bluuebunny/crossref_metadata_2025 huggingface dataset:
An Investigation Into the Beneficial Effects of High-Dose Interferon beta 1-a, Compared to Low-Dose Interferon Beta 1-a (the base therapeutic regimen) in moderate to severe COVID-19
Authors: Darazam Ilad Alavi , Hatami Firouze , Rabiei Mohammad Mahdi , Pourhoseingholi Mohamad Amin , Shabani Minoosh , Shokouhi Shervin , Moradi Omid , Gharehbagh Farid Javandoust , Mirtalaee Nasrinsadat , Negahban Halimeh , Amirdosara Mahdi , Zangi Masoud , Hajiesmaeili Mohammadreza , Kazempour Muhanna , Shafigh Navid
Published: January 2021

Introduction: Coronavirus disease 2019 (COVID-19) has been a serious obstacle in front of public health. Interferon-beta 1a (IFN-β 1a) has been used to treat patients with COVID-19. We aimed to compare the effectiveness of high dose IFN-β 1a compared to low dose IFN-β 1a (the base therapeutic regimen) in moderate to severe COVID-19 cases.Methods: In this randomized, controlled, and clinical trial, eligible patients with confirmed SARS-CoV-2 infections were randomly assigned to receive one of the two following therapeutic regimens: The intervention group was treated with high dose IFN-β 1a (Recigen) (Subcutaneous injections of 88μg (24,000 IU) on days 1, 3, 6) + lopinavir /ritonavir (Kaletra) and the control group was treated with low dose IFN-β 1a (Recigen) (Subcutaneous injections of 44μg (12,000 IU) on days 1, 3, 6) + lopinavir /ritonavir (Kaletra) (400mg/100 mg twice a day for 10 days, orally, in all two groups). Result:A total of 168 COVID- 19 confirmed patients underwent randomization; 83 were assigned to the intervention group and 85 were assigned to the control group. Median Time To Clinical Improvement (TTIC) for cases treated with low dose of IFN-β1a was shorter than that for cases treated with high dose of IFN-β1a (6 vs10 days; P=0.018). Hazard Ratio for TTCI in the Cox regression model was 1.56 (95% CI: 1.05-2.30, P-value=0.026). Due to differences between some baseline clinical factors between intervention and control group, we; therefore, performed an adjusted analysis by including spo2, D-dimer and CRP in Cox regression model. The model failed to reach a significant difference between two groups. The adjusted HR was 1.37 (95% CI: 0.88-2.12, P-value=0.16). No difference was observed in terms of mortality between two groups. ConclusionThe use of high-dose IFN-β 1a did not improve TTCI in hospitalized patients with moderate to severe COVID-19. Also, it has not any significant effect in mortality reduction compared with treating with low-dose IFN-β 1a.Trial registration: The trial was confirmed by the Ethics in Medical Research Committee of the Shahid Beheshti University of Medical Sciences. signed informed consents were obtained from all the participants or their legally authorized representatives. This trial has been registered as ClinicalTrials.gov, NCT04521400.
Parent-adolescent communication about Sexual and Reproductive Health Issues and Associated Factors among Mothers in Wogdie District, North Ethiopia
Authors: Ewnetu Lioul , Mekonnen Alemtsehay , Alemu Yibeltal , Shume Workineh
Published: January 2021

Background: Adolescence is a stage of rapid transition of physical, psychological and emotional development. Parent-adolescent communication has great role on the reduction of SRH problem of adolescents. However evidences shows that there is a silence between parent and adolescent because of this adolescent are affected by STIs, HIV, unsafe abortion and unwanted pregnancy. Therefore this study tried to identify factors that hinder communication in Wogdie district North East Ethiopia.Method: A community based cross-sectional study supplemented with qualitative data was conducted. Six hundred fifteen mothers were selected by multi-stage sampling method for quantitative study. Interviewer administered questionnaire was used for quantitative data collection. Multiple binary logistic regression analysis was executed to assess the association between variables. Participants were selected by purposive sampling method for qualitative part. Fourteen participants were participated in in-depth interview. The qualitative data was transcribed manually using verbatim approach.Results: The magnitude of parent-adolescent communication was 198 (32.8%) with 95% CI (29.1, 36.7). Rural residence of mother [AOR=0.056, 95% CI (0.01, 0.331)], family size of >6 [AOR=0.338, 95% CI (0.13, 0.874)], maternal education status of uneducated [AOR=0.421, 95% CI (0.186, 0.951)], maternal occupational status of housewife [AOR=0.085, 95% CI (0.024, 0.298)], low wealth status [AOR=0.316, 95% CI (0.129, 0.777)], poor maternal knowledge about SRH [AOR=0.063, 95% CI (0.024, 0.164)] and negative maternal attitude towards SRH communication [AOR=0.037, 95% CI (0.008, 0.169)] were have significant negative association with parent-adolescent communication. Cultural taboo, fear and lack of knowledge were reasons that hinder communication.Conclusion: Communication on sexual and reproductive health issue between parent and adolescent was low. Home to home and community health education of mothers is important to create good knowledge and positive attitude about sexual and reproductive communication.
Professional Image of Nursing and Midwifery in East Africa: An Exploratory Analysis
Authors: Ndirangu Eunice Wambui , Sarki Ahmed , Mbekenga Columba , Edwards Grace
Published: January 2021

