bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of measurement differences of anterior chamber depth and axial length on lens thickness evaluation in cataract patients: a comparison of two tests
Authors: Xu Jiayi , Li Chen , Wang Lijun , Li Caixin , Li Xin , Lu Peirong
Published: October 2020

Background: The purpose of this study was to investigate the agreement of lens thickness (LT) measurements made by contact A-scan ultrasonography and Lenstar LS900 as well as the influence of anterior chamber depth (ACD) and axial length (AL) measurement differences on LT measurement in cataract patients in the two techniques.Methods: 1247 cataract patients (1247 eyes) participated in this retrospective cross-sectional study. Ocular biometric measurements were performed with Lenstar LS900 and A-scan ultrasonography respectively, and the measured results of AL, ACD and LT were compared using Pearson correlation coefficients (r) and Bland-Altman analyses.Results: Bland-Altman analyses showed poor agreement between the A-scan ultrasonography and Lenstar LS900 in measuring AL and ACD. The average difference of LT was 0.01 mm; the consistency limit was -0.86 mm, 0.88 mm; and 95.27% of datapoints were within the 95% consistency limit. The consistency of LT measurements between the two techniques was poor for those subjects whose ACD or AL values were beyond the 95% consistency limit. Among the subjects whose AL or ACD values measured by A-scan ultrasonography were greater than those measured by Lenstar LS900, 93.33% of them were within the 95% consistency limit, suggesting that the consistency of LT measurement between the two techniques was poor. Of patients whose ACD or AL measured by A-scan ultrasonography were smaller than that of Lenstar LS900, 96.01% of them were within the 95% consistency limit.Conclusions: There was good agreement of the LT measurements between A-scan ultrasonography and Lenstar LS900, except for the axis deviating from the apparent axis during A-scan ultrasonography. If this error can be avoided, A-scan ultrasonography can replace Lenstar LS900 in LT measurement in cataract patients.
Discontinuation and switching of postpartum contraceptive methods over twelve months in Burkina Faso and the DRC: a secondary analysis of the Yam-Daabo trial
Authors: Coulibaly Abou , Millogo Tieba , Baguiya Adama , Tran Nguyen Toan , Yodi Rachel , Seuc Armando , Cuzin-Kihl Asa , Thieba Blandine , Landoulsi Sihem , Kiarie James , Mashinda Désiré , Kouanda Seni
Published: October 2020

Introduction : Women who use contraceptive methods sometimes stop early, use methods intermittently or switched contraceptive methods. All these events (discontinuations and switching) contribute to the occurrence of unwanted and close pregnancies. This study aimed to explore contraceptive discontinuation and switching during the Yam-Daabo project to measure the effect of interventions on the continuation of contraceptive methods use.Methods: We conducted a secondary analysis of the Yam-Daabo trial data. We choose the discontinuation and switching of a modern contraceptive method as outcome measures. We performed a survival analysis by using the Stata software package to estimate the effect of the interventions on contraceptive discontinuation. We also studied the main reasons for discontinuation and switching.Results: In total, 637 out of the 1,120 women used at least one contraceptive method (of any type), with 267 women in the control and 370 in the intervention group. Modern methods were used by 179 women of control group compared to 279 women of intervention group with 24 and 32 who discontinued, respectively. We observed no statistically significant association between interventions and modern methods discontinuation and switching. However, the discontinuation of modern methods was higher in pills and injectables users than implants and IUDs users. The pooled data comparison showed that, in reference to the women who had not switched while using a modern method, the likelihood of switching to a less or equal effectiveness method among the women of the control group was 3.8(95% CI: 1.8-8.0) times the likelihood of switching to a less or equal effectiveness method among the women of the intervention group. And this excess was statistically significant (p<0.001). The main reason for discontinuation and switching was method-related (141 over 199), followed by partner opposition with 20 women.Conclusion: The results of this study show no statistically significant association between interventions and modern methods discontinuation. Discontinuation is more related to the methods themselves than to any other factor. It is also important to set up specific actions targeting women's partners and influential people in the community to counter inhibiting beliefs.Trial registration: Pan African Clinical Trials Registry (PACTR201609001784334, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=1784).
‘They Just Came with the Medication Dispenser’ – A Qualitative Study of Service User Involvement and Welfare Technology in Public Home Care Services
Authors: Glomsås Heidi Snoen , Knutsen Ingrid Ruud , Fossum Mariann , Halvorsen Kristin
Published: October 2020

BackgroundPublic home care for the elderly is a key area in relation to improving health care quality. It is an important political goal to increase elderly people’s involvement in their care and in the use of welfare technology. The aim of this study was to explore elderly service users’ experience of user involvement in the implementation and everyday use of welfare technology in public home care services.MethodThis qualitative study has an explorative and descriptive design. Sixteen interviews of service users were conducted in five different municipalities over a period of six months. The data were analysed using reflexive thematic analysis. Results Service users receiving public home care service are not a homogenous group, and the participants had different wishes and needs as regards user involvement and the use of welfare technology. The analysis led to four main themes: 1) diverse preferences as regards user involvement, 2) individual differences as regards information, knowledge and training, 3) feeling safe and getting help, and 4) a wish to stay at home for as long as possible.ConclusionThe results indicated that user involvement was only to a limited extent an integral part of public home care services. Participants had varying insight into and interest in welfare technology, which was a challenge for user involvement. User involvement must be facilitated and implemented in a gentle way, highlighting autonomy and collaboration, and with the focus on respect, reciprocity and dialogue.
A Neonate with Amniotic Band Syndrome and Osteomyelitis
Authors: Zafaranloo Nazanin , Moshfegh Fereshteh , Mohagheghi Parisa , Beigi Babak , Nourozi Elahe
Published: October 2020

