bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of a natural plant ingredient — Pulsatilla saponin B4 on clinical mastitis and serum inflammatory indices in dairy cows
Authors: Shen Liuhong , Qian Bolin , Lv Shangkui , You Liuchao , Zhang Yue , Shen Yu , Xiao Jinbang , Su Zhetong , Dong Ke , Zong Xiaolan , Yu Shumin , Cao Suizhong , Yang Shilin , Feng Yulin
Published: August 2020

Background

To investigate the effect of Pulsatilla saponin B4, a purified extract form Pulsatilla Chinensis, on the treatment of clinical mastitis in dairy cows, 12 healthy cows were used as the control group (group A, no treatment), and 36 cows with mastitis were divided into 3 groups based on the quaque die (QD) intramuscular injection (IM) dose used in the as follows, group B (15 mL), group C (30 mL), group D (60 mL). Identified the microorganisms in milk during the experiment,samples in test groups were cultured, isolated, and verified by quantitative real-time polymerase chain reaction (qPCR). Somatic cell count (SCC) and serum inflammatory indices in cows were measured with a 1-day interval in group C and compared with group A.
Results

Results showed that bacterial detection rates were 100% (group B), 83.33% (group C) and 100% (group D). After the treatment bacterial detection rates dropped to 50.00% (group B), 50.00% (group C), and 41.67% (group D). The medicine was effective in all test groups and showed a dose-effect relationship. Serum haptoglobin (HP), prostaglandin E2 (PGE2), interleukin-1 alpha (IL-1α), interleukin-1 beta (IL-1β), interleukin-2 (IL-2), interleukin-8 (IL-8), interleukin-10 (IL-10) and tumour necrosis factor alpha (TNF-α), interleukin-4 (IL-4), leukotriene B4 (LTB4) also the SCC were significantly higher than healthy cows (P < 0.05) on the day (d) 1 in group C but had no significant difference with group A after treatment.
Conclusion

Treatment with Pulsatilla saponin B4 relieved mastitis, leading to relieve of bacterial infection, SCC and levels of serum inflammatory factors effectively in cows with mastitis after being administered for 4–6 days QD.
Practical lineshape of a laser operating near an exceptional point
Authors: An Kyungwon , Kim Jinuk , Kim Juman , Seo Jisung , Park Kyu-Won , Songky Moon
Published: August 2020

We present a practical laser linewidth broadening phenomenon in the viewpoint of high sensitivity of an exceptional point (EP). A stochastic simulation model is implemented to describe the fluctuations in the cavity resonance frequencies. The linewidth originated from external noises are maximized at the EP. The linewidth enhancement factor behaves similarly to the Petermann factor although the Petermann effect is not considered. In the long coherence time limit, the power spectral density of the laser exhibits a splitting in the vicinity of the EP although the cavity eigenfrequencies coalesce at the EP.
Linking Technology to Address the Social and Medical Determinants of Health for Safer Use of Medicines
Authors: Woosley Raymond Leon , Simmons June , Sefilyan Ester M. , Atkins Sandra K. , Black Kristin , Read William A.
Published: August 2020

Background: Both medical and social issues can negatively affect health outcomes, especially for vulnerable populations. Assessing risk from these two perspectives independently, two non-profit organizations each developed a decision support program to identify medication-risk that could negatively impact health outcomes. This raises the question, could a combined program have greater potential for improved outcomes.Methods: HomeMeds℠ (HM), a social health program in which trained social services staff make home visits to vulnerable clients, was combined with MedSafety Scan (MSS), a medical health, clinical decision support tool. Data captured in the home visit were entered into the HM and MSS programs to analyze each patient’s drug risk profile and their list of medicines to detect those patients at greatest risk of adverse health outcomes caused by medications. Results: One hundred and eight patients (mean age 77 with multiple co-morbidities and LACE+ score >29) received a post-discharge home visit by trained social services staff. The number of drugs reported as being taken was 10.4 ± 5.1 (range 1-26) which was less than prescribed at discharge in 62% of patients (range 1-8). Both programs detected serious risk of medication-induced harm, mostly from different causes. HomeMeds detected medically relevant events such as unreported falls (24), dizziness (37), confusion (27) and uncontrolled pain (37). MedSafety Scan identified 22 patients with moderate to very high risk of cardiac arrhythmia due to their medicines. In 65% of patients, an average of 6.2 ± 5.6 potentially serious drug interactions were detected by MedSafety Scan but not HomeMeds.Conclusions: Combined analyses of data from these two decision support programs that approach health issues and patient needs from different perspectives yielded complementary findings that address both medical and social determinants of health after hospital discharge. These have the potential to reduce medication-induced harm, costly re-hospitalization and/or emergency room visits. The results of this quality improvement project are encouraging and support the further evaluation of this combined approach in other vulnerable populations such as the seriously mentally ill, frail, those confined to home, opiate-dependent or otherwise impaired.
Wild Edible Fruits of Arunachal Pradesh, India: Ethno-Medicinal Uses, Socio Economic Importance and Role in Rural Economy and Livelihood Security
Authors: Hazarika Tridip , Tayeng Basik
Published: August 2020

The authors have withdrawn this preprint due to erroneous posting.
Development of PREPARE (PREdicting PAtients’ Long-Term Outcome for REcovery): A Practically Usable Prediction Model for Quality of Life of ICU Survivors
Authors: Wubben Nina , Boogaard Mark van den , Ramjith Jordache , Bisschops Laurens LA , Frenzel Tim , Hoeven Johannes G van der , Zegers Marieke
Published: August 2020