Background: Evidence suggests that there is a negative image of nursing and midwifery that does not promote these professions as attractive career options. Furthermore, there is a paucity of studies documenting how nursing and midwifery is perceived in East Africa and where such studies exist they are country-specific. The aim of this study was to explore views regarding the image of nursing and midwifery among nurses and midwives in three East African countries, Kenya, Tanzania and Uganda.Methods: An exploratory descriptive cross-sectional study administered online using Survey Monkey Questionnaires assessed the views and perceptions of nurses and midwives regarding the image of nursing and midwifery professions. Descriptive statistics and Pearson’s Chi square tests were used to analyse the data. The semi-structured questions were analysed using content analysis. Results: A total of 551 participants took part in the study. The majority were females (61.8%), registered nurses/midwives (45.8%), and aged 30-39 years (34.2%). Most of the respondents were from Kenya (39.7%) and Uganda (32.9%). About two-thirds of the nurses and midwives in this study perceived nursing/midwifery as both trusted and respected professions and expressed having a level of control over how their image was portrayed. Conversely, the nurses and midwives were conscious that the public had mixed responses about the nursing/midwifery professions specifically, some members of the public described nurses/midwives as professionals, knowledgeable and caring, others perceived nurses/midwives to be rude, cruel, unkind, lazy, unkempt, and maids.Conclusion: This study offers an interesting insight about the image of nursing/midwifery in East Africa. Findings from this study will inform policy makers and educators about key concepts that affect the image of nursing and midwifery in East Africa. The findings will be used to design marketing materials to help improve the image of nursing and midwifery in the region and other African countries.
Factors affecting patient safety culture in terms of compliance with preventing bloodborne pathogens among general hospital nurses
Authors: Kim Na young , Moon Kyoung Ja
Published: January 2021

Background: The present study aims to investigate the relationship between patient safety culture and the prevention of transmitting bloodborne pathogens among nurses at a general hospital.Methods: The participants were 284 nurses working at a general hospital located in a city, and the data were collected between April 26 and May 15, 2019. Questionnaires on patient safety culture and the prevention of bloodborne pathogens were used, and SPSS version 22.0 was used for descriptive and hierarchical regression analysis.Results: The results showed that the following factors affected the prevention of bloodborne pathogens: experience with needle stick and sharps injuries (β = -0.94), teamwork (β = 0.41), knowledge and attitude toward patient safety (β = 0.34), leadership (β = 0.15), and priority of patient safety (β = 0.14). The model's explanatory power was 53% (F = 32.26, p =< 0.001).Conclusions: To increase the compliance of general hospital nurses with practices that promote the prevention of bloodborne pathogens, it is necessary to actively prevent needle sticks and sharps injuries. It is also necessary to prioritize patient safety and to develop and verify the effects of various programs that emphasize factors of patient safety culture, such as leadership, teamwork, knowledge, and attitude.
Age-related decline in the expression of GDF9 and BMP15 genes in follicle fluid and granulosa cells derived from poor ovarian responders 
Authors: Gong Yan , Li-Ling Jesse , Xiong Dongsheng , Wei Jiajing , Zhong Taiqing , Tan Hao
Published: January 2021

Background: Growth differentiation factor 9 (GDF9) and bone morphogenetic protein 15 (BMP15) genes play important roles in folliculogenesis. Altered expression of the two have been found among patients with poor ovarian response (POR). In this prospective cohort study, we have determined the expression of the GDF9 and BMP15 genes in follicle fluid (FF) and granulosa cells (GCs) derived from poor ovarian responders grouped by age, and explored its correlation with the outcome of in vitro fertilization and embryo transfer (IVF-ET) treatment. Methods: A total of 196 patients with POR were enrolled from a tertiary teaching hospital. The patients were diagnosed by the Bologna criteria and sub-divided into group A (< 35 year old), group B (35-40 year old), and group C (> 40 year old). A GnRH antagonist protocol was conducted for all patients, and FF and GCs were collected after oocyte retrieval. Expression of the GDF9 and BMP15 genes in the FF and GCs was determined with enzyme-linked immunosorbent assay (ELISA), quantitative real-time polymerase chain reaction (qRT-PCR) and Western blotting. Results: Compared with group C, groups A and B had significantly more two pronuclei (2PN) oocytes and transplantable embryos, in addition with higher rates of implantation and clinical pregnancy (P < 0.05). The expression level of GDF9 and BMP15 genes in the FF and GCs differed significantly among the three groups (P < 0.05), showing a trend of decline along with age. The ratio of GDF9/BMP15 mRNA levels were similar among the three groups (P > 0.05). The relative levels of GDF9 and BMP15 proteins in GCs have correlated with the relative mRNA levels in GCs and protein concentrations in FF (P < 0.05). Conclusions: For poor ovarian responders, in particular those over 40, the expression of GDF9 and BMP15 is declined along with increased age and in accompany with poorer oocyte quality and IVF outcome, whilst the ratio of GDF9/BMP15 mRNA levels remained relatively constant.
The Comparison of Efficacy and Complications of Coblation and Radiofrequency Thermocoagulation for V2/V3 Idiopathic Trigeminal Neuralgia: A Retrospective Cohort Study of 292 Cases
Authors: Wang ChenHui , Dou Zhi , Yan MengWei , Tang Yuanzhang , Zhao Rui , Han YuJie , Ni Jiaxiang
Published: January 2021