Background: Amniotic band syndrome (ABS) comprises of a spectrum of congenital malformations involving the limbs more often, but any other anatomic region of fetus could be involved (1). Its prevalence has been reported to range from 0.19 to 8.1 per 10000 live births (2). There are different theories for explaining the etiology of amniotic bands, but it has been considered to have a multifactorial etiology. (2) Fetoscopic release of amniotic bands affecting one or more extremities can prevent limb loss or preserve limb function when distal fellow is still identifiable on preoperative ultrasound scans (3)(4). ABS occurs in 77% of fetuses with multiple anomalies (5). Both males and females are equally affected (6). Osteomyelitis in neonates is relatively uncommon, but burdened with an increased hospital stay and possible long‐term sequela if not diagnosed on time (18). The long bones are the most frequently affected sites (18).Case presentation: Here we are introducing a neonate with left upper extremity necrosis due to ABS which needed amputation and it was associated with severe chronic osteomyelitis.Conclusion: Amniotic band syndrome mostly involves the limbs. It is important to diagnose it as soon as possible, because with the interprofessional teamwork approach, an optimal patient result with fetoscopic or surgery procedures could be achieved.
The Value of Epicardial Adipose Tissue for the Patients Treated with Percutaneous Coronary Intervention: A Systemic Review and Meta-analysis
Authors: Xu Tan , Xu Ming
Published: October 2020

BackgroundAccumulating evidences suggest that the prognostic value of epicardial adipose tissue (EAT) on no-reflow, in-stent restenosis (ISR), infarct size, and main adverse cardiovascular events (MACE) for the patients treated with percutaneous coronary intervention (PCI). The relationship between EAT and outcomes of patients underwent PCI is still partly elusive. MethodsTo elucidate the relationship in detail, we searched PubMed, web of science, and the Cochrane Library for studies evaluating the association of EAT and patients treated with PCI. Thirteen studies enrolling 3683 patients were eventually include in our systemic review and meta-analysis. ResultsThe EAT measured by thickness or volume was significantly higher in the ISR group compared to those in the non-ISR group (The standard mean difference -0.34, 95% CI, -0.49, -0.18, p <0.0001; I2 =36%). The incidence of no-reflow was significantly higher in thicker EAT group compared to thin EAT group (pooled relative ratio 1.52, 95%CI 1.29-1,80, p <0.0001; I2 =0%). Thicker EAT was significantly associated with MACEs (pooled relative ratio 1.50, 95% 1.18-1.90, p =0.008). A lower EAT volume is associated with larger infarct size in ST elevated myocardial infarction patients treated with primary PCI (standard mean difference was -5.45, 95% CI -8.10, -2.80; p <0.0001; I2 =0%). In summary, our systemic review and meta-analysis suggest that high EAT is related with a significant increased risk of non-reflow, MACE and decreased infarct size in patients with coronary artery disease treated with PCI. This paradox phenomenon demonstrates that the quality of EAT may play more important role than the solely thickness or volume of EAT.
Effect of Periodontal Debridement Plus Systemic Azithromycin v/s Periodontal Debridement as Unique Therapy in Subjects with Periodontitis: A Randomized Controlled Clinical Trial.
Authors: Navarrete Mariely , Oñate Héctor , Loyola Katarina , Olivares Pamela
Published: October 2020

Background: Recently, it has been suggested that azithromycin (AZM) may be a useful adjunct to non-surgical periodontal therapy (NSPT). However, current scientific evidence is still not conclusive as to its efficacy as an adjunct of NSPT. This study aimed to evaluate the effect of the systemic administration of AZM as an adjunct to NSPT on the clinical and microbiological variables of patients with periodontitis.Methods: Eighteen volunteers with Periodontitis received NSPT combined with placebo or AZM (500 mg/day) for 3 days (n=9/group). They were monitored clinically for probing pocket depth (PPD), clinical attachment level (CAL), plaque index (PI) and bleeding on probing (BoP) at baseline and during the first, third and sixth month and monitored microbiologically at baseline and at 3 and 6 months after therapy. The microbiological variables were detected by conventional polymerase chain reaction tests. The normality was checked using the Shapiro-Wilk test. The level of statistical significance was measured by the unpaired t-test, Mann-Whitney U, Fisher’s exact and Chi-Square tests.Results: Fourteen patients completed the study (n=7/group). The group receiving NSPT + AZM presented with a significantly lower mean PPD at 3 (p = 0.05) and 6 months (p = 0.04) with a greater probing depth reduction (p = 0.02). Moreover, at the third month post NSPT, there was a significant increase in the number of sites with a PPD 1–3 mm (p < 0.001) and a decrease in the number of sites with a PPD 4–6 mm (p < 0.001). In addition, a significant decrease in the mean number of sites with a PPD ≥ 7 mm (p = 0.04) was detected at 6 months post treatment. There was also a significant decrease in BoP at 1 (p = 0.01), 3 (p < 0.001) and 6 (p = 0.01) months post intervention. Conclusions: AZM as an adjuvant to NSPT provides additional beneficial effects for PPD and BoP compared to NSPT alone. This could be related to its anti-inflammatory properties more than to its antibiotic characteristics.Trial registration: ClinicalTrials.gov: NCT03629288. https://clinicaltrials.gov/ct2/show/NCT03629288Retrospectively registered on August 14, 2018.
A Simple Noninvasive Model to Predict Significant Fibrosis in Children with Chronic Hepatitis B
Authors: Zhang Kang-Ling , Chen Xiu-Qi , Lv Zi-Li , Huang Li , Yun Xiang , Yang Mei-Xiong , Lan Lian-Chen , Tang Qing , shan qingwen
Published: October 2020

