bluuebunny/crossref_metadata_2025 huggingface dataset:
Association between Hemoglobin and Diabetic Peripheral Neuropathy at Different Glycosylated Hemoglobin Levels in Type 2 Diabetes Mellitus Patients
Authors: Zhou Lingling , Xu Xiaojuan , Sheng Hui , Qu Shen , Cui Ran
Published: March 2020

Background To investigate the possible association of diabetic peripheral neuropathy (DPN) and serum hemoglobin levels in type 2 diabetes mellitus (T2DM) patients with different glycosylated hemoglobin levels. Methods A total of 995 patients were involved in this retrospective cross-sectional study. Laboratory medical data and electromyography results from the patients were collected. The patients were divided into five groups according to their HbA1c levels (Group 1: HbA1c ≤7%, Group 2: HbA1c 7% to ≤8%, Group 3: HbA1c 8% to ≤9%, Group 4: 9% to ≤10%, and Group 5: >10%). Differences in clinical data in the five groups were compared. Analysis of variance (ANOVA) and binary logistic regression analysis were used. All analyses were performed using SPSS 24 (SPSS Inc., Chicago, IL, USA). P value < 0.05 was considered to indicate statistical significance. Results A correlation was found between the prevalence of DPN and anemia in both sex groups. Age, BMI, duration of diabetes, ALT, serum creatinine, TC, TG, LDL, FPG, FCP, and hemoglobin A1c differed to a statistically significant extent in different groups. Group 5 showed the highest prevalence of DPN in both sex groups. Hemoglobin levels were higher in Group 5 than in other groups, while composition of anemia was not statistically different. Binary logistic regression showed hemoglobin to be negatively related to the prevalence of DPN in Group 5 in men and in Group 4 in women. Conclusion Hemoglobin level was negatively associated with the occurrence of DPN at the HbA1c level of >10% in men and 9 to 10% in women in T2DM patients. HbA1c must be considered in exploring the correlation between hemoglobin and DPN.
Innovating Editorial Practices: Academic Publishers at Work
Authors: Horbach Serge Pascal Johannes Maria , Halffman Willem
Published: March 2020

Background: Triggered by a series of controversies and diversifying expectations of editorial practices, several innovative peer review procedures and supporting technologies have been proposed. However, adoption of these new initiatives seems slow. This raises questions about the wider conditions for peer review change and about the considerations that inform decisions to innovate. Methods: We carried out field visits to the editorial office of two large academic publishers to study their editorial process. We set out to reveal how the benefits of peer review innovations are understood and to describe the considerations that inform the implementation of innovations.Results: This study shows how the publishers’ internal hierarchy determines whose arguments are most likely to prevail and it explicates the different meanings attached to editorial practices by different actors. We furthermore show that the editorial process is closely connected to commercial practices of creating business value, and the very specific terms in which business value is understood, such as reputation considerations and the urge to increase efficiency.Conclusion: This demonstrates that commercial considerations extend much further than the publishers’ choice for business or publication models and reach into the very heart of the editorial and peer review process.
Targeted Exome Sequencing Identified a Novel USH2A Mutation in a Chinese Usher Syndrome Family
Authors: Xing Dongjun , Zhou Huaiyu , Yu Rongguo , Wang Linni , Hu Liying , Li Zhiqing , Li Xiaorong
Published: March 2020

Background To identify the gene mutation in a Chinese family with Usher syndrome type 2 and describe the clinical features. Methods A 23-year-old man complain of 10-year nyctalopia and a 3-year decline in visual acuity in both eyes accompanied by congenital dysaudia. To clarify the diagnosis, the clinical symptoms of the patient were observed and analysed in combination with comprehensive ophthalmologic examinations as well as genetic analysis(Targeted exome sequencing, TES). Results Typical clinical presentation of Usher syndrome on fundus features was found, which included a wax yellow-like disc, bone-spicule formations, and retinal vessel stenosis. Optical coherence tomography(OCT) and optical coherence tomography angiography (OCTA) showed loss of the ellipsoid zone and a reduction in paracaval vessel density in both eyes. Genetic analysis identified the presence of novel homozygote of c.8483_8486del (p.S2828fs) in USH2A, a gene responsible for Usher syndrome type 2 (OMIM:276901). This novel mutation in USH2A led to premature translation termination, resulting in the deletion of 19 fibronectin type 3 domains(FN3), which plays an important role in protein binding. Based on the clinical manifestations and genetic result, the patient was diagnosed with Usher syndrome type 2. Conclusions We found a novel mutation of c.8483_8486del in USH2A gene through TES techniques for 381 inherited retinal disease (IRD) related genes. The results of this study broaden the spectrum of mutations in Usher syndrome type 2 and suggest that the combination of TES molecular diagnosis and clinical information can help USH patients obtain a better diagnoses.
Universal risk assessment upon hospital admission for screening of carriage with multidrug-resistant microorganisms (MDRO) in a Dutch tertiary care centre (2016 – 2019)
Authors: Hout Denise van , Bruijning-Verhagen Patricia , Blok Hetty , Troelstra Annet , Bonten Marc
Published: March 2020