Background: Coblation is a novel technique in respect of treating idiopathic trigeminal neuralgia. We aimed to identify the efficacy and complications between radiofrequency thermocoagulation (RFT) and coblation for V2/V3 idiopathic trigeminal neuralgia (ITN) and investigate the risk factors associated with postoperative facial numbness.Methods: We retrospectively reviewed our cohort of 292 patients who had undergone RFT or coblation for V2/V3 ITN. The characteristics of the baseline were collected before surgery. Pain scores, the degree of facial numbness and other complications were evaluated at discharge and 1month, 3 months, 6 months and 12 months after surgery.Results: Postoperative pain intensity was apparently alleviated in both groups. The initial and 12-months remission rates were 94.0% and 75.3% in coblation group compared with 96.9% and 78.4% in RFT group (P=0.462, P=0.585). The degree of postoperative facial numbness tended to be more severe in RFT group at discharge, 1 month, 6 months and 12 months (P=0.006, P=0.026, P=0.004, P=0.003). Factors significantly associated with more severe facial numbness were procedure of RFT (OR=0.46, 95%CI: 0.28-0.76, P=0.002), history of previous RFT at the affected side (OR=2.33, 95%CI: 1.21-4.48, P=0.011), and ITN with concomitant continuous pain (OR=0.36, 95%CI: 0.18-0.71, P=0.004).Conclusion: Coblation could reduce the degree of postoperative facial numbness for ITN, and the efficacy was no less effective than RFT. History of previous RFT at the affected side, procedure of RFT, ITN with concomitant continuous pain was identified as significant factors of the development of postoperative facial numbness.
Pressurized Intra-Peritoneal Aerosol Chemotherapy (PIPAC): increased intraperitoneal pressure does not affect distribution patterns but leads to deeper penetration depth of doxorubicin in a sheep model
Authors: Mimouni Myriam , Richard Christophe , Adenot Pierre , Letheule Martine , Tarrade Anne , Sandra Olivier , Dahirel Michèle , Lilin Thomas , Lecuelle Benoit , Gélin Valérie , Cohen Julien , Fauconnier Arnaud , Vialard François , Huchon Cyrille , Chavatte-Palmer Pascale
Published: January 2021

Background

Pressurized Intra-Peritoneal Aerosol Chemotherapy (PIPAC) is an innovative treatment against peritoneal carcinomatosis. Doxorubicin is a common intra-venous chemotherapy used for peritoneal carcinomatosis and for PIPAC. This study evaluated the impact of increased PIPAC intraperitoneal pressure on the distribution and cell penetration of doxorubicin in a sheep model.

Methods

Doxorubicin was aerosolized using PIPAC into the peritoneal cavity of 6 ewes: N=3 with 12mmHg intraperitoneal pressure (group 1) and N=3 with 20mmHg (group 2). Samples from peritoneum (N=6), ovarian (N=1), omentum (N=1) and caecum (N=1) were collected for each ewe. The number of doxorubicin positive cells was determined using the ratio between doxorubicine fluorescence-positive cell nuclei (DOXO+) over total number of DAPI positive cell nuclei (DAPI+). Penetration depth (μm) was defined as the distance between the luminal surface and the location of the deepest DOXO+ nuclei over the total number of cell nuclei that were stained with DAPI. Penetration depth (μm) was defined as the distance between the luminal surface and the location of the deepest DOXO+ nuclei.

Results

DOXO+ nuclei were identified in 87% of samples. All omental samples, directly localized in front of the nebulizer head, had 100% DOXO+ nuclei whereas very few nuclei were DOXO+ for caecum. Distribution patterns were not different between the two groups but penetration depth in ovary and caecum samples was significantly deeper in group 2.

Conclusions

This study showed that applying a higher intra-peritoneal pressure during PIPAC treatment leads to a deeper penetration of doxorubicin in ovarian and caecum but does not affect distribution patterns.
IRLnc: A novel functional noncoding RNA contributes to intramuscular fat deposition
Authors: Wang Ligang , Zhou Zhong-Yin , Zhang Tian , Zhang Longchao , Hou Xinhua , Yan Hua , Wang Lixian
Published: January 2021

