bluuebunny/crossref_metadata_2025 huggingface dataset:
Does Skeletal Muscle Loss and Sarcopenia Predispose Patients for the Development of a Paraconduit Hernia After Minimally Invasive Esophagectomy? – A Propensity Matched Case-control Study
Authors: Hietaniemi Henriikka , Järvinen Tommi , Ilonen Ilkka , Räsänen Jari
Published: January 2022

BackgroundParaconduit hernia is a relatively common long-term complication after esophagectomy which has the potential to cause great morbidity and even mortality. The aim of this study is to examine the relationship between sarcopenia and muscle mass loss and paraconduit hernia after minimally invasive esophagectomy in esophageal adenocarcinoma patients who have received neoadjuvant treatment.MethodsAll minimally invasive esophagectomies done for patients with neoadjuvant-treated esophageal or esophagogastric junction adenocarcinoma at our institution between 2008 and 2018 were included in this study. Propensity score matching was utilized to minimize confounding effects of retrospective data analysis. Computed tomography scans were used to measure skeletal muscle mass and to quantify sarcopenia.ResultsThe incidence of paraconduit hernia was 14 out of 171 patients (8.2%). The hernia was surgically repaired in 10 (71.4%) of patients. A total of 23 (82.1%) patients in the matched group were sarcopenic before start of neoadjuvant treatments, 22 (78.6%) after neoadjuvant treatments and 24 (85.7%) at 6 months of follow-up. Skeletal muscle area, skeletal muscle index or prevalence of sarcopenia had no correlation with paraconduit hernia developement. Using the median change of skeletal muscle area between pre-neoadjuvant and 6 months follow-up visit as a threshold to divide the patients into two equal size groups yielded no significantly different survival curves using Kaplan-Meier analysis (p = 0.6).ConclusionParaconduit hernia is a relatively common complication after minimally invasive esophagectomy for neadjuvantly treated adenocarcinoma patients. Sarcopenia and muscle mass loss are not predictive factors for paraconduit hernia.
Measurement Accuracy of Artificial Intelligence in the Form of Convolutional Neural Networks for Cervical Lordosis on Lateral Radiographs
Authors: Fujimori Takahito , Suzuki Yuki , Kita Kosuke , Kanie Yuya , Takenaka Shota , Kaito Takashi , Ukon Yuichiro , Watabe Tadashi , Kido Shoji , Okada Seiji
Published: January 2022

Although cervical alignment is important for evaluating spine disorders, manual measurement is time-consuming and burdensome. We aimed to validate the usefulness of artificial intelligence (AI) in the form of convolutional neural networks for automated measurement of lordosis on lateral cervical x-rays. We included 4546 cervical x-rays from 1674 patients. For all x-rays, a well-experienced spine surgeon labeled the caudal endplates of C2 and C7, the data for which were used as ground truth. The accuracy of AI measurements was tested by 5-fold cross-validation and by comparison with measurements obtained by 2 surgeons. The mean absolute error (MAE) of the AI model in 5-fold cross-validation was 3.6° ± 5.5° at the C2–C7 angle, and the model took 206 seconds to measure 4546 x-rays. The MAE for measurement of 416 radiographs of 168 randomly selected patients was 3.3° ± 3.8° for the AI model, 3.9° ± 3.4° for Surgeon 1, and 3.8° ± 4.7° for Surgeon 2. Thus, the AI model had a significantly smaller error than Surgeon 1, and its error was not significantly different from that of Surgeon 2.In conclusion, AI can assist in routine medical care and can be helpful in research that measures large numbers of images.
Ocular Emergencies Visits after Corneal Transplantation at a Tertiary Eye Care Hospital of Saudi Arabia
Authors: AlMudhaiyan Tariq , AlAmry Mohammed , Khandekar Rajiv , Al-Ghadeer Huda A.
Published: January 2022

Purpose: To evaluate the profile of patients with post-keratoplasty complications and their presentation at an emergency center. Design: Retrospective one-armed cohort study. Methods: Data were evaluated on patients who underwent corneal grafts in 2019 and presented to an emergency unit. Data were collected on patient demographics, presenting symptoms, clinical details, diagnosis at emergency visit, final diagnosis, best-corrected visual acuity (BCVA) at presentation and at the last follow up after management. Severe visual impairment (SVI) and graft rejection were tested for correlations to other factors. Results: The study sample was comprised of 149 eyes of 124 patients with a mean age of 27.5 years. Keratoconus was indicated for keratoplasty in 94 (75.8%) patients. The main presenting symptoms were pain 57 (38.3%) and red eye in 52 (34.9%) patients. The median interval between emergency visit and keratoplasty was 1.6 years. There were 63 (42.3%) patients who had emergency visits due to suture-related problems. The rates of SVI and graft rejection at the time of discharge after managing emergencies in eyes with previous keratoplasty were 14.1% (95% CI 8.5; 19.7) and 13.4 (95% CI 7.9; 18.9) respectively. Keratoconus (OR = 22.8) and young age (P<0.001) were negatively associated to SVI after management. Conclusion: Patients with keratoplasty are at high-risk for severe vision loss and should be counselled to seek urgent eye care for early detection and management of sight threatening complications to improve graft survival and vision.
The spatial distribution and Calculator for Severity and Death for COVID-19
Authors: Monteiro Camila Nascimento , Mafra Ana Carolina Cintra Nunes , Vieira Regis Rodrigues , Cavalcante Denise de Fátima Barros , Miraglia João Luiz , Bonfim Daiana , Palacio Danielle da Costa , Martins Alessandra Cristina Ferreira , de Lima Ruchelli França , Duim Etienne Larissa , de Almeida Leticia Yamawaka , Belotti Lorrayne , Martins Renata Soares , Neto João Peres
Published: January 2022

