bluuebunny/crossref_metadata_2025 huggingface dataset:
Derivation of "specific population who could benefit from Rosuvastatin": A secondary analysis on randomised controlled trial to uncover novel value of Rosuvastatin for precise treatment of ARDS
Authors: Zhang Shi , Lu Zhonghua , Wu Zongsheng , Xie Jianfeng , Yang Yi , Qiu Haibo
Published: June 2020

Background

The high heterogeneity of ARDS contributes to paradoxical conclusions from previous investigations of rosuvastatin for ARDS. Identification of the population (phenotype) who could benefit from rosuvastatin is a novel exploration for precise treatment of ARDS.

Methods

The patient population for this analysis consisted of unique patients with ARDS enrolled in the SAILS trial (Rosuvastatin vs. Placebo). Phenotypes were derived using consensus k means clustering applied to routinely available clinical variables within 6 hours of hospital presentation before receiving placebo or rosuvastatin. Kaplan–Meier statistic was used to estimate the 90 day cumulative mortality for screening specific population who could benefit from rosuvastatin, with cut-off value as P <0.05.

Results

The derivation cohort included 585 patients with ARDS. Of the 4 derived phenotypes, phenotype 3 was identified as "specific population who could benefit from rosuvastatin" since rosuvastatin resulted in a significant reduction in 90 day cumulative mortality for ARDS (hazard ratio [HR] 0.29 [95% CI 0.09, 0.93]; P=0.027). Meanwhile, there were no significant differences in baseline characteristics between those assigned to rosuvastatin and those assigned to placebo. Additionally, rosuvastatin markedly improved the free of cardiovascular failure (10.08±3.79 in Rosuvastatin group vs 7.31±4.94 in Placebo group, P=0.01) and coagulation abnormality (13.65±1.33 vs 12.15±3.77, P=0.02) to day 14 in phenotype 3. Patients classified as phenotype 3 exhibited but not limited to the relative higher platelet count (390.05±79.43×10^9/L), lower CRP (20.23±11.99μg/L) and Creat (1.42±1.08 mg/dl), compared with patients classified as other phenotypes. Besides that, rosuvastatin seemed to increase 90 day mortality for patients in phenotype 4 (HR 2.76[95% CI 0.09, 9.93], P=0.076), with its adverse effect on the reduction of free of renal failure to day 14(4.70±4.99 vs 10.17±4.69, P=0.01). Patients in phenotype 4 showed a relative severe illness baseline features particularly renal failure.

Conclusions

This secondary analysis of SAILS trial identified the specific population who can benefit from rosuvastatin using machine learning applied to clinical variables at the time of hospital presentation, which uncovered a novel value of rosuvastatin for the treatment of ARDS, with validation clinical trials to be warranted to assess these further.
The "State of Implementation" Progress Report (SIPREP): A Pilot Demonstration of a Navigation System for Implementation
Authors: Miech Edward J , Larkin Angela , Lowery Julie C , Butler Andrew J , Pettey Kristin M , Rattray Nicholas A , Penney Lauren S , Myers Jennifer , Damush Teresa M
Published: June 2020

Background: Implementation of new clinical programs across diverse facilities in national healthcare systems like the Veterans Health Administration (VHA) can be extraordinarily complex. Implementation is a dynamic process, influenced heavily by local organizational context and the individual staff at each medical center. It is not always clear in the midst of implementation what issues are most important to whom or how to address them. In recognition of these challenges, implementation researchers within VHA developed a new systemic approach to map the implementation work required at different stages and provide ongoing, detailed and nuanced feedback about implementation progress.Methods: This observational pilot demonstration project details how a novel approach to monitoring implementation progress was applied across two different national VHA initiatives. Stage-specific grids organized the implementation work into columns, rows and cells, identifying specific implementation activities at the site level to be completed along with who was responsible for completing each implementation activity. As implementation advanced, item-level checkboxes were crossed off and cells changed colors, offering a visual representation of implementation progress within and across sites across the various stages of implementation. Results: Applied across two different national initiatives, the SIPREP provided a novel navigation system to guide and inform ongoing implementation within and across facilities. The SIPREP addressed different needs of different audiences, both described and explained how to implement the program, made ample use of visualizations, and revealed both what was happening and not happening within and across sites. The final SIPREP product spanned distinct stages of implementation. Conclusions: The SIPREP made the work of implementation explicit at the facility level (i.e., who does what, and when) and provided a new common way for all stakeholders to monitor implementation progress and to help keep implementation moving forward. This approach could be adapted to a wide range of settings and interventions, and is planned to be integrated into the national deployment of two additional VHA initiatives within the next 12 months.
Male Gender is A Risk Factor For Sever Form of COVID-19 Illness and Worse Outcome in The Middle East
Authors: Hachim Ibrahim Y , Hachim Mahmood Y , Naeem Kashif Bin , Hannawi Haifa , Salmi Issa Al , Hannawi Suad
Published: June 2020

