressive symptoms was 17.9% [95% Confidence Interval: 13.8 - 22.0]. PLHIV with severe depressive symptoms were more likely to have no professional activity, and to be current or former tobacco smokers but were less likely to be overweight or obese. Conclusions The prevalence of severe depressive symptoms is high among older PLHIV living in West Africa. How to integrate the measurement and the management of depressive symptoms in the standard of care should be investigated, both for older PLHIV on ART but also for newly diagnosed older patients, in order to achieve the 90-90-90 objectives.
Decoding and Reasoning Mental States in Major Depression and Social Anxiety Disorder
Authors: Maleki Gheysar , Zabihzadeh Abbas , Richman Mara J. , Demetrovics Zsolt , Mohammadnejad Fatemeh
Published: March 2020

Background: Major depression (MDD) and social anxiety (SAD) disorders are debilitating psychiatric conditions characterized by disturbed interpersonal relationships. Despite these impairments in social interaction, little research has simultaneously evaluated the dysfunction in two aspects of theory of mind (ToM) in these disorders: Affective ToM or decoding mental states and cognitive ToM or reasoning mental states. Taking this into consideration, the current study attempts to compare both decoding and reasoning abilities in MDD, SAD, and healthy controls (HC). Methods: Subjects were 37 patients with MDD, 35 patients with SAD, and 35 HCs. ToM was measured with the Reading the Mind in the Eyes Test (RMET) and the Faux Pas Task, which assessed decoding skills and reasoning mental states, respectively. Results: Results showed that in decoding mental states, both the SAD and MDD groups achieved lower scores than HC group; moreover, there was no significant difference between SAD and MDD groups in decoding mental states. However, in reasoning mental states, SAD and HC groups had higher scores than the MDD group and no differences observed between SAD and HC groups in reasoning ability. Conclusions: Results of this study are discussed on generalized impairment in ToM or dysfunction in both decoding and reasoning mental states in MDD and only reasoning dysfunction in SAD.
Transcriptome analysis of heat stress and drought stress in pearl millet based on Pacbio full-length transcriptome sequencing
Authors: Sun Min , Zhang Ailing , Huang Dejun , Khan Imran , Yan Haidong , Wang Xiaoshan , Zhang Xinquan , Zhang Jian , Huang Linkai
Published: March 2020

Background: Heat and drought are the serious threats to crop growth and development. As the sixth cereal crop in the world, pearl millet can be used not only for food and forage but also as bioenergy. Pearl millet has high tolerance under heat and drought. Given this, it is considered as an ideal crop for plant stress tolerance studying and can be used to excavate heat-resistant genes. Results: In this study, we used Pacbio sequencing data as a reference sequence to analyze the Illumina data of pearl millet for 48 hours under heat and drought stress. By taking an overview of previous studies, we found 26,299 new genes and 63,090 new transcripts, and the number of gene annotations increased by 20.18%. We identified 2,792 transcription factors (TFs) and 1,223 transcriptional regulators (TRs). There were 318 TFs and 149 TRs differentially expressed under heat stress, and 315 TFs and 128 TRs were differentially expressed under drought stress. By RNA sequencing, we identified 6,920 genes and 6,484 genes differentially expressed under heat stress and drought stress, respectively. Comparing DEGs under heat tolerance with DEGs under drought stress, we found that even in the same pathway, pearl millet would choose a different protein response. Conclusions: This information will provide new insights to study pearl millet at molecular and genetic level to understand the mechanisms involved in drought and heat stress tolerance.
Integrated mRNA and miRNA expression profiling analyses of Pinus massoniana roots and shoots in response to phosphate deficiency
Authors: Fan Fuhua , Shang Xianwen , Ding Guijie , Zhou Zijing , Tan Jianhui
Published: March 2020