Background In Dutch hospitals a 6-point questionnaire is mandatory for risk-assessment to identify carriers of multidrug-resistant organisms (MDRO) at the time of hospitalization. Presence of one or more risk factors is followed by microbiological culturing and pre-emptive isolation. We evaluated the test characteristics of this screening tool in identifying new MDRO carriers. MethodsA cross-sectional study using routinely collected healthcare data was performed in a Dutch tertiary hospital between 1 January 2015 and 1 August 2019 including all admissions with an MDRO risk assessment performed on the day of admission. MDRO risk-assessment included: (1) known MDRO carriage, (2) previous hospitalization in another Dutch hospital during a known outbreak, (3) previous hospitalization in a foreign hospital, (4) living in an asylum centre, (5) professional exposure to livestock farming and (6) household membership of a methicillin-resistant Staphylococcus aureus (MRSA) carrier. Sensitivity of the risk assessment was estimated by comparing observed prevalence of newly detected MDRO carriage to expected prevalence of carriage in the Dutch population upon hospital admission. Results 144,051 hospital admissions of 84,485 unique patients were included. In total, 4,480 (3.1%) admissions had a positive MDRO risk-assessment (i.e. ≥1 risk factors present). In 1,516 (34%) admissions microbiological screening was performed, of which 341 (23%) yielded MDRO. 81 patients were categorized as new MDRO carriers, as identified through MDRO risk-assessment, reflecting 0.06% (95% CI: 0.04%–0.07%) of all admissions and 1.8% (95% CI: 1.4%–2.2%) of those with positive risk assessment. MDRO included ESBL-producing and/or multidrug-resistant Enterobacterales (n=52, 64%), MRSA (n=26, 32%), carbapenem-resistant Enterobacterales (CRE) (n=2, 3%) and VRE (n=1, 1%). The numbers of “MDRO risk-assessments needed to perform” and individual “MDRO risk-assessment questions needed to ask” to detect one new MDRO carrier upon admission were 1,778 and 10,420, respectively. Estimated sensitivities of the risk-assessment for detecting MDRO carriage were <1%, for ESBL-E and VRE, <2% for CRE and 18% for MRSA. Conclusions The number of risk-assessments needed to perform to detect one new MDRO carrier upon hospital admission was high, and the vast majority of carriers most likely remained undetected. The current MDRO risk assessment upon admission strategy needs thorough reconsideration.
Prognostic model based on the Geriatric Nutritional Risk Index and sarcopenia in patients with diffuse large B-cell lymphoma
Authors: Go Se-Il , Kim Hoon-Gu , Kang Myoung Hee , Park Sungwoo , Lee Gyeong-Won
Published: March 2020

Background Systemic inflammation and cachexia are associated with adverse clinical outcomes in diffuse large B-cell lymphoma (DLBCL). The Geriatric Nutritional Risk Index (GNRI) is one of the main parameters used to assess these conditions, but its efficacy in DLBCL is inconclusive. Methods We retrospectively reviewed 228 DLBCL patients who were treated with R-CHOP immunochemotherapy (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone). The patients were stratified according to GNRI score (> 98, 92 to 98, 82 to < 92, and < 82) as defined in previous studies. Additionally, the extent of sarcopenia was categorized as sarcopenia-both, sarcopenia-L3/PM alone, and non-sarcopenia-both according to skeletal muscle index. Results Survival curves plotted against a combination of GNRI and sarcopenia scores revealed two clear groups as follows: high cachexia risk (HCR) group (GNRI < 82, sarcopenia-both, or GNRI 82-92 with sarcopenia-L3/PM alone) and low cachexia risk (LCR) group (others). The HCR group had a lower complete response rate (46.5% vs. 86.6%) and higher frequency of treatment-related mortality (19.7% vs. 3.8%) and early treatment discontinuation (43.7% vs. 8.3%) compared with the LCR group. The median progression-free survival (PFS) (not reached vs. 10.3 months, p < 0.001) and overall survival (OS) (not reached vs. 12.9 months, p < 0.001) were much shorter in the HCR group than in the LCR group. On multivariable analyses, the HCR group was shown to be an independent negative prognostic factor for PFS and OS after adjusting the National Comprehensive Cancer Network-International Prognostic Index (NCCN-IPI). Conclusions A combined model of GNRI and sarcopenia may provide prognostic information independently of the NCCN-IPI in DLBCL.
Identification of a four-gene panel predicting overall survival for lung adenocarcinoma
Authors: Chunyu Li , Qizhong Long , Danni Zhang , Jun Li , Xianming Zhang
Published: March 2020