BackgroundIntramuscular fat (IMF) is associated with meat quality and insulin resistance in animals. Research on genetic mechanism of IMF decomposition has positive meaning to pork quality and diseases such as obesity and type 2 diabetes treatment. In this study, an IMF trait segregation population was used to perform RNA sequencing and to analyze the joint or independent effects of genes and long intergenic non-coding RNAs (lincRNAs) on IMF.ResultsA total of 26 genes including six lincRNA genes show significantly different expression between high- and low-IMF pigs. Interesting, one lincRNA gene, named IMF related lincRNA (IRLnc) not only has a 292-bp conserved region in 100 vertebrates but also has conserved up and down stream genes (<10 kb) in pig and humans. Real-time quantitative polymerase chain reaction (RT-qPCR) validation study indicated that nuclear receptor subfamily 4 group A member 3 (NR4A3) which located at the downstream of IRLnc has similar expression pattern with IRLnc. RNAi-mediated loss of function screens identified that IRLnc silencing could inhibit both of the RNA and protein expression of NR4A3. And the in-situ hybridization co-expression experiment indicates that IRLnc may directly binding to NR4A3. As the NR4A3 could regulate the catecholamine catabolism, which could affect insulin sensitivity, we inferred that IRLnc influence IMF decomposition by regulating the expression of NR4A3.ConclusionsIn conclusion, a novel functional noncoding variation named IRLnc has been found contribute to IMF by regulating the expression of NR4A3. These findings suggest novel mechanistic approach for treatment of insulin resistance in human beings and meat quality improvement in animal.
New Onset Diabetes Mellitus and Cardiovascular Events in Korean Patients with Acute Myocardial Infarction Receiving High-Intensity Statins
Authors: Choi Jah Yeon , Choi Cheol Ung , Choi Byoung Geol , Park Yoonjee , Kang Dong Oh , Jang Won Young , Kim Woohyeun , Na Jin Oh , Kim Jin Won , Kim Eung Ju , Rha Seung-Woon , Park Chang Gyu , Seo Hong Seog , Jeong Myung Ho , Chae Sung-Chull , Seong In-Whan , Yoon Chang-Hwan , Cha Kwang Soo , Oh Seok Kyu
Published: January 2021

Background: High-intensity statin therapy is typically used in patients with acute myocardial infarction (AMI) for secondary prevention. However, there have been consistent concerns regarding its association with diabetes mellitus. We investigated the effect of high-intensity atorvastatin and rosuvastatin on new-onset diabetes mellitus (NODM) and cardiovascular outcomes over a 3-year follow-up period.

Methods: Data from the Korea Acute Myocardial Infarction Registry were collected from November 2011 to October 2015, and 13,104 patients with AMI were enrolled from major cardiovascular centers. Among them, 2,221 patients without diabetes who had been administered with high-intensity atorvastatin (40–80 mg) and rosuvastatin (20 mg) were investigated. The atorvastatin and rosuvastatin groups were evaluated for the incidence of NODM and major adverse cardiac events (MACE) including death, myocardial infarction, and revascularization cases in the following 3 years.

Results: Baseline characteristics were comparable between the two groups. Event-free survival rate of NODM and MACE was not significantly different between the atorvastatin and rosuvastatin groups (92.5% vs. 90.8%, respectively; Log-rank P-value = 0.550). The event-free survival rate of MACE was also not significantly different between atorvastatin and rosuvastatin groups (89.0% vs. 89.6%, respectively; Log rank P-value = 0.662). Multivariate Cox analysis revealed that statin type was not a prognostic factor in the development of NODM and MACE.

Conclusions: Administering high-intensity atorvastatin and rosuvastatin in patients with AMI produced comparable effects on NODM and clinical outcomes, suggesting their clinical equivalence in secondary prevention.
Anti-malarial activity of the leaf latex of Aloe weloensis (Aloaceae) against plasmodium parasites 
Authors: Amare Gedefaw Getnet , Degu Amsalu , Kifle Zemene Demelash
Published: January 2021

Lack of available vaccines and emerging resistance on the anti-malarial drug have provided the necessity to find noble plant--based anti-malarial drugs. The leaf latex Aloe weloensis has been used in folk medicine against malarial and other human ailments in Ethiopia. Hence, the present study aimed to investigate the anti-malarial activity of the leaf latex of A. weloensis against Plasmodium parasites to validate its traditional claim. Methods: The leaf latex of A. weloensis was evaluated in vitro anti-malarial activity against 3D7 strain of Plasmodium falciparum. The prophylactic and curative models were employed to determine in vivo anti-malarial activity of the latex against P. berghei infected mice, and antioxidant activity of the leaf latex of A. weloensis was assessed in DPPH assay. Results: The leaf latex of Aloe weloensis endowed with free radical inhibition activity (IC50 = 10.25 μg/ml). The latex of A. weloensis leaf was demonstrated inhibitory activity against 3D7 strain of P. falciparum (IC50 = 9.14 μg/ml). The prophylactic and curative effect of the latex was found to be dose-dependent. Parasitemia reduction was significant (200 mg/kg, p<0.01, 400 and ,600 mg/kg, p<0.001) in prophylactic test compared to the control. Parasitemia level of the mice treated with 200, 400, and 600 mg/kg doses of the latex significantly (p<0.001) reduced with suppression of 36%, 58%, and 74% respectively in the curative test. The leaf latex significantly (p<0.01) improved mean survival times, packed cell volume , rectal temperature, and bodyweight of P. berghei infected mice. Conclusion: The result was confirmed the anti-malarial activity of the leaf latex of Aloe weloensis at various doses which corroborates the traditional uses of the plant.
Self-esteem, Social Support and Coping Strategies of left-behind Children in Rural China, and the Intermediary Role of Subjective Support：a cross-sectional survey
Authors: Cui Shu , Cheng Fangshuo , Zhang Ling , Zhang Chao , Yuan Qiuyu , Huang Cui , Zhang Kai , Zhou Xiaoqin
Published: January 2021

Background: Negative coping strategies and behavioral problems are common among Chinese left-behind children, which are relate to a variety of negative consequences. At this stage of development, the relevant factors of coping strategies need to be further studied, in which social support and self-esteem are worthy of our attention. The aim of this study is to detect the current situation of self-esteem, social support, and coping styles of left-behind children (LBC) in rural China.