Background: To develope a noninvasive model for significant fibrosis in children with chronic hepatitis B (CHB). Methods: A total 116 CHB pediatric patientswere who had undergone liver biopsy were included in the study. The gold standard of fibrosis was assessed by liver histology. blood routine examination, coagulation function, liver biochemistry, viral serology and viral load were analyzed. Receiver operating characteristic (ROC) curve analysis was used to analyze sensitivity and specificity of all possible cut-off values.Results: Based on the correlation and difference analysis, 7 available clinical parameters [Total bile acid (TBA), Gamma-glutamyl transpeptidase(GGT)，Aspartate transaminase(AST)，Direct bilirubin to total bilirubin ratio (D/T)，Alanine aminotransferase(ALT)，Prealbumin，(PA)，and Cholinesterase（CHE）were included for modeling analysis. A model to predict significant liver fibrosis (Ishak fibrosis score ≥2) was derived using the two best parameters (PA and GGT) The original model was. After mathematical calculation, the G index 600×GGT/PA2 predicts significant fibrosis with an area under the receiving operating characteristics (AUROC) curve of 0.733，95% IC (0.643-0.811). The area under the receiver operating characteristic curve (AUROC) of G index (0.733,) was higher than that of APRI (0.680) and FIB-4(0.601) to predict significant fibrosis in children with CHB. If the G index's values outside 0.28-1.16, 52% of children with CHB could avoid liver biopsy with an overall accuracy of 75%.Conclusions: The G index can predict and exclude significant fibrosis in children with HBV, which may reduce the liver biopsy need for children with CHB.
Efficacy of Acupuncture for Persistent and Intractable Hiccups: A Protocol for Systematic Review and Meta Analysis of Randomized Controlled Trials
Authors: Zhang Yu , Jiang Xudong , Wang Zhijie , He Mingming , Lv Zimeng , Yang Gaiqin , Qin Weixun
Published: October 2020

Background: Persistent and intractable hiccups are a common clinical symptom that cause considerable physical pain to patients and severely damage their quality of lives. An increasing number of studies have demonstrated that acupuncture applied at acupoints dominated by Cuanzhu (BL2) can be used as one of the nonpharmacological therapies for controlling intractable hiccups. However, there is insufficient evidence evaluating the safety and effectiveness of those interventions. Therefore, this study is intended to conduct a systematic review and meta-analysis to provide evidence for a further study investigating alternative treatment options for persistent and intractable hiccups.Methods: Randomized controlled trials (RCTs) of adult patients aged >18 years who meet the criteria for intractable hiccup diagnosis will be included, regardless of gender, nationality, and education level. Eight electronic databases will be searched, including four Chinese databases (CNKI, SinoMed, Wanfang Database, and Chinese Scientific Journal Database), four English databases (Web of Science, Medline, Embase, and Cochrane Library), from their date of establishment to September 2020. Two independent reviewers will evaluate the title summary for each RCT. Disagreements will be discussed with a third commentator. Data integration, heterogeneity analysis, subgroup analysis, and sensitivity analysis, will be performed using R-3.3.2 software. The RevMan 5.3 software will be used for the meta-analysis, and the “risk of bias” assessment will be conducted based on the methodological quality of the included trials recommended by the Cochrane Handbook 5.1. The quality evaluation of this study will be completed by the Grading of Recommendations, Assessment, Development, and Evaluation.Discusstion: This systematic review will provide evidence to assess the validity and safety of applying acupuncture at acupoints dominated by Cuanzhu (BL2) for persistent and intractable hiccups, which may provide clinicians with more choices in the treatment of this disease.Systematic review registration: PROSPERO CRD42020114900
Intraoperative 18F-FDG Flexible Autoradiography for Tumour Margin Assessment in Breast-conserving Surgery – A First-in-Human Multicentre Feasibility Study
Authors: Jurrius Patriek A.G.T. , Grootendorst Maarten R , Krotewicz Marika , Cariati Massimiliano , Kothari Ashutosh , Patani Neill , Karcz Paulina Patrycja , Nagadowska Monika , Vyas Kunal N , Purushotham Arnie , Turska-d'Amico Maria
Published: October 2020