Object Lung cancer is the most frequently diagnosed carcinoma and the leading cause of cancer-related mortality. Although molecular targeted therapy and immunotherapy have made great progress, the overall survival (OS) is still poor due to a lack of accurate and available prognostic biomarkers. Therefore, in this study we aimed to establish a multiple-gene panel predicting OS for lung adenocarcinoma. Methods We obtained the mRNA expression and clinical data of lung adenocarcinoma (LUAD) from TCGA database for further integrated bioinformatic analysis. Lasso regression and Cox regression were performed to establish a prognosis model based on a multi-gene panel. Nomogram was built based on the model. The receiver operating characteristic (ROC) curve and the Kaplan–Meier curve were used to assess the predicted capacity of the model. The prognosis value of the multi-gene panel was further validated using a dataset from GEO. Gene set enrichment analysis (GSEA) was performed to explore potential biological mechanisms of a novel prognostic gene signature. Results A four-gene panel (including DKK1, GNG7, LDHA, MELTF) was established as a prognostic indicator for OS of LUAD. The ROC curve revealed good predicted performance in both test cohort (AUC = 0.740) and validation cohort (AUC = 0.752). Each patient was calculated a risk score according to the model based on the four-gene panel. The results showed that the risk score was an independent prognostic factor, and the high-risk group had a worse OS compared with the low-risk group. The nomogram based on this model shows better prediction performance. GNG7 was decreased in LUAD and its mRNA expression was negatively correlated with the DNA methylation level. GSEA demonstrated the main enrichment pathways of GNG7 were cell cycle, RNA degradation, DNA replication, et al. Conclusion Our study proposed a novel four-gene panel to predict the OS of LUAD, which may contribute to predicting prognosis accurately and making the clinical decisions of individual therapy for LUAD patients. GNG7 might act a crucial role in genesis and progression of LUAD.
Feasibility of Multi-Parametric Magnetic Resonance Imaging Combined with Machine Learning in the Assessment of Necrosis of Osteosarcoma after Neoadjuvant Chemotherapy: A Preliminary Study
Authors: Huang Bingsheng , Wang Jifei , Sun Meili , Chen Xin , Xu Danyang , Li Zi-Ping , Ma Jinting , Feng Shi-Ting , Gao Zhenhua
Published: March 2020

Background Response evaluation of neoadjuvant chemotherapy (NACT) in patients with osteosarcoma is significant for the termination of ineffective treatment, the development of postoperative chemotherapy regimens, and the prediction of prognosis. However, histological response and tumour necrosis rate can currently be evaluated only in resected specimens after NACT. A preoperatively accurate, noninvasive, and reproducible method of response assessment to NACT is required. In this study, the value of multi-parametric magnetic resonance imaging (MRI) combined with machine learning for assessment of tumour necrosis after NACT for osteosarcoma was investigated. Methods Twelve patients with primary osteosarcoma of limbs underwent NACT and received MRI examination before surgery. Postoperative tumour specimens were made corresponding to the transverse image of MRI. One hundred and two tissue samples were obtained and pathologically divided into tumour survival areas (non-cartilaginous and cartilaginous tumour viable areas) and tumour-nonviable areas (non-cartilaginous tumour necrosis areas, post-necrotic tumour collagen areas, and tumour necrotic cystic/haemorrhagic and secondary aneurismal bone cyst areas). The MRI parameters, including standardised apparent diffusion coefficient (ADC) values, signal intensity values of T2-weighted imaging (T2WI) and subtract-enhanced T1-weighted imaging (ST1WI) were used to train machine learning models based on the random forest algorithm. Three classification tasks of distinguishing tumour survival, non-cartilaginous tumour survival, and cartilaginous tumour survival from tumour nonviable were evaluated by five-fold cross-validation. Results For distinguishing non-cartilaginous tumour survival from tumour nonviable, the classifier constructed with ADC achieved an AUC of 0.93, while the classifier with multi-parametric MRI improved to 0.97 ( P =0.0933). For distinguishing tumour survival from tumour nonviable, the classifier with ADC achieved an AUC of 0.83, while the classifier with multi-parametric MRI improved to 0.90 ( P <0.05). For distinguishing cartilaginous tumour survival from tumour nonviable, the classifier with ADC achieved an AUC of 0.61, while the classifier with multi-parametric MRI parameters improved to 0.81( P <0.05). Conclusions The combination of multi-parametric MRI and machine learning significantly improved the discriminating ability of viable cartilaginous tumour components, which can provide an objective and accurate basis for NACT response evaluation in osteosarcoma.
Reactive breastfeeding support at an Australian Breastfeeding Association drop-in service
Authors: Burns Elaine , Duursma Louise , Triandafilidis Zoi
Published: March 2020

Background In Australia, during the early establishment phase of breastfeeding, women can access telephone peer support counselling provided by the Australian Breastfeeding Association (ABA) however options for face-to-face peer support are limited. The known factors which improve ongoing and exclusive breastfeeding include face-to-face support, peer and/or professional support, and trained personnel. This study aimed to examine women’s experiences of accessing one breastfeeding drop-in peer support service provided by trained peer support volunteer counsellors from the ABA.Methods Women who accessed the service were invited to participate in an anonymous online survey which collected both quantitative and qualitative data. Participants were asked about their experiences of breastfeeding support, as well as their experiences of the drop-in service. In total, 53 women completed the online survey, and subsequent analysis generated descriptive statistics and qualitative themes.Findings Responses to the survey revealed that women attended the drop-in lounge with infants ranging in age from less than 1 week through to 12 months of age. Most women reported attending with infants aged 0-8 weeks of age 72% (n37). The predominant presenting problems identified were sore/damaged nipples, difficulties with infant latching to the breast, or concerns about using nipple shields. Analysis of the open text qualitative responses revealed one overarching theme ‘Support to continue breastfeeding’ and four subthemes: ‘feeling listened to and not judged’; ‘emotional support and confidence building’; ‘the importance of face-to-face, practical support'; and ‘the need for ongoing, free access’.Discussion In this study many women were seeking support for ongoing breastfeeding difficulties. Some were referred to health professional’s for investigation of restricted tongue movement. Health professionals who had limited breastfeeding knowledge and skills were identified as most unhelpful in providing support with ongoing breastfeeding difficulties. Women valued having access to trained peer counsellors, who had the capacity to provide non-judgemental, face-to-face support; who could sit through a feed; in a space that was ‘safe’; and who could enhance a woman’s confidence with breastfeeding over the course of her full breastfeeding journey.Conclusion Women described the importance of access to a reactive drop-in service which was dedicated to breastfeeding support and which was available in response to need.
Determinants of Mother to Child Transmission of HIV In Public Hospitals of West Shewa Zone, Oromiya Region: mixed method study.
Authors: Banja Fufa Hunduma , Gebrehanna Ewnat
Published: March 2020