The authors have withdrawn this preprint due to erroneous posting.
Effect of Intensive Care Provided by Nurse Practitioners for Postoperative Patients: A Retrospective Observational Before-and-after Study
Authors: Mori Kazunao , Makino Satoshi , Takabayashi Takuya , Kurosawa Masahiro , Ohashi Wataru , Tsukamoto Yoko , Okumura Masatoshi , Fujita Yoshihito , Fujiwara Yoshihiro
Published: August 2020

Background Since April 2016, nurse practitioners (NPs) have provided inter-professional team collaborative care for postoperative patients in our intensive care unit (ICU). To assess the effectiveness of NP practice, we compared patient outcomes with and without NP care in our ICU. Methods This retrospective observational cohort study was undertaken at Aichi Medical University Hospital in Japan from 01 April 2015 and 31 March 2017. Mechanically-ventilated postoperative patients who stayed in the ICU for >2 days were eligible for inclusion. We compared the patient outcomes between the period without NP care from April 2015 to March 2016 (physician group) and the period with NP care from April 2016 to May 2017 (NP-physician group). The primary outcome was ICU length of stay. Secondary outcomes were mechanical ventilation days and total hospital length of stay. To further determine the factors associated with ICU length of stay, multiple regression analysis was performed for age, Acute Physiology and Chronic Health Evaluation (APACHE) II score, NP-physician group, and physician group. Results A total of 387 patients were included in the study. Among these patients, 213 were assigned to the NP-physician group and 174 were assigned to the physician group. The NP-physician group had shorter ICU length of stay than the physician group (4.8 ± 4.8 days versus 6.7 ± 10.3 days, p < 0.021). There were no significant differences between the two groups in mechanical ventilation days or total hospital length of stay. In the multiple regression analysis for ICU length of stay, APACHE II score and NP-physician group were associated with ICU length of stay. Specifically, NP-physician group reduced ICU length of stay by 2.6 days ( p = 0.003), and APACHE II score one-point decrease reduced ICU length of stay by 0.2 days ( p = 0.012). Conclusions The present study demonstrated shorter ICU length of stay in patients with NP care and a significant association between NP participation in the ICU team and ICU length of stay.
Intraoperative Fluid Overload Predicted Postoperative Debridement in Major Sacrum Tumor Resection: A Retrospective Case-control Study
Authors: Zhao Hong , Song Yingchao , Dong Sen , Feng Yi
Published: August 2020

Background Sacrum tumor resection is with high morbidity due to complex anatomy, sacral nerves involvement, massive bleeding and tumor malignancy. Risk factors related with complications following sacrectomy were not clearly defined.Method Anesthetic database of Peking University People’s Hospital, Beijing, China was searched for all patients (aged 14-70 years of age) received sacrum tumor surgery from 2014 to 2017. As part of the bleeding control program, intra-aortic balloon occlusion (IABO) was applied to patients whose tumor volume was more than 200 cm3, a tumor that had invaded cephalad to the S2-S3 disc space, or tumor with an abundant blood supply. Results Finally 355 patients who underwent sacrectomy were included in this study, among whom 278 patients received intraoperative IABO, whose duration of aortic occlusion was 72±33 min. Extensive hemorrhage (>2000 ml) occurred in 61(21.9%) patients receiving IABO. Fifty-six patients in IABO Group required postoperative debridement due to wound infection. The independent risk factor identified by logistic regression was fluid excess (calculated as volume infused (crystalloid, colloid, CRC and FFP), minus blood loss and urine output, divided by body weight (kg)), and decision tree analysis found that the cut-off point for fluid excess was 38.5 ml/kg. Then propensity score matching of intraoperative blood loss and aortic occlusion duration was adopted for patients whose fluid excess >38.5 ml/kg and those whose was lower or equal. Afterwards, 91 pairs of patients were generated. Fluid excess was significantly different (46 vs. 30 ml/kg, P=0.000) for patients whose fluid excess was >38.5 ml/kg, and required more postoperative debridement (24 (26.3%) vs. 12 (13.1%), P=0.000) than those whose was lower or equal. Conclusion In this retrospective cohort study about sacrum tumor resection, duration of aortic occlusion and anesthesia were identified as predictors for massive bleeding. Fluid overload was related with high morbidity and studies are needed to further improve clinical prognosis.
Prediction of Subclinical Chorioamnionitis After Cervical Cerclage
Authors: Li Li , PAN MIAN , Yan Jianying , Huang Xinxin , Qiu Liyin , Ma Mei , Zhang Jun
Published: August 2020