IntroductionIn women undergoing breast-conserving surgery (BCS) 20-25% require a re-operation as a result of incomplete tumor resection. An intra-operative technique to assess tumor margins accurately would be a major advantage. A novel method for intraoperative margin assessment was developed by applying a thin flexible scintillating film to specimens - flexible autoradiography (FAR). A single arm, multi-center study was conducted to evaluate the feasibility of intraoperative 18F-FDG FAR for the assessment of tumor margins in BCS.MethodsEighty-eight patients with invasive breast cancer undergoing BCS received ≤300 MBq of 18F-FDG 60-180 minutes pre-operatively. Following surgical excision, intraoperative FAR was performed using the LightPath® Imaging System. The first 16 patients were familiarization patients, the remaining 72 patients were entered into the main study. FAR images were analyzed post-operatively by three independent readers. Areas of increased signal intensity were marked, mean decay corrected radiances and tumor-to-tissue background (TBR) determined, agreement between histopathological margin status and FAR assessed and radiation dose to operating theatre staff measured. Subgroup analyses were performed for various covariates, with thresholds set based on ROC curves.ResultsData analysis was performed on 66 patients. Intraoperative margin assessment using FAR was completed on 385 margins with 46.2% sensitivity, 81.7% specificity, 8.1% PPV, 97.7% NPV and an overall accuracy of 80.5%, detecting both invasive carcinoma and DCIS. A subgroup analysis based on 18F-FDG activity present at time of imaging revealed an increased sensitivity (71.4%), PPV (9.3%) and NPV (98.4%) in the high-activity cohort with mean tumor radiance and TBR of 126.7 ± 45.7 photons/s/cm2/sr/MBq and 2.1 ± 0.5, respectively. Staff radiation exposure was low (38.2 ± 38.1 µSv).Conclusion18F-FDG FAR is a feasible and safe technique for intraoperative tumor margin assessment. Further improvements in diagnostic performance require optimizing the method for scintillator positioning and/or the use of targeted radiopharmaceuticals.Trial registrationClinicalTrials.gov- Identifier: NCT02666079- Date of registration: 28 January 2016- URL: https://clinicaltrials.gov/ct2/show/NCT02666079ISRCTN registry- Reference: ISRCTN17778965- Date of registration: 11 February 2016- URL: http://www.isrctn.com/ISRCTN17778965
Discussion of QOL (with Concise Summary of Newer Clinical Research) in Colorectal Cancer Patients Treated in a Retrospective Trial on the Effect of Surgical Resection Margins on Survival, with Relation to Operation Type
Authors: Arslani Nuhi , RACHIMIS Philip R.
Published: October 2020

Background: the survival of patients treated for CRC is showing a trend of increase and with it increasing concern for the QOL of the operated patient. The aim of this study was to examine the relative influence of distal and circumferential resection margin lenght on survival among a select group patients (undergoing routine treatment) in our institution, with no metastases, and not operated on as an emergency. We also hoped to provide a concise reflection of newer clinical research on the topic.Methods: records of 303 patients, that were operated on between January 2009 and January 2014, were retrospectively reviewed for this study. Patients who underwent emergency surgery and those with metastases were excluded, which left 128 patients suitable for statistical analysis. Results: the number of survivors was noticeably higher than the number of deaths in all groups. Analysis with the Mann-Whitney-Wilcoxon test showed statistically significant differences (p < 0.05) in survival between the group with different CRM-s (p=0.01396), and could not be found between different DRM groups (p=0.1132). The logistic regression model of survival analysis showed that the size CRM is an independent predictor (p = 0.0202, AIC = 92.181) and the size of the DRM is not (p = 0.119, AIC = 109.89). Conclusions: a distal resection margin smaller than 1 cm may be oncologically acceptable in a complete R0 excision, which could theoretically help surgeons perform SSR operations with better oncological and functional results.
In-Vitro Investigation of Antimicrobial Effect of Bark Root Extracts of Solanum Incanum and Croton Macrostachyus
Authors: Shigut Moa Melaku , Serbessa Tagesu Abdisa , Keneni Dele Abdissa , Deressa Feyissa Begna , Debelo Motuma
Published: October 2020

Background: The increasing antibiotic resistance exhibited by pathogenic microbial infectious agents has led to the screening of several medicinal plants for their potential antimicrobial activity. An in vitro experimental investigation was conducted with the aim to evaluate antibacterial effect of bark root extracts of S. incanum and C. macrostachyus against S. aureus and E. coli. It was experimental study from January 2019 to November 2019 in Jimma University. The crude extracts of S. incanum and C. macrostachyus were done using petroleum ether, ethanol and distilled water by maceration methods. The antibacterial activity tests were assessed using agar well diffusion and minimum inhibition concentration methods. Results: C. macrostachyus bark rout ethanol extracts have shown an antibacterial effect against E. coli and S. aureus with maximum mean zone of inhibition of 15±0.58 mm and 17.33±0.89 mm respectively. In case of S. incanum it is also the ethanol extract that showed highest mean zone of inhibition of 22.67±0.89 mm and 22.33±0.89 mm against E. coli and S. aureus respectively. The positive control Gentamicin (10µ gm/disc) inhibited the growth of E. coli and S. aureus with recorded mean zone of inhibition about 23 ±0.58 mm and 24.67± 0.33 mm respectively. Therefore the ethanol extract of Croton macrostachyus and S. incanum showed minimum inhibitor concentration against S. aureus and E. coli than other solvents. Conclusion: Bioactive compounds of medicinal plant extracts have been used to overcome the challenges of antimicrobial resistance. The current experimental study showed that, the bark root extract of Solanum incanum and Croton macrostachyus have high potent of antibacterial activities against E. coli and S. aureus . This study therefore substantiates the use of Solanum incanum and Croton macrostachyus as an antimicrobial medicinal plant.
Impact of Integrated Genetic Information on Diagnosis and Prognostication for Myeloproliferative Neoplasms in the Next-Generation Sequencing Era
Authors: Lee Jong-Mi , Lee Howon , Eom Ki-Seong , Lee Sung-Eun , Kim Myungshin , Kim Yonggoo
Published: October 2020