Background: Mother-to-child transmission of HIV (MTCT) is when Human Immune deficiency Virus (HIV) of positive mother passes the virus to her baby. Without intervention transmission rate of HIV ranges from 15% to 45%, which can be reduced to below 5% with effective intervention. In Ethiopia, final mother-to-child transmission rate was 15% in 2016 which is much higher than target of the country to reduce transmission to lower than 5% by 2020. Aim of the study is to identify determinants of transmission of HIV from mother to child in West Shoa zone of Oromiya Region which has total population more than 2.1 million.Methods: Mixed methods: unmatched case-control study among children tested HIV positive and negatives at the end of PMTC follow up; N=96(24 cases, 72 controls) and one-on-one questioner for mothers of positive infant conducted during June to August 2019; focusing on PCR done during the last two years (June 2017 to July 2019), in public hospitals. Variables of interest were collected using structured and semi-structured questioner and data abstraction forms from mothers of exposed infants, medical records of mothers and children.Result: Majority among cases(70.8%) were not included in to option B+ program. Home delivery increases 6 times chance of HIV, AOR = 6.0; CI (1.5–29.2), none inclusion in to option B+ increase 18 chance of HIV transmission, AOR = 18.0; CI (5.0–68.1). Partner noninvolvement to HIV care increases chance of transmission by 7.3 times, AOR=7.3; CI(1.1–37.4). Mother-to- mother support program decrease chance of transmission by 86.5% with AOR = 0.13; CI (0.11–0.39). Poor ANC knowledge and practices among rural residents and unstable marriage in urban residents contributed to unaware MTCT of HIV.Conclusion: ART clinics should focus on and strengthen mother-to-mother support program, should create space for partner involvement to HIV care and provide training for Health Extension Workers(HEW). Health education and awareness creation should be implemented by HEW to improve ANC practice, reduce home delivery and increase voluntary counseling and testing among residents.
Genome-wide analysis of the WRKY gene family in the cucumber genome and transcriptome‑wide identification of WRKY transcription factors that respond to biotic and abiotic stresses
Authors: Chen Chunhua , Chen Xueqian , Han Jing , Lu Wenli , Ren Zhonghai
Published: March 2020

Background: Cucumber ( Cucumis sativus L.) is an economically important vegetable crop species. However, it is susceptible to various abiotic and biotic stresses. WRKY transcription factors play important roles in plant growth and development, particularly in the plant response to biotic and abiotic stresses. However, little is known about the expression pattern of WRKY genes under different stresses in cucumber. Results: In the present study, an analysis of the new assembly of the cucumber genome (v3.0) allowed the identification of 61 cucumber WRKY genes. Phylogenetic and synteny analyses were performed using related species to investigate the evolution of the cucumber WRKY genes. The 61 CsWRKYs were classified into three main groups, within which the gene structure and motif compositions were conserved. Tissue expression profiles of the WRKY genes demonstrated that 24 CsWRKY genes showed constitutive expression (FPKM > 1 in all samples), and some WRKY genes showed organ-specific expression, suggesting that these WRKYs might be important for plant growth and organ development in cucumber. Importantly, analysis of the CsWRKY gene expression patterns revealed that 7 CsWRKY genes strongly responded to both salt and heat stresses, 12 genes were observed to be expressed in response to infection from downy mildew and powdery mildew, and three CsWRKY genes simultaneously responded to all treatments analysed. Some CsWRKY genes were observed to be induced/repressed at different times after abiotic or biotic stress treatment, demonstrating that cucumber WRKY genes might play different roles during different stress responses and that their expression patterns vary in response to stresses. Conclusions: Sixty-one WRKY genes were identified in cucumber, and insight into their classification, evolution, and expression patterns was gained in this study. Responses to different abiotic and biotic stresses in cucumber were also investigated. Our results provide a better understanding of the function of Cs WRKY genes in improving abiotic and biotic stress resistance in cucumber.
Perioperative Hypoalbuminemia is a Risk Factor for Wound Complications Following Posterior Lumbar Interbody Fusion
Authors: He Zhongyuan , Zhou Kai , Zhong Weiyang , Tang Ke , Quan Zhengxue , Liu Shaoyu , Su Bao
Published: March 2020