Methods: 322 children from 3 schools in China enrolled in this study, including 236 LBC and 86 non-left-behind children (NLBC) to assess self-esteem, social support and coping strategies.

Results: The LBC group had lower self-esteem score and lower total social support (subjective support, objective support and support-seeking behavior) than the NLBC group. In terms of coping strategies, the LBC group was lower than the NLBC group in problem-solving and rationalization. The self-esteem score in LBC was significant positive associated with the subjective support score, objective support score, problem-solving and help-seeking score. In addition, self-esteem has significant mediating effect between subjective support and problem-solving, subjective support and help-seeking, respectively.

Conclusions: The finding indicate that Chinese LBC’s self-esteem and social support need to be improved. Given the significant correlativity between self-esteem, subjective support and coping strategy, it is necessary to promote Chinese LBC’s self-esteem and social support, especially subjective support.
The diagnostic value of LGALS1 in esophageal cancer and its potential molecular pathways via bioinformatic analysis
Authors: Li Dan , Yang Heng , Lei Yue , Guo Qiang , Ji Yanmei , Guo Jialong
Published: January 2021

Background: Esophageal cancer (ESCA) was one of the most common malignant tumors. The purpose of this study was to reveal the role and potential regulatory mechanism of LGALS1 in the progression of ESCA.Methods: Oncomine, Timer and TCGA databases were used to analyze the expression level of LGALS1 and its value in the diagnosis of ESCA. The correlation between LGALS1 expression and the clinicopathological characteristics in ESCA patients was analyzed through the Ualcan database. In the TCGA database, we performed Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and Gene Set Enrichment Analysis (GSEA) to elucidate the potential mechanism underlying the role of LGALS1 in ESAC pregression. Besides, LGALS1 co-expressed genes were imported into the STRING database to build a protein-protein interaction (PPI) network. Hub genes were screened by the CytoHubba plug-in in Cytoscape and was verified in Gene Expression Profiling Interactive Analysis (GEPIA) and TCGA databases.Results: LGALS1 was highly expressed in ESCA tissues. Increased LGALS1 expression was related to age, ethnicity, clinical stage, tumor grade, and histological subtype of ESCA patients, and receiver operating characteristic (ROC) analysis showed that the area under the curve (AUC) was 0.8511 (P < 0.001). GO and KEGG showed that LGALS1 co-expressed genes, in which 482 genes were included, were mainly involved in endothelial cell differentiation, transforming growth factor receptor signaling pathway, epithelial cell proliferation, ECM receptor interactions, leukocyte migration, transcriptional disorders during cancer, PI3K/AKT signaling pathway and so on. Moreover, GSEA showed that elevated expression of LGALS1 was mainly enriched in ECM receptor interaction, cancer pathway, and TGF beta signaling pathway. The hub genes (COL1A1, FN1, COL1A2, COL3A1, COL5A1, COL5A2, COL4A2, COL18A1, and COL6A1) were highly expressed and had diagnostic significance in ESCA.Conclusion: LGALS1 expression level was elevated in ESCA tissues and might be a potential diagnostic marker for ESCA patients.
An ethnobotanical study on the Chuanqing People of China based on an herbal market survey at the Dragon Boat Festival
Authors: Wang Qinghe , Zhao Ling , Gao Chi , Zhao Jiawen , Ren Zixuan , Shen YuXiang , Yao Ruyu , Yin HongXiang
Published: January 2021

Background: The Chuanqing People (穿青人) are an ethnic group native to Guizhou Province of China, with a unique culture and rich knowledge of traditional medicinal plants. The herbal market at the Dragon Boat Festival plays an important role in the inheritance of traditional medicinal knowledge among the Chuanqing People. This study aims to record the characteristics, current situation, and problems of medicinal plant usage by the Chuanqing People of China. Such information is important for the inheritance and protection of the Chuanqing People’s traditional medical knowledge. Methods: Data were collected through key informant interviews, semi-structured interviews, and taxonomic identification. The results were compared with those of traditional Chinese medicine and other ethnic medicines in Guizhou Province. Data were analyzed with use-value (UV) and cultural importance index (CI) values. Results: A total of 102 species from 53 families and 92 genera were recorded, with Orchidaceae and Asparagaceae (6 species each), Berberidaceae and Compositae (5 species each), and Apocynaceae, Ranunculaceae, Rosaceae, and Polygonaceae (4 species each) as the predominant families. The most frequently used taxon was Hedera nepalensis var. sinensis (Tobler) Rehder (UV and CI=0.29). Moreover, 71 investigated human ailments were grouped into 12 categories. Diseases of the musculoskeletal system and connective tissue (34 mentions) were the most frequently mentioned in this study. Conclusions: The traditional herbal market during the Dragon Boat Festival is a hotspot of traditional medicinal plant knowledge of the Chuanqing People. However, urbanization threatens the inheritance of local medicinal plant knowledge. This study highlights the traditional medicinal knowledge of the Chuanqing People, providing basic data for further research on and protection of minority medicine.
Rapid Response Team activation after major hip surgery: patient characteristics and outcomes
Authors: Pritchard Angus , Jones Daryl , Bellomo Rinaldo , Hardidge Andrew , Harley Ian , Tan Chong Oon , Nazareth Justin , Guha Ranj , Ellard Louise , Hu Raymond , Churilov Leonid , Weinberg Laurence
Published: January 2021