Background: Latin America has one of the highest COVID-19 mortality rates in the world, driven by inequality in its population. We aimed to analyze the spatial distribution and factors associated with the risk of SARS and death in COVID-19 cases using routine record data and to develop and validate a prognostic tool for risk of death by Covid-19. Methods: A cross-sectional study was conducted from March 2020 to April 2021 in the South Zone of the city of São Paulo, SP, Brazil, with 16,061 positive cases of COVID-19. The data were -obtained from the records of the Brazilian Ministry of Health notification systems for flu-like syndrome (eSUS-VE) and hospitalized SARS (SIVEP-Gripe). The spatial distribution of the cases is represented in 2D kernel density. To assess the possible factors associated with the outcomes, generalized linear and generalized additive logistic models were adjusted. To assess the discriminatory power the C-statistic was used. A calculator was developed based on a prognostic model for the risk of death, validated with accuracy measures in the sample, internal validation and temporal validation. Results: The average age of patients was 42.1 years. Evolved to SARS 925 (11.98%) and 375 (2.37%) died. The comorbidities associated with a higher risk of SARS were obesity (OR=25.32) and immunodepression (OR=12.15). The comorbidities associated with a higher risk of death were renal diseases (OR=11.8) and obesity (OR=8.49), with clinical and demographic information being more important than the spatial area. The COVID-19 risk of death calculator showed an accuracy of 92.2% in the sample build, 92.3% in the internal validation and 80% in the temporal validation.Conclusions: Age and comorbidities were identified as the most associated factors to the severity of the disease. For the death analysis, the socioeconomic condition is included in addition to these factors. The calculator can be used and implemented in services of varying complexity because it contains easily accessible information to guide prevention and care.
Chemically Defined Elicitors Activate Priming in Tomato Seedlings
Authors: Kharat Kiran R. , Pottathil Raveendran
Published: January 2022

Background:
Tomato (Solanum lycopersicum L.) is an important crop that possesses about 35,000 genes. The treatment of plants with elicitors or pathogen attacks causes a cascade of defense reactions. The regulation of metabolic pathways by multigene families at transcriptional and translational levels leads to activation or inhibition of various signaling pathways. We investigated tomato responses to the BamFXTM solution containing Zn and Cu elicitors and report the results of comparative transcriptome analysis of tomato seeds treated with Zn and Cu elicitors. The seeds were treated with optimum concentrations of Bam-FX solutions and subjected to cold methanolic extraction methods to obtain the secondary metabolites produced within them at different time intervals post-Bam-FX treatment. The metabolite mixture was analyzed using gas chromatography-mass spectrometry (GCMS). In transcriptome sequencing, GO and KEGG analyses revealed that the majority of the DEGs in BamFx-treated tomato was associated with primary and secondary metabolism, plant hormone signal transduction, TF regulation, transport, and responses to stimuli.
Results:
The secondary metabolites found in the BamFX treated tomato seedlings - Esters of Fumaric acid, Succinic acid, thiocyanic acid, octadecanoic acid, benzoic acid, hexenoic acid, heptanoic acid, Nicotinic acids, carbamic acid and Diethylmalonic acid. The transcript levels of most auxin transporter-encoding genes changed significantly in the BamFX-treated seedlings (e.g., Solyc01g007010.3, a RING-type E3 ubiquitin transferase). The gene Solyc07g061720.3 for Gibberellin 2-oxidase and the Phorbol-ester/DAG-type domain-containing protein (Solyc02g068680.1) associated with the intracellular signalling genes were found upregulated in the BamFx-treated seeds. Also, we identified six upregulated genes involved in the protein kinase activity signalling pathways in the BamFX-treated seedlings. The time-dependent effect of the BamFX (1:500 for 60 min) was found to be regulating many signal transduction pathways. Abscisic acid signalling pathway genes (Solyc09g015380.1) were upregulated in BamFX-treated (1:500 for 60 min) plants.
Conclusion:
This study identified many candidate genes for future functional analyses and laid a theoretical foundation for an improved understanding of the molecular mechanisms involved in the BamFx treatment of tomatoes to improve stress resistance.
A Simple and Rapid Method to Assess the Quality of River Water: Correlation Between Electrical Conductivity and Fecal Coliform Density in Hyogo Prefecture, Japan
Authors: Horiguchi Hanna , Shigemura Katsumi , Kitagawa Koichi , Kitakawa Madoka , Nakazawa Minato , Noyori Tatsuhiko , Inoue Motomu , Moriwaki Michika , Onishi Reo , Yoshimura Chisato , Kobayashi Mayumi , Suzaki Toshinobu
Published: January 2022