Abstract
Background: Although serum albumin levels are increasingly used as an indicator of nutritional status in the clinic, the relationship between perioperative hypoalbuminemia and wound complications after posterior lumbar interbody fusion in the treatment of lumbar degenerative disease remains ambiguous. The aim of this study was to evaluate perioperative serum albumin in relation to postoperative wound complications after posterior lumbar interbody fusion in the treatment of single-segment lumbar degenerative disease.
Methods: We reviewed patients who underwent single-segment posterior lumbar interbody fusion surgery from December 2014 to April 2017 in the Department of Orthopedics at the First Affiliated Hospital of Chongqing Medical University. Perioperative (preoperative and early postoperative) serum albumin levels were assessed in all patients and were used to quantify nutritional status. We divided the patients into a surgical wound dehiscence ( SWD ) group and a normal wound healing group, and into an surgical site infection(SSI)group and a non-SSI group. To evaluate the relationship between perioperative serum albumin level and postoperative wound complications, we conducted univariate and multiple logistic regression analyses.
Results: A total of 554 patients were enrolled in the study.The univariate and multiple logistic regression analysis of these differences showed that preoperative serum albumin <3.5 g/dl and postoperative serum albumin:<3.0 g/dl were significantly related to SWD (P<0.05). There were also significant differences between the surgical site infection (SSI) groups in terms of preoperative serum albumin <3.5 g/dl(P=0.001), postoperative serum albumin <3.5 g/dl (P<0.023) and <3.0 g/dl(P<0.001).Additionally, the increased hospitalization costs and length of hospitalization were statistically significant for patients with perioperative hypoproteinemia.
Conclusions: For patients who underwent single-segment posterior lumbar interbody fusion surgery, we need to pay more attention to steroid use,perioperative hypoalbuminemia, which are more likely to be associated with increased wound complications, hospitalization costs and length of hospitalization after surgery. Adequate assessment and management of these risk factors will help reduce wound complications and hospital stays for surgical patients and will save medical costs.
Keywords: hypoalbuminemia,malnutrition,risk factors,single-segment lumbar fusion,postoperative incision complications,retrospective studies.
Profiles of autophagy-related genes in esophageal adenocarcinoma
Authors: Zhu Lei , Dong Lin , Yang Fugui , Li Qinchuan
Published: March 2020

Background: Several studies have demonstrated autophagy was involved in the process of esophageal adenocarcinoma (EAC). The aim of this study was to explore autophagy-related genes (ARGs) correlated with overall survival (OS) in EAC patients. Methods: Expressions of ARGs in EAC and normal samples were downloaded from TCGA database. GO and KEGG enrichment analyses were used to investigate the ARGs bioinformatics functions. Univariate and multivariate cox regressions were performed to identify prognostic ARGs and the independent risk factors. ROC curve was established to evaluate the feasibility to predict the prognosis. Finally, the correlations between ARGs and clinical features were further explored. Results: Thirty significantly different ARGs were selected from EAC and normal tissues. Functional enrichments showed these ARGs were mainly related apoptosis. Multivariate cox regression analyses demonstrated eight ARGs were significantly associated with OS. Among these eight genes, BECN1 (HR=0.321, P=0.046), DAPK1 (HR=0.636, P=0.025) and CAPN1 (HR=0.395, P=0.004) played protective roles in survival. Gender (HR=0.225, P=0.032), stage (HR=5.841, P=0.008) and risk score (HR=1.131, P＜0.001) were independent prognostic risk factors. ROC curves showed better efficacy to predict survival using the risk score. Additionally, we found BECN1, DAPK1, VAMP7 and SIRT1 genes were correlated significantly with survival status, gender, primary tumor and tumor stage (all P ＜0.05). Conclusion: Our findings suggested that autophagy was involved in the process of EAC. Several ARGs probably could serve as diagnostic and prognostic biomarkers and may help facilitate therapeutic targets in EAC patients.
Combining cellular immunotherapy was an optional choice for unresectable advanced HCC: a systematic review and meta-analysis
Authors: Wang Jing , Feng Lingxin , Zhang Linwei
Published: March 2020

Background The efficacy of cellular immunotherapy in advanced hepatocellular carcinoma (HCC) was controversial. This study was conducted to compare the effectiveness of combining cellular immunotherapy with that of incurable treatment alone. Methods The Ovid Medline, Embase, Cochrane Library and Pubmed were systematically searched due to January 8th 2020. The keywords include “immunotherapy”, “HCC” and study type. Treatment response was evaluated and progression-free survival (PFS) and overall survival (OS) were calculated using hazard ratio (HR) and 95% confidence interval (CI). Results A total of 19 studies with 1,275 patients were included in the meta-analysis. The median complete response rate (CR) was 19% in combining cellular immunotherapy comparing to 9% in the control group (RR=0.55, P=0.003). No significant difference was found in partial response and stable disease (RR=1.06 and 0.78, P>0.05, respectively). The progression disease rate was higher in the non-cellular immunotherapy group (31%) compared to the cellular immunotherapy group (RR=2.20, P=0.002). Patients treating with cellular immunotherapy had a better OS and PFS compared to those without cellular immunotherapy (HR=0.52 and 0.63, P<0.001). In the subgroup analysis, the only CIK infusion therapy and combined DC with CIK perfusion therapy patients had a better OS (HR=0.52 and 0.49, P<0.001 and P=0.002, respectively). Conclusion Our results suggested that combining use of cellular immunotherapy in advanced HCC could increase the complete response rate, and thereafter extend the progression-free and overall survival rate. Subgroup analysis suggested that combining use of CIK and DC or using CIK alone could provide the benefit in survival outcome.
FKBP-related ncRNA-mRNA axis in breast cancer
Authors: Xiong Hanchu , Chen Zihan , Zheng Wenwen , Sun Jing , Fu Qingshuang , Teng Rongyue , Chen Jida , Xie Shuduo , Wang Linbo , Yu Xiao-Fang , Zhou Jichun
Published: March 2020