Objective: To explore non-invasive indices for predicting subclinical chorioamnionitis following cervical cerclage. Methods: We performed a retrospective analysis of 80 singleton pregnant women who underwent cervical cerclage surgery in our hospital. Eighty patients were divided into either a histological chorioamnionitis group (n=57) and non-histological chorioamnionitis group (n=23). Gestational age before cervical cerclage, cervical dilation size, vaginal microbiota, cervical microbial colonization, and inflammatory indicators related to peripheral blood cells (white blood cell count, neutrophil count, lymphocyte count, platelet count, CRP, neutrophil/lymphocyte ratio, platelet/white blood cell ratio, etc.) at pre-surgery time and onset of labor post-surgery were compared, and an independent sample t-test and multivariate logistic regression analysis were performed to study the risk factors associated with histological chorioamnionitis. Histological chorioamnionitis was used as the outcome variable, and receiver operating characteristic (ROC) curve analysis was performed to determine the cut-off value and evaluate the predictive value of these indicators for chorioamnionitis. Results: 1) Single-factor logistics analysis showed that the preoperative number of platelets, indicators related to peripheral blood cells during onset of labor post-surgery（the total number of leukocytes，neutrophils，platelets， platelet/white blood cell ratio） , the area under the curve of each indice was all statistically significant. Their cut-off values ​​were 229.5×109/L; 10.245×109/L; 9.86×109/L; 240.5×109/L; 1.022 respectively. 2) Additional multivariate logistic regression analysis was performed. Preoperative number of platelets, the number of white blood cells and platelet/white blood cell ratio during onset of labor were identified as significant variables. 3) The statistically significant variables (preoperative platelets, white blood cells and platelet/white blood cell during onset of labor) obtained from multi-factor analysis were grouped according to the cut-off value. A joint screening system was established that specified that two or more indicators are positive as joint screening, with a screening sensitivity of 87.5%, and specificity of 45.5%. Conclusions: After cervical cerclage, the number of white blood cells and the ratio of platelet/white blood cell during onset of labor combined with preoperative number of platelets have predictive value for potential histological chorioamnionitis in pregnant women with cervical cerclage.
13 year old Female with Progressive Pseudorheumatoid Dysplasia misdiagnosed as Juvenile idiopathic arthritis
Authors: Omar Anjumanara Anver , Ahmed Salman , Rodrigues John Chris , Owino Lawrence
Published: August 2020

Background: Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in childhood and is of unknown aetiology. Progressive pseudorheumotoid dysplasia is a rare, autosomal recessively inherited, non-inflammatory musculoskeletal disorder caused by mutations occurring in the WISP3 gene. Joint cartilage is the primary site of involvement, leading to arthralgia, joint stiffness, contractures, enlargement of the epiphyses and metaphysis of the hand joints, spinal abnormalities, short stature, early osteoarthritis, and osteoporosis. The clinical features resemble juvenile idiopathic arthritis (JIA), and patients with PPD are usually misdiagnosed as JIA.Case Presentation: A 13 year old female presented to the rheumatology clinic with history of joint pains, bone pains and bone deformity for 5 years. Weight and Height were below the 3rd centiles. There was none tender swelling of metacarpophalangeal and interphalangeal joints and with scoliosis. Radiographs of the hands revealed widening of the epiphyses. With these findings Progressive Pseudorhematoid Dysplasia was suspected and genetic testing for WISP1, WISP2 and WISP3 was requested. A homozygous, likely pathogenic, variant was identified in WISP3 gene which confirmed our diagnosis.Conclusion: Progressive Pseudorhematoid Dysplasia is a rare form of spondylo-epi-metaphyseal dysplasia and clinically misdiagnosed as Juvenile Idiopathic arthritis. It’s important to consider PPD especially in patients with normal inflammatory markers who are being followed up for arthritis and not improving on anti-rheumatic intervention.
Focal Maculopathy in the Senile Cataract Population
Authors: Zhang Mei , Yuan Kun , Liu Jingwen , Zheng Haoran
Published: August 2020

Objective: Optical Coherence tomography (OCT) was employed to screen for maculopathy in the senile cataract population, investigate its incidence, and establish a healthy mode of management for maculopathy.Methods: A visual examination, slit-lamp microscope examination, direct ophthalmoscopic fundus examination, and a macular OCT examination were performed on 102 people with senile cataracts who were over 60 years in our hospital from January 1, 2019, to July 31, 2019. The demographic characteristics such as sex, age, physical examination mode: organization/individual, and routine physical examination items: presence or absence of hypertension, body mass index (BMI), blood biochemistry, total cholesterol, triglyceride (TG), fasting blood glucose and others.Results: Of the 102 subjects in the study, 28 were positive for maculopathy according to the OCT examination. Univariate analysis found that there were statistical differences between sexes and the presence of maculopathy (p<0.05). There were no significant differences in age, visual acuity, hypertension, BMI, fasting blood glucose, TG, total cholesterol, and cataract type (P>0.05). Multivariate logistic regression analysis, including all factors that might affect maculopathy, indicated that positivity for maculopathy and age (OR =2.549, 95%CI: 1.129–5.756, p<0.05) and gender (OR=3.907, 95%CI: 1.241–12.302, p<0.05) were related.Conclusion: The incidence of maculopathy in the senile cataract population was higher than that in the elderly population without cataract disease, and the proportion is 27.45%. Screening for maculopathy in the senile cataract population, especially among the elderly and females, should be improved.
CSF FAM3C- a possible biomarker of Alzheimer’s disease
Authors: Bian Chunmei , Li Wei , Wang Liping , Long Zhenzhen , Xue Ping , Guan Siming
Published: August 2020