The identification of risk-factors, predicting the disease severity and outcome in novel coronavirus-disease-19 (COVID-19) patients, is essential to improve responsiveness to this pandemic. The association between gender and wide-range of clinical, pathological, and epidemiological factors was studied in 200-patients recruited during March-April 2020. A higher prevalence of COVID-19 infection in male (72%) compared to females (28%). Age and history of previous comorbidities were nearly comparable between genders (P value 0.75 and 0.97, respectively), male-patients had higher incidence of sever-critical form of the disease (44.67%) compared to only 23.22% in female-patients (P < 0.001). A 26.39% and 1.79% of male and female patients needed Intensive-care-unit (ICU) admission(P < 0.001), respectively. Male-patients developed a significant higher rate of lung injury presented as bilateral airspace consolidation in the plain chest X-ray at admission (38.89%) compared to 23.21% in female patient (P = 0.036%). A significant impairment of the renal-function (P = 0.031) and liver-function tests with higher level of lactate-dehydrogenase (LDH) (P < 0.001), serum bilirubin (P < 0.001), alanine-transferase; ALT (P = 0.036), and aspartate-aminotransferase, AST (P = 0.022) in male patients compared to female patients. In conclusion, this is the first detailed analysis in the middle east that thoroughly investigate the role of gender in determining the clinical course and severity of COVID-19 infection. Males compared to their age matched females, with same prevalence of comorbidities were more vulnerable to the sever COVID-19 illness with higher probability for ICU admission.
Expression and predictive value of leucine rich α-2 glycoprotein in ischemic heart disease
Authors: Gao Wei , Wu Runda , Yin Jiasheng , Ma Yuanji , Guo Junjie , Zhong Xin , Huang Dong , Ge Junbo
Published: June 2020

Background : The expression and predictive value of leucine rich α-2 glycoprotein (LRG) in ischemic heart disease, including coronary artery disease (CAD), myocardial infarction (MI) and chronic total occlusion (CTO), remain unclear.Methods : A total of 231 patients were included and divided into 4 groups: control group (N=39), CAD group (N=73), MI group (N=67) and CTO group (N=52). LRG was determined and compared within groups. MI group was then divided into 2 subgroups according to LRG expression. The association between LRG expression and clinical characteristics, peak Troponin T (TNT), left ventricular ejection fraction (LVEF) and in-hospital stay was investigated.Results : LRG expression in MI group was significantly higher than that in control group (37.9±12.8 vs 25.3±8.9, P<0.001). LRG expression in CAD and CTO group were similar with that in control group (CAD vs Con, 23.1±6.8 vs 25.3±8.9, P=0.233; CTO vs Con, 22.0±7.8 vs 25.3±8.9, P=0.082). In MI group, patients with increased LRG had higher peak TNT (4.80 (2.34-10.0) vs 2.46 (0.89-4.98), P=0.002), lower LVEF (48.7±10.2 vs 54.8±8.4, P=0.009) and longer in-hospital stay (10.4±5.4 vs 8.0±2.9, P=0.027). Linear regression showed that LRG was independently associated with in-hospital stay. ROC curve showed the area of LRG under the curve (AUC) was 0.859.Conclusions : LRG expression was elevated in MI patients compared with controls, angiography confirmed CAD and CTO patients. In the MI subgroup, patients with elevated LRG had higher peak TNT, lower LVEF and longer in-hospital stay. Whether LRG is associated with major adverse cardiovascular events and long term prognosis needs further investigation.
Vancomycin-Lock Therapy for Prevention of Catheter-Related Bloodstream Infection in Very Low Body Weight Infants
Authors: Liang Hong , Zhang Lian , Guo Xiaoping , Sun Li
Published: June 2020

Background: This study was to evaluate the effectiveness and safety of vancomycin- lock therapy for the prevention of catheter-related bloodstream infection (CRBSI) in very low body weight (VLBW) preterm infant patients.Methods: One hundred and thirty-seven cases of VLBW preterm infants who retained peripherally inserted central catheters (PICCs) were retrospectively reviewed, including 68 treating with heparin plus vancomycin (vancomycin-lock group) and 69 with heparin only (control group). The incidence of CRBSI, related pathogenic bacteria, adverse events during the treatment, complications, antibiotic exposure, PICC usage time, hospital stay, etc. were compared between the above two groups.Results: The incidence rate of CRBSI in the vancomycin-lock group (4.4%, 3/68) was significantly less than in the control group (21.7%, 15/69, p=0.004). Total antibiotic exposure time during the whole observation period was significantly shorter in the group than in the control group (11.2±10.0 vs 23.6±16.1 d; p<0.001). No hypoglycemia occurred during the locking, and the blood concentrations of vancomycin were not detectable.Conclusions: Vancomycin-lock may effectively prevent CRBSI in Chinese VLBW preterm infants, prolong the usage time of PICC line, and reduce the exposure time of antibiotics, without causing obvious side complications.
Molecular Detection of Rickettsia in Fleas from Micromammals in Chile with Potential Public Health Implications
Authors: Salas Lucila Moreno , Carniglia Mario Espinoza , Schmeisser Nicol Lizama , Fuentes Luis Gonzalo Torres , Fuente María Carolina Silva de la , Lareschi Marcela , Acuña Daniel González
Published: June 2020

BackgroundFleas are important vectors of pathogenic bacteria that pose public health concerns worldwide, including Rickettsia. Micromammals, and especially rodents, are the main flea hosts, therefore they play a fundamental role in the spread of flea-borne diseases and various species of rodent fleas can also parasitize humans. In addition to this, many rodent species are capable of inhabiting wild environments and adapting to rural and urban environments, which could favor a continuous gradient of transmission between domestic and wild species. The aim of this study was to detect, characterize, and compare Rickettsia spp. from the fleas of micromammals in areas with different human population densities in Chile.MethodsTo determine Rickettsia in fleas of micromammals, we analyzed 1,315 fleas obtained from 1,512 micromammals, which were captured in 29 locations with different human population densities in Chile. We used polymerase chain reaction (PCR) amplification of the gltA, rpoB, and ompB genes to detect Rickettsia in fleas.ResultsThe prevalence of Rickettsia among flea species ranged from 0%–35.1%. Fifteen flea species were found to be Rickettsia-positive. Areas of lower human density have the highest prevalence of Rickettsia. The phylogenetic tree shows two well-differentiated clades. Rickettsia belli is positioned as basal in a clade. Another clade is subdivided into two subclades, and are related to Rickettsia of typhus group.ConclusionsConsidering that fleas are generalist parasites, and that they are frequently found and abundant in rodents, which are closely related to humans, the detection of potential emerging zoonotic pathogens in rodent fleas highlights the risk of infection to humans.
Nondestructive estimation of potato yield using relative variables derived from multi-period LAI and hyperspectral data based on weighted growth stage
Authors: Luo Shanjun , He Yingbin , Li Qian , Jiao Weihua , Zhu Yaqiu , Zhao Xihai
Published: June 2020