This is a report regarding the development of a simple survey method for monitoring water pollution in the Toga River in Kobe City, Japan. This river is popular with local citizens as a water park, and especially in the summer, various activities are introduced to encourage children to play in the river. However, in recent years, contamination by fecal coliforms, probably caused by the accidental influx of domestic wastewater, often limits children from playing in the water. From May to October 2019, water samples were collected from five locations in the Toga River and the concentration of fecal coliforms was measured, along with the electrical conductivity and the chloride ion concentration of the river water, to establish a method for estimating the fecal coliform density (FCD) as a quicker alternative to a culture test. By comparing these parameters with the actual density of fecal coliforms, a high correlation was found between the electrical conductivity and FCD. On the other hand, there was almost no correlation between FCD and the chloride concentration. Receiver operating characteristic (ROC) analysis was used to evaluate the method that uses the electrical conductivity as an estimating parameter. The area under the curve (AUC) was used to determine the performance of the ROC curve algorithm. The calculated AUC value stayed high, above 0.95, over a wide range of threshold values of FCD, suggesting that this rapid method is appropriate for assessing the quantity of contaminating fecal coliforms in the range of 300–2,000/100 mL.
New exploration of bladder cancer-related immune gene biomarkers in predicting the prognosis of urinary system tumors
Authors: Zheng Jun , Zhang Junyong , Zhang Weili
Published: January 2022

Background: Bladder cancer (BLCA) ranks first among genitourinary system tumors in terms of its incidence, and it is associated with poor prognosis due to its high recurrence and metastasis rates. In recent years, in-depth research on tumor microenvironment (TME) and immune infiltration has greatly improved the management of urinary system tumors, especially for advanced BLCA. Therefore, this study aimed to construct a risk scoring model with related immune genes as the independent prognostic factors, so as to estimate BLCA survival according to immune gene expression characteristics. Methods: Here, we downloaded clinical and mRNA data of BLCA in TCGA database and utilized them as the model test set. Clinical samples with incomplete tumor staging or grading information were excluded from this study. Differentially expressed genes (DEGs) between BLCA and normal tissues were identified for GO and KEGG functional enrichment. Further, the prognostic DEGs were obtained by screening the identified DEGs. Thereafter, univariate, multivariate and Lasso regression analyses were performed on immune genes from the as-identified prognostic DEGs. As a result, four independent related immune genes (OAS1, APOBEC3H, LBP1, ANHAK) were obtained, which were then incorporated in the construction of an immune risk scoring model. Finally, TCGA-clear cell renal cell carcinoma (CCRCC) was used as a validation set to validate the risk model.Results: Upon multivariate analyses of both test and validation sets, the four independent genes used to construct the risk scoring model were the independent prognostic factors. As revealed by Kaplan-Meier (KM) curve of BLCA, patient survival time showed significant negative relation to risk score, as verified in validation set. Moreover, the receiver operating characteristic (ROC) curve suggested that, the area under the curve (AUC) was greatly improved when the risk score was used in combination with clinical characteristics, revealing that the risk score might have a better diagnostic value in clinic. Conclusion: This study builds an immune risk assessment model based on the relationship between immunity and BLCA. Finally, four immune-associated prognostic genes were obtained, and the applicability of the model constructed using these four genes to predict urinary system tumors was verified.
Breastfeeding and its Determinants
Authors: Lopes Edna Duarte , Monteiro Alzerina Maria Rocha Lima , Varela Djenifa Odília Barbosa Fernandes Cardoso , Trigueiros Dulcineia Elisa Lima Rodrigues , Spencer Irina Maia , Soares Janice de Jesus Xavier , Vieira Nívia Maria da Luz Pires
Published: January 2022

Background

Exclusive breastfeeding (EBF) is essential for maternal and child health. Breast milk is considered the most appropriate food for children in the first years of life. Studies conducted in Cape Verde (1) show a prevalence of EBF below the recommended values (2). The determining factors of early weaning in the country are not known. The present study aims to estimate the prevalence of EBF and identify its determinants in Cape Verde.
Method

This is a cross-sectional, observational, quantitative, and analytical study. The study population consisted of mothers of children aged 2 years or younger who were users of health centers on the islands of Santo Antão, S. Vicente, Sal, Santiago, and Fogo. The chi-square test was used to evaluate the association between the duration of EBF and the variables maternity leave, maternal education, family income, and health care. A binary logistic regression analysis was used to analyze the effects of the following variables as predictors of breastfeeding: maternal age, maternal education, marital status, family income, location of residence, pregnancy planning, prenatal care, number of prenatal visits, maternity leave, birth weight, breastfeeding in the first hour after delivery, parity, and breastfeeding counseling.
Results

A total of 1717 mothers aged between 13 and 49 years (Md = 26 years) were interviewed. Most were single (58.9%), had a secondary education (57%), were unemployed (59.3%), and resided in Santiago (35.7%). Breast milk being the best food for the baby/a developmental aid (33%) was the most prevalent reason for breastfeeding. The most cited reasons for stopping breastfeeding or never having breastfed were work (19.8%), insufficient milk (16%), and not liking to breastfeed (9.0%). At the time of data collection, 32.50% of the mothers had breastfed, and 49.2% continued to breastfeed exclusively but without reaching the 6 months necessary for breastfeeding to be considered EBF.
Conclusion

The prevalence of EBF in Cape Verde can be considered moderate. Maternal age, educational level, number of prenatal visits, and parity were significantly associated with breastfeeding. There was no significant relationship of maternity leave, maternal education, and family income with EBF. Receiving breastfeeding counseling was the only health care variable that was associated with the duration of EBF (p = 0.029).
Single I.V.-ketamine Augmentation of Newly Initiated Venlafaxine Hydrocortisone for Treatment-resistant Depression: Randomized, Double-blind Controlled Study Protocol
Authors: Du Yun , Feng Ruobing , Zhang Wenle , Fang Jiexin , Ma Ke , Wang Encong , Hu Yongdong
Published: January 2022

