bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparaison des Kess-Kess de Hmar Lakhdad (Emsien, Maroc) et des monticules micritiques de l'anticlinorium de Philippeville (Frasnien, Belgique) [A Comparison between the Kess-kess of Hmar Lakhdad (Emsian, Morocco) and the mud mounds of the Philippeville Anticlinorium (Frasnian, Belgium)]
Authors: HILALI Atika , LACHKHEM Hassan , BOULVAIN Frédéric
Published: April 2020

The Kess-kess of Hmar Lakhdad are Devonian mud mounds, located SE of Erfoud (Moroccan Antiatlas). Fenestral structures, which are very abundant, occur from the base to the top of most buildups. These structures are classified in two groups: stromatactis s.s. and stromatactoid fenestrae, each of them showing a high morphological variability. These fenestrae look very similar to the structures already described from the Belgian mud mounds. However, their attribution to sponges cannot be demonstrated. Microstromatolithes, a microbial structure, are common in the Moroccan and Belgian buildups. The numerous sedimentological similarities between the two types of mounds allow to assign the facies of the Kess-kess to the coral-crinoidal limestones at the base of the Belgian buildups. This comparison justifies a paleoecological and paleobathymetrical interpretation of the Moroccan mud mounds.
Characteristics of Obstructive Sleep Apnea Patients With a Low Body Mass Index: Emphasis on the Obstruction Site Determined by Drug-Induced Sleep Endoscopy
Authors: Woo Hyun-Jae , Lim Jae Hyun , Ahn Jae-Cheul , Lee Yu Jin , Kim Dong-Young , Kim Hyun-Jik , Rhee Chae-Seo , Won Tae-Bin
Published: April 2020

Objectives. This study aimed to elucidate the patterns of upper airway collapse in obstructive sleep apnea (OSA) patients with a low body mass index (BMI).Methods. We designed and conducted a retrospective cohort study. Consecutive patients diagnosed with OSA who underwent drug-induced sleep endoscopy (DISE) were included. Patients were classified into four groups according to their BMI. Age, sex, and polysomnography data were investigated. The patterns of upper airway collapse were characterized by the structures involved (soft palate, tongue base, lateral pharyngeal wall, and epiglottis). We compared the patterns of upper airway collapse in the supine and lateral decubitus position among the four BMI groups using the chi-square test and multivariate binary logistic regression analysis.Results. A total of 627 patients (male, 517; mean age, 47.6±12.8 years) were included, consisting of 45, 79, 151, and 352 patients who were underweight or lower normal-weight (defined as the low BMI group), upper normal-weight, overweight, and obese, respectively. Severity indicators of OSA, such as the overall apnea-hypopnea index and duration of SaO2 below 90%, were significantly lower in patients with a low BMI than in obese patients, while their average oxygen saturation was significantly higher. The most common obstruction site in the supine position was the tongue base in patients with a low BMI (100%), whereas this obstruction site was significantly less common in obese patients (54.8%). Tongue base obstruction was mostly relieved in the lateral position, with no discernible obstruction in 86.7% of the low BMI patients.Conclusion. Airway obstruction in OSA patients with a low BMI is mostly due to tongue base obstruction, which improves in the lateral position. These characteristics should be kept in mind when considering treatment options for this subgroup of OSA patients.
Psychometric properties of the North American version of the Flodén ATODAI (Attitudes Toward Organ Donor Advocacy Instrument): a validation study
Authors: Flodén Anne , Stadtler Maria , Collazo Stephanie E Jones , Mone Tom , Ash Rick , Fridlund Bengt
Published: April 2020

Background: Intensive and critical-care nurses are the key to successful donor management in the critical-care setting. No studies measuring attitudes toward organ donor advocacy existed before 2011, when the 51-item Swedish “Attitudes Toward Organ Donor Advocacy Scale” was developed. The aim of this study was to translate, adapt and establish the psychometric properties of the North American version of the Flodén ATODAI (Attitudes Toward Organ Donor Advocacy Instrument) in terms of validity and reliability. Methods: A multi-step approach was used: Initial translation; Back-translation; Review and synthesis of these translations; Expert panel (N=7) rated the prefinal version of the instrument for content validity index (CVI); International panel made adjustments guided by the expert panel . Reliability testing with test and retest of the adjusted 46-item version was conducted using intraclass correlation coefficient (ICC), weighted kappa ( ҡ Weight ), sign test, and Cronbach’s alpha coefficient (α), (N=50); and finally Delphi technique procedure with a preselected Delphi panel (N=15). Results: The CVI was determined to be greater than the 0.05 significance level. Item level (I-CVI) ranged 0.82-1.0, with a mean of 0.97. Scale level (S-CVI) on the entire instrument was 0.97. Test-retest procedure was performed to estimate stability. In total, 34 of the items had good-to-high ICC. Accepting an ICC of > 0.70 resulted in a total of 24 items. Homogeneity reliability was estimated by α and was calculated for these items where α=0.90. In total, 20 of the items had a substantial or almost perfect ҡ Weight and 23 showed a moderate ҡ Weight . None of the items showed systematical differences. The Delphi technique procedure was used on the 22 items with ICC <0.70 resulted in adjustments establishing that consensus was achieved. Conclusions: Undertaking this multi-step, cross-cultural adaptation procedure has effectively ensured that the 46-item Flodén ATODAI [North America version] produces valid and reliable measurements.
Comparison of three dimensional reconstruction and conventional computer tomography angiography in patients undergoing zero-ischemia laparoscopic partial nephrectomy
Authors: Wu Xiaorong , Jiang Chen , Wu Guangyu , Shen Chao , Fu Qibo , Chen Yonghui , Liu Dongming , Xue Wei
Published: April 2020