Background
The accurate estimation of potato yield at regional scale is crucial for food security, precision agriculture and agricultural sustainable development.
Methods
In this study, we developed a new method using multi-period relative vegetation indices (rVIs) and relative LAI (rLAI) data to improve the accuracy of potato yield estimation based on weighted growth stage. Two experiments of field and greenhouse (water and nitrogen fertilizer experiments) in 2018 were performed to obtain the spectra and LAI data of the whole growth stage of potato. Then the weighted growth stage was determined by three weighting methods (improved analytic hierarchy process method, IAHP; entropy weight method, EW; and optimal combination weighting method, OCW) and Slogistic model. A comparison of the estimation performance of rVI-based and rLAI-based models with single stage and weighted stage was completed.
Results
The results showed that among the six test rVIs (rNDVI, rCIred edge, rCIgreen, rEVI2, rNDRE and rMTCI), rCIred edge was the optimal index of the single-stage estimation models with the correlation with potato yield. The most suitable single stage for potato yield estimation was the tuber expansion stage. For weighted growth stage models, the OCW-LAI model was determined as the best one to accurately predict the potato yield with adjusted R2 value of 0.8333, and the estimation error about 8%.
Conclusion
This study emphasizes the importance of inconsistent contributions of multi-period or different types of data to the results when they are used together, and the weights need to be considered.
Mel Aggravates Pyroptosis Induced by Temozolomide Through Inhibiting NRF2-are Pathway in Glioblastoma
Authors: Pan Hao , wang Handong , Wang Qiang , Niu Wenhao , Wu Qi , Jia Yue , Sun Kangjian , Chen Longbang
Published: June 2020

Background:Glioblastoma(GBM) is a common malignant tumor of the brain. It has been verified that melatonin(MEL) can inhibit glioma proliferation. But its mechanism has not been fully elucidated. We intend to examine the mechanism of MEL on glioma cells from the perspective of pyroptosis and Nrf2. Methods:Expression of MEL receptor in glioma was detected by western blot. GBM cell viability treated with temozolomide(TMZ) plus MEL was detected by CCK-8. Pyroptosis rate was determinate by flow cytometric analysis. Western blot was used to detect the Nrf2 and pyroptosis related protein level after MEL treatment. Orthotopic tumor growth inhibition study was performed to further investigate the tumor inhibition effect of TMZ plus MEL.Results:We first confirmed MEL receptor was abundant in glioma tissue and cell lines. After combined treatment of TMZ and MEL, cell viability decreased significantly as compared to those of TMZ treatment alone. Also, the ratio of pyroptosis and ROS level increased, followed by elevated expression of pyroptosis related protein. Furthermore, MEL can induce a diminution of Nrf2 expression in glioma in dose- and time-dependent manner. TMZ can increase Nrf2-ARE pathway expression, which also can be deprived by MEL. Its inhibition of Nrf2 depends on dephosphorylation of IGF-1/AKT/mTOR pathway. More importantly, after overexpression of Nrf2 in glioma cells, the level of pyroptosis-related protein elevated by MEL decreased, suggesting that the effect of MEL on promoting pyroptosis is dependent on its inhibition of Nrf2. In vivo results further confirmed that MEL plus TMZ induced significantly decreased tumor size and increased pyroptosis rate, but had no significant effect on mouse body weight, ALT, AST.Conclusion:MEL can inhibit the phosphorylation of IGF-1/AKT/mTOR pathway at millimol level, which further reduces the expression of Nrf2 and promotes pyroptosis of glioma cells. Considering the modest efficacy of TMZ chemotherapy, MEL can be considered as a potential chemotherapy sensitizer to improve the chemotherapy effect of glioma.
PRDM16 inhibits cell proliferation and migration via epithelial to mesenchymal transition by directly targeting pyruvate carboxylase in papillary thyroid cancer
Authors: Liu Wan-Lin , Guan Qing , Wen Duo , Ma Ben , Xu Wei-Bo , Hu Jia-Qian , Wei Wen-Jun , Li Duan-Shu , Wang Yu , Xiang Jun , Liao Tian , Ji Qinghai
Published: June 2020