Background: The critical issue of treating Treatment-Resistant Depression (TRD) is to improve antidepressant effect rapid onset and the recovery rates. Significant antidepressant effects of ketamine onset rapidly, but decay rapidly and repeated dosing increases the risks. This study aimed to explore the efficacy and safety of single intravenous ketamine, combined with venlafaxines hydrochloride for TRD.Methods: 32 patients with treatment-resistant depression will be randomly selected to undergo a four weeks double-blind treatment with single-dose ketamine (0.5 mg/kg over 40 min) and venlafaxine hydrochloride (4 weeks) or midazolam maleate (0.045 mg/kg over 40 min) and venlafaxine hydrochloride (4 weeks). Depressive symptoms will be measured by the Montgomery–Asberg Depression Rating Scale (MADRS) and the 16-item Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR16). Adverse effects will be measured by the Brief Psychiatric Rating Scale-4 (BPRS-4), Young Manic Rating Scale (YMRS), the Clinician-Administered Dissociative States Scale (CADSS), Frequency and Intensity of Side Effects Rating/Global Rating of Side Effects Burden (FISER/GRSEB）and Patient Rated Inventory of Side Effects (PRISE). Patients will be assessed at baseline, after intervention 1, 2, 4, 24, 48, 72 hours and 7, 14, 21 and 28 days.Discussion: This study will provide important information on whether this new combined intervention can rapidly relieve the symptoms of depression and improve the remission rates of treatment-resistant depression.
Research On The Risk And Benefit Cooperative Decision of Reservoir Flood Limited Water Level
Authors: Li Xiaoying , Zhang Yan , Tong Zechun , Niu Guo-Yue
Published: January 2022

The inconsistency between water consumption and the annual rainfall distribution makes it important to make full use of the flood water resource. The adjustment of the flood limited water level (FLWL) is an effective way to improve the flood water utilization, where the staged control of the FLWL plays an important role. Flood season segmentation is the basis for determining the FLWL and tapping the utilization potential of flood resources. The circular distribution method is used to segment, and the relative frequency method is used to verify. Maintaining the balance between benefit and flood control safety is the key work for the FLWL decision. The performances of water supply and hydropower generation are selected to be benefit index, and the extreme risk rate is risk index. Based on the game theory, the multi-objective cooperative decision-making model is established. Nash negotiation solution of staged FLWL is obtained by Nash negotiation theorem. The optimal scheme is determined according to the fuzzy pattern recognition theory. A reservoir is taken as an example, firstly, considering that the risk and benefit are equally valued, the FLWL of the optimal scheme in the pre-flood season is 129.0m, and the post-flood season is 128.5m. By adjusting the preference value for risk and benefit, the optimal FLWL scheme under different preferences for risk and benefit in each stage is determined.
The Relationship Between Spatial Patterns of Urban Land Uses and Air Pollutants in the Tehran Metropolis, Iran
Authors: Gheshlaghpoor Soheil , Abedi Seyedeh Sanaz , moghbel masoumeh
Published: January 2022

Context: Urban expansion has led to land use changes in metropolises, which in turn cause landscape pattern changes and intensive ecological issues in urban areas. Objective: The main objective of this research is to investigate the relationship between different land use patterns and air pollutants (NO2, SO2, CO, O3) in the metropolis of Tehran. Method:The Local Climate Zone (LCZ) scheme and Landsat 8 satellite images were used to extract urban land uses in Tehran. Additionally, Sentinel-5P satellite images were used to calculate and evaluate air pollutants in summer (2020) and winter (2021).Then, the relationship between the spatial composition and configuration of urban land uses and air pollutants was computed using Pearson correlation coefficient and multiple linear regression in summer 2020 and winter 2021.Results: The results indicate that the distribution or concentration of air pollutants is different from the spatial pattern of land use. The spatial composition and configuration of man-made land uses, including the classes of compact mid-rise, compact low-rise, large low-rise, and heavy industry, had a positive correlation with NO2 and SO2 (Sig<0/038). In contrast, the pollutant CO had a significant negative correlation with the green spaces of types A (dense trees) (Sig: 0/004, (99%)) and B (scattered trees) (Sig: 0/034, (95%)). Conversely, the spatial composition and configuration of man-made land uses had a negative correlation with O3 (Sig<0/047) while had a positive correlation with green spaces (Sig<0/047). Conclusion: The obtained results show that quantitative analysis can help to develop more complex strategies and scenarios in future research.
Can a supranational medicines agency restore trust after vaccine suspensions? The case of Vaxzevria
Authors: Albanese Andrea , Fallucchi Francesco , Verheyden Bertrand
Published: January 2022

Over the first half of March 2021, the majority of European governments suspended Astrazeneca's Vaxzevria vaccine as a precaution following media reports of rare blood clots. We analyse the impact of the European Medicines Agency's (EMA) March 18th statement assuring the public of the safety of Vaxzevria and the immediate reinstatement of the vaccine by most countries on respondents' intention to get vaccinated.By relying on survey data collected in Luxembourg and neighbouring areas between early March and mid-April, we observe that the willingness to be vaccinated was severely declining in the days preceding the EMA statement. We implement a regression discontinuity design exploiting the time at which respondents completed the survey and find that the vaccine reinstatement substantially restored vaccination intentions.
The Prognostic Value of Comprehensive Geriatric Assessment on the Management of Older Patients With Small Cell Lung Cancer
Authors: Chun You Jin , Kim Kwang Joon , Lee Ji Yeon , Choi Ji Won , Kim Tae Hee , Kim Hye Ryun , Cho Byoung Chul , Hong Min Hee , Kim Chang Oh
Published: January 2022