Background Breast cancer (BC) is a disease with morbidity ranking the first of women worldwidely. FK506-binding protein (FKBP) family has been demonstrated to possess various functions by interacting with different molecular targets in BC. However, a comprehensive ncRNA-mRNA regulatory axis of FKBP has not yet been reported. Methods FKBP related miRNAs were obtained from miRWalk database. Then, potential lncRNAs, transcription factors as well as mRNAs of screened differentially expressed miRNAs (DE-miRNAs) were analysed by using LncBase v.2, miRGen v3 and miRWalk database. Additionally, differential expression and prognostic analysis of lncRNAs were evaluated using TANRIC database. Next, GO annotation and KEGG pathway analysis were processed using DAVID database. Protein-Protein Interaction (PPI) network was established and hub genes were identified using STRING database. Finally, differential expression and prognostic analysis of hub genes were further conducted using UALCAN and bc-GenExMiner v4.2 database, respectively. Results Eleven DE-miRNAs, consisting of four FKBP4 related DE-miRNAs and seven FKBP5 related DE-miRNAs, were screened. 482 predicted lncRNAs were found for DE-miRNAs. Then, expression and prognostic results of nine of top twenty lncRNAs of BC were significantly identified. LINC00662 and LINC00963 expression were significantly associated with patients’ overall survival (OS). Then, nine potential upstream transcription factors were identified in motifs of DE-miRNAs. 320 target genes were identified for GO annotation and KEGG pathway analysis, which were mainly enriched in cysteine-type endopeptidase activity involved in apoptotic process. Construction and analysis in PPI network showed that RAB7A was selected as a hub gene with the toppest connectivity scores. Differential expression analysis of nine in top ten hub genes of BC were significantly identified. RAB7A and ARRB1 expression were significantly related with BC patients’ OS. Conclusions In current study, we firstly established a predicted FKBP-related ncRNA-mRNA regulatory network, thus exploring a comprehensive interpretation of molecular mechanisms and providing potential clues in seeking novel therapeutics for BC. In the future, much more experiments should be conducted to verify our findings.
High level of resistance in the mosquito Anopheles arabiensis to pyrethroid insecticides from low malaria transmission zone of Moroto district, Karamoja region, Uganda: Implication for malaria vector control
Authors: Echodu Richard , Anena Juliet , Iwiru Tereza , Mireji Paul , Malinga Geoffrey Maxwell , Opiyo Elizabeth A. , Iga Julius , David Onanyang
Published: March 2020

Background Karamoja region of Uganda previously classified as low malaria transmission zone is currently experiencing significant upsurge of malaria incidences. Long lasting insecticidal nets (LLINs) impregnated with pyrethroids constitute a major tool for malaria control in this region. Efficacy of this tool can be hampered by resistance to the pyrethroids in the Anopheles mosquito vectors. Resistance status of these mosquitoes in this region is poorly understood, effectively hampering better understanding of the impact of LLINs in the malaria control initiative. Here, we assessed susceptibility of the Anopheles arabiensis from the region to deltamethrin, permethrin (pyrethroids) and pirirmiphos-methyl (organophosphate) insecticides. Method We collected anopheline mosquito larvae from their natural habitats and reared them to adult emergence in situ field insectary in Karamoja region. We then identified them morphological to species level and exposed 513 emerge adult female An gambiae s.l., mosquitoes to diagnostic dosages of deltamethrin (0.05%), permethrin (0.75%) and pirimiphos-methyl (0.25%) pyrethroids exposure using the standard WHO insecticide susceptibility test assay. Synergic assays using piperonyl butoxide (PBO) were done to check for the involvement of detoxification enzymes in pyrethroid resistant populations. We then screened for knockdown resistance (KDR) and mosquito species diversity using Polymerase Chain Reaction (PCR). Results Majority (96%) of the mosquitoes we sampled were identified as An. arabiensis and 4% as An. gambiae sensu stricto . We observed cross-resistance to both deltamethrin (11.9%) and permethrin (47%) but susceptibility (100% mortality) to pirimiphos-methyl in An. arabiensis . The pre-exposure to PBO ameliorated the resistance to both pyrethroids. We detected homozygous KDR -eastern variant in 1.8 and 50% of the An. arabiensis and An. gambiae s.s. respectively. Conclusion Anopheles arabiensis and An. gambiae s.s. are the malaria vector in Karamoja region with An. arabiensis predominating. Both species are susceptible to pirimiphos-methyl but resistant to both deltamethrin and permethrin, through a metabolic process (phenotype). Mosquotoes with genetic (kdr) mutations for resistance were minimal and hence have minimal contribution to the pyrethroid resistance profile. An. arabiensis can thus be controled in Karamoja region using deltamethrin and/or permethrin impregnated mosquito nets integrated with PBO and/or through indoor residual spraying of sprayable human dwellings with pirimiphos-methyl.
A survey on health care data using Machine learning Algorithms
Authors: B Manjulatha , Pabboju Suresh
Published: March 2020

Big data in the healthcare has been growing rapidly in recent years. A massive amount of patient’s data is generated through various sources in this digitalized environment including wearable devices, mobile devices, electronic health records and medical centres. The medical data, which are exploding exponentially includes a large volume of structured and unstructured data. Patients information is shared and managed by many sources such as insurance, in the form of prescription, healthcare providers including the attackers which causes a severe security threats their confidential data. Cybercriminals use a variety of social engineering attacks like phishing, leakage of data, embedding virus and trojan horse into the attachments, DNS snooping, sniffing, and many more. In this paper a brief overview is done on different data mining and security techniques which are implemented in healthcare data. The study and its presentation in this context would be helpful in not only analysing but also predicting chronic diseases depending upon the available stored data which has been collected from various sources in the area of medical expert system.
The role of the globular heads of the C1q receptor in TcdA-induced human colonic epithelial cell apoptosis via a mitochondria-dependent pathway
Authors: Liang Jinhua , Ning Yongzhong , Dong Li , Li Qi , Chen Ling , Xu Yanmin
Published: March 2020