Background
PRDM16 (known as MEL1), a member of PR domain zinc finger family, has been implicated in multiple biological processes including cancers. It is not clearly yet whether PRDM16 is involved in tumor progress of papillary thyroid cancer (PTC).
Methods
We identified PRDM16 expression level in PTC tissues by qRT-PCR and analyzed its relationship with clinical characteristics in both Fudan University Shanghai Cancer Center (FUSCC) cohort and TCGA cohort. We tested the function of PRDM16 in PTC cells both in vivo and in vitro. We found direct downstream target of PRDM16, pyruvate carboxylase (PC) by RNA-sequencing, rescue experiments, Luciferase assay and Chromatin Immunoprecipitation assay.
Results
PRDM16 was downregulated in papillary thyroid cancer tissues and was significantly related with lymph node metastases and extrathyroid extension in both FUSCC and TCGA cohorts. Overexpression of PRDM16 could attenuate proliferation and migration of PTC cells via inhibiting epithelial to mesenchymal transition process. PC was upregulated in papillary thyroid cancer tissues. Knockdown of PC could inhibit proliferation and migration in TPC-1 and K1 cells. The repression effect on cell proliferation and migration from PRDM16 was PC dependent. PRDM16 could directly bind to PC promoter and inhibited its expression at transcription level. Moreover, the mRNA expression level of PRDM16 and PC was negatively related in human PTC tissues.
Conclusions
In conclusion, PRDM16 exhibited anti-tumor effect and EMT inhibition function in PTC by directly binding with PC promoter. PRDM16 may be a novel therapeutic target in papillary thyroid cancer.
Disentangling Microbial Syntrophic Mechanisms for Hexavalent Chromium Reduction in Autotrophic Biosystems
Authors: Zhang Baogang , Liu Jun , Sheng Yizhi , Shi Jiaxin , Dong Hailiang
Published: June 2020

Background: Hexavalent chromium [Cr(VI)] is one of ubiquitous heavy-metal contaminants in groundwater, and electron donors are considered to be a key parameter for Cr(VI) biotransformation. During autotrophic remediation process, however, much remains to be unveiled that how complex syntrophic microbial communities couple Cr(VI) reduction with other elemental cycles. Results: Two series of Cr(VI)-reducing groundwater bioreactors were independently amended by elemental sulfur (S0) and iron (Fe0), and inoculated with the same inoculum. After 160 days incubation, both bioreactors showed the similar archaea-dominating microbiota compositions, whereas a higher Cr(VI) reducing rate and more methane production were detected in the Fe0-driven one. Metabolic reconstruction of 23 retrieved genomes revealed complex symbiotic relationships driving distinct elemental cycles coupled with Cr(VI) reduction in bioreactors. In both bioreactors, these inferred Cr(VI) reducers were assumed to live in syntrophy with oxidizers of sulfur, iron, and volatile fatty acids (VFAs) and methane produced by carbon fixers and multi-trophic methanogens, while hydrogen slowly released via an Fe0 corrosion process might readily facilitate methanogenesis and more methane oxidation might be linked to Cr(VI) reduction in the Fe-bioreactor.Conclusion: These findings provide insights into mutualistic symbioses of carbon, sulfur, iron and chromium metabolisms in groundwater systems, providing implications for both in-situ and ex-situ bioremediation of contaminated groundwater.
Construction and Analysis of lncRNA-mediated ceRNA Network in Nasopharyngeal Carcinoma Based on Weighted Correlation Network Analysis
Authors: Zou Zhenning , Liu Shuguang , Ha Yanping , Huang Bowan
Published: June 2020

Background: Increasing evidence indicated that aberrant expression of long noncoding RNAs (lncRNAs) are involved in tumorigenesis and progression of nasopharyngeal carcinoma (NPC). The purpose of this study is to construct a lncRNA-mediated ceRNA network based on Weighted correlation network analysis (WGCNA) and explore the relationship between the constituents of the ceRNA network and the prognosis of patients with NPC.Methods: In this study, WGCNA was performed on the GSE102349 to find modules of highly correlated genes. The preservation of the modules was examined by GSE68799. GSE12452 was utilized to identify the differentially expressed lncRNAs and mRNAs. GSE32960 was utilized to identify the differentially expressed miRNAs. Through annotation and intersection, the lncRNAs and mRNAs in the same WGCNA modules and the miRNAs were used to construct a ceRNA network. Next, the prognostic value of the constituents of the ceRNA network was evaluated by survival analysis. Furthermore, a risk score model for predicting progression-free survival (PFS) of NPC patients was established via lasso penalized Cox regression based on the differentially expressed genes, and the differences in the expression of the lncRNAs and mRNAs in the ceRNA network between high- and low-risk groups were investigated.Results: Fourteen stable modules were identified using GSE102349 based on WGCNA. A ceRNA network composed of 11 lncRNAs, 15 miRNAs and 40 mRNAs was established. The lncRNAs and mRNAs in this network were from turquoise and salmon modules. Survival analysis indicated that ZNF667-AS1, four mRNAs (LDHA, LMNB2, TPI1, and UNG), and hsa-miR-142-3p in the ceRNA network were significantly correlated with the prognosis of NPC. Gene set enrichment analysis indicated that the up-regulation of ZNF667-AS1 was associated with some immune-related pathways. Besides, a risk score model consisting of 12 genes was constructed and showed a good performance in predicting PFS in NPC patients. Among the 11 lncRNAs in the ceRNA network, SNHG16, SNHG17, and THAP9-AS1 were up-regulated in the high-risk group of NPC, while ZNF667-AS1 was down-regulated in the high-risk group of NPC.Conclusions: These results will promote our understanding of the crosstalk among lncRNAs, miRNAs, and mRNAs in the tumorigenesis and progression of NPC.
HOXA-AS2 Promotes Glioblastoma Carcinogenesis by Targeting miR-885-5p Thus Releasing RBBP4 mRNA
Authors: Shou Jixin , Gao Haidong , Cheng Sen , Wang Bingbing , Guan Haibo
Published: June 2020