Background: Rapid response teams (RRTs) are a critical care resource that review deteriorating patients within the hospital. We aimed to describe demographic, preoperative, surgical, anesthetic, and postoperative characteristics of patients who required RRT activation after major hip surgery. We also sought to assess whether these characteristics where associated with mortality during the index hospital admission.Methods: We reviewed an RRT database of adult patients undergoing orthopedic surgery at a university teaching hospital. We then retrospectively reviewed the medical records to extract a priori–defined patient, preoperative, surgical, anesthetic, and postoperative data of major hip surgery admissions between September 2014 and December 2017. Patients who survived the index hospital stay were compared to those who died.Results: Overall, 187 patients had postoperative RRT activations. Median (interquartile range) age was 84.0 (78-90) years; 125 (67%) were female, and most patients had at least one significant comorbidity, median Charlson Comorbidity Index (CCI) 5.0 (4.0-7.0). The majority of patients were frail (68%), American Society of Anesthesiologists physical status Class 3 or greater (91%), and underwent nonelective surgery (88%). Median (interquartile range) time from surgery to RRT activation was 29.4 (11.3–75.0) hours, and 25 (13%) patients had unplanned admissions to intensive care or high dependency units. Compared to patients who survived RRT activation, those who died displayed higher mean CCI (6.5 [1.8] vs. 5.5 [2.1], p = 0.02), were more frail (80.1% vs. 56.5%, OR = 3.2, 95% CI: 1.2,8.1; p = 0.03), and received less intraoperative opioids (intravenous morphine equi-analgesia: median = 5.8 (0.1–8.20 vs. 11.7 (3.7–19.0) mg, p = 0.03). They were also more likely to have received an urgent medical review prior to RRT activation (62% vs. 40%, OR = 2.4, 95% CI: 1.1, 5.6); p = 0.05.Conclusions: Death after RRT activation occurred in 1 in 7 patients undergoing major hip surgery. Common patient characteristics included advanced age (> 82 years), frailty, high CCI, and emergency surgery. Further studies investigating perioperative surveillance teams in the identification of the high-risk patients before surgery and deteriorating patients after major hip surgery are warranted.
Pulp volume changes after piezocision-assisted tooth movement: a randomized clinical trial
Authors: Hatrom Abdulkarim A. , Howait Mohammad S. , Zawawi Khalid H. , Al-Turki Ghassan A. , Alansari Reem A. , Almehayawi Nouf F. , Alammari Sarah H. , Mohammed Raghda A. , Hassan Ali Habib
Published: January 2021

Background

Orthodontic treatment has some undesirable side effects, such as root resorption and a decrease in the size of the pulp tissue which are relatively associated with the duration of the orthodontic treatment. Piezocision-assisted tooth movement was introduced as a minimally invasive surgical procedure with an aim to shorten orthodontic treatment time. This prospective randomized clinical trial was aimed to compare the pulp volume changes of maxillary anterior teeth after en-masse retraction with or without piezocision-assisted orthodontics.

Methods

Patients who required orthodontic treatment with bilateral maxillary first premolar extractions and en-masse retraction were recruited. Patients were randomly divided into extraction with piezocision, or only extraction, serving as controls. Pulp volume and root length changes of the maxillary six anterior teeth were measured and compared between the two groups using a 3-Dimensional analytical software. Paired and independent sample t-tests were used to compare within and between groups. Bivariate correlation was done between the mean change in pulp volume and its corresponding root length. The significance level was set at α = 0.05.

Results

A total of 23 patients were included, 12 in the piezocision, and 11 in the control group. At the end of the en-masse retraction phase (mean = 122.74 ±3.06 days) pulp volume was significantly decreased in all six anterior teeth in both groups ( P < 0.01). The decrease in pulp volume was not statistically different between both groups, ( P > 0.05). There was a statistically significant but moderate correlation only between the pulp volume change of the right canine and its root length, r = 0.44, P = 0.034.

Conclusions

The effect of piezocision-assisted orthodontic tooth movement on the pulp volume was comparable to the conventional orthodontic treatment. The degree of change in pulp volume does not appear to be related to the amount of root resorption.