Background: Since next-generation sequencing has been widely used in clinical laboratory, diagnosis and risk stratification of hematologic malignancies are greatly dependent on genetic aberrations.Methods: In this study, we analyzed the genomic landscape of 200 patients with myeloproliferative neoplasms (MPNs) using targeted panel sequencing covering including 86 genes. Conventional bone marrow karyotyping was also performed to determine chromosomal aberration. We analyzed relationships between genetic profiles and clinical outcomes including acute transformation, bone marrow fibrosis and death.Results: Mutations in JAK2, CALR, and MPL were detected in 76.4% of MPNs. The proportion of patients with clonal genetic markers increased up to 86.4% when all detectable genetic aberrations were included. Significant co-occurring genetic aberrations potentially associated with phenotype and/or disease progression, including those in JAK2/SF3B1 (P = 0.017) and TP53/del(13q), del(5q), -7/del(7q) and complex karyotypes (P = 0.038, P < 0.001, P < 0.001 and P < 0.001, respectively) were detected. We also identified genetic aberrations associated with patient outcomes: TP53 and -7/del(7q) for inferior survival (HR, 95% CI: 64.2, 3.8-1096.5, P = 0.0041, HR, 95% CI: 14.0, 1.5-132.7, P = 0.0219), RUNX1, TP53 and IDH1/2 for leukemic transformation (HR, 95% CI: 68.1, 3.6-1300.4, P = 0.005, HR, 95% CI: 16.3, 1.2-222.7, P = 0.0364, HR, 95% CI: 32.5, 2.8-371.1, P = 0.0051), SF3B1, IDH1/2, ASXL1 and del(20q) for fibrotic progression (HR, 95% CI: 31.5, 4.1-243.3, P = 0.0009, HR, 95% CI: 21.2, 3.4-132.2, P = 0.0011, HR, 95% CI: 4.3, 1.1-16.4, P = 0.0358, HR, 95% CI: 44.5, 6.1-323.0, P = 0.0002). We compared risk stratification systems and found that mutation-enhanced prognostic scoring systems could identify lower risk polycythemia vera and essential thrombocythemia and higher risk primary myelofibrosis (P < 0.001, P < 0.001 and P < 0.001, respectively). Furthermore, the new risk stratification systems showed better predictive capacity of patient outcome. Conclusions: These results collectively indicate that integrated genetic information can enhance diagnosis and prognostication in patients with myeloproliferative neoplasms.
Wearing Surgical Masks Coupled With Restricting the Flow of People in Patient Wards Versus Preventive Atomization Inhalation in Preventing Fever After General Anesthesia Surgery: A Retrospective Analysis During COVID-19
Authors: Chen Tingli , Hou Lina , Sun Kai , Wei Qiang , Li Fei , Tan Wanlong
Published: October 2020

Background: The COVID-19 could be transmitted through aerosols, and aerosol can be produced by atomization inhalation. Preventative aerosol inhalation is prohibited in our hospital during COVID-19, however the number of cases of fever after surgery has not increased significantly. We want to know whether wearing surgical masks coupled with restricting the flow of people in patient wards has same effect with preventive atomization inhalation in preventing fever after surgery, and we wonder whether preventive atomization inhalation is unnecessary during COVID-19, as long as strictly wearing surgical masks and restricting the flow of people in patient wards have been met.Methods: Eight kinds of common surgery were covered in this retrospective analysis, including total thyroidectomy (for the treatment of thyroid carcinoma), total adrenalectomy (adrenal tumor), radical gastrectomy (gastric cancer), radical nephrectomy (renal cell carcinoma), radical prostatectomy (prostate cancer), radical resection for sigmoid colon cancer, radical resection for rectal cancer and appendectomy (appendicitis). Cases in Group A underwent preventive atomization inhalation whilst cases in group B wore surgical masks and restricted the flow of people in patient wards. Occurrence of fever, occurrence of fever recurrence and the maximum temperature in the first week after surgery were analyzed in this study.Results: No significant differences can be seen between group A and group B in terms of occurrence of fever, occurrence of fever recurrence and the maximum temperature after surgery in the first week.Conclusion: Wearing surgical masks combined with restricting the flow of people in patient wards has same effect with preventive atomization inhalation in preventing fever after general anesthesia surgery, which means, during COVID-19, preventive atomization inhalation might not be necessary as long as strictly wearing surgical masks and restricting the flow of people in patient wards have been met.
Urolithiasis Management in Resource-Limited Settings: A Multicentric Retrospective Study in the Democratic Republic of Congo
Authors: Diasiama Pablo Diangienda Kuntima Diasiama , Molamba Dieudonné Molamba Moningo , Makulo Jean-Robert Rissasy , Sumaili Ernest Kiswaya , Mafuta Eric Musalu , Ngoma Alain , Loposso Mathieu Nkumu , Punga-Maloe Augustin Monga Lembe , Lufuma Simon Lua Nkandi , Haymann Jean-Philippe , Daudon Michel
Published: October 2020

ObjectiveThis study aimed to analyze different therapeutic modalities used in the treatment of urolithiasis in the Democratic Republic of Congo.ResultsAmong the 194 patients included in this study, 69% (n=133) were males, with a male to female ratio of 2.2: 1, and an age mean (SD) of 48.1 (17.3) years. Urolithiasis was symptomatic in 52.6% (n=141) of patients. Renal colic was the most common clinical expression. Overall, 86.1% (n=167) of stones were removed by surgery, 9.8% spontaneously resolved, 3.1% were extracted after ureteroscopy, and 1% of patients had undergone extracorporeal shock wave lithotripsy. Lumbotomy was the most frequent used route (39.2%) in conventional surgery. The mean (SD) size of the extracted stones was 23.4 (17.0) mm.Most patients in this study were treated by conventional surgery. These results suggest the need to increase the use of minimally invasive surgery.
Associations Between Skin Autofluorescence, Advanced Glycation End-Products and Chronic Low Back Pain
Authors: Umimura Tomotaka , Eguchi Yawara , Inage Kazuhide , Kitazaki Hitoshi , Shiga Yasuhiro , Maki Satoshi , Inoue Masahiro , Norimoto Masaki , Sato Takashi , Sato Masashi , Suzuki Masahiro , Enomoto Keigo , Konno Kenta , Hirasawa Rui , Hattori Fumiya , Furuya Takeo , Ohtori Seiji , Orita Sumihisa
Published: October 2020