Background: With the development of three dimensional (3D) reconstruction and printing technology, it has been widely using in the field of urology. However, there have been few studies reporting the role of 3D reconstruction in zero-ischemia partial nephrectomy (PN). The aim of this study was to assess the role of 3D reconstruction and conventional computer tomography angiography (CTA) in zero-ischemia laparoscopic partial nephrectomy (LPN).Methods: A total of 60 consecutive patients undergoing zero-ischemia LPN between October 2017 and March 2018 who underwent CTA (CTA group including 30 patients) and 3D reconstruction (3D group including the remaining 30 patients) preoperatively were included. 3D reconstruction and CTA images were prepared which were used to demonstrate the number and spatial interrelationships of the location of renal tumors and tumor feeding arteries. These radiological findings were directly correlated with intraoperative surgical findings at laparoscopy. Baseline, perioperative variables and the rate of accurate tumor feeding artery orientation were compared between groups.Results: All LPNs were completed without conversion to renal hilar clamping or open surgery. Preoperative 3D reconstruction identified that 15 patients had only one tumor feeding artery, 12 had two, and another 3 had three, while the conventional CTA revealed that 22 patients had one tumor feeding artery, 8 had two (P>0.05). The mean operation time was shorter and estimated blood loss was less in the 3D group (P<0.05) and the rate of accurate tumor feeding artery dissection was higher in the 3D group (91.7%) in comparison with the CTA group (84.2%). The baseline characteristics and renal function outcomes had no statistical differences between groups. Conclusions: 3D reconstruction can provide comprehensive information for the preoperative evaluation and intraoperative orientation about tumor feeding arteries that may facilitate tumor resection during zero-ischemia LPN for renal tumors.
Molecular surveillance of the Pfmdr1 N86Y allele among Congolese pregnant women with asymptomatic malaria
Authors: Dossou-Yovo Louis Regis , Ntoumi Francine , Koukouikila-Koussounda Felix , Vouvoungui Jeannhey Christevy , Adedoja Ayodele , Nderu David , Velavan Thirumalaisamy P , Lenga Arsene
Published: April 2020

Background: Malaria in pregnancy is associated with considerable morbidity and mortality Regular surveillance of artemisinin−based combination therapy tolerance or resistance molecular makers is vital for effective malaria treatment, control and eradication programmes. P. falciparum multiple drug resistance-1 gene (Pfmdr1) N86Y mutation is associated with reduced susceptibility to lumefantrine. This study assessed the prevalence of Pfmdr1 N86Y in Brazzaville, Republic of Congo. Methods: A total 1001 of P. falciparum−infected blood samples obtained from asymptomatic malaria pregnant women having a normal child delivery at the Madibou Integrated Health Center were analysed.Pfmdr1 N86Y genotyping was conducted using PCR-Restriction fragment length polymorphism (RFLP). Results: The wild type Pfmdr1 N86 allele was predominant (>68 %) in this study whereas a few isolates carrying the either the mutant allele (Pfmdr1 86Y) alone or both alleles (mixed genotype). The dominance of the wildtype allele (pfmdr1 N86) indicates the plausible decline P. falciparum susceptibility to lumefantrine. Conclusion: This study gives an update on the prevalence of Pfmdr1 N86Y alleles in Brazzaville, Republic of Congo. It also raises concern on the imminent emergence of resistance against artemether−lumefantrine in this setting. Our study underscores the importance to regular artemether−lumefantrine efficacy monitoring to inform malaria control programme of the Republic of Congo.
Community based programs to improve the oral health of Australian Indigenous adolescents: A systematic review and recommendations to guide future strategies.
Authors: Gwynn Josephine , Skinner John , Dimitropoulos Yvonne , Masoe Angela , Rambaldini Boe , Christie Vita , Sohn Woosung , Gwynne Kylie
Published: April 2020

Background: To review the international literature on community-based interventions aiming to improve the oral health of Indigenous adolescents and identify which demonstrate a positive impact.Methods: Data sources were MEDLINE, EMBASE, CINAHL, SCOPUS, the COCHRANE library and the Australian Indigenous HealthInfoNet. Articles were included where they: were published in English from 1990 onwards; described oral health outcomes for Indigenous adolescents aged 10 to 19 years; implemented a community based oral health intervention. The Quality Assessment Tool for Quantitative Studies from the Effective Public Health Practice Project was applied.Results: Nine studies met inclusion criteria; two rated strong in quality; only one study was conducted with an urban community; five reported moderate community engagement. Five intervention strategies were identified, and schools were the most common setting reported. Statistically significant improvements were described in eight studies with the most frequently reported outcome being change in decayed missing or filled teeth.Conclusions: Few good quality peer reviewed international studies of community-based oral health interventions which address the needs of Indigenous adolescents exist. Studies must include strong Indigenous community leadership and governance at all stages of the research, adopt participatory action-based research approaches, and are required in urban communities.
Prefilled pen versus prefilled syringe: a pilot study evaluating two different methods of methotrexate subcutaneous injection in patients with JIA
Authors: Roszkiewicz Justyna , Swacha Zbigniew , Smolewska Elzbieta
Published: April 2020