Background The prognostic value of a comprehensive geriatric assessment (CGA) for the management of older cancer patients remains to be established. This study investigated the association of each CGA variable with overall survival (OS) in older small cell lung cancer (SCLC) patients.Methods A retrospective cohort enrolled 21 older SCLC patients over 65 years from March 2018 to 2019 at the Yonsei Cancer Center. The CGA was performed before treatment and included the following instruments: Frailty, a circumference of arm/calf, body mass index (BMI), sarcopenia (e.g., Timed Up and Go test [TUG], grip strength), comorbidity, polypharmacy, function, nutrition, depression, and cognitive function. The correlations of oncological and geriatric variables with OS were determined. The log-rank test and a Cox model were used for the analysis. Prognostic factors of OS were examined by using the Kaplan-Meier method.Results The median age was 75 years (range 67-85). All patients had the Eastern Cooperative Oncology Group performance status (ECOG PS) 0-2. The median survival was 9.93 months (1.53-36.30). Among CGA parameters, activities of daily living (ADL) and nutritional status had significant differences in OS in univariate analysis. In multivariate analysis, only nutritional status was independently associated with survival (HR 0.17 [95% CI 0.05-0.57]). Median OS for low nutritional status was 5.63 months and the normal nutrition group was 15.5 months (p = .004).Conclusions Geriatric assessment detects more information than routine oncological evaluation alone, such as ECOG PS. Pre-treatment nutritional status measured by CGA appears to be a predictor of OS in older SCLC patients. A prospective study with larger sample size is desirable in the future.
Impact of chronic co-infection in pulmonary Mycobacterium avium complex disease after treatment initiation
Authors: Urabe Naohisa , Sakamoto Susumu , Shimanuki Yui , Kanokogi Takumi , Motohashi Takumi , Anzai Nanami , Kato Chiaki , Yamaguchi Asuka , Tokita Nozomi , Homma Sakae , Kishi Kazuma
Published: January 2022

Background: The impact of co-infection with other pathogenic microorganisms after initiation of treatment for pulmonary Mycobacterium avium complex (MAC) disease has not been clearly demonstrated. This study sought to clarify clinical outcomes of co-infection with MAC after antimycobacterial therapy for MAC.Methods: Co-infection status was designated as the detection of pathogenic microorganisms other than MAC in at least two consecutive sputum cultures 6-24 months after initiation of treatment. Chest computed tomography (CT) findings and culture results were compared between co-infection and MAC alone groups. Results: The co-infection and MAC alone groups comprised 12 and 36 patients, respectively. The proportion of patients with sputum culture positive for MAC after 24 months of therapy did not differ significantly between the two groups [25% (3/12) vs. 16.7% (6/36); p=0.671]. The proportion of patients with improved chest CT score after 24 months of starting treatment compared to baseline was significantly lower for the co-infection group than for the MAC alone group [16.7% (2/12) vs. 79.4% (27/34); p<0.001]. In the co-infection group, mean CT score values at 12 and 24 months did not differ from baseline. However, the MAC alone group showed significant improvement at 12 and 24 months compared with baseline.Conclusions: Co-infection with other pathogenic microorganisms has no effect on the therapeutic efficacy of MAC but interferes with improvement in chest CT findings.
Universal Health Coverage for Undocumented Migrant Workers in Thailand: Challenges in Policy Implementation
Authors: Tawaytibhongs Orawan
Published: January 2022

Background: The number of international migrants has been increasing from 2.8% of the world population in 2010 to 3.6% in 2020 according to a recent estimation of the United Nations (UN). One of the many challenges in migrants’ health is to obtain universal health coverage (UHC) in the host countries. The Sustainable Development Goals (SDG) urge policymakers to achieve UHC for all regardless of their nationality that each country is responsible for planning and implementing adequate policies towards migrant’s health. According to the Thai migration report in 2019, almost 5 million non-Thai are residing in Thailand. A majority are low-skilled migrant workers (LSMW) from neighbouring countries including Cambodia, Laos, and Myanmar (CLM). Only half of the LSMW, including the undocumented migrant workers (UMW), were covered by public health insurance in 2018. A significant number of UMW has no entitlement to any health insurance due to various barriers. The study was to review the gaps and challenges in health policies related to migrant workers. Recommendation will be introduced as the conclusion. Methods: Literature review from Pubmed, Biomed Central, and Google Scholar and discussion using WHO Universal Health Coverage cube as a framework Results: From the literature review showed the evolution of Thailand’s migration policies and migrant health insurance schemes. Intersectoral collaboration among the Ministry of Interior (MOI), the Ministry of Labour (MOL), and the Ministry of Public Health (MOPH) has been established yet fragmented with bureaucratic nature. Gaps in migrant health policy implementation persist due to the restrictive nature of migrant policies. The processes of providing social protection in health (SPH) to UMW are more of legalizing than protecting of human rights. The discourse that migrants are a burden to the health system still prevails. Discrimination towards LSMW has substantial negative impact on migrant health policies. The accessibility to basic health services remained limited. Additionally, little was achieved regarding the promotion of equal rights and working opportunities. Conclusion: To increase SPH for the vulnerable population is more than providing financial coverage. Improving access to social health assistance will have positive impact on the health outcomes of migrant workers. This paper proposes practical implementation at local health system.
Use and subjective experience of the impact of a motor-assisted movement exerciser in people with amyotrophic lateral sclerosis: a multicentre observational study
Authors: Maier André , Gaudlitz Marcel , Grehl Torsten , Weyen Ute , Steinbach Robert , Großkreutz Julian , Rödiger Annekatrin , Koch Jan Christoph , Lengenfeld Teresa , Weydt Patrick , Günther René , Wolf Joachim , Baum Petra , Metelmann Moritz , Dorst Johannes , Ludolph Albert Christian , Kettemann Dagmar , Norden Jenny , Koc Ruhan Yasemin , Walter Bertram , Hildebrandt Barbara , Münch Christoph , Meyer Thomas , Spittel Susanne
Published: January 2022