Objective: The aim of this study was to determine whether advanced glycation end-products (AGEs) measured by skin autofluorescence (SAF) can serve as a biomarker for chronic low back pain. 111 patients who visited the outpatient clinic were included in this prospective cohort study. They were divided into a chronic low back pain group (C group: 48 patients, mean age 52.2) and a group without low back pain (N group: 63 healthy volunteers, mean age 40.8). SAF was measured as a parameter of AGEs using an autofluorescence reader. Measurements of low back pain visual analog scale (VAS), presence of diabetes, and SAF were recorded, and correlations between VAS or diabetes and SAF were investigated. Results: The C group had significantly higher SAF (2.20 vs 1.97, p<0.05) than the N group, whereas the SAF for diabetes patients was significantly higher (2.7 vs 2.1, p<0.05) than subjects without diabetes. SAF had no correlation with VAS (P=0.18). SAF is an indicator of AGE accumulation correlated with chronic low back pain and diabetes.
Outcomes of Definitive Chemoradiotherapy for Stage Iva (T4b Vs N4) Esophageal Cancer Based on the Japanese Classification System: A Retrospective Single-center Study 
Authors: Wada Yuki , Anbai Akira , Takagi Noriko , Kumagai Satoshi , Okuyama Eriko , Nanjo Hiroshi , Sato Yusuke , Motoyama Satoru , Hashimoto Manabu
Published: October 2020

Background: Based on the Japanese classification of esophageal cancer, Stage IVa involves locally advanced T4b disease and/or lymphatic spread (N4). Stage IVa disease is generally treated using chemoradiotherapy (CRT) for patients in good condition. However, it is unclear whether there are differences in prognoses or progression patterns between T4b non-N4 and non-T4b N4 cases. This study compared the outcomes of CRT for Stage IVa esophageal cancer according to T/N factors.Methods: We retrospectively identified 68 patients with Stage IVa esophageal cancer who underwent definitive CRT at our center between January 2009 and March 2013. The patients’ medical records, diagnostic images, and radiation plans were reviewed, as well as their treatment outcomes, progression patterns, prognostic factors, and toxicities evaluated based on version 5.0 of the National Cancer Institute Common Terminology Criteria for Adverse Events.Results: The 68 patients (58 men and 10 women) included had a median age of 67 years (range: 37–87 years). The histological classifications were squamous cell carcinoma (66 patients), adenocarcinoma (one patient), and verrucous carcinoma (one patient). The T/N classifications were T4b non-N4 (29 patients), non-T4b N4 (25 patients), and T4b N4 (14 patients). Local control (complete or partial response) was achieved in 58 patients (85%). The median overall survival was 13 months (2-year rate: 32.1%) and the median progression-free survival was 7 months (2-year rate: 16.4%). We did not manage to detect significant differences between the T/N groups in terms of overall survival, progression-free survival, and progression pattern. Multivariate analyses revealed that independent prognostic factors were nadir hemoglobin and nadir albumin during the CRT period, as well as performance status at CRT initiation. Grade 3 or worse toxicities were observed in 55 patients (81%), and five patients died because of treatment-related adverse events.Conclusion: At our center, there were no significant differences in prognoses or progression patterns among patients with T4b non-N4, non-T4b N4, and T4b N4 esophageal cancer. Thus, it seems impractical to modify CRT regimens based on T/N factors, and delivering sufficient doses of both radiotherapy and chemotherapy is important for adequately treating Stage IVa esophageal cancer regardless of T/N factors.
Malus toringoides (Rehd.) Hughes Improves Metabolic Syndrome and Liver Injury in High-Fructose-Induced Mice
Authors: Quan Xiang Hua , Guo Qie , Li Xiang-Peng , Liang Yu , Cui Meng-Na , Li Jing , Huang Shan , Li Bin
Published: October 2020

Background: Malus toringoides (Rehd.) Hughes, as a traditional medicinal and edible plant used in Tibet, China, is used to treat hypertension, hyperlipemia and liver diseases. This present study was designed to investigate the effects of ethanol extract of M. toringoides (EMT) on metabolic syndrome (MS) and liver injury in high-fructose-induced mice. Methods: The C57BL/6J male mice were divided into five groups (n=8). Con group was drunk with standard water, Fru group and the other three with 30% high-fructose water for 8 weeks. EMT (195 mg/kg, 390 mg/kg, 780 mg/kg) was administered to each of high fructose groups simultaneously. Glucose tolerance tests (GTT) were performed. Blood samples were collected from eyeball. The mice were euthanized. Liver and epididymal fat were weighed. The palmitic acid (PA)-induced HepG2 cells were used to evaluate the protective effect of EMT on liver lipid accumulation. Results: The administration of EMT is helpful to maintain near normal body weight, blood glucose, insulin, organ index, glucose tolerance, and serum levels of TC, TG, LDL-C, HDL-C, Apo-B, and Apo-A1 (P < 0.05 or P < 0.01). EMT treatment significantly improved liver injury by the down-regulation of liver lipid accumulation, oxidative stress and inflammatory mediators in high-fructose-induced mice (P < 0.05 or P < 0.01). In vitro, EMT (25 µg/mL-200 µg/mL) significantly decreased lipid droplet accumulation and TG content in PA-induced HepG2 (P < 0.05 or P < 0.01).Conclusion: EMT can obviously improve high fructose-induced MS in mice. In vitro, EMT can inhibit PA-induced lipid accumulation in HepG2 cells.which may emphasizes the use of M. toringoides supplementation in everyday life of over-weighted persons and opens perspectives for clinical trials.
Phylogeography and Population Genetic Structure of Red Muntjacs: Evidence of Enigmatic Himalayan Red Muntjac From India
Authors: Singh Bhim , Kumar Ajit , Uniyal Virendra Prasad , Gupta Sandeep KUMAR
Published: October 2020