BACKGROUND: Methotrexate is the most commonly used disease-modifying antirheumatic drug recommended in the treatment of juvenile idiopathic arthritis. It can be administered orally or subcutaneously, the latter method is associated with fewer side effects and higher drug bioavailability. Nevertheless, the pain associated with injection is a considerable drawback of this treatment option in the pediatric population. Currently, there are two single-use subcutaneous injection devices available: the prefilled syringe and the prefilled pen. This prospective, two-sequence crossover study aimed to compare ease of use, frequency of therapy side effects, injection-site pain and parent/patient preference of those methotrexate parenteral delivery systems.METHODS: 23 patients with juvenile idiopathic arthritis, already treated with subcutaneous methotrexate in the form of prefilled syringe in the period October 2018 – April 2019 completed a questionnaire evaluating their experience with this device. Subsequently, children received a one-month supply of pen autoinjector and completed the same questionnaire, regarding their experience with the new methotrexate delivery system. If the patient was not performing the injections himself the questionnaires were completed by the caregiver administrating MTX. The results obtained in both questionnaires were compared using the Wilcoxon matched-pairs signed-rank test.RESULTS: 82,6% patients and their caregivers voted for the prefilled pen as their preferred method of subcutaneous methotrexate administration. Moreover, the injection with the prefilled pen was reported as less painful in comparison to the prefilled syringe (p<0.01). Side effects of methotrexate were less pronounced after the prefilled pen treatment, this difference was most prominent regarding gastrointestinal adverse events associated with the injection (p<0.01).CONCLUSION: Administration of methotrexate using the pen device is a promising way of subcutaneous methotrexate delivery in children with juvenile idiopathic arthritis, as the injection is less painful and associated with fewer side effects.
Young Medical Doctors’ Perspectives on Professionalism: A Qualitative Study Conducted in Public Hospitals in Pakistan
Authors: Jalil Aisha , Mehmood Qaisar Khalid , Fischer Florian
Published: April 2020

Background: Professionalism is amongst the major dimensions indicating the competence of medical doctors. A low professionalism affects the overall outcome of healthcare services. This study explores the perspectives of young medical doctors on professionalism in Pakistan.Methods: A qualitative study based on in-depth interviews was conducted with 60 young medical doctors, aged less than 40 years, who studied medicine in Pakistani universities, were Pakistani nationals, and were employed at various hierarchal levels from house officer to consultant specialist in public tertiary hospitals in Pakistan. The respondents were identified through a multistage maximum heterogeneity sampling strategy. A semi-structured interview guide was developed based on a previous extensive literature review. Written consent was obtained from the hospitals and study participants. Qualitative thematic analysis was applied to analyse the data. Results: The data analysis revealed a rigidity of opinions, inflexibility blocking the acceptance of contrasting perspectives, and perceived superiority over all other professions and over patients. The belief that patients know nothing was common among all participants. Similarly, doctors believed that there is no need to include a professionalism and humanity course in the medical school curriculum. The majority of respondents thought that social science topics are irrelevant to medicine and are common-sense things that they already know. The doctors recognised high professionalism in themselves, while reporting unprofessional behaviour demonstrated by their colleagues. The reported characteristics include using social media applications during duty hours, ridiculing patients, substance use such as cigarettes in the office, referrals of complicated cases to other hospitals, freeing up beds before holidays and inappropriate salaries. Conclusions: Findings implied low medical professionalism among young doctors. This should be immediately addressed by policymakers. Lack of training about professionalism, ethics and humanity in healthcare service delivery, and a lack of performance monitoring and evaluation mechanisms at public hospitals are the major factors contributing to this substandard medical practice. There is a need to revisit the curriculum taught to medical students in order to strengthen professionalism. It is important to improve the skills of being ‘teachable’ and to provide acceptance of other viewpoints in cases where interprofessional collaborations are to be established by medical doctors.
Involvement of the pulmonary arteries in patients with Takayasu arteritis: a prospective study from a single center in China
Authors: Kong Xiufang , Ma Lili , Lv Peng , Cui Xiaomeng , Chen Rongyi , Ji Zongfei , Chen Huiyong , Lin Jiang , Jiang Lindi
Published: April 2020

Background: Takayasu arteritis (TA) is a large-vessel vasculitis that can involve pulmonary arteries (PAs). We studied multiple clinical characteristics related to pulmonary artery involvement (PAI) in TA patients.
Methods: We enrolled 216 patients with TA from a large prospective cohort. PAI was assessed in each patient based on data from magnetic resonance angiography/computed tomography angiography. Pulmonary hypertension, cardiac function, and pulmonary parenchymal lesions were evaluated further in patients with PAI based on echocardiography, New York Heart Association Functional Classification and pulmonary computed tomography, respectively. These abnormalities related to PAI were followed up to evaluate treatment effects.
Results: PAI was detected in 56/216 (25.93%) patients, which involved the pulmonary trunk, main PAs and small vessels in the lungs. Among patients with PAI, 28 (50%) patients were accompanied by pulmonary hypertension, which was graded as ‘severe’ in 9 (16.07%), ‘moderate’ in 10 (17.86%) and mild in 9 (16.07%). Twenty-six patients (46.43%) patients showed advanced NYHA function (III: 20, 35.71%; IV: 6, 10.71%). Furthermore, 21 (37.50%) patients presented with abnormal pulmonary parenchymal lesions in the area corresponding to PAI (e.g., the mosaic sign, infarction, bronchiectasis). During follow-up, two patients died due to heart failure and pulmonary thrombosis. In the remaining patients, the abnormalities mentioned above improved partially after routine treatment.
Conclusions: PAI is common in TA patients. PAI can cause pulmonary hypertension, cardiac insufficiency and pulmonary parenchymal lesions, which worsen patients’ prognosis.
Favorable efficacy of rituximab in ANCA-associated vasculitis patients with excessive B cell differentiation
Authors: Miyazaki Yusuke , Nakayamada Shingo , Kubo Satoshi , Ishikawa Yuichi , Yoshikawa Maiko , Sakata Kei , Iwata Shigeru , Miyagawa Ippei , Nakano Kazuhisa , Tanaka Yoshiya
Published: April 2020