Background: Clostridioides (formerly Clostridium) difficile infection is the leading cause of antibiotic-associated colitis. Studies have demonstrated that C. difficile toxin A (TcdA) can cause apoptosis in many human cell types. The purpose of this study was to investigate the relationships among exposure to TcdA, the role of globular heads receptor of C1q (gC1qR) gene and the underlying intracellular apoptotic mechanism of human colonic epithelial cells (NCM 460).Methods: In this study, gC1qR expression was examined using real-time polymerase chain reaction (PCR), western blot and immunohistochemical staining analysis. Cells viability was assessed by the water-soluble tetrazolium salt (WST-1) assay, apoptosis of cells was assessed by flow cytometry and terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling (TUNEL) Assay. Mitochondrial function was assessed via reactive oxygen species (ROS) generation, changes in the mitochondrial membrane potential (ΔΨm) and the content of ATP.Results: Our study demonstrated that the concentration of TcdA increasing from 10 ng/ml to 20 ng/ml inhibited cell viability and induced cell apoptosis ( p < 0.01). Moreover, TcdA induced gC1qR mRNA and protein expression. Overexpression of gC1qR could cause the mitochondrial dysfunction (including production of ROS, decrease of ΔΨm and the content of ATP) and cell apoptosis. However, silencing of gC1qR gene could reverse the TcdA-induced cell apoptosis and mitochondrial dysfunction.Conclusion: Therefore, these data support a mechanism wherein gC1qR plays a crucial role in TcdA-induced human colonic epithelial cells apoptosis involving a mitochondrial dependent manner.
Clinical implications of the American Joint Committee on Cancer (AJCC) 8th edition update in seminoma pT1 subclassification
Authors: Fontes-Sousa Mário , Lobo João , Magalhães Helena , Cassis João , Malheiro Mariana , Ramos Sância , Henrique Rui , Martins Ana , Maurício Maria Joaquina
Published: March 2020

Background Seminoma accounts for 30-50% of Testicular Germ-Cell Tumors (TGCT) - the most common solid malignancy in men aged 15-35 years. The American Joint Committee on Cancer (AJCC) 8th edition (2018) created the subclassifications pT1a (tumor size < 3 cm) and pT1b (≥ 3 cm), despite not universally recognized. The authors propose to further understand its potential impact in clinical practice.Methods: All consecutive cases of seminoma stage I pT1 treated at two institutions between January2005 and December 2016. Clinical data were retrieved, and variables were analyzed using SPSS. Reviewof relevant literature on the topic.Discussion: Seminoma pT1 was identified in 58 patients. By using newly AJCC criteria, 29 (50.0%) would have been pT1a and 29 (50.0%) pT1b. Median follow- up time 5.8 years. Three recurrences wererecorded (2 in pT1a and 1 in pT1b, all under surveillance protocol); no deaths occurred. Rete testis invasion (RTI) and extensive necrosis (EN) were associated with pT1b (P<0.0001 and P=0.023, respectively), therefore pT1b was associated with RTI and EN, known adverse biological features, but the clinical impact could not to be assessed with the present methodology. Our results suggest an excellent prognosis, regardless of subcategorization, thus a larger population and a longer follow-up time areneeded to understand the impact of the updated criteria.Conclusions: In our population, the retrospective analysis of the newly created AJCC criteria showed no significant difference in recurrence or death, although pT1b was associated to adverse biological markers. We would recommend using the AJCC staging system, although the individual risk of relapse, long-term toxicities and patient preferences should be taken into account when considering surveillance or active treatment options.
Effect of Hookah (water pipe) smoking on Anti-Mullerian Hormone levels
Authors: Albeitawi Soha , Almehaisen Lama , Obeidat Rawan , Shehab Qasem , Elisabetta Garavaglia
Published: March 2020

Purpose: Hookah (water pipe) smoking, an ancient method of tobacco smoking, is regaining widespread popularity all over the world. Although research in this field is still lacking, its harmful effect on human health through the increased risk of cardiovascular disease, infection, and cancer has been proven. Cigarette smoking has been found to have a detrimental effect on reproductive function. However, no data about the effect of hookah smoking on human fertility or reproductive outcomes are available. In this study, we aimed to determine if smoking hookah has a harmful effect on human ovarian reserve, anti-Mullerian hormone levels, and cycle regularity. Methods: A total of 100 healthy women within the 25-35 years age range undergoing laboratory investigations were randomly chosen to participate. After obtaining consent, they filled a questionnaire about smoking habits and menstrual data. Blood samples were withdrawn for anti-Mullerian hormone testing. The anti-Mullerian hormone levels of 50 women smoking hookah but not cigarettes were compared to 50 non-smoking women. Collected data were analyzed by analysis of variance and independent samples T-test. Results: There were no significant differences in mean anti-Mullerian hormone levels and cycle regularity between hookah smokers and non-smokers. Conclusion: Hookah smoking has no significant effect on anti-Mullerian hormone levels.
Live birth rates in different subgroups of poor ovarian responders according to Bologna criteria and POSEIDON group classification
Authors: Mashayekhy Mehri , Barabi Forouzan , Arabipoor Arezoo , Zolfaghari Zahra
Published: March 2020