Background Masson pine ( Pinus massoniana ) is primarily present in subtropical and tropical areas of China, which are severely deficient in inorganic phosphate (Pi). Although some studies identified transcriptomic and proteomic responses to Pi deficiency in Masson pine seedlings, different tissues, especially the roots, that exhibit primary responses to low-Pi stress, have not been well studied. To shed further light on the complex responses of Masson pine to Pi deficiency, a spatiotemporal experiment was performed to identify differentially expressed mRNAs and miRNAs under Pi-deficient conditions. Results Spatiotemporal analyses of 72 RNA sequencing libraries provided a comprehensive overview of the dynamic responses of Masson pine to low-Pi stress. Differentially expressed gene analysis revealed several high-affinity phosphate transporters and nitrate transporters, reflecting the crosstalk between nitrate and Pi homeostasis in plants. The MYB family was the most abundant transcription factor family identified. miRNA differential expression analysis identified several families that were associated with Pi deficiency, such as miR399. In addition, some other families, including novel miRNA families in Masson pine, were dramatically changed in response to Pi starvation. GO and KEGG analyses of these mRNAs and targets of miRNAs indicated that metabolic processes were most enriched under Pi deficiency. Conclusions This study provided abundant spatiotemporal transcriptomic information to functionally dissect the response of Masson pine seedlings to Pi deficiency, which will aid in further elucidation of the biological regulatory mechanisms of pines in response to low-Pi stress.
Assessing Accuracy and Precision of 3D Augmented Reality Holographic models derived from DICOM data
Authors: Uribe Jesus , Vu Lan , Laguna Benjamin , Courtier Jesse
Published: March 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 the Microsoft HoloLens 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
Mining of Subtype Markers for the Prognosis of Ovarian Cancer based on Methylation Data
Authors: Yin Lili , Zhang Ningning , Yang Qing
Published: March 2020

Background: Ovarian cancer is one of three major malignancies involving the female reproductive system, and its morbidity and mortality are ranked number 3 and number 1 among gynecological tumors, respectively. DNA methylation (MET), as one of the main epigenetic modes, is closely related to the occurrence and development of ovarian cancer. To guide individualized treatment and improve the prognosis in ovarian cancer patients, it is of great significance to elucidate effective MET subtype markers.Methods: A total of 571 ovarian cancer MET samples were downloaded from the Cancer Genome Atlas (TCGA), and a COX proportional hazards model was established using the MET spectrum and clinically pathological parameters. Subsequently, the consensus clustering of CpG loci with a significant difference in both univariate and multivariate analyses was performed to screen the molecular subtypes, and these CpG loci were subjected to gene function annotation. Finally, CpG MET loci associated with poor prognosis in ovarian cancer patients were further screened by constructing a weighted gene co-expression network analysis (WGCNA).Results: A total of 250 prognosis-related MET loci were obtained by COX regression and 6 molecular subtypes were screened by clustering. There was a remarkable MET difference between most subtypes, of which Cluster 2 had the highest MET level and demonstrated the best prognosis in patients, while Cluster 4 and Cluster 5 had a MET level significantly lower than that of the other subtypes and demonstrated a very poor prognosis. All Cluster 5 samples were at a high grade, while the percentage of Stage IV samples in Cluster 4 was evidently greater than that in the other subtypes. Using the co-expression network, 5 CpG loci were eventually obtained: cg27625732, cg00431050, cg22197830, cg03152385, and cg22809047. The clustering analysis shows that the prognosis in patients with hypomethylation was significantly worse than that in patients with hypermethylation. Conclusions: These MET molecular subtypes can be used not only to evaluate the prognosis in ovarian cancer patients but also to fully distinguish the tumor stage and histological grade in these patients. Prognosis-related CpG loci can be applied as biomarkers for individualized treatment in ovarian cancer patients.
Computed Tomography Evaluation Of Normal Canine Abdominal Lymph Nodes: Retrospective Study Of Size And Morphology According To Body Weight And Age In 45 Dogs
Authors: Teodori Simone , Aste Giovanni , Tamburro Roberto , Labate Antonio Morselli , Simeoni Francesco , Vignoli Massimo
Published: March 2020