Objectives: B-cell depletion by rituximab (RTX) is an effective treatment for anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis (AAV). However, peripheral B cell phenotypes and the selection criteria for RTX therapy in AAV remain unclear.Methods: Phenotypic characterization of circulating B cells was performed by 8-color flow cytometric analysis in 54 newly diagnosed AAV patients (20 granulomatosis with polyangiitis and 34 microscopic polyangiitis). Patients were considered eligible to receive intravenous cyclophosphamide pulse (IV-CY) or RTX. All patients also received high-dose glucocorticoids (GC). We assessed circulating B cell phenotypes and evaluated the efficacy after 6 months of treatment. Results: There were no significant differences in the rate of clinical improvement, relapses, or serious adverse events between patients receiving RTX and IV-CY. The rate of Birmingham Vasculitis Activity Score (BVAS)-improvement at 6 months tended to be higher in the RTX group than in the IV-CY group. The proportion of effector or class-switched memory B cells increased in 24 out of 54 patients (44%). The proportions of peripheral T and B cell phenotypes did not correlate with BVAS at baseline. However, among peripheral B cells, the proportion of class-switched memory B cells negatively correlated with the rate of improvement in BVAS at 6 months after treatment initiation (r = -0.28, p = 0.04). Patients with excessive B cell differentiation were defined as those in whom the proportion of class-switched memory B cells or IgD-CD27- B cells among all B cells was >2 SDs higher than the mean in the HCs. The rate of BVAS-remission in patients with excessive B cell differentiation was significantly lower than that in patients without. In patients with excessive B cell differentiation, the survival rate, the rate of BVAS-remission, and dose reduction of GC were significantly improved in the RTX group compared to those in the IV-CY group after 6 months of treatment. Conclusions: The presence of excessive B cell differentiation was associated with treatment resistance. However, in patients with circulating B cell abnormality, RTX was effective and increased survival compared to IV-CY. The results suggest that multi-color flow cytometry may be useful to determine the selection criteria for RTX therapy in AAV patients. (349/350 words)
Self-Assessed Life Expectancy Among Older Adults in Côte D’Ivoire
Authors: Moussa Richard K , Diaby Vakaramoko
Published: April 2020

Background The purpose of this study was to estimate individuals’ expected longevity based on self-assessed survival probabilities and determine the predictors of such subjective life expectancy in a sample of elderly people (50 years and older) in Côte d’Ivoire. Methods Paper-based questionnaires were administered to a sample (n=267) of older adults residing in the city of Dabou, Côte d’Ivoire in May 2017. Information on subjective expectations regarding health, comorbidities, and self-assessed survival probabilities were collected. We estimated self-assessed life expectancy and its determinants using a two-pronged approach by: (i) estimating individuals’ life expectancy using the self-assessed survival probabilities (SSPs), and (ii) applying a finite mixture of regression models to form homogenous groups of individuals (clusters/components) and investigate the determinants. A spline-based approach was used to estimate the overall distribution of life expectancy for each individual using two to four points of self-assessed survival probabilities. A finite mixture of regression models was used to identify homogeneous groups of individuals (i.e. clusters/components) of the overall subjective life expectancy distribution of the study participants. Results The mean subjective life expectancy in older people varied according to four components/clusters. The average subjective life expectancy among the elderly was 79.51, 78.89, 80.02 and 77.79 years in the first, second, third and fourth component of the subjects' overall subjective life expectancy, respectively. The effect of sociodemographic characteristics, comorbidities, and lifestyle on subjective life expectancy varied across components. For instance, a U-shape relationship between household per capita income and subjective life expectancy was found for individuals classified into the third component, and an inverse U-shape relationship was found for individuals classified into the fourth component. Conclusions We extended the estimation of subjective life expectancy by accounting for heterogeneity in the distribution of the estimated subjective life expectancy. This approach improved the usual methods for estimating individual subjective life expectancies and may provide insight into the elderly’s perception of aging, which could be used to forecast the demand for health services and long-term care needs.
Functional MYB transcription factor gene HtMYB2 is associated with anthocyanin biosynthesis in Helianthus tuberosus L.
Authors: Gao Jieming , Sun Xuemei , Zong Yuan , Yang Shipeng , Wang Lihui , Liu Baolong
Published: April 2020