BackgroundWe investigated the phylogeographic pattern of red muntjac across its distribution range, intending to address the presence of distinct lineages from Northwest India. The Complete mitogenome analysis revealed that India holds three mitochondrial lineages of red muntjac, whereas four were identified from its entire distribution range: Himalayan red muntjac (M. (m.) aureus), Northern red muntjac (M. vaginalis), Srilankan+Western Ghat India (M. malabaricus) and Southern red muntjac (M. muntjak) from Sundaland. ResultsOur mitogenome analysis revealed that India holds three mitochondrial lineages of red muntjac whereas four were identified from its distribution range: Himalayan red muntjac (M. (m.) aureus), Northern red muntjac (M. vaginalis), Sri-Lankan+Western Ghat India (M. malabaricus) and Southern red muntjac (M. muntjak) from Sundaland. The newly identified Himalayan red muntjac was found in the Northwestern part of India, which was previously described based on their morphological differences. Estimates of the divergence timing indicated that the Northwest lineages and Northern lineage split during the late Pleistocene approximately 0.83 Myr (CI95%:0.53–1.26), which is the younger lineages; whereas, M. malabaricus is the most primitive lineage among all the red muntjac. Microsatellite results also supported the mitochondrial data and evident the presence of three distinct genetic clusters within India. Conclusions The pronounced climate fluctuation during the Quaternary period is regarded as the most important factor influencing the current spatial distribution of forest-dwelling species to restrict themselves in north-west areas. Our finding provided evidence of new lineages within the red muntjac group from India, and it should be managed as an evolutionary significant unit (ESUs). There is a need for taxonomic revision for Himalayan red muntjac (M. (m.) aureus) and also suggested its conservation status under IUCN Red List.
Cascading Rupture of Patches of High Seismic Energy Release Controls the Growth Process of Episodic Tremor and Slip Events
Authors: Nakamoto Keita , Hiramatsu Yoshihiro , Uchide Takahiko , Imanishi Kazutoshi
Published: October 2020

Slip phenomena on plate interfaces reflect the heterogeneous physical properties of the slip plane and thus exhibit a wide variety of slip velocities and rupture propagation behaviors. Recent findings on slow earthquakes reveal similarities and differences between slow and regular earthquakes. Episodic tremor and slip (ETS) events, a type of slow earthquake widely observed in subduction zones, likewise show diverse activity. We investigated the growth of 17 ETS events beneath the Kii Peninsula in the Nankai subduction zone, Japan. Analyses of waveform data recorded by a seismic array enabled us to locate tremor hypocenters and estimate the migration patterns and spatial distribution of the energy release of tremor events. Here we describe three major features in the growth of ETS events. First, independent of their start point and migration pattern, ETS events exhibit patches of high seismic energy release on the up-dip part of the ETS zone, suggesting that the location of these patches is controlled by inherent physical or frictional properties of the plate interface. Second, ETS events usually start outside the high-energy patches, and their final extent depends on whether the patches participate in the rupture. Third, we recognize no size dependence in the initiation phase of ETS events of different sizes with comparable start points. These features demonstrate that the cascading rupture of high-energy patches governs the growth of ETS events, just as the cascading rupture of asperities govern the growth of regular earthquakes.
A single-dose mRNA vaccine provides a long-term protection for hACE2 transgenic mice from SARS-CoV-2
Authors: Huang Qingrui , Ji Kai , Tian Siyu , Wang Fengze , Huang Baoying , Tong Zhou , Tan Shuguang , Hao Junfeng , Wang Qihui , Tan Wenjie , Gao George Fu , Yan Jinghua
Published: October 2020

The rapid expansion of COVID-19 pandemic has made the development of a SARS-CoV-2 vaccine a global health and economic priority. Taking advantages of versatility and rapid development, three SARS-CoV-2 mRNA vaccine candidates has entered clinical trials with a two-dose immunization regimen. However, the waning antibodies response in convalescent patients after SARS-CoV-2 infection and the emergence of human re-infection have raised widespread concern about a short duration of SARS-CoV-2 vaccine protection. Here, we developed a nucleoside-modified mRNA vaccine in lipid-encapsulated form which encoded SARS-CoV-2 RBD, termed as mRNA-RBD. A single immunization of mRNA-RBD elicited both robust neutralizing antibody and cellular response, and conferred a near-complete protection against wild SARS-CoV-2 infection in lungs of hACE2 transgenic mice. Noticeably, high levels of neutralizing antibodies response induced by mRNA-RBD vaccination could maintain for at least 6.5 months and conferred a long-term remarkable protection for hACE2 transgenic mice against SARS-CoV-2 infection in sera transfer study. These data demonstrated that a single dose of mRNA-RBD provided long-term protection against SARS-CoV-2 challenge.
Bark and Cambial Variation in the Genus Clematis (Ranunculaceae) in Taiwan
Authors: Yang Sheng-Zehn , Chen Po-Hao , Chen Chien-Fan
Published: October 2020