Backgrounnd: The impact of Alzheimer's disease (AD) on the living quality and life expectancy has becoming increasingly severe, but the pathogenesis of AD is still being studied .This study aimed to investigate whether Family with sequence similarity 3 member C (FAM3C), which has been reported to be possibly associated with cognitive function, was associated with the incidence of AD.Methods: A total of 282 participants from Alzheimer’s Disease Neuroimaging Initiative (ADNI) were included. The demographic data, cerebrospinal fluid (CSF) FAM3C content, neuropsychological scores, CSF amyloid protein level, CSF tau protein level, and imaged data were collected. One-way analysis of variance and chi-square test were used to compare demographic data, neuropsychological test scores, CSF protein levels, and imaging data of three groups. Partial correlation analysis and multiple linear regression analysis were used to investigate the relationship between FAM3C and AD diagnostic indicators in different dimensions. An ordered multi-classification logistic regression model was established to determine whether FAM3C is related to the onset of AD. Results: Lower levels of FAM3C were observed in AD and mild cognitive impairment (MCI) groups. CSF FAM3C level was related to whole-brain atrophy and temporal lobe atrophy, worse cognitive performance, decreased amyloid β 1-42 (Aβ1-42), and lower regional cerebral glucose metabolism. Conclusion: CSF FAM3C might be a potential diagnostic biomarker of AD. Further study on concrete mechanisms may contribute to early diagnosis and treatment of AD.
RNA-Seq profiling revealed PBMC RNA as potential biomarker for hepatocellular carcinoma
Authors: Han Zhiyi , Feng Wenxing , Hu Rui , Ge Qinyu , Ma Wenfeng , Zhang Wei , Xu Shaomin , Zhan Bolin , Zhang Lai , Sun Xinfeng , Zhou Xiaozhou
Published: August 2020

Background

Hepatocellular carcinoma is one of the most common malignancies with extremely high incidence and mortality rates. Although there have been many studies focus on biomarkers study, few have been reported on PBMC RNA profiles of hepatocellular carcinoma.
Methods

In this study, we attempted to profile the expression of Peripheral Blood Mononuclear Cells (PBMCs) RNA by using RNA-seq technology and compared the transcriptome between hepatocellular carcinoma patients and the healthy controls. 17 patients and 17 healthy controls involved in this study, PBMCs RNA were sequenced. The sequencing data were analyzed with bioinformatics tools and qRT-PCR was used for selected differential expressed gene validation.
Results

It is showed that 1578 dysregulated genes found including 1334 upregulated genes and 244 downregulated genes. GO enrichment and KEGG analysis denoted most of the differential expressed genes (DEGs) involved in immune response are closely related to hepatocellular carcinoma. Expression of the 6 selected genes (DEGs, SELENBP1, SLC4A1, SLC26A8, HSPA8P4, CALM1, and RPL7p24) were confirmed by qRT-PCR, and higher sensitivity and specificity obtained by ROC analysis of the 6 genes. CALM1 was found gradually decreasing along with the tumor enlarged.
Conclusions

It is suggested potential biomarker for diagnosis, classification and therapeutic target of hepatocellular carcinomas. This study provided new visions into development of liver cancer and potential efficient clinical diagnosis in the future.
Association of Immunohistochemical Markers of Tumor Subtype with Response to Neoadjuvant Chemotherapy and Survival in Patients with Muscle-Invasive Bladder Cancer
Authors: Razzaghdoust Abolfazl , Ghajari Mahdi , Torbati Peyman Mohammadi , Jafari Anya , Salahi Maryam , Mofid Bahram , Basiri Abbas
Published: August 2020

Background: Clinical application of a readily accessible biomarker for identification of bladder cancer patients most likely to respond to neoadjuvant chemotherapy (NAC) could help clinicians avoid unnecessary chemotherapy and prevent its subsequent complications in patients unlikely to drive clinical benefit. The primary objective of this study was to investigate the association of immunohistochemical markers of tumor subtype with response to NAC and survival of muscle-invasive bladder cancer (MIBC) patients. Methods: MIBC patients treated with NAC in two tertiary referral hospitals were retrospectively included in the study. The tissue microarrays (TMAs) were assembled from transurethral resection of bladder tumor (TURBT) specimens and immunohistochemistry (IHC) was performed on the TMA slides. The association of independent variables, including singular IHC markers, combined IHC markers, and clinical covariates with clinical complete response (CR) to NAC, and overall survival (OS) was assessed using logistic regression and Cox proportional hazard regression analysis, respectively. Kaplan-Meier curves were plotted for different IHC-based subtypes. Results: Data from 140 MIBC patients treated with NAC were retrospectively reviewed. A total of 63 patients with available TURBT specimen were eligible to be included in the analysis. Our results showed that the IHC signature of KRT5/6(+)/KRT20(-), as a combined marker of basal subtype, was the only covariate significantly associated with the CR to NAC (p = 0.037). After a median follow-up of 41 (range, 12-76) months, no statistically significant differences in OS were found between different IHC-based subtypes (Log rank P = 0.721). In Cox proportional hazard regression analysis, age >65yr was independently associated with poorer OS after NAC (hazard ratio [HR], 2.26; 95% confidence interval [CI], 1.02–5.05), but failed to remain significant after adjusting for creatinine clearance (HR, 1.54; 95% CI, 0.58–4.10).Conclusion: The IHC expression of KRT5/6 and KRT20, as a readily accessible combined marker may help us to identify patients most likely to benefit from chemotherapy. The clinical utility needs to be established in larger prospective studies.
Age, gender and BCG vaccination status as risk factors for Leprosy in endemic areas of northern Brazil.
Authors: Lima Luana Nepomuceno Gondim Costa , Paz Jasna Letícia Pinto , Silvestre Maria do Perpétuo Socorro Corrêa Amador , Moura Letícia Siqueira , Furlaneto Ismari Perini , Lima Karla Valéria Batista
Published: August 2020