Objective: Motor-assisted movement exercisers (MME) enable device-assisted physical therapy delivered in domestic settings. This observational study captures the frequency of MME use, subjective experience of the therapy provided and MME recommendation. Method: The prospective cohort study was implemented at ten ALS centres (02/2019-10/2020) and coordinated by the research platform Ambulanzpartner. Participants assessed symptom severity, frequency of use and subjective benefit of therapy on a numerical rating scale (NRS, 0 to 10 points). The likelihood of recommending the MME was determined by the Net Promotor Score (NPS). Results: Data for 144 participants were analysed. Weekly MME applications ranged from 1 to 4 in 41%, 5 to 7 in 42% and >7 in 17% of participants. Particularly positive results were achieved in the following domains: amplification of a sense of achievement (67%), diminution of the feeling of having rigid limbs (63%), diminution of the feeling of being immobile (61%), improvement of general wellbeing (55%) and reduction of muscle stiffness (52%). Participants with more pronounced self-rated muscle weakness were more likely to note a beneficial effect on preservation and improvement of muscle strength under MME treatment (p<0.05). The NPS for the MME was high (+61). Conclusion: High-frequency MME-assisted treatment (defined as a minimum of five sessions a week) was administered in the majority of participants (59%) in addition to physical therapy. Most patients stated to have achieved their individual objectives of MME intervention as evidenced by a high level of satisfaction. The results underline the justification for extended MME treatment as part of the ALS care concept.
Identification and characterization of pyrethroid-resistant miRNAs in the genome of malaria vector Anopheles Sinensis
Authors: Xu Xia , Asghar Sana , Hu Changjiang , Si Feng-Ling , Tao Fei , Chen Bin
Published: January 2022

Background: microRNAs (miRNAs) are small endogenous non-coding RNAs that play important roles in many developments, differentiation, apoptosis, and innate immunity in insects. Pyrethroid resistance has become the unique largest obstacle for the mosquito control, and An. sinensis is the main malaria vector mosquito in Eastern and other Asian countries. Methods: We investigated miRNA expression profiles associated with pyrethroid-resistant in An. sinensis by Illumina Hiseq sequencing. Meanwhile, we applied bioinformatics methods to identify miRNAs and their target genes associated with pyrethroid resistance in. miRNAs selected in the bioinformatics approach were confirmed by RT-qPCR. In addition, dual luciferase reporter was also performed to verify the interaction of miRNA and its target genes.Results: We obtained 7,120,612- 7,157,914 clean RNA sequencing reads from the different sample sequencing. A total of 329 miRNAs (included 246 novel ones) were identified by Illumina Hiseq sequencing. Thirty-nine miRNAs were significantly down-regulated in the pyrethroid-resistant populations in comparison of those in susceptible strain. Furthermore, 1909 and 6696 target genes were predicted for the dysregulated 20 known and 19 novel miRNAs respectively. GO annotation and KEGG pathway analyses for the predicted genes of dysregulated miRNAs revealed that they might be involved in a broad range of biological processes related with the pyrethroids, such as integral component of plasma membrane, intracellular binding, catalytic activity, signal transduction, protein transport and several key pathways including ABC transporters. Through miRNA-gene network analysis, 13 key miRNAs and 34 mRNAs of their target genes were predicted. Consistent with the RNA-seq results, nine miRNAs are significantly down-regulated by RT-qPCR in pyrethroid-resistant strains of An. sinensis. In addition, luciferase reporter assay demonstrated that miR-87 directly bound with the 3’UTR of target gene Sinensis_GLEAN_10013226. Conclusion: This study provides the whole-genome information of miRNAs and their characteristics in An. sinensis, which lays an important foundation for further research on miRNAs associated with pyrethroid resistance. Targeting the miRNA-mRNA network may be a new strategy to overcome insecticide resistance in mosquito vectors.
Combining OSMAC, Metabolomic and Genomic Methods on Termite Symbiotic Fungi for the Production and Annotation of Halogenated Azaphilones and Ilicicolins
Authors: Hebra Téo , Pollet Nicolas , Touboul David , Eparvier Véronique
Published: January 2022

We mined a collection of termite mutualistic strains from French Guiana to explore metabolites of symbiotic microorganisms. Molecular networks reconstructed from a metabolomic analysis using LC-ESI-MS/MS methodology led us to identify two families of chlorinated polyketides, i.e. azaphilones from Penicillium sclerotiorum and ilicolins from Neonectria discophora. To define the biosynthetic pathways related to these two types of scaffolds, we used a whole genome sequencing approach followed by hybrid assembly from short and long reads. We found two biosynthetic gene clusters including two FAD-dependent halogenases. To exploit the enzymatic promiscuity of the two identified FAD halogenases, we sought to biosynthesize novel halogenated metabolites. An OSMAC strategy was used and resulted in the production of brominated analogs of ilicicolins and azaphilones as well as iodinated analogs of azaphilones.
A large-Scale Survey of Current Status of Scientific Research and Innovation Ability Cultivation for Undergraduates
Authors: Zhou Fuling , Luo Ping , Wang Hairong , Shen Hui , Yuan Yufeng , Zhang Xian
Published: January 2022