Background: Tuber color is an important trait for Helianthus tuberosus L. (Jerusalem artichoke), but the molecular mechanism underlying it is unknown. Results: In the current study, high-throughput RNA-sequencing was used to compare the transcriptomes between plants with tubers with red or white epidermis. Compared with the white-skinned tubers of cultivar QY3, anthocyanin biosynthesis structural genes had greater expression in the red-skinned tubers of cultivar QY1, indicating that the anthocyanin biosynthesis pathway was activated in ‘QY1’; quantitative PCR confirmed this difference in expression. HtMYB2 (Unigene44371_All) was the only MYB transcription factor，homologous to the MYB transcription factor regulating anthocyanin biosynthesis, expressed in the red tuber epidermis of ‘QY1’. HtMYB2 resembled an MYB transcription factor, regulating anthocyanin biosynthesis, and possessing an intact SANT/MYB and MYB-like DNA-binding domain. The anthocyanin concentration in the root, stem, leaf, flower, and tuber epidermis of ‘QY1’ was higher than in ‘QY3’, especially tuber epidermis. Correspondingly, HtMYB2 had greater expression in these tissues of ‘QY1’ than in ‘QY3’. The expression of HtMYB2 was associated with anthocyanin accumulation in the different tissues. Overexpression of HtMYB2 activated the anthocyanin biosynthesis pathway, accumulating the pigment in leaves of transgenic tobacco, supporting the model that HtMYB2 regulated anthocyanin biosynthesis. Further experiments found that HtMYB2 had the same coding sequence and genomic sequence in ‘QY1’ and ‘QY3’, but that there were several single nucleotide polymorphisms and one insertion–deletion (indel) mutation of 21 nucleotides in the promoter region between the two alleles. The deletion of three nucleotides “AAA” made the promoter of ‘QY1’ predicted to contain one more possible promoter region. A specific primer, based on the indel, could differentiate between cultivars with red or white tuber epidermis. The genetic variation in HtMYB2 was associated with the tuber skin color in a natural population.Conclusions: RNA-seq can successfully isolate the candidate gene (HTMYB2) controlling anthocyanin biosynthesis in purple epidermis of Jerusalem artichoke tuber. HTMYB2 can regulate anthocyanin biosynthesis in plants and is closely related to the formation of purple phenotype in tubers. This study should be useful in understanding the genetic mechanism underlying different tuber skin colors and in breeding new H. tuberosus cultivars with different tuber skin colors.
A modified surgical technique of shortening renal ischemia time in left renal cancer patients with Mayo level II-IV tumor thrombus
Authors: Zhuo Liu , Guodong Zhu , Xun Zhao , Shiying Tang , Peng Hong , Li Zhang , Liwei Li , Shudong Zhang , Guoliang Wang , Xiaojun Tian , Cheng Liu , Ma Lulin , Hongxian Zhang
Published: April 2020

Background to explore the safety and effectiveness of a modified surgical technique which could shorten the time of renal ischemia in left renal cancer and Mayo level II to IV inferior vena cava (IVC) tumor thrombusMethod We retrospectively analyzed the clinical data of 14 cases with left renal cell carcinoma (RCC) and Mayo level II to IV IVC tumor thrombus from February 2015 to July 2019. Preoperative imaging showed that there was no obvious sign of tumor thrombus invading the blood vessel wall. During the surgery, after the right renal artery, the right renal vein and the distal end of IVC were blocked, the balloon catheter was used and the tumor thrombus was removed completely from the IVC. The incision of IVC was closed by Satinsky clamp to make IVC partially blocked. Then the right renal artery and right renal vein were released. The incision of IVC was sutured continuously. At last, the Satinsky clamp and the blocking band at the distal end of the IVC were released.Result There were 8 cases (57.1%) of Mayo level II, 3 cases (21.4%) of Mayo level III and 3 cases (21.4%) of Mayo level IV. The operation was successfully completed in all 14 patients. There were 2 cases (14.3%) operated by complete laparoscopic approach, 8 cases (57.1%) by open approach, and 4 patients (28.6%) by laparoscopic conversion to open approach. The occlusion time of right renal artery and vein (renal ischemia time) was 3 to 15 minutes, with an average of (6.8±3.2) minutes. The mean time of IVC occlusion was (19.4±4.9) min. Preoperative creatinine was 66 to 130 μmol/L, with an average of (96.6 ± 21.2) μmol/L. One week after operation, serum creatinine was 64 to 632 μmol/L, with an average of (132.4 ± 144.9) μmol/L. Among the 14 cases, 5 (42.9%) had early postoperative complications. Besides one of the 14 patients died in perioperative period, the median follow-up of other 13 cases was 10 months (range: 4-29 months). The 5 (35.7%) of the 14 cases were died of disease.Conclusion This modified procedure was relatively safe and effective in shortening the time of renal ischemia in left RCC patients with Mayo II to IV IVC tumor thrombus.
Effect of silver diammine fluoride on micro-ecology of plaque from extensive caries of deciduous teeth - in vitro study
Authors: Liu Baoying , LIU Jin , ZHANG Di , YANG Zhi lei , FENG Ya ping , WANG Meng
Published: April 2020