Background: HOXA-AS2, a lncRNA, had been proved to exert the promoting effect on glioblastoma, but its regulatory mechanism was not fully revealed. Our study focused on the interaction and role of HOXA-AS2/miR-885-5p/RBBP4 axis in the development of glioblastoma. Methods: qRT-PCR was used to detect the expression of lncRNA, miRNA and mRNA in glioblastoma tissues and cells. Dual luciferase assay, RIP assay and RNA pull-down assay were applied to reveal the interaction among HOXA-AS2, miR-885-5p and RBBP4. The cell functional experiments such as CCK-8, BrdU assay and cell adhesion etc. were used to analyze the effect of HOXA-AS2/miR-885-5p/RBBP4 axis on glioblastoma cells. Results: HOXA-AS2 and RBBP4 were overexpressed in 33 glioblastoma tissue samples and glioblastoma cells, as well as HOXA-AS2 and RBBP4 contributed to the tumorigenesis of glioblastoma cells. On the other hand, miR-885-5p was proved to be down-regulated in 33 glioblastoma tissue samples and glioblastoma cells, and it was an obstacle to the malignant phenotypes of glioblastoma cells. Meanwhile, HOXA-AS2 could negative regulate miR-885-5p, thereby promoting the RBBP4 expression since RBBP4 was targeted by miR-885-5p. Finally, HOXA-AS2 was proved to act as the positive role in glioblastoma cells via negative regulating miR-885-5p to release RBBP4.Conclusion: HOXA-AS2 promotes the tumorigenesis of glioblastoma through targeting miR-885-5p to induce the RBBP4 expression.
Effect of low dose Bupivacaine with Fentanyl on hemodynamic response: A Prospective cohort study
Authors: Obsa Mohammed Suleiman , Negash Behaku Awel , Kassa Adugna Aregawi , Muzeyan Suleiman Jemal , Helill Shamill Eanga
Published: June 2020

Background: A conventional dose of local anesthetics is used during spinal anesthesia. However an unwanted hemodynamic effect by administration of adjuvants with low dose of local anesthetics has been observed. The purpose of the study was to compare the effect of low dose Bupivacaine with Fentanyl versus normal dose Bupivacaine alone on hemodynamic response in elderly patients. Methods: A Prospective cohort study was employed on a total of 64 elderly patients undergoing lower extremity orthopedics surgery. An exposed group (group BF) received 10mg of 0.5% isobaric bupivacaine with 25mcg of fentanyl and a non-exposed group (Group B) received 15 mg of 0.5% isobaric bupivacaine alone. Systematic random sampling technique was used to select study participants. Parametric data was analyzed by using independent t-test, nonparametric data by using Mann-Whitney U-test and homogenous categorical data by using chi-square test and fisher exact test. The level of statistical significance for all tests was found to be P < 0.05. Results: The incidence of hypotension was higher in group B than group BF (37.5% vs. 9.4%, respectively) and statistically significant differences was observed (p=0.008). The onset of sensory block and regression of motor block to zero were faster in group BF than in group B (p <0.05). TAR was also prolonged in group BF (P<0.05). Conclusion: Low dose Bupivacaine with Fentanyl has lower incidence of hypotension, fast onset of sensory block and prolonged first analgesia request time than bupivacaine alone Therefore, we recommends the use of low dose bupivacaine with fentanyl to have a better hemodynamic stability than conventional dose of bupivacaine for elderly patients who undergoes lower extremity surgery.
Proline-rich Protein 11 Overexpression is Associated With a More Aggressive Phenotype and Poor Overall Survival in Ovarian Cancer Patients
Authors: zhan yu , wu xueyuan , zheng gang , jin jingjing , li chaofu , yu guanzhen , li wenfeng
Published: June 2020

Background: The proline-rich protein 11 (PRR11) is a newly identified oncogene that exerts a strong association with a poor prognosis in various kinds of human cancers, yet its role in ovarian cancer (OC) remains unknown. Thus, the study aims to evaluate the level of PRR11 protein expression and its function in human ovarian cancer.Methods: In the present study, we used immunohistochemistry analysis to evaluate the levels of PRR11 protein expression in human specimens from 49 OC patients who underwent curative surgery in the First Affiliated Hospital of Wenzhou Medical University2007 to 2015.Results: In our analysis, 57.1% of the primary OC tumor tissue evaluated, presented over expression of PRR11. Meanwhile, survival analysis showed that the overall survival (OS) of patients presenting PRR11 over expression was significantly lower than the OS of the PRR11 negative patient group. Furthermore, in subsequent experiments we found that silencing PRR11 expression inhibited tumor cell proliferation and cell migration in vitro. In addition, cells subjected to PRR11 knockdown exhibited a decrease in tumor grow in vivo. The down regulation of PRR11 was acompanied by a decrease in N-cadherin and early growth response protein 1 (EGR1) expression.Conclusions: our results suggest that PRR11 may be considered as a potential target for prognosis assessment and gene therapy modalities for patients with OC.
The Impact of COVID-19 pandemic on Obstetrics and Gynecology Residency Programs and perspectives on adaptive ways of training in Ethiopia
Authors: Gudu Wondimu , Wondafrash Mekitie , Bekele Delayehu , Nigatu Balkachew , Birrara Malede , Feyessa Mekdes Daba
Published: June 2020