BackgroundThe morphological characteristics of the largest lymphatic vessels and lymph nodes of the body have been described through ultrasonography, although food and gas in the gastrointestinal tract can often have negative effects on the response of small abdominal structures. The aim of the study was to describe the size of normal abdominal lymph nodes (ALs) in dogs affected by disease, not including lymphadenomegaly or lymphadenopathy, and divided according to body weight and age. The ALs studied included the jejunal, medial iliac, portal, gastric, splenic, and pancreaticoduodenal lymph nodes.ResultsMultiple statistical analyses among the three groups showed that all measurements of the ALs increased according to body weight changes (P <0.05). The most reliable values were the volume measurements (P <0.001) compared to the length, thickness and width. A single analysis between just two groups showed different values (P>0.1). Mixed results emerged from a comparison of weight categories and age; only the jejunal lymph nodes showed a possible correlation (P<0.1). Other characteristics (shape, attenuation and enhancement) are subsequently reported.Conclusions and Clinical RelevanceThe resulting data can be used to categorize CT measurements of normal ALs displayed based on the body weight and age of the subjects. This study was able to detect an objective parameter of normalcy that can serve as a reference for the evaluation of infectious or neoplastic events.
Investigation on Urinary and Serum Alpha Klotho in Dogs with Chronic Kidney Disease
Authors: Yi Hong jae , Lee Jong bok , Lee Kyu pil , Song Kun ho , Seo Kyoung won
Published: March 2020

Background: As a co-receptor for fibroblast growth factor 23, klotho plays a pivotal role in phos-phate metabolism. The kidney is known to be not only the main source of soluble alpha-klotho but also functions as the principal regulator maintaining its concentration. Previous studies in human par-ticipants showed that the concentration of soluble alpha-klotho in serum and urine decreased in chronic kidney disease (CKD) patients. However, no previous study has assessed soluble alpha-klotho levels in dogs. This study aimed to measure serum and urinary alpha-klotho levels in CKD dogs and identify their associations with International Renal Interest Society (IRIS) CKD stages and other parameters known to be associated with CKD.Methods: Serum and urinary alpha klotho concentrations were measured by a commercially avail-able canine-specific sandwich enzyme-linked immunosorbent assay kit and compared between groups by a nonparametric Kruskal–Wallis test. Spearman’s correlation coefficient was used to eval-uate the relationships between variables. A stepwise multiple regression analysis was performed to estimate the effects of independent predictors on klotho concentrations.Results: The urine klotho-to-creatinine ratio (UrKl/Cr) was significantly lower in stage 3 dogs than the control group and was significantly lower in dogs with stage 3 and 4 CKD than in those with stage 1 and 2 disease. UrKl/Cr was negatively correlated with serum symmetric dimethylarginine (sSDMA), blood urea nitrogen (BUN), creatinine, and phosphorus concentration. Serum alpha-klotho concentration in dogs with stages 2 and 3 CKD were significantly lower than those in the control group. There was no significant correlation between serum alpha-klotho and BUN, creatinine, and phosphorus concentrations. No statistically significant differences were observed in UrKl/Cr and se-rum alpha-klotho concentration between groups based on sex, age, urine protein-to-creatinine ratio (UPC), or blood pressure.Conclusions: UrKl/Cr decreased in dogs with advanced CKD, and it was negatively correlated with sSDMA, BUN, creatinine, and phosphorus concentrations. Thus, klotho may play a role in the path-ogenesis of CKD and its clinical consequences, including CKD-mineral bone disorder, in dogs. Alt-hough serum klotho concentration was negatively correlated with sSDMA levels, it was not appar-ently related to IRIS CKD stage or other parameters known to be associated with CKD.
Two-stage revision total knee arthroplasty with antibiotic-impregnated hydroxyapatite
Authors: Hasegawa Masahiro , Tone Shine , Naito Yohei , Wakabayashi Hiroki , Sudo Akihiro
Published: March 2020