Background: The mechanism of action of silver diammine fluoride (SDF) on plaque micro-ecology is seldom studied. This study investigated micro-ecological changes in dental plaque on extensive caries of deciduous teeth after topical SDF treatment. Methods: Deciduous teeth with extensive caries freshly removed from school children were collected in clinic. Unstimulated saliva collection and initial plaque sampling were done before tooth extraction, then each caries was topically treated with 38% SDF in vitro. After intervention, each tooth was stored respectively in artificial saliva at 37℃. Repeated plaque collections were done at 24 hours and 1 week post-intervention. Post-intervention micro-ecological changes including microbial diversity, microbial metabolism function as well as species correlations were analyzed and compared after pyrosequencing of the DNA from the plaque sample using Illumina MiSeq platform. Results: After SDF application, microbial diversity decreased (P>0.05), although not statistically significant. Microbial community composition post-intervention was noticeably different from that of supragingival and pre-intervention plaque as well as saliva. At 1 week post-intervention, the relative content of Pseudomonas, Fusobacterium and Pseudoramibacter was noticeably higher than before, while most of the other bacteria was noticeably reduced, although not statistically significant (P>0.05). The inter-microbial associations became more complex, much more positive associations among survived bacteria were observed than negative ones. COG function classification diagram showed carbohydrate transportation and metabolic functions in the plaque were significantly reduced at 24 hours and 1 week post-intervention. Conclusions: SDF has extensive antimicrobial effect on dental plaque, which may reduce carbohydrate metabolism in dental plaque and help promote new balance of the plaque flora.
Determining Healthcare Workforce Requirements for Kuluva Hospital in West Nile-Uganda, using the Workload Indicators of Staffing Need (WISN)
Authors: Onzima Robert Anguyo DDM , Govule Philip , Apangu Titus , Harogha Alan , Wibale Wilson , Debo Ronald , Ambayo Richard , Awudo Jimmy Lulua , Maryekmungu Immaculate , Bayoru Aziku Celina Likico , Nanyingi Miisa , Karengera Innocent
Published: April 2020

Introduction:

Health workforce shortage is a major threat to global public health with a greater implication for low-resourced countries. The right placement of the available staff in many health facilities remains a challenge due to inadequate information on exact workload and work pressure that staff undergo in course of work. This study aimed to determine the need for key health workforce cadre in Kuluva hospital using Workload Indicators of Staffing Need (WISN) methodology.
Method:

The study followed a predominantly quantitative approach of Workload Indicator Staffing Needs (WISN) methodology. We held a meeting with hospital management to understand policy issues and procedures. The key staff were interviewed in departments, available records reviewed, practices observed to establish the available working time, activity standards and time taken to perform other supportive activities. Service statistics was generated from HMIS data of 2016/17. Data was analyzed manually using calculator and Microsoft Excel spreadsheet.
Results

All cadre categories had the same available working time of 1,504 hours in a year with 105 staff of the studied cadres required to perform all activities in Kuluva hospital based on WISN calculation. Although overall work pressure was 30%, 5 out of 7 staff cadre categories experienced work pressure of varying degrees – medical officers (70%), laboratory staff (70%) and clinical officers (60%) were most affected compared to nurses (30%) and midwives (10%). There was perfect number of anesthetists but surplus nursing assistants than needed by the hospital. Amidst shortage, the critical cadres still spent significant time on non-professional activities; medical officers (24%) and midwives (25%).
Conclusion

These findings can provide insight into the management of Kuluva hospital to address the current disparities in the health workforce in terms of numbers and skill mix for continuous improvement of health service delivery to the population it serves.
The molecular effect of a polymorphic microRNA binding site of Wolfram Syndrome 1 gene in dogs
Authors: Koller Dora , Kubinyi Eniko , Elek Zsuzsanna , Nemeth Helga , Miklosi Adam , Sasvari-Szekely Maria , Ronai Zsolt
Published: April 2020

Background
Although the molecular function of wolframin remains unclear, the lack of this protein is known to cause stress in the endoplasmic reticulum. Some variants in the Wolfram Syndrome 1 gene (WFS1) were associated with various neuropsychiatric disorders in humans, such as aggressiveness, impulsivity and anxiety.
Results
Here we present an in silico study predicting a single nucleotide polymorphism (rs852850348) in the canine WFS1 gene which was verified by direct sequencing and was genotyped by a PCR-based technique. We found that the rs852850348 polymorphism is located in a putative microRNA (cfa-miR-8834a and cfa-miR-1838) binding site. Therefore, the molecular effect of allelic variants was studied in a luciferase reporter system that allowed assessing gene expression. We demonstrated that the variant reduced the activity of the reporter protein expression in an allele-specific manner. Additionally, we performed a behavioral experiment and investigated the association with this locus to different performance in this test. Association was found between food possessivity and the studied WFS1 gene polymorphism in the Border collie breed.
Conclusions
Based on our findings, the rs852850348 locus might contribute to the genetic risk of possessivity behavior of dogs in at least one breed and might influence the regulation of wolframin expression.
Prediction and Analysis of Hub Genes in Ovarian Cancer Based on Network Analysis
Authors: Li Yan , Wang Juan , Zhu Yan , Chen Youguo
Published: April 2020

Objective

The aim of the present study was to identify the interactions among transcription factors (TFs), microRNAs (miRNAs) and mRNAs in ovarian serous cystadenocarcinoma (OV) to investigate the mechanisms.
Method:

Gene expression data were obtained from the Gene Expression Omnibus (GEO) database. Differentially expressed genes (DEGs) were screened between tumor and nontumor samples using the online tool GEO2R based on the limma package of R language. The coexpression between genes was identified using the weighted gene corepression analysis (WGCNA) package of R language to construct a coding-noncoding network. Gene Ontology (GO) enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were conducted for the genes in the coexpression network. The expression and prognostic value of the hub genes in coexpression were further validated in The Cancer Genome Atlas (TCGA) dataset. The interactions among miRNAs, mRNAs and TFs were predicted using miRGen and mirWalk to construct the TF-miRNA-mRNA regulatory network.
Result