BackgroundStudies on the anatomical characteristics of stems of Taiwanese species from the Clematis genus (Ranunculaceae) are scarce. The aim of this study was to investigate and compare cambial variation in stems of 22 Clematis species. ResultsThe rhytidome (outer bark) was either cogwheel-like or continuous, except for in the species Clematis tashiroi. Key features of the genus were eccentric to elliptical or polygonous-lobed stems, wedge-like phloem, wedge-like rays, indentations in the axial parenchyma, and ray dilatation. The cortical sclerenchyma fibers were embedded in the phloem rays with approximately 23% of the Clematis species. Both C. psilandra and C. tsugetorum had restricted vessels. There were three vascular bundle patterns, with approximately 27% of the Clematis species in Taiwan having 12 vascular bundles. The vessels dispersed throughout the stem were semi-ring-porous in most species, but were ring-porous in others. No species had diffuse-porous vessels. Only two species had a primary xylem ring located around the pith. Secondary xylem rays split the secondary xylem into parts, increasing stem diameter. The developmental stage of each sample was determined, with the initial ring-like periderm being produced in the primary phloem during the second stage. ConclusionsThe cambial variations described in this study provide a foundation for further morphological studies of the Clematis genus.
Current Status of Aggressive End-of-Life Care in Children with Hematologic Malignancy: A Population Based Study
Authors: Yotani Nobuyuki , Shinjo Daisuke , Kato Motohiro , Matsumoto Kimikazu , Fushimi Kiyohide , Kizawa Yoshiyuki
Published: October 2020

Background: Hematologic malignancies are the most frequent type of cancer in children but limited data are available regarding the quality of end-of-life care (EOLC) for children with hematologic malignancies. The aims of this study were (i) to compare aggressive EOLC between children with hematologic malignancies and those with solid tumors; and (ii) to describe factors associated with aggressive EOLC in children with hematologic malignancies.Methods: We retrospectively reviewed 0- to 18-year-old patients with cancer, who died between April 2012 and March 2016 in Japan using the Diagnosis Procedure Combination per-diem payment system. Indicators of aggressive inpatient EOLC were defined as intensive care unit admission, cardiopulmonary resuscitation (CPR), intubation and/or mechanical ventilation, hemodialysis, or extra-corporeal membrane oxygenation in the last 30 days of life, or intravenous chemotherapy in the last 14 days. We determined factors associated with aggressive EOLC using regression models. Data regarding use of blood transfusion were also obtained from the database.Results: Among 1199 patients, 433 (36%) had hematological malignancies. Children with hematologic malignancies were significantly more likely than those with solid tumors to have intubation and/or mechanical ventilation (37.9% vs. 23.5%), intensive care unit admission (21.9% vs. 7.2%), CPR (14.5% vs. 7.7%), hemodialysis (13.2% vs. 3.1%) or extra-corporeal membrane oxygenation (2.5% vs. 0.4%) in their last 30 days, or intravenous chemotherapy (47.8% vs. 18.4%; all P < .01) within their last 14 days of life. Over 90% of children with hematological malignancies received a blood transfusion within the last 7 days of life. For hematological malignancies, age under 5 years was associated with CPR and ≥2 aggressive EOLC indicators. Longer hospital stays had decreased odds of ≥2 aggressive EOLC indicators.Conclusion: Children with hematologic malignancies are more likely to have aggressive EOLC compared to those with solid tumors. A younger age and shorter hospital stay might be associated with aggressive EOLC in children with hematologic malignancies.
A clinical-radiomics nomogram for functional outcome predictions in ischemic stroke
Authors: Wang Hao , Sun Yi , Ge Yaqiong , Wu Pu-Yeh , Lin Jixian , Zhao Jing , Song Bin
Published: October 2020

Background: Stroke remains the reading cause of death and disability worldwide. Effective and prompt prognostic evaluation is vital for management strategy choice. Radiomics is an emerging non-invasive method used to identify the quantitative imaging indicators for predicting important clinical outcomes. This study was to investigate and validate a radiomics nomogram for predicting ischemic stroke prognosis using the modified Rankin scale (mRS).Methods: Totally 598 consecutive patients with subacute infarction confirmed by diffusion-weighted imaging (DWI) in 2018-2019 were retrospectively assessed. They were assigned to the good (mRS ≤ 2) and poor (mRS > 2) functional outcome groups, respectively. Then, 399 and 199 patients examined by MR scanners 1 and 2, respectively, were assigned to the training and validation cohorts, respectively. Infarction lesions underwent manual segmentation on DWI, extracting 402 radiomic properties, including infarction volume. A radiomics nomogram encompassing patient characteristics and the radiomics signature was built using a multivariate logistic regression model. The performance of the nomogram was evaluated in the training and validation cohorts. Ultimately, decision curve analysis was implemented to assess the clinical value of the nomogram.Results: Stroke lesion volume showed average performance with an area under the curve (AUC) of 0.678. The radiomics signature, including 11 radiomics features, exhibited good prediction performance. Meanwhile, the radiomics nomogram, encompassing clinical characteristics (age, hemorrhage and 24 h National Institutes of Health Stroke Scale score) and the radiomics signature, presented good discriminatory potential in the training cohort (AUC=0.80; 95% confidence interval [CI] 0.75–0.86), which was validated in the validation cohort (AUC=0.73; 95%CI 0.63–0.82). In addition, it demonstrated good calibration in the training (p=0.55) and validation (p=0.21) cohorts. Decision curve analysis confirmed the clinical value of this nomogram.Conclusions: The novel noninvasive clinical-radiomics nomogram shows good performance in predicting ischemic stroke prognosis.