Trial registration: NCT03180151.
Characterization of carbapenem non-susceptible Gram-negative Bacilli isolated from the feces of 10,000 inpatients in Southern China
Authors: Duan Xiaonv , Li Si , Peng Yuan , Qin Yingcheng , Rui YongYu
Published: January 2021

Background: Carbapenem non-susceptible Gram-negative bacilli (CNS-GNB) were dominant pathogen causing clinical infections. The human intestine was important reservoir of gram-negative bacilli (GNB), but there were few studies to analysis the prevalence of fecal colonization with them.Methods: Fecal samples were collected from hosiptal screening test for GNB was conducted by using home-made MacConkey agar. Antimicrobial susceptibility was determined by the automatic microbiology analyzer and drug-resistant genes were characterized by polymerase chain reaction assays and DNA sequencing. The whole genome sequencing were used to analysis the characteristic of genetic structure of the isolates.Results: A total of 680 CNS-GNB were collected. Acinetobacter spp. were the dominant genus (33.8%, 230/680) of the 22 genera. Carbapenemase genes were identified in 307 isolates (45.1%, 307/680), including 206 (30.3%, 206/680) blaNDM; 51 (7.5%, 51/680) blaVIM-2, 48 (7.1%, 48/680) blaIMP, and seven (1.0%, 7/680) blaKPC-2. The blaNDM genes were first detected in three isolates, Providencia vermicola, Achromobacter spp., and Cupriavidus gilardii. Co-existence of blaVIM and blaIMP genes was detected in five isolates; Achromobacter co-producing VIM and IMP has not been previously reported. The mcr-1 gene was identified in five strains of Acinetobacter and one strain of Klebsiella pneumoniae. In addition, we detected seven isolates harboring the blaAFM-1 gene, a novel metallo-β-lactamase gene. This was first genomic analysis of ST11 Klebsiella pneumoniae co-producing NDM-5 and mcr-1, which revealed that blaNDM-5 and mcr-1 are located on two different plasmids. The plasmid harboring blaNDM-5, which was composed of a typical IncX3-type backbone, and the mcr-1 gene, was located between an IS30-like element ISApl1 and a PAP2-like encoding gene in the IncHI2-type plasmid. Conclusions: the overall prevalence of fecal carriage of CNS-GNB in 10,000 stool samples was 7.45% (745/10000), and CNS-GNB producing carbapenemase were up to 45.1% (307/680). Most CNS-GNB cases were associated with infectious disease, multiple hospitalizations, or long-term care, and a high prevalence of underlying disease.
Commercial and public payer opioid analgesic prescribing policies: A case study
Authors: Arfken Cynthia L , Lehr Victoria Tutag
Published: January 2021

Background: One strategy to address the high number of U.S. opioid-related deaths is to restrict high-risk or inappropriate opioid analgesic prescribing and dispensing. Federal and state laws and regulations have implemented restrictions but less is known about commercial and public payers’ policies aside from clinician anecdotal reports that these policies are increasing. To assess the number and types of policies with temporal trends, we examined commercial and public (Medicaid) payer policies in one state, Michigan, that has high opioid-related deaths and implemented opioid analgesic prescribing laws. Methods: Policies for seven large commercial payers and the public payer for 2012-2018 were reviewed and categorized by actions. Joinpoint regression was used to summarize temporal trends on number of policies for all payers and subgroups. Results: Across the seven years, there were 529 action policies (75.57 (95% confidence intervals (CI) 35.93, 115.22) actions per year) with a range of 36 to 103 actions by payer. Limitations on number of days for initial and prior authorizations were the most frequently implemented policy.. The temporal trend showed a decline in new policies from 2012 to 2013 but a steady increase from 2014 to 2018 (average annual percent change or AAPC=29.6% (95% confidence intervals 13.2%, 48.5%)). The public payer (n=47 policies) showed no increase in number of policies over time (AAPC=2.9% (95% CI -41.6%, 61.6%).Conclusions: The eight commercial and public payers implemented many new policies to restrict opioid analgesic prescribing with a steady increase in the number of such policies implemented from 2014 to 2018. This case study documented that at least in one state with high opioid-related deaths and multiple commercial payers, new and different policies were increasingly implemented creating barriers to patient care. The impact of these policies is understudied, complicating recommendation of best practices.
Associations Between I/ D polymorphism in the ACE gene and lung cancer: an updated systematic review and a meta-analysis
Authors: Chen Junjian , Sun Mao , Zhou Min , Lu Renfu
Published: January 2021

Background: This study has evaluated the association between the I/D polymorphism in the ACE gene and lung cancer risk by constructing a meta-analysis.Methods: The heterogeneity in the study was tested by the Cochran c2-based Q statistic test and I2 test, and then the random ratio or fixed effect was utilized to merge the odds ratios (OR) and 95% confidence interval (CI), to estimate the strength of the association between ACE polymorphisms and susceptibility to lung cancer. We have performed Sensitivity analysis. Using funnel plot and Begg's rank test investigated the publication bias. All data Statistical analyses were performed using Stata 12.0 and Revman 5.3.Results: A total of 4307 participants (2181 patients; 2126 controls) were included in twelve case-control studies selected. No significant association was found between the ACE I/D polymorphism and lung cancer risks (II vs ID + DD: OR = 1.22, 95% CI = 0.89–1.68; II + ID vs DD: OR = 1.21, 95% CI = 0.90–1.63; I vs D: OR =1.15, 95% CI = 0.95–1.39). In the subgroup analysis by ethnicity, no significant association between this polymorphism and lung cancer risks was also found among Asia and Caucasian populations for the comparison of II vs ID + DD, II + ID vs DD and I vs D genetic models.Conclusion: Our study indicated that the ACE I/ D polymorphism was not associated with the risk of lung cancer.
Exosomes derived from stem cells from apical papilla promote craniofacial soft tissue regeneration by enhancing Cdc42-mediated vascularization
Authors: Liu Yao , Zhuang Xueying , Yu Si , Yang Ning , Zeng Jianhong , Liu Xuemei , Chen Xu
Published: January 2021

Background: Reconstruction of complex critical-size defects (CSD) in the craniofacial region is a major challenge, and soft tissue regeneration is crucial in determining the therapeutic outcomes of craniofacial CSD. Stem cells from apical papilla (SCAP) are neural crest-derived mesenchymal stem cells (MSCs) that are homologous to cells in craniofacial tissue and represent a promising source for craniofacial tissue regeneration. Exosomes, which contain compound bioactive compounds, are the key factors in stem cell paracrine action. However, the roles of exosomes derived from SCAP (SCAP-Exo) in tissue regeneration are not fully understood. Here, we explored the effects and underlying mechanisms of SCAP-Exo on CSD in maxillofacial soft tissue.