Background: Wuhan University Medical College has implemented the reform of innovative education for undergraduates. This study aims at investigating the practice of the Innovation Education Reform and find out problems to be improved. Methods: Total 670 questionnaires were distributed to undergraduate students from the Wuhan University Medical College. The main categories involved the evaluation of practicability, students' support and satisfaction for innovative education reform. Results: Most students have high support for scientific research innovation. Totally 92.5% of the students believe teachers' guidance is important for conducting scientific research. Only 40% of students believe that they can get information about innovation activities. About 60.64% of students think the basic knowledge of books can’t meet their learning requirements and 83.62% students think it is necessary for the school to set up research and training courses. Setting up problem discussion classes (65%) and teachers’ teaching attitude and methods (70%) are most satisfied, followed by academic lectures (53%). Less than half of the students are satisfied with the undergraduate tutorial system (49%), the experimental facilities provided by the school (46.5%), and innovative atmosphere (39%). The evaluation of students’ own scientific research innovation ability is also not very high (12.31%). Conclusions: Scientific research training plays an important role in the cultivation of college students' scientific research and innovation ability, and teachers play a leading role. Undergraduate tutorial system, opening laboratory and the other managements contribute to innovative education. However, in the process of implementation, some problems still need to be continuously improved.
Evaluation of Ab Externo Subretinal Bands Removal During Pars Plana Vitrectomy for Rhegmatogenous Retinal Detachment Complicated by Proliferative Vitreoretinopathy
Authors: Elbaha Samir , Ghoneem Mohammed , Abousamra Amir , Abouhussein Mahmoud
Published: January 2022

Background

To compare the safety and efficacy of Ab-externo subretinal bands removal in comparison with classical Ab-interno approach during pars plana vitrectomy for primary rhegmatogenous retinal detachment.
Methods

Subjects aged 28-62 years with primary RRD complicated by proliferative vitreoretinopathy (PVR) with subretinal bands interfering with retinal flattening were treated by pars plana vitrectomy (PPV) and silicone oil injection. Subretinal bands were removed using the classical AB interno approach through one or more retinotomies in ten patients (group A) and using AB externo approach in twenty cases (group B). Post-operative follow-up visits occurred at 1 day, 1 week, 1 month, and 3 months, after surgery. The main outcomes were assessment of subretinal bands removal efficacy, documentation of complications, anatomical reattachment rate, and postoperative best-corrected visual acuity (BCVA).
Results

There was no statistically significant difference between both groups regarding patients’ age, gender, lens status, and the onset of retinal detachment. Seventy percent of both groups presented with inferior retinal detachment while ten percent presented with temporal detachments and twenty percent had a total retinal detachment. Both groups had a statistically significant improvement in postoperative visual acuity in comparison with preoperative visual acuity (P=0.005 for group A and P=<0.001 for group B). There was no statistically significant difference between both groups regarding preoperative (P= 0.928) and postoperative (P=0.185) visual acuity. A higher incidence of complications was reported in group A (40%) in comparison with group B (30%) but this difference was not statistically significant (P=0.69). More Epimacular membranes were seen postoperatively in group A (30%) in comparison with group B (20%) but again this difference was not statistically significant (P=0.657). Subretinal hemorrhage was seen in ten percent of cases in both groups. Intraocular pressure was measured in every follow-up of all patients in both groups, no statistically significant difference was found between both groups.
Conclusions

Both techniques are effective and safe to remove subretinal bands with similar outcomes.
Mitochondrial Dynamics of Bcl-2 Family During E2-Induced Apoptosis Correlates with the Malignant of Endometrial Cancer Cells
Authors: Yaguchi Takahiro , Taira Hirofumi , Kameno Misaki , Kawakami Junji
Published: January 2022

Endometrial adenocarcinoma has two type: Type I has an estrogen-derived etiology and low-grade endometrial cancer cells, on the other hand, Type II occurs estrogenindependent and is high-grade endometrial cancer cells. However, it is not well understood that the relationship between the exposure of estrogen and the grade of endometrial cancer cells. So, we investigated how estrogen affected the grade of endometrial cancer cells. In the present study, we focused on the localization and expression of Bcl-2 family that regulate the mitochondrial membrane potential in HEC1 and HEC50B cells. Cell viability was decreased by 17-b-estradiol (E2 ) and E2 disturbed the mitochondrial membrane potential followed by activating caspase-9 and caspase-3 in both cells. These results suggested that E2 induced apoptosis in HEC1 and HEC50B cells. B-cell lymphoma 2 (Bcl-2) and Bcl-2-associated death promoter (Bad) expression were decreased and B-cell lymphoma-extra large (Bcl-XL ) and Bcl-2-associated X protein (Bax) expression were increased at the mitochondrial outer membrane in HEC1 cells. On the other hand, Bcl-2 and Bcl-XL expression were decreased and Bad and Bax expression were increased at the mitochondrial outer membrane in HEC50B cells. In conclusion, the dynamics of the Bcl-2 family during E2 -induced apoptosis was found to be different depending on the grade of endometrial cancer cells. We hope that the dynamics of Bcl-2 family proteins such as Bcl-XL and Bad will be used to diagnose the grade of malignant of endometrial cancer cells.
Comprehensive Analysis of Prognostic And Immune Infiltrates For Foxps Transcription Factors In Human Breast Cancer
Authors: Yi Jianing , Zeng Yuanjun , Zou Lianhong , Zeng Jie , Zhang Chaojie , Liu Luyao , Fan Peizhi
Published: January 2022