Background: Antibiotic-impregnated hydroxyapatite (HA) has been used as a new drug delivery system for the treatment of periprosthetic joint infection (PJI) of the knee. The aim of this study was to evaluate the clinical results of this treatment in patients with PJI. Methods: Fourteen consecutive cases of PJI of the knee who were scheduled to undergo two-stage knee revision were enrolled. In the first stage, all components were removed with thorough debridement, and antibiotic-impregnated HA was inserted in the bone and joint space. In the second stage, revision total knee arthroplasty (TKA) was performed after eradication of infection. The mean period from removal of all components and treatment with antibiotic-impregnated HA to revision TKA was 3.4 months. Clinical and radiographic evaluations were performed after a mean follow-up of 5.1 years following revision TKA. Predictors of reinfection were evaluated. Results: Eleven patients had no recurrent infection, whereas 3 patients showed recurrent infection. No knees had osteolysis or loosening after revision TKA. The present study demonstrated no predictors for reinfection. Conclusion: Antibiotic-impregnated HA could be effective for the treatment of infected knee arthroplasty.
Added value of Contrast Enhanced Mammography (CEM) in staging of malignant breast lesions – a feasibility study
Authors: Åhsberg Kristina , Gardfjell Anna , Nimeus Emma , Rasmussen Rogvi , Behmer Catharina , Zackrisson Sophia , Ryden Lisa
Published: March 2020

Objectives: The aim of this feasibility study was to evaluate the added value of contrast enhanced mammography (CEM) in preoperative staging of malignant breast lesions, beyond standard assessment with digital mammography and ultrasound, as a base for a future prospective randomized trial. Materials and methods: Fifty patients, with confirmed or strongly suspected malignant breast lesions after standard assessment (digital mammography (DM) and ultrasound (US)), scheduled for primary surgery, were invited to undergo CEM as an additional preoperative procedure. The primary endpoint was change in treatment plan defined as mastectomy instead of partial mastectomy or contrariwise, bilateral surgery instead of unilateral or neoadjuvant treatment instead of primary surgery. Accuracy in tumour extent estimation compared to histopathology was evaluated by Bland Altman statistics. Number of extra biopsies and adverse events were recorded. Results: The study cohort consisted of 47 patients. In 10/47 (21%), findings from CEM affected the treatment plan. Agreement with histopathology regarding extent estimation was better for CEM (mean difference -1.36, SD +/- 18.45) in comparison with DM (-4.18, SD +/- 26.20) and US (-8.36, SD +/- 24.30). Additional biopsies were taken from 19 lesions in 13 patients. Nine biopsies showed malignant outcome. No major adverse events occurred.Conclusion: Feasibility of preoperative additional CEM was found to be excellent without any serious negative effects. Results imply an added value of CEM in preoperative staging of breast cancer. Further evaluation in larger prospective randomized trials is needed.
FDNC5/Irisin improves the therapeutic efficacy of bone marrow-derived mesenchymal stem cells for myocardial infarction
Authors: Deng Jingyu , Zhang Ning , Wang Yong , Yang Chao , Xin Chao , Zhao Jinming , Jin Zhitao , Cao Feng , Zhang Zheng
Published: March 2020