The blue module was identified as significantly associated with OV, and a coexpression network were constructed through WGCNA analysis. The expression and prognostic value of the hub genes in the blue module were validated in the TCGA dataset. A total of 164 common differentially expressed miRNAs (DEMs) were screened from 2 miRNA datasets. A TF-miRNA-mRNA regulatory network composed of 2 TFs, 6 miRNAs and 199 mRNAs was constructed. QRT-PCR was also conducted to identify the expression of the 6 key miRNAs (hsa-mir-193b, hsa-mir-296, hsa-mir-29b-2, hsa-mir-29c, hsa-mir-34a and hsa-mir-421) in ovarian serous cystadenocarcinoma.
Conclusion

We constructed a validated TF-miRNA-mRNA network in OV, and TFs might regulate mRNAs by regulating miRNAs to act on the progression of OV.
Autophagy in spinal ligament fibroblasts: evidence and possible implications for ossification of the posterior longitudinal ligament
Authors: yang yuehua , Lin zunwen , Chen Jiangwei , Ding Sheng , Mao Weiwei , shi sheng , Liang Biru
Published: April 2020

Background
The molecular mechanisms of ossification of the posterior longitudinal ligament (OPLL) remains to be elucidated. The aim of the present study was to investigate the autophagy of spinal ligament fibroblasts derived from patients with OPLL and to examine whether autophagy associated gene expression was correlated with the expression of osteogenic differentiation genes.
Methods
Expression of autophagy associated genes was detected in 21 samples from patients with OPLL patients and 16 non-OPLL patients. The correlation of autophagy associated gene expression and the expression of osteogenic differentiation genes was analyzed by Pearson’s correlation. The expression of autophagy associated genes of fibroblasts was assessed by reverse transcription-quantitative Polymerase Chain Reaction (RT-qPCR), western blotting and immunofluorescence. The rate of autophagy was assessed by flow cytometry. After knockdown using small interfering RNA targeting Beclin1, the expression of osteogenic differentiation genes were compared in spinal ligament fibroblasts.
Results
In clinical specimens, mRNA expression levels of microtubule-associated protein 1 light chain 3 and Beclin1 were higher in the OPLL group compared with the non-OPLL group. Pearson correlation analysis demonstrated that Beclin1 expression was positively correlated with expression of osteocalcin (OCN) (r = 0.8233, P < 0.001), alkaline phosphatase, biomineralization associated (ALP) (r = 0.7821, P < 0.001) and collagen type 1 (COL I) (r = 0.6078, P = 0.001). Consistently, the upregulation of autophagy associated genes in fibroblasts from patients with OPLL were further confirmed by western blotting and immunofluorescence. The rate of autophagy was also increased in fibroblasts from patients with OPLL. Furthermore, knockdown of Beclin1 led to a decrease in the expression of OCN, ALP and COL I by 63.2% (P < 0.01), 52% (P < 0.01) and 53.2% (P < 0.01) in ligament fibroblasts from patients with OPLL, respectively.
Conclusions
Beclin1-mediated autophagy was involved in the osteogenic differentiation of ligament fibroblasts, and promoted the development of OPLL.
FibroBox: a novel noninvasive tool for predicting significant liver fibrosis and cirrhosis in HBV infected patients
Authors: Lu Xiao-Jie , Li Xiu-Hui , Sun Jing-Yu , Zhang Xin , Yuan Zhao-Xin , Yang Xiao-Jun
Published: April 2020

Background China is a highly endemic area of chronic hepatitis B. The accuracy of common noninvasive biomarkers including TE, APRI and FIB-4 for staging fibrosis is not enough in Chinese cohort.Methods Using liver biopsy as a gold standard, a novel noninvasive indicator was developed using laboratory tests, ultrasound measurements and liver stiffness measurements with machine learning techniques to predict significant fibrosis and cirrhosis in patients infected with HBV in north and east part of China. We retrospectively evaluated the diagnostic performance of the novel indicator named FibroBox, Fibroscan, aspartate transaminase-to-platelet ratio index (APRI), and FIB-4 in HBV patients from Jilin and Huai’an (training sets) and also in Anhui and Beijing cohorts (validation sets).Results Of 1289 eligible HBV patients who had liver histological data, 63.2% had significant fibrosis and 22.5% had cirrhosis. In lasso regression and filter methods, fibroscan results, platelet count, alanine transaminase (ALT), prothrombin time (PT), type III procollagen aminoterminal peptide (PIIINP), type IV collagen, laminin, hyaluronic acid (HA) and diameter of spleen vein were finally selected as input variables in FibroBox. Consequently, FibroBox was developed of which the area under the receiver operating characteristic curve (AUROC) was significantly higher than that of TE, APRI and FIB-4 to predicting significant fibrosis and cirrhosis. In the Anhui and Beijing cohort, the AUROC of FibroBox was higher than TE, APRI and FIB-4 for significant fibrosis (0.88, 95% CI 0.72 to 0.82; 0.87, 95% CI 0.83 to 0.91, respectively) and cirrhosis (0.87, 95% CI 0.82 to 0.92; 0.90, 95% CI 0.85 to 0.94, respectively).Conclusions FibroBox, compared with TE, APRI and FIB-4, has a better performance in predicting liver fibrosis in Chinese cohorts, which may serve as a feasible alternative to liver biopsy.
Clinical Characteristics of SARS-CoV-2 Infection in Haikou: a study of a family cluster
Authors: Chen Hui Juan , Qiu Jie , Wu Biao , Wang Zhen Ping , Chen Yang , Chen Feng
Published: April 2020