Forkhead-box-P family include FOXP1/2/3/4 and its clinical significance still remains unclear in breast cancer(BRCA). We analysed the expressions of FOXPs in BRCA patients to determine diagnostic and prognostic values. Our results indicated that the transcriptional levels of FOXP3/4 were up-regulated in BRCA patients, but FOXP2 were down-regulated. No statistically significant correlation were found between the expression levels of FOXPs in Pathologic stage. FOXP2/3 had a significantly high AUC value in the detection of breast cancer, with 96.8% or 95.7% in accuracy respectively. Our study also suggested that BRCA patients with high transcription levels of FOXP1/2/4 were significantly associated with longer OS. In contrast, BRCA patients with high transcription levels of FOXP3 was not statistically related with OS. Our work revealed that FOXPs was closely related to the alteration of extensive immune checkpoints in breast invasive carcinoma. Additionally, FOXP3 has a significant positive correlation with PDCD1, CD274, CTLA4 and TMB in breast cancer, and FOXP3 expression showed a statistically significant correlation with infiltration of immune cells. Finally, we found that FOXP3 expression predicted the breast cancer cells response to anticancer drugs. Altogether, our work strongly suggests that FOXPs could serve as a biomarker for tumor detection, therapeutic design and prognosis.
Secreted Phosphoprotein 1 (SPP1) Promotes Angiogenesis of Glioblastoma Through Up-regulating PSMA Expression Via Transcription Factor HIF-1α
Authors: Tu Wenjing , Zheng Hui , Li Liangdong , Zhou Changshuai , Feng Mingtao , Chen Lei , Li Deheng , Chen Xin , Hao Bin , Cao Yiqun , Gao Yang
Published: January 2022

Background: Glioblastoma multiforme (GBM) is a highly vascular-rich and devastatingly aggressive type of malignant brain tumors, thus anti-angiogenesis therapy plays an essential role in the treatment of GBM. Our previous study had showed that the prostate-specific membrane antigen (PSMA) promoted angiogenesis of GBM though interacting with Integrin β4 (ITGB4) and regulating NF-kB signaling pathway. This study aims to explore the upstream molecular mechanism of GBM regulating the expression of PSMA and promoting angiogenesis process.Methods: Human cytokine antibody array and bioinformatics were used to explore potential cytokines involved in regulating PSMA expression. Recombinant protein was applied and Western blot, qRT-PCR were assessed to verify that the contributing cytokine was SPP1. Expression levels, prognosis and receiver operation characteristic (ROC) curve of SPP1 were determined by bioinformatics to evaluate its clinical value. ELISA was conducted to evaluate the variation of SPP1 in the serum of GBM patients pre- and post-surgery. Potential transcription factor mediating the expression of PSMA was sifted through PROMO and JASPAR website. ChIP assay and dual luciferase were used to confirm that the transcription factor regulating PSMA expression was HIF-1α. Cellular migration and tube formation ability were assessed by scratch assay and tube formation assay in human umbilical vein endothelial cells (HUVECs).Results: We demonstrated that cytokine SPP1 secreted from GBM could regulate the expression of PSMA in HUVEC. SPP1 was abundantly expressed in the GBM, and the high expression of SPP1 is associated with poor prognosis. Recombinant protein SPP1 could promote migration and tube formation ability of HUVEC. The mechanistic study revealed that SPP1 regulated the expression of PSMA through transcription factor HIF1α. In addition, knockdown of HIF1α could reduce the expression of PSMA in HUVEC, and block the ability of SPP1 in promoting migration and tube formation of HUVEC. Furthermore, SPP1 and HIF1α both had a high value of clinical diagnosis with considerable sensitivity and specificity.Conclusions: In this study, we identified that upstream cytokine SPP1 secreted from GBM could upregulate PSMA expression in endothelial cells via transcription factor HIF1α, which constructs a positive chain in angiogenesis and provides promising candidates for targeted therapy of GBM.
Alpha-1-antitrypsin in Plasma Exosomes and Pericardial Fluid Exosomes Are Associated With Severity of Rheumatic Heart Disease
Authors: Sharma Shruti , Sarkar Subendu , Chakraborti Anuradha
Published: January 2022

Rheumatic heart is an autoimmune sequel of pharyngitis and rheumatic fever that leads to permanent heart valves damage, especially the mitral valves. The mitral valves, which are responsible for the binding of auto-antibodies during immune response generation, leads to valves scarring and eventually mitral valve dysfunction. Recently, exosomes (EXOs), the nano-sized-vesicles, which ranges in size from 30-150 nm, are involved in various cardiovascular physiological and pathological processes. These vesicles are found in several body fluids such as plasma, serum and also in cell culture media. Exosomal cargo contains proteins, which are taken up by the recipient cells and modulates the cellular characteristics. The role of exosomal proteins in RHD is still obscure. Hence, the present study is designed to unveil the role of exosomal proteins in increasing disease severity during RHD. In this study, the exosomes were isolated from biological fluids (plasma and pericardial fluid) of RHD patients as well as from their respective controls. Protein profiling of these isolated exosomes revealed that alpha-1 antitrypsin is up-regulated in the biological fluids of RHD patients. The augmented levels of exosomal alpha-1 antitrypsin, was further, validated in biological samples and mitral valve tissues of RHD patients, which was further correlated with the disease severity. These findings suggest that increased levels of exosomal alpha-1 antitrypsin is responsible for increased severity during RHD.