Background In 2018, 208.619 new cases of the leprosy were reported to the World Health Organization (WHO). Of these, 30.957 occurred in the Americas region and 28.660 (92.6% of the total in the Americas) were reported in Brazil. This study aimed to show the reality of the profile of a population in an endemic leprosy area in northern Brazil in relation to age, gender and BCG (bacilo Calmette-Guérin) vaccination status, through the collection of data in the field with evaluation of the study individuals, recruited by spontaneous demand.Methods 405 individuals participated in the study, being 100 multibacillary, 57 paucibacillary and 248 healthy contacts.Results A relationship was observed between the occurrence of the disease, as well as the multibacillary form with the largest age group. The male gender was associated with leprosy per se, with the multibacillary form and was the largest representative of the group that was not vaccinated once.Conclusion BCG vaccination was effective both in protecting against leprosy per se and in the multibacillary form. These results are limited by sample size, may not be conclusive and will need further confirmation in a larger cohort.
Introducing NMMF WAMS, an open-source PAMGuard plug-in, and some pilot data for its use as a welfare acoustic monitoring system
Authors: Jones Brittany L , Oswald Michael , Tufano Samantha , Baird Mark , Ridgway Sam H.
Published: August 2020

The authors have removed this preprint version from Research Square.
Construction and Validation of a Metabolic Risk Model Predicting Prognosis of Colon Cancer
Authors: Li Chao , Liu Tao , Yue Meng , Zuo Didi , Zhang Jiantao
Published: August 2020

Background

Metabolic genes have played a significant role in tumor development and prognosis. In this study, we constructed a metabolic risk model to predict the prognosis of colon cancer based on The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO).
Methods

We downloaded gene expression profile from TCGA database and retrieved differentially expressed metabolic genes. Then we conducted univariate cox regression analysis and Least Absolute Shrinkage and Selection Operator (LASSO) Cox regression analysis to identify prognosis-related genes and construct the metabolic risk model. Then we validated the risk model in TCGA and GEO datasets by Kaplan-Meier analysis, time-dependent receiver operating characteristic (ROC), risk score, univariate and multivariate cox regression analysis. Finally, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways and GO (Gene Ontology) enrichment analyses were conducted to reveal the biological processes and pathways of genes by Gene Set Enrichment Analysis (GSEA).
Results

We extracted 753 metabolic genes and identified 139 differentially expressed metabolic genes from TCGA database. Then 15 prognostic genes were dug out and 8 genes were filtered into LASSO cox regression analysis. An eight-gene prognostic model was constructed after 1000 resamples. The gene signature has been proved to have an excellent ability to predict prognosis by validation based on TCGA and GEO database. Finally, GSEA showed that multiplex metabolism pathways correlated with colon cancer.
Conclusion

We identified eight metabolic prognostic genes and developed a metabolic risk model based on TCGA and GEO database to predict overall survival rate of colon cancer.
Bacterial etiology of lower respiratory tract infection:a surveillance report from a Chinese large teaching hospital from 2015 to 2019
Authors: zhang zhen , tian lei
Published: August 2020

Background

Sputum is the most common specimen type of lower respiratory tract in China, but its cultivation result is easily confused by the bacteria colonized in the oral cavity and pharynx. It is very difficult to evaluate the clinical significance of sputum culture results both for clinicians and microbiologists. Bronchoscope alveolus lavage fluid(BALF)is a good specimen, which can accurately reflect the situation of lower respiratory tract infections (LRIs).
Methods

The accumulated data of BALF culture and antimicrobial susceptibility test in our hospital from January 2015 to October 2019 were reviewed and analyzed.
Results

The positive rate of BALF culture in our hospital was 18.3% (3467/18935) in 2015–2019. The most common pathogens were Klebsiella pneumoniae (18.1%, 627/3467), Pseudomonas aeruginosa (16.9%, 587/3467) and Acinetobacter baumannii (14.0%, 485/3467). For the eight most common pathogens, 40–70 years old was the highest age of distribution, but for Escherichia coli and Streptococcus pneumoniae, 0–5 years old was also the higher age of distribution. The antibiotic resistance rate of K. pneumoniae to imipenem and meropenem was 30.6% and 30.8%, respectively. The sensitivity of P. aeruginosa to antibiotics other than minocycline and ticarcillin clavulanic acid was all more than 60%. However, the resistance rate of A. baumannii to antibiotics other than tegacyclin and minocycline was all more than 80%.
Conclusions

40–70 years old was the high incidence age of lower respiratory tract bacterial infection. K. pneumoniae resistant to carbapenems (CR-K. pneumoniae) and A. baumannii were a great challenge to clinical treatment and bacterial resistance control.
A Candidate Multi-Epitope Vaccine Against Pathogenic Chandipura Vesiculovirus Identified using Immunoinformatics.
Authors: Deb Debashrito , Basak Srijita , Kar Tamalika , Narsaria Utkarsh , Castiglione Filippo , Paul Abhirup , Pandey Ashutosh , Srivast Anurag Prakash
Published: August 2020