Background: The impact of Covid-19 on healthcare system and trainings has been tremendous and unpredictable. In addition to service re-organization, teaching institutions will have to devise adaptive mechanisms to cope up with the disruption in medical education and residency training. Objectives: to assess the effect of Covid-19 pandemic on obstetrics and gynecology residency program and explore residents’ & program directors’ perspectives on alternative academic approaches in Ethiopia.Methods: This is a cross sectional mixed method study which was conducted at 12 institutions engaged in obstetrics and gynecology residency training in Ethiopia from May to June 2020. Quantitative data were collected from 240 residents employing an online platform (Google Forms) and focus group discussion was conducted using the ZOOM video-conferencing platform with eleven chief residents and eight program directors. Quantitative data analysis was performed using Stata 15 statistical software while thematic synthesis approach was used for the qualitative data analysis assisted by ATLAS.ti 7 for windows. Ethical clearance was obtained from IRB of Saint Paul’s Hospital Millennium Medical College. Results: All levels of residents from all residency sites were represented. The level of residents’ engagement in various routine clinical services vary depending on the type of service during COVID-19 pandemic period. Residents’ involvement in routine ANC, high risk clinics are “slightly” reduced while in Gynecology OPDs, the reduction was “severe”. There was no effort made to address the psychological impact of the pandemic on residents. The level of reduction in didactic and clinical teaching (rounds, case presentations, seminars, management sessions ranged from “some” to “complete interruption” for most of the residents at different years of training. Although the reduction in obstetric practical exposure (normal delivery, cesarean delivery) was “slight”, there was “sever” reduction to “complete suppression” (>80%) in major gynecologic surgeries primarily affecting final year residents. Research activities are completely halted in most of the institutions. Generally, adaptive methods to sustain the residency training were implemented in very few of the institutions. Conclusions: There was significant disruption in all domains of the residency training following the report of the first case of COVID-19 in Ethiopia. The preparedness and response of the programs was very poor and there was limited effort in implementing adaptive teaching methods in almost all of the institutions.
Early combination treatment with existing HIV antivirals: an effective treatment for COVID-19? 
Authors: Dallocchio Roberto Nico , Dessì Alessandro , Vito Andrea De , Delogu Giovanna , Andrea Pier , Madeddu Giordano
Published: June 2020

Since no effective therapy exists, we aimed to test existing HIV antivirals for combination treatment of Coronavirus disease 19 (COVID-19). Our molecular docking findings suggest that lopinavir, ritonavir, darunavir, and atazanavir activated interactions with the key binding sites of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) protease with a better Ki for lopinavir, ritonavir, and darunavir. Furthermore, we evidenced the ability of remdesivir, tenofovir, emtricitabine, and lamivudine to be incorporated in SARS-CoV-2 RNA-dependent RNA polymerase in the same protein pocket where poses the corresponding natural nucleoside substrates with comparable Ki and activating similar interactions. In principle, the four antiviral nucleotides might be used effectively against SARS-CoV-2. The combination of a protease inhibitor and two nucleoside analogues should be evaluated in clinical trials for the treatment of COVID-19.
Endothelial Shear Stress Enhancements: A Potential Solution for Critically Ill Covid-19 Patients
Authors: Nour Sayed
Published: June 2020

Rationale: Most critically ill Covid-19 patients succumb to multiple organ failure and / or cardiac arrest as a result of comorbid endothelial dysfunction disorders which had probably aggravated by conventional mechanical assist devices. Even worse, mechanical ventilators prevent the respiratory pump from performing its crucial function as a potential generator of endothelial shear stress (ESS) which controls microcirculation and hemodynamics since birth. The purpose of this work is to bring our experience with ESS enhancement and pulmonary vascular resistance (PVR) management as a potential therapeutic solution in acute respiratory distress syndrome (ARDS). We propose a noninvasive device composed of thoracic and infradiaphragmatic compartments that will be pulsated in an alternating frequency (20/40 bpm) with low-pressure pneumatic generator (0.1-0.5 bar). Oxygen supply, nasogastric ± endotracheal tubes are considered. Proof-of-concept: prototypes were tested in pediatric models of refractory cardiac arrest (≥20min), showed restoration of hemodynamics (BP≥100 mm Hg) and urine output, regardless of heartbeats, pharmacological supports and mechanical ventilation. Conclusions ESS enhancement represents a more effective treatment to increase tissue oxygenation and improve hemodynamic in ARDS. A cost-effective method which could be induced with a non-invasive pulsatile device adaptable to cardiopulmonary-circulatory biophysics to maintain a fully functional respiratory pump and avoid confrontation of the opposite hydraulic circuits.
Linking the Effect of Psoriatic Arthritis-Related Foot Involvement to the Leeds Foot Impact Scale using the International Classification for Functioning, Disability and Health.
Authors: Carter Kate , Tannous Caterina , Walmsley Steven , Rome Keith , Turner Deborah E
Published: June 2020

Background Previous research to describe the impact of foot involvement in psoriatic arthritis has used the Leeds Foot Impact Scale in Rheumatoid Arthritis (LFIS-RA) in the current absence of any psoriatic arthritis foot-specific tools. However, the LFIS-RA is a rheumatoid arthritis disease-specific outcome measure and its content validity for evaluating the experiences of people with psoriatic arthritis-related foot involvement is unknown. The study objective was to determine the content validity of the LFIS-RA for assessing people with psoriatic arthritis, using the International Classification of Functioning, Disability and Health (ICF) as the frame of reference. Method Concepts within each item of the LFIS-RA were linked to the best-matched ICF categories using established linking rules, which enable a systematic and standardised linking process. All concepts were independently linked to the ICF by 2 investigators with different professional backgrounds, which included occupational therapy and podiatry. The list of ICF categories derived from previous research that pertained to the foot with psoriatic arthritis was then compared with the ICF categories linked to the LFIS-RA. The comparison was undertaken in order to determine the extent to which concepts important and relevant to people with psoriatic arthritis-related foot involvement were addressed. Results Thirty-five distinct ICF categories were linked to LFIS-RA, which related to body functions (44%), activities and participation (35%), environmental factors (16%) and body structure (5%). In comparison with the ICF categories derived from concepts of the foot in psoriatic arthritis previously defined, the LFIS-RA provided coverage of key constructs including pain, functioning, daily activities, footwear restrictions and psychological impact. Other concepts of importance in psoriatic arthritis such as skin and toenail involvement, self-management and paid employment were not addressed in the LFIS-RA. Conclusion Content validity of the LFIS-RA to determine the impact of foot functional impairments and disability in people with psoriatic arthritis was not supported by the results of this study. Future work should consider the development of a psoriatic arthritis foot-specific patient reported outcome measure, using the LFIS-RA as an important foundation.
Diabetic Retinopathy Screening in Urban Primary Care Setting with a Handheld Smartphone-based Retinal Camera.
Authors: Queiroz Márcia S , de Carvalho Jacira Xavier , Bortoto Silvia Ferreira , de Matos Mozania Reis , Cavalcante Cristiane das Graças Dias , Andrade Elenilda Almeida Silva , Correa-Giannella Maria Lúcia , Malerbi Fernando K
Published: June 2020