Background The beneficial functions of bone marrow mesenchymal stem cells (BM-MSCs) decline with decreased cells survival, limiting their therapeutic efficacy for myocardial infarction (MI). Irisin, a novel myokine which is cleaved from its precursor fibronectin type III domain-containing protein 5 (FNDC5), is believed involved in a cardioprotective effect but little was known on injured BM-MSCs and MI repair yet. Here, we investigated whether FNDC5 or irisin could improve the low viability of transplanted BM-MSCs and increase their therapeutic efficacy after MI. Methods BM-MSCs, isolated from dual-reporter firefly luciferase and enhanced green fluorescent protein positive (Fluc + –eGFP + ) transgenic mice, were exposed to normoxic condition and hypoxic stress for 12 h, 24 h, and 48 h, respectively. In addition, BM-MSCs were treated with irisin (20 nmol/L) and FNDC5 +/+ in serum deprivation (H/SD) injury. Furthermore, BM-MSCs were engrafted into infarcted hearts with or without FNDC5 +/+ . Results Hypoxic stress contributed to increased apoptosis, decreased cells viability and paracrine effects of BM-MSCs while irisin or FNDC5 +/+ alleviated these injuries. Longitudinal in vivo bioluminescence imaging illustrated that MSCs FNDC5+/+ treatment improved the survival of transplanted MSCs, which ameliorated the increased apoptosis and decreased angiogenesis of BM-MSCs in vivo . Furthermore, MSCs FNDC5+/+ therapy significantly reduced fibrosis and alleviated injured heart function. Conclusions The present study indicated that irisin or FNDC5 improved BM-MSCs engraftment and paracrine effects in infarcted hearts, which might provide a potential therapeutic target for MI.
Less Pathological Axillary Involvement is Observed in Breast Cancer Patients with Autoimmune Thyroid Disease
Authors: YALÇIN SELİM , Cosar Ramazan , Güngünes Askın , Cifci Aydın , Durmaz Senay Arikan
Published: March 2020

Background: Autoimmune thyroid disease is more frequently observed in breast cancer patients. There are not enough studies showing the prognostic significance of this association in terms of breast cancer. The aim of this study was to determine the breast cancer molecular subgroup frequency and to examine the relationship between autoimmune thyroid disease and the breast cancer in terms of prognosis and predictive factors. Methods: One hundred and one patients have been included to study. They have been divided into subgroups according to molecular classification. The patients with high serum anti-thyroid peroxidase levels were considered positive for autoimmune thyroid disease. Prognostic and predictive parameters [tumor stage, tumor size, axillary lymph node involvement, histologic grade, lymphovascular , perineural invasion, hormone receptor status, HER2 (Human Epidermal Growth Receptor 2) over expression] were compared between breast cancer patients with autoimmune thyroid disease and those patients without autoimmune thyroid disease. Results: The prevalence of thyroid autoimmunity was 23.8% (n = 24) in breast cancer patients. The axillary lymph node involvement in autoimmune thyroid disease positive breast cancer patients was lower than autoimmune thyroid disease negative patients (37.5% versus 61% respectively, p = 0.043). There were no significant differences between the two groups in terms of other prognostic parameters. More importantly, there was a significantly negative correlation between anti thyroid peroxidase levels and axillary lymph node involvement in patients (r= -0.245, p=0.014). Conclusion: Positive axillary lymph nodes, have been found to be lower in breast cancer patients accompanied by autoimmune thyroid disease. This result supports the view that thyroid autoimmunity is a positive prognostic factor in terms of breast cancer. The mechanism through which it is effective should be examined in new studies. Trial registration: A written approval was granted by the Kirikkale University, Faculty of Medicine, Clinical Research Ethics Committee through the 01/09 Numbered and 19.01.2016 Dated Decision in order to conduct this study. Keywords: Thyroid autoimmune, breast cancer, prognostic factors
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: March 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. Imaging studies showed a slightly lower density lesion in the liver with high fluorodeoxyglucose uptake. 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.
Why does Mycophenolate use only for kidney complications in Schonlein Henoch Syndrome? Case report
Authors: Gicchino Maria Francesca , Iafusco Dario , Marrapodi Maria Maddalena , Melone Rosa , Cuomo Giovanna , Zanfardino Angela , Giudice Emanuele Miraglia del , Olivieri Alma Nunzia
Published: March 2020