Chandipura vesiculovirus (CHPV) is a rapidly emerging pathogen responsible for causing acute encephalitis. Due to its widespread occurrence in Asian and African countries, this has become a global threat, and there is an urgent need to design an effective and non-allergenic vaccine against this pathogen. The conventional method of vaccine design involves large proteins or whole organism which leads to unnecessary antigenic load with increased chances of allergenic reactions. In addition, the process is also very time consuming and labour intensive. These limitations can be overcome by peptide-based vaccines comprising of short immunogenic peptide fragments that can elicit highly targeted immune responses, avoiding the chances of allergenic reactions, in a relatively shorter time span. The multi-epitope vaccine constructed using CTL, HTL and IFN-γ epitopes was able to elicit specific immune responses when exposed to the pathogen, in-silico. Not only that, Molecular Docking and Molecular Dynamics Simulation studies confirmed a stable interaction of the vaccine with the immune receptors. Several physicochemical analyses of the designed vaccine candidate confirmed it to be highly immunogenic and non-allergic. The computer-aided analysis performed in this study suggests that the designed multi-epitope vaccine can elicit specific immune responses and can be a potential candidate against CHPV.
Outcomes in patients with pT3N0M0 breast cancer with and without postmastectomy radiotherapy
Authors: Li Chunyan , Wang Jiangfeng , Mo Miao , Yuan Jing , Luo Jurui , Jin Kairui , Wang Xuanyi , Yang Yilan , Ma Jinli , Mei Xin , Yang Zhaozhi , Yu Xiaoli , Guo Xiaomao , Chen Xingxing
Published: August 2020

Background The role of adjuvant postmastectomy radiotherapy (PMRT) remains controversial for patients with pT3N0M0 breast cancer after mastectomy, especially when patients were treated with the updated adjuvant chemotherapy and much more advanced radiation technology. The present analysis compared locoregional recurrence-free survival (LRFS), disease-free survival (DFS), and breast cancer-specific survival (BCSS) in pT3N0M0 patients treated with mastectomy, stratified by PMRT use.Methods Between October 2000 and 8 September 2016, the database of the Breast Cancer Center of Shanghai yielded 114 patients with node-negative non-metastatic breast cancer with tumors >5 cm. Fifty-nine (51.8%) received adjuvant PMRT. Univariate and multivariate analysis were performed to assess the risk factors for survival. Differences between the two groups were compared using the log-rank test.Results The median follow-up was 62.3 months. Five-year LRFS was 100% in the PMRT group vs. 98.1% in the non-PMRT group (P=0.17); 5-year DFS was 93.2% in the PMRT group vs. 90.5% in the non-PMRT group (P=0.40). Univariate analysis identified a family history of malignant tumors, lymphovascular invasion (LVI), or triple-negative breast cancer (TNBC) molecular subtype were associated with higher locoregional recurrence (LRR) (P<0.05); furthermore, patients who were estrogen receptor-negative (P=0.0593) or who had grade 3 histologic features (P=0.0776) tended to have a higher rate of LRR. No PMRT was the only risk factor independently associated with poorer DFS (P=0.042) on multivariate analysis. No difference in BCSS was observed between the two groups.Conclusions The present study demonstrated a low LRR rate and good survival for node-negative breast cancer >5 cm. PMRT tended to improve LRFS and significantly improved DFS. Patients with risk factors including positive family history, TNBC subtype, LVI positivity, and grade 3 disease are at high risk for LRR and might benefit from PMRT.
Genetic Variations in MexAB-OprM Efflux Pump Regulators and Their Association with Antibiotic Resistance and Sequence type in Clinical and Epidemiologically High-risk Clones of Pseudomonas Aeruginosa.
Authors: Aguilar-Rodea Pamela , Zúñiga Gerardo , Cerritos René , Rodríguez-Espino Benjamín Antonio , Rodea Gerardo E. , Reyes-López Alfonso , Arroyo Ana Estela Gamiño , Galindo Juan Carlos Vigueras , Castellanos-Cruz María del Carmen , Parra-Ortega Israel , Clavijo Hector Olivares , VELAZQUEZ-GUADARRAMA NORMA , Rosas-Pérez Irma
Published: August 2020

Background: Pseudomonas aeruginosa is a major opportunistic pathogen involved in healthcare-associated infections with high mortality rates. This bacterium exhibits elevated resistance to a wide range of antibiotics, resulting in part from the overexpression of efflux pumps, among which MexAB-OprM stands out as constitutive. Antibiotic resistance in clinical isolates is associated with mutations in the mexR, nalC, and nalD repressors that modulate the expression of this efflux pump. This study identifies point mutations in the mexR, nalC, and nalD genes and investigates their associations with antibiotic resistance and sequence type in clinical and epidemiologically high-risk clones of P. aeruginosa. Results: A total of 91 P. aeruginosa strains isolated at a pediatric hospital in Mexico (2007–2015) were classified according to their resistance to antibiotics. The strains were typed by multilocus sequencing of 7 genes. The MexAB-OprM efflux pump phenotype was determined using the minimal inhibitory concentration for the reporter antibiotic carbenicillin in the presence/absence of the efflux pump inhibitor Phe-Arg-β-naphthylamine. Sequencing of the mexR, nalC, and nalD genes to identify mutations was performed. Genetic relationship among the strains was evaluated by a phylogenetic inference analysis using maximum likelihood to construct a phylogenetic network. The relationship between variables was determined by a principal component analysis. STs revealed six main complexes. Mutations in the mexR, nalC, and nalD genes revealed 27 different haplotypes. Pan-drug and extensive drug resistant profiles were associated with specific STs with haplotypes 1 (ST1725, endemic clone), 8, 12 (ST233, epidemiologically high-risk clone), and 5 [related to dead when compared to ST1725 and ST233 (RRR 23.34; p=0.009 and RRR 32.01; p=0.025)], however the resistance in these strains was not mainly attributed to the MexAB-OprM phenotype. Strains with the same haplotype and resistant profile showed different pump behavior.Conclusions: A significant relationship between ST and resistant profiles was observed; on one hand, the mexR-nalC-nalD haplotypes were not related to the MexAB-OprM efflux pump phenotypic behavior. On the other hand, the relationship between mexR-nalC-nalD haplotypes and phylogenetically related ST, suggest mutations in these repressors are highly maintained within these STs.
Phase II Study of Capecitabine Combined With Intensity-Modulated Radiotherapy After D1/D2 Lymph Node Dissection in Patients with Gastric Cancer
Authors: Ren Hua , Wang Xin , Wang Wei-Hu , Wang Shu-Lian , Song Yong-Wen , Liu Yue-Ping , Tang Yuan , Li Ning , Liu Wen-Yang , Fang Hui , Li Ye-Xiong , Zhao Dong-Bing , Chi Yihebali , Yang Lin , Jin Jing
Published: August 2020