Aims: To evaluate diabetic retinopathy (DR) screening with a portable handheld smartphone-based retinal camera and telemedicine in an urban primary health care setting; to evaluate the learning curve for image acquisition, performed by healthcare personnel without previous experience on retinal imaging. Methods: Prospective study that enrolled patients with type 2 diabetes mellitus (T2DM) followed at a primary healthcare unit in São Paulo, Brazil. After a brief training in image acquisition, there was further continuous feedback during the remote image reading process. Each patient underwent two fundus and one anterior ocular segment images per eye, after mydriasis. Patients were classified according need of referral. Results: A total of 627 adult individuals with T2DM underwent retinal evaluation. The population was composed by 63.2% female individuals, age median of 66 years-old, diabetes duration 10.7 ± 8.2 years and A1c 7.7 ± 1.9% (61 + 20.8 mmol/mol). The most prevalent associated comorbidities were arterial hypertension (80.3%) and dyslipidemia (50.2%). Referral decision was possible in 81.2% patients. Most patients had absent or non-referable DR; the main ocular media opacity detected was cataract. After the 7th day of image acquisition, the daily rate of patients whose images allowed clinical decision was maintained above 80%. A higher A1c was associated with referable DR. Conclusion: A low-cost DR screening strategy with a handheld device and telemedicine is feasible and has the potential to increase coverage of DR screening in underserved areas; the possibility of mobile units is relevant for DR screening in the context of Covid-19 pandemic.
The number of circulating endothelial progenitor cells from septic patients are associated with different infectious organisms
Authors: Zhu Yingying , Yang Nana , Zhu Jing , Fu Chao , Tian Xinghan , Zhang Fusen , Zhao Lei , Zhu Jingwei , Lv Kaixuan , Wang Chunting
Published: June 2020

Background

Endothelial progenitor cells (EPCs) can affect the repairment of endothelial injury by improving the process of re-endothelialization and angiogenesis in sepsis patients. However, the markers of EPCs have not been standardized nowadays, and the changes of EPCs are still unclear in patients with different infectious organisms. This study explored the relationship between the number of EPCs and different infectious organisms in patients with sepsis.

Materials and Methods

39 septic patients and 20 healthy controls were enrolled in this study. The number of CD34+/KDR+, CD133+/KDR+, CD34+/CD133+/KDR+, CD34+, CD133+, and KDR+ cells were all analyzed through flow cytometry. Analysis of adhesion function of EPCs were also performed by counting the number of adherent cells in different cultured time points (4 days, 14 days, and 21 days).

Results

The number of EPCs in peripheral blood of septic patients were higher than that of healthy controls, but there were no significant differences between sepsis group and septic shock group, also between the survival group and the non-survival group. Additionally, the percentages of CD34+/CD133+/KDR+ cells in Gram-positive bacteremia group was significantly higher than the Gram-negative bacteremia group and negative blood culture group; the percentage of KDR+ cells in both Gram-positive bacteremia group and Gram-negative bacteremia group were significantly higher than the negative blood culture group. Furthermore, the adhesion function of EPCs in healthy controls was significantly higher than in septic patients.

Conclusions

The number of circulating EPCs and the adhesion function of EPCs in patients with sepsis are associated with different infectious organisms.
Retrospective Analysis of Pediatric Patients with Multiple Rare-Earth Magnet Ingestion: A Single-Center Experience from China.
Authors: Zheng Yucan , Zhang Zhihua , Yan Kunlong , Guo Hongmei , Li Mei , Lian Min , Liu Zhifeng
Published: June 2020

Background The aim of this study was to characterize patients with multiple rare-earth magnet ingestion in a single-pediatric medical center, reveal the harm of rare-earth magnets foreign bodies in digestive tract, and develop a clinical management algorithm. Methods This was a retrospective review of patients with rare-earth magnets foreign bodies in digestive tract admitted to a university-affiliated pediatric medical center in China, between January 2016 to December 2019, with a subset of medical data including clinical symptoms, signs, treatments and outcomes. Results A total of 51 cases were included in this study, including 36(70.6%) males and 15(29.4%) females. The magnets were passed naturally in 24(47.1%) patients and removed by intervention in 27(52.9%) patients, including five(9.8%) cases by endoscopy and 22(43.1%) cases by surgery. 22(43.1%) cases had gastrointestinal obstruction, perforation, and fistula. Compared with the non-surgical group, the proportion of males in the surgical group was higher (21/23 vs 15/28, p=0.004), and the visiting time to hospital was longer (80(72) vs 26(5), hours, p=0.008). Conclusions The rate of surgical intervention is high in multiple rare-earth digestion cases and the consequences are serious, and a more efficient management algorithm for these cases should be needed. A policy for strictly restricted or prohibited the sale of the toys with multiple rare-earth magnets needed to put into the agenda. Trial registration The study will be retrospectively registered.
Interobserver variability in target volume delineation in definitive radiotherapy for thoracic esophageal cancer: A multi-center study from China
Authors: Chang Xiao , Deng Wei , Wang Xin , Zhou Zongmei , Yang Jun , Guo Wenling , Liu Miaoling , Qi Xiaolu , Li Ling , Zhang Kaixian , Zhang Min , Shi Yonggang , Liu Ke , Zhao Yidian , Wang Huitao , Yu Zhilong , Zhang Jihong , Wang Lihua , Qiao Xueying , Han Chun , Zhu Shuchai , Zhang Ruohui , Chen Junqiang , Hu Cairong , Zhang Fuquan , Hou Xiaorong , Pang Qingsong , Zhang Wencheng , Li Gaofeng , Lin Hailei , Sun Xinchen , Ge Xiaoling , Li Caihong , Ge Hong , Li Dingjie , Wang Yadi , Lu Na , Gao Xianshu , Qin Shangbin , Tian Yuan , Xiao Zefen
Published: June 2020