Background : Henoch Schonlein purpura (HSP) is an acute small vessel vasculitis. It is the most common vasculitis in children. Although the cause is unknown, IgA seems to play a central role in the pathogenesis of Henoch Schonlein purpura. The major clinical features include a palpable purpuric rash on the lower extremities, abdominal pain or renal involvement, and arthritis. Cutaneous manifestations are the essential elements in the diagnosis of Henoch Schonlein purpura. The palpable purpura is characteristically 2 to 10mm in diameter and is usually present on the lower extremities. There are no specific diagnostic tests available for diagnosing this condition. Laboratory studies are useful to exclude other conditions that may mimic Henoch Schonlein purpura. In majority of the cases, the disease is self-limited. Relapsing can occur, in particular during the first year of the disease. There is no consensus on a specific treatment. Corticosteroids are effective in rapid resolution of renal and abdominal manifestations. Immunosuppressive drugs, such as Mycophenolate Mofetil may be a better treatment choice in case of renal involvement.Case report : We report a case of a 14 years old girl affected from recurrent Henoch Schonlein Purpura. From the age of nine years patient presented three episodes of purpura with gastrointestinal involvement, in particular hematemesis, abdominal pain and diarrhoea. Each episode was treated with high doses of corticosteroids (methylprednisolone in vein or prednisone per os). Patient came to our Department during the third episode of Purpura. In consideration of the recurrence of the Henoch Schonlein Purpura and the gastrointestinal involvement we decided to start Mycophenolate Mofetil treatment. Patient’s conditions improved thanks to Mycophenolate Mofetil treatment. Conclusion: In our case of recurrent HSP Mycophenolate Mofetil treatment has been very effective, avoiding the adverse events of a prolonged steroid treatment. This experience teaches us that immunosuppressive agents may be very useful to induce and maintain remission not only in renal involvement, but in all cases of persistence, recurrence or complicated forms of Henoch Schonlein purpura in children.
Statistical Joint Modeling of Longitudinal CD4 Cell variation and Time-to-Lost Follow-up from ART Predictors on HIV/AIDS Patients: A case of Mekelle General Hospital
Authors: Gebrerufael Gebru Gebremeskel
Published: March 2020

Back ground: Time-to-lost follow-up and CD4 cell variation measures are the outcome variables of infection in HIV/AIDS patients after starting ART in this study. The time-to-lost follow-up from ART was determined by month time interval among dates of ART commencement to drop-out, as documented by the health information data administrator. The main goal of this study was to identify association of CD4 cell variation measurements on time-to-lost follow-up and main predictors of HIV/AIDS positive patients.Methods: Institution based retrospective cohort study design was used among 216 HIV/AIDS patients under ART follow-up from period September 11, 2013 to September 5, 2016 at Mekelle General Hospital, Ethiopia and employed both survival and longitudinal outcome to fit separate and statistical joint modeling approach.Results: A total of 216 HIV/AIDS patients were selected using systematic random sampling technique to analyze the longitudinal and survival outcome using joint model study. The result of this study showed that relationship between CD4 cell variation on hazard of time-to-lost follow-up was negatively statistical significant. Thus, time-to-lost follow-up from ART is less probable to occur in HIV/AIDS patients which have higher CD4 cell evolution. In survival sub-model Baseline CD4, sex of male, living in rural and comorbidity HIV/TB were significant factors of risk to time-to-lost follow-up from ART of HIV/AIDS patients. The longitudinal sub-model shows Baseline CD4 cell and being bedridden were significant factors of variation at 5% significance levels.Conclusions: The author assessed relationship of repeated measured CD4 cell variation on hazard of time-to-lost follow-up was negatively statistical significant and performance of both separate and statistical joint sub-models in terms model parsimony, smaller AIC & smaller standard error in statistical joint model performs. Thus, the author concluded that statistical joint model was preferred for simultaneous analyses of repeated biomarker CD4 cell and survival time-to-lost follow-up data.