Background: Adjuvant chemoradiotherapy (ACRT) with oral capecitabine and intensity-modulated radiotherapy (IMRT) was well tolerated in a phase I study in patients who had undergone partial or total gastrectomy for locally advanced gastric cancer. This phase II study aimed to further determine the efficacy and toxicity of this combination after radical resection and D1/D2 lymph node dissection (LND) for local advanced gastric patients.Methods: Forty patients (median age, 53 years; range, 24–71 years) with pathologically confirmed adenocarcinoma who underwent D1/D2 LND were included in this study. The patients received ACRT comprising IMRT (total irradiation dose: 45 Gy delivered in daily 1.8-Gy fractions on 5 days a week over 5 weeks) and capecitabine chemotherapy (dose: 800 mg/m² twice daily throughout the duration of RT). The primary study endpoint was disease-free survival (DFS) and the secondary endpoints were overall survival (OS), toxic effects, and treatment compliance.Results: The 3-year DFS and OS were 66.2% and 75%, respectively. The median time to recurrence was 19.5 months (range, 6.1–68 months). Peritoneal implantation (n = 10) was the most common recurrence pattern, and the lung was the most common site of extra-abdominal metastases (n = 5). Nine patients developed grade 3 or 4 toxicities during ACRT. Two patients discontinued ACRT, while 11 underwent ACRT without receiving the entire course of capecitabine. There were no treatment-related deaths.Conclusion: The ACRT protocol described herein showed acceptable safety and efficacy for local advanced gastric cancer received radical gastrectomy and D1/2 LND.Trial registration: ClinicalTrials.gov, NCT01674959. Registered August 2012 - Retrospectively registered, http://www.isrctn.com/ISRCTN12345678
The suitability of glioblastoma cell lines as models for primary glioblastoma cell metabolism
Authors: Arthurs Anya Lara , Keating Damien J , Conn Simon J
Published: August 2020

Background
In contrast to most non-malignant cells, cells comprising Glioblastoma multiforme (GBM), a deadly brain tumour with extremely poor prognosis, preferentially utilise glycolysis over oxidative phosphorylation for metabolism in a phenomenon known as the ‘Warburg effect’. As effective treatments for GBM are severely lacking, research into therapeutics targeting the disease’s highly glycolytic state offer a promising avenue to improve patient survival. These studies often employ GBM cell lines for in vitro studies which translate poorly to the in vivo patient context.
Methods
The metabolic traits of the seven most commonly used GBM cell lines were assessed using a Seahorse Bioscience Metabolic Flux Analyser and compared to primary GBM cells and primary healthy mixed neural cells from the same patients.
Results
In support of the glycolytic nature of the patient-derived GBM cell lines, basal mitochondrial rate (p = 0.043) and ATP-linked respiration (p < 0.001) were significantly lower than primary adjacent normal cells from the same patient and reserve capacity (p = 0.037) and Krebs Cycle capacity (p = 0.002) were significantly higher for 12 patients. While no cell line was found to accurately replicate all metabolic attributes of primary GBM cells, specific parameters could be modelled by specific lines.
Conclusions
U251MG, U373MG and D54 lines are recommended for researching mitochondrial metabolism, and the D645 line for researching ATP-linked respiration. The T98G cell line recapitulated glycolysis-related metabolic parameters of the primary GBM cells and is recommended for research relating to glycolysis. These findings can guide preclinical research into the development of novel therapeutics targeting metabolic pathways in GBM.
Virtual adaptation of healthcare quality improvement training programmes in response to COVID-19: A rapid narrative review
Authors: Khurshid Zuneera , Brún Aoife De , Moore Gemma , McAuliffe Professor Eilish
Published: August 2020