Purpose: To investigate the interobserver variability (IOV) in target volume delineation of definitive radiotherapy for thoracic esophageal cancer (TEC) among cancer centers in China, and ultimately improve contouring consistency as much as possible to lay the foundation for multi-center prospective studies.Methods: Sixteen cancer centers throughout China participated in this study. In Phase 1, three suitable cases with upper, middle, and lower TEC were chosen, and participants were asked to contour a group of gross tumor volume (GTV-T), nodal gross tumor volume (GTV-N) and clinical target volume (CTV) for each case based on their routine experience. In Phase 2, the same clinicians were instructed to follow a contouring protocol to re-contour another group of target volume. The variation of the target volume was analyzed and quantified using dice similarity coefficient (DSC).Results: Sixteen clinicians provided routine volumes, whereas ten provided both routine and protocol volumes for each case. The IOV of routine GTV-N was the most striking in all cases, with the smallest DSC of 0.37 (95% CI: 0.32-0.42), followed by CTV, whereas GTV-T showed high consistency. After following the protocol, the smallest DSC of GTV-N was improved to 0.64 (95% CI: 0.45-0.83, P=0.005) but the DSC of GTV-T and CTV remained constant in most cases.Conclusion: Variability in target volume delineation was observed, but it could be significantly reduced and controlled using mandatory interventions.
Application of sample balance-based multi-perspective feature ensemble learning for prediction of user purchasing behaviors on mobile wireless network platforms
Authors: Zhang Huibing , Dong Junchao
Published: June 2020

In recent years, with the rapid development of wireless communication network, M-Commerce has achieved great success. Relying on mobile phones, tablets and other wireless communication devices for online shopping has become a mainstream way for users to consume. Users leave a lot of historical behavior data when shopping on the M-Commerce platform. Using these data to predict future purchasing behaviors of the users will be of great significance for improving user experience and realizing mutual benefit and win-win result between merchant and user. Therefore, a sample balance-based multi-perspective feature ensemble learning was proposed in this study as the solution to predicting user purchasing behaviors, specifically including: 1) “Sliding window”-centroid under-sampling was combined with sample balance method was used, while the positive sample size was enlarged using “sliding window”, centroid under-sampling was used to reduce the negative sample size within “sliding window”, so as to acquire user’s historical purchasing behavioral data with sample balance. 2) Influence feature of user purchasing behaviors were extracted from three perspectives—user, commodity and interaction, in order to further enrich the feature dimensions. Meanwhile, feature selection was carried out using XGBSFS algorithm. 3) An ensemble learning model—five-fold cross validation stacking—which could be used to predict user purchasing behaviors was raised. Three prediction models—XGBoost-Logistics, LightGBM-L2 and cascaded deep forest models—so that they could realize mutual collaboration and the overall prediction ability of the ensemble learning model could be improved. 4) Large-scale real datasets were experimented on Alibaba M-Commerce platform. The experimental results show that the proposed method has achieved better prediction effect in various evaluation indexes such as precision and recall rate.
GSG2 knockdown suppresses cholangiocarcinoma progression by regulating cell proliferation, apoptosis and migration
Authors: Zhou Jun , Huang Ranglang , Nie Wanpin , Yuan Jiajia , Zhang Zeyu , Mi Liangliang , Wang Changfa
Published: June 2020

Background: Cholangiocarcinoma (CCA) is the second most common type of hepatocellular carcinoma with high aggressiveness and extremely poor prognosis. Homo sapiens germ cell associated 2 (GSG2) is a histone H3 threonine-3 kinase required for normal mitosis. Nevertheless, the role and mechanism of GSG2 in progression and development of CCA remain elusive.
Methods: In the present study, correlation between GSG2 and CCA was elaborated by IHC, Mann-Whitney U and Spearman grading correlation. GSG2 knockdown cell lines were successfully constructed and further used to construct mouse xenotransplantation models. Subsequently, cell proliferation, cell apoptosis, cell cycle and cell migration were detected by MTT assay, Flow Cytometry and wound-healing assay, respectively.
Results: It was demonstrated that GSG2 was overexpressed in CCA specimens and relevant cell lines. The statistical analysis determined that high GSG2 expression was positively associated with more advanced tumor grade. Importantly, GSG2 knockdown inhibited cell proliferation, migration, promoted cell apoptosis and arrested cell cycle in G2 phase. Meanwhile, in vivo results also supported that GSG2 knockdown inhibit tumor growth. Additionally, GSG2 was involved in CCA progression via suppressing EMT.
Conclusions: In summary, our findings suggested that GSG2 may be a potential therapeutic target for CCA patients.