Background Recently, some studies evaluated the live births rates (LBRs) in two poor ovarian responders (POR) classification methods separately, but present study was designed to compare the LBRs among different groups of patients on the basis of Bologna criteria or POSIEDON group classifications and find the important predictive factors for LBR in patients with POR. Methods In this cross-sectional study, the database containing clinical and laboratory information on infertility treatment cycles were evaluated from December 2015 to December 2017 and all the patients with at least one POR after standard controlled ovarian stimulation (COH) during IVF/ICSI cycles were evaluated. The eligible patients were enrolled and divided into five and four groups according to the Bologna criteria and POSEIDON groups’ classifications, respectively. Results 812 patients with POR diagnosis were investigated which in overall 517 of them had embryo transfer in the last treatment cycle (63.6%) and total clinical pregnancy rate 19.3% (100 cases) and live birth rates 16.1% (86 cases) were found. When the patients were grouped on the Basis of the POSEIDON classification, the highest LBR was observed in the POSEIDON group III. On the other hand, according to the Bologna criteria, 41 patients were not included in any group, and in the analysis of cycle outcome, the LBR in the Bologna group II was more than other groups. The multivariable regression analysis revealed that the significant independent variables remained in the model as important predictive factor for live births in the study population were the number and quality of the transferred embryos transmission (good and excellent quality), and the POSSIDON classification group (POSSIDON group III). Conclusions On the basis of present results, the POSEIDON group classification could be more comprehensive and practical than Bologna criteria for diagnosing and categorizing POR patients. In addition, it was found the number and quality of transferred embryos were the most important prognostic factor for live birth in POR patients; therefore we suggest to consider COH protocols with a freezing embryos strategy, and the collection of more good quality embryos to improve the probability of a live birth.
Flood Realities, Development Faults and Perceptions – Natural and Anthropogenic causes of 2014 Flood in Kashmir
Authors: MALIK ISHFAQ HUSSAIN , Hashmi S Najmul Islam
Published: March 2020

The regularity of risk in modern societies permeates everyday life— from the air that we breathe, to the food that we eat, to the water we drink and to where we work and live. We live in a globalized world associated with risk societies which is caused by a myriad of global processes. These processes interact to produce an unforeseen dangers and endless array of risks. Kashmir being politically and ecologically fragile area needs a special understanding in terms of its physical and political geography. Kashmir suffered the worst flood in last 109 years in the year 2014. The present research analyses the disaster management in Jammu and Kashmir with special emphasis on causes of 2014 flood in Kashmir Valley. It digs deeper into the politics of urbanization and how the state has turned a blind eye to lake encroachment and land grab. The flood occurred due to the mismanagement of the resources and the faulty means of development. Increased level of urbanisation and its unplanned growth, and encroachment on the banks of Jhelum River proved to be detrimental to the environment and people. The other factors like deforestation, glacial melt and destruction of wetlands in the fragile Himalayan ecosystem particularly in the Western Himalayas, lack of proper disaster management plan in the valley, climate change, land grab, extensive catchment of Jhelum River, administrative laxity, lack of proper flood channel for Jhelum River etc. corroborated in the occurrence of the flood. The combination of these factors increased the vulnerability of the people to the 2014 flood in Kashmir Valley. Natural calamities are known to change politics, and ﬂoods are a great leveller. The political instability and unsettled conditions in Kashmir compound problems many times over.
Antioxidant dressing therapy versus standard wound care in chronic wounds (REOX study): Study protocol for a randomized controlled trial
Authors: Comino-Sanz Inés María , López-Franco María Dolores , Castro Begoña , Pancorbo-Hidalgo Pedro Luis
Published: March 2020

Background: A wound that does not heal in the orderly stages of the healing process or does not heal within three months is considered a chronic wound. Wound healing is impaired when the wound remains in the inflammatory stage for too long. A range of factors can delay the healing process: imbalance between proteases and protease inhibitors in the wound bed; bacterial colonization and the presence of biofilm; and oxidative stress.Recently, wound management has improved significantly. A new antioxidant dressing has been developed, which combines an absorbent matrix obtained from Locust Bean Gum (LBG) galactomannan and a hydration solution with curcumin and N-acetylcysteine (NAC). This dressing combines the advantages of moist healing in exudate management and free radical neutralization, achieving wound reactivation.The primary aim of this study is to compare the effect of antioxidant dressing on chronic wound healing with the use of standard wound dressing in patients with hard-to-heal wounds.Methods: We will conduct a multicentre, open, randomized, controlled trial with parallel groups. Participants will be selected from three primary public health-care centres, located in Andalucía (southern Spain). Patients will be randomized into an intervention group (antioxidant dressing) or control group (standard wound dressing). Assessment will be carried out in weeks 2, 4, 6 and 8. The follow-up of patients will be prolonged until week 8 or complete healing.Discussion: The findings from this study should provide scientific evidence on the efficacy of 20 the antioxidant dressing as an alternative for the treatment of chronic wounds. This study fills 21 some of the gaps in the existing knowledge about patients with hard-to-heal wounds.