Information and communication technology is playing a major role in ensuring continuity of healthcare services during the COVID-19 pandemic. The pandemic has also disrupted healthcare quality improvement (QI) training and education for healthcare professionals and there is a need to rethink the way QI training and education is delivered. The purpose of this rapid evidence review is to quickly but comprehensively collate studies to identify what works and what does not in delivering QI training and education using distance-learning modalities. Three healthcare databases were searched along with grey literature sources for studies published between 2015 and 2020. Studies with QI training programmes or courses targeting healthcare professionals and students with at least one component of the programme being delivered online were included. A total of nineteen studies were included in the review. Most studies had a mixed methods design and used blended learning methods, combining online and in-person delivery modes. Most of the included studies reported achieving desired outcomes, including improved QI knowledge, skills and attitudes of participants and improved clinical outcomes for patients. Some benefits of online QI training delivery include fewer required resources, reducing the need for on-site instructors, increased programme reach, and more control and flexibility over learning time for participants. Some limitations of online delivery modes include limited learning and networking opportunities, functional and technical problems and long lead time for content adaptation and customization. The review highlights that distance learning approaches to QI help in overcoming barriers to traditional QI training. Virtual training environment holds great potential in delivering standardised training and distance collaborations which will be of utmost importance in the post-COVID environment. The review offers guidance on important questions to be considered in delivering QI programmes through distance learning modes.
Developing and validating the risk perceptions and behavioral responses questionnaire for COVID-19 (Risk PreceptCOVID-19): an application of the extended parallel process model
Authors: Jahangiry Leila , Sarbakhsh Parvin , Reihani Parvin , Samei Sirous , Sohrabi Zahara , Tavousi Mahmoud , Mintazeri Ali
Published: August 2020

Background: In order to understand how people perceive, process, and respond to COVID-19 risk information, a valid and reliable instrument is needed. This study aimed to develop an instrument to measure the risk perceptions of people about COVID-19 based on the Extended Parallel Process Model (EPPM). Methods: This cross-sectional study was conducted in Tabriz, Iran. First, a comprehensive literature review was conducted to develop the initial draft of Risk-percept COVID-19. Then, in order to obtain a pre-final version of the instrument, face and content validity were conducted. After that, construct validity (exploratory and confirmatory), internal consistency using test-retest reliability and Cronbach’s alpha of the instrument were measured. Results: Forty two item were initially generated. During the content validity, it was reduced to 29 items. The exploratory factor analysis (EFA) revealed four factors (perceived response efficacy, perceived threats (severity and susceptibility), perceived self-efficacy, and defensive responses (denial, avoidance and reactance) that accounted for 49.97 of the observed variance. The confirmatory factor analysis (CFA) designated a model with appropriate fitness for the data. Cronbach’s alpha coefficient for the dimensions ranged from .697 to .793, and the Intraclass Correlation Coefficient (ICC) ranged from .71 to .80 within acceptable ranges. Conclusion: the current findings show that the Risk-percept COVID-19 is a valid and reliable instrument to assess the cognitions and perceptions of adults.
Studies on Highly Dense Pure YIG Polycrystalline Ceramics Fabricated by Tape-casting Method
Authors: Zhao Chong , Li Yingkui , Shen Xiaofei , Cao Zhijun , Cao Zhiquan , Wen Zicheng , Yuan Xuanyi , Ma Chaoyang , Cao Yongge
Published: August 2020

Pure phase Y3Fe5O12 (YIG) ceramics was successfully produced by tape-casting forming process and one-step solid-state reaction method. With the sintering temperature above 1100 ºC, the pure phase YIG ceramics was synthesized with no YIP or Fe2O3 phase in XRD patterns. YIG ceramic sintering at 1400 ºC for 10 h showed a clear grain structure with an obvious grain boundary, and no pores were observed in the SEM images. YIG ceramics in this paper has a high relative density which was 99.8% and the saturation magnetization was 28.2 emu/g at room temperature. The hysteresis loss at temperatures of 230-360 K was smaller than 10 mJ/kg. The tan Se was nearly zero at 6~7 GHz and 11~12 GHz, showing that it can be used as a good material for microwave applications. In addition, the low values of tan and tan indicates that it may have a good electromagnetic wave absorption ability.
Epidemiological Characteristics of COVID-19 under Government-mandated Control Measures in Inner Mongolia, China
Authors: Du Sha , Lu Haiwen , Su Yuenan , Bi Shufeng , Wu Jing , Wang Wenrui , Yu Xinhui , Yang Min , Zheng Huiqiu , Wang Xuemei
Published: August 2020

BackgroundThere were 75 local confirmed cases during the COVID-19 epidemic followed by an outbreak of Wuhan in Inner Mongolia. The aims of our study were to provide reference to control measures of COVID-19 and scientific information for supporting government decision-making for serious infectious disease, in remote regions with relatively insufficient medical resources like Inner Mongolia.MethodsThe data published by Internet were summarized in order to describe the epidemiological and clinical characteristics of patients with COVID-19. The basic reproductive number (R 0 ), incubation period, time from illness onset to confirmed and the duration of hospitalization were analyzed. The composition of imported and local secondary cases and the mild/common and severe/critical cases among different ages, genders and major clinical symptoms were compared.ResultsIn 2020, from January 23 to February 19 (less than 1 month), 75 local cases of COVID-19 were confirmed in Inner Mongolia. Among them, the median age was 45 years old (34.0, 57.0), and 61.1% were male and 33 were imported (44.0%). 29 (38.7%) were detected through close contact tracking, more than 80.0% were mild/common cases. The fatality rate was 1.3% and the basic reproductive number (R 0 ) was estimated to be 2.3. The median incubation period was 8.5 days (6.0~12.0) and the maximum incubation period reached 28 days. There was a statistically difference in the incubation period between imported and local secondary cases ( P <0.001). The duration of hospitalization of patients with incubation period <8.5 days was higher than that of patients with incubation period ≥8.5 days (30.0 vs. 24.0 days).ConclusionIn Inner Mongolia, an early and mandatory control strategy by government associated with the rapidly reduced incidence of COVID-19, by which the epidemic growth was controlled completely. And the fatality rate of COVID-19 was relatively low.