Background: The outbreak of sever acute respiratory syndrome coronavirus 2(SARS-CoV-2) has become a great threat to the world. No study has been done on the mild or asymptomatic SARS-CoV-2 in a family cluster.Methods: We report the epidemiological, clinical, laboratory, radiological, and clinical outcomes of five patients in a family cluster.Results: We enrolled a family of five patients who was confirmed with SARS-CoV-2 infection. One of them worked in Wuhan and returned to Danzhou, Hainan on January 22,2020. The other four family members, who did not travel to Wuhan, became infected with the virus after several days of contact with the family member. Five family members (aged 33–57years) presented with fever, cough or no symptom onset. Three of them had negative nucleic test on first swab sampling. One of them was not confirmed until the third nucleic acid test. Two of them had radiological ground-glass lung opacities. Two patients presenting with fever had lymphopenia or decreased white blood cells. No one had increased C-reactive protein or lactate dehydrogenase levels. After treatment, they were discharged.Conclusions: Person-to-person transmission of SARS-CoV-2 was confirmed in family setting. Concerns should be raised for the asymptomatic persons in a family cluster.
Using the Kano model to associate the number of confirmed cases of COVID-19 in a population of 100,000 with case fatality rates: an observational study
Authors: Su Shih-Bin , Kan Wei-Chih , Lin Jui-Chung John , Yeh Yu-Tsen , Chien Tsair-Wei
Published: April 2020

Background: One of the key factors to understand the spread of COVID-19 is the case fatality rate(CFR) rates for counties/regions. However, many merely reported those CFRs on the basis of total confirmed cases(TCC) instead of per population of 100, 000. As such, the disparate definitions of CFR yield inconsistent results in COVID-19 situations. Whether both incident rate and the CFR can be indicators to identify a country/region hit by COVID-19 under(or out of) control is still unclear. This study aims to (1) develop a diagram to disperse both TCC and CFR on a population base of 100,000(namely TCC100 and CFR100, respectively) using the Kano model, (2)discuss selected countries/regions with success on preventative measures to keep COVID-19 under control(i.e., relatively lower TCC100 and CFR100 or CFR), and (3) design an app to display both TCC100 and CFR100 or CFR for all infected countries/regions. Methods: We downloaded the COVID-19 data of confirmed cases and deaths in countries/regions on a daily basis from the Github website. Three values, TCC100, CFR100, and CFR, were computed for each country/region and displayed on the Kano model. The lower TCC100 and CFR values were deemed as having the COVID-19 situation more under control. An app was developed to display both TCC100 and CFR100 on Google Maps. Results: The correlation coefficient(CC) between TCC100 and CFR100 is 0.92(t=37.87) based on 285 count data (i.e., 12, 225, and 48 dispersed on the Kano diagram) obtained in comparison to the pair of TCC100 and CFR with the CC=-0.02(t=-0.25) and counts(i.e., 56, 145, and 84 on the Kano diagram). The state of Washington, USA, was found having the highest TCC100(=3498.15), CFR100 (=16548.96) and CFR(=5%) in comparison to (1)Taiwan[TCC100(=1.65), CFR100 (=2.17), CFR(=1%)] and (2)South Korea[TCC100(=20.34), CFR100 (=39.8), CFR(=2%)] on April 12,2020. Conclusion: We illustrated both TCC100 and CFR along with CFR100 to compare countries/regions on a Kano diagram to understand the COVID-19 situations better. A larger TCC100 value was strongly associated with a larger CFR100 value that needs further verifications in the future. An app was developed to display both TCC100 and CFR for countries/regions on a dashboard laid over Google Maps.
Bacteria-induced expression of the pig-derived protegrin-1 transgene specifically in the respiratory tract of mice enhances resistance to airway bacterial infection
Authors: zeng fang , Zhao Chengcheng , Wu Xiao , Dong Rui , Li Guoling , Zhu Qingchun , Zheng Enqin , Liu Dewu , Yang Jinzeng , Moisyadi Stefan , Urschitz Johann , Li Zicong , Wu Zhenfang
Published: April 2020

Background About 70% of all antibiotics produced in the world are used in the farm animal industry. The massive usage of antibiotics during farm animal production has caused rapid development of antibiotic resistance in bacteria, which poses a serious risk to human and livestock health when treating bacterial infections. Protegrin-1 (PG-1) is a potent antimicrobial peptide (AMP), initially identified in pig leukocytes with a broad-spectrum antibacterial and antiviral activity, and a low rate of inducing bacterial resistance. Results To develop genetic approaches for reducing the use of antibiotics in farm animal production, we produced transgenic mice carrying a bovine tracheal AMP gene promoter-controlled PG-1 transgene. The PG-1 transgene was specifically expressed in the respiratory tract of transgenic mice upon induction by bacterial infection. These PG-1 transgenic mice exhibited enhanced resistance to nasal bacterial infection as the infected transgenic mice showed a higher survival rate, lower bacterial load and milder histological severity than the infected wild-type control littermates. Conclusions The present study provides a promising genetic strategy to prevent airway bacterial infections in animals by bacteria-inducible tissue-specific expression of PG-1 transgene, an approach which may also be helpful for reducing the possibility of inducing bacterial resistance.