Methods: SCAP-Exo were isolated and identified by transmission electron microscopy and nanoparticle tracking analysis. The effects of SCAP-Exo on wound healing and vascularization were detected by measuring the wound area and performing histological and immunofluorescence analysis on the palatal gingival CSD of mice. Real-time live cell imaging and functional assays were used to assess the effects of SCAP-Exo on the biological functions of endothelial cells (ECs). Furthermore, the molecular mechanisms of SCAP-Exo-mediated EC angiogenesis in vitro were tested by immunofluorescence staining, Western blot and pull-down assays. Finally, in vivo experiments were carried out to verify whether SCAP-Exo could affect vascularization and wound healing through cell division cycle 42 (Cdc42).

Results: We found that SCAP-Exo promoted tissue regeneration of palatal gingival CSD by enhancing vascularization in the early phase in vivo and that SCAP-Exo improved the angiogenic capacity of ECs in vitro . Mechanistically, SCAP-Exo elevated cell migration by improving cytoskeletal reorganization of ECs via Cdc42 signalling. Furthermore, we revealed that SCAP-Exo transferred Cdc42 into the cytoplasm of ECs and that the Cdc42 protein could be reused directly by recipient ECs, which resulted in the activation of Cdc42-dependent filopodium formation and elevation in cell migration of ECs.

Conclusion: This study demonstrated that SCAP-Exo had a superior effect on angiogenesis and effectively promoted craniofacial soft tissue regeneration. These data provide a new option for SCAP-Exo to be used in a cell-free approach to optimize tissue regeneration in the clinic.
Hepatic safety of repeated treatment with pyronaridine-artesunate (PA) versus artemether-lumefantrine (AL) in patients with uncomplicated malaria: A secondary analysis of the WANECAM 1 data from Bobo-Dioulasso, Burkina Faso.
Authors: Compaoré Yves Daniel , Zongo Issaka , Somé Anyirékun F. , Barry Nouhoun , Nikiema Frederick , Kabore Talato N. , Aminata Ouattara , Kabre Zachari , Wermi Kadidiatou , Zongo Moussa , Yerbanga Rakiswende S. , Sagara Issaka , Djimdé Abdoulaye , Ouédraogo Jean Bosco
Published: January 2021

Background: The use of pyronaridine-artesunate (PA) has been associated with scarce transaminitis in patients. This analysis aimed to evaluate the hepatic safety profile of repeated treatment with PA versus artemether-lumefantrine (AL) in patients with consecutive uncomplicated malaria episodes in Bobo-Dioulasso, Burkina Faso.Methods: We secondarily analyzed data from a clinical trial conducted from 2012 to 2015, in which participants with uncomplicated malaria were assigned to either PA or AL arms and followed up to 42 days. Subsequent malaria episodes within a 2-years follow up period were also treated with the same ACT initially allocated. Transaminases (AST/ALT), alkaline phosphatase (ALP), total and direct bilirubin were measured at days 0 (baseline), 3, 7, 28 and on some unscheduled days if required. The proportions of non-clinical hepatic adverse events (AEs) following first and repeated treatments with PA and AL were compared within study arms. The association of these AEs with retreatment in each arm was also determined using a logistic regression model.Results: A total of 1379 malaria episodes were included in the intention to treat analysis with 60% of all cases occurring in the AL arm. Overall, 179 non-clinical hepatic AEs were recorded in the AL arm versus 145 in the PA arm. Elevated ALT was noted in 3.05% of treated malaria episodes, elevated AST 3.34%, elevated ALP 1.81%, and elevated total and direct bilirubin in 7.90% and 7.40% respectively. Retreated participants were less likely to experience elevated ALT and AST than first episode treated participants in both arms. One case of Hy’s law condition was recorded in a first treated participant of the PA arm. Participants from the retreatment group were 76% and 84% less likely to have elevated ALT and AST respectively in the AL arm and 68% less likely to present elevated ALT in the PA arm. In contrast, they were almost 2 times more likely to experience elevated total bilirubin in both arms.Conclusion: Pyronaridine-artesunate and artemether-lumefantrine showed similar hepatic safety when used repeatedly in participants with uncomplicated malaria. Pyronaridine-artesunate represents therefore a suitable alternative to the current first line antimalarial drugs in use in endemic areas.Trial Registration: Pan African Clinical Trials Registry. PACTR201105000286876
Identification of prognostic signature based on the copy number variation (CNV) and expression in acute myeloid leukemia
Authors: Niu Changchun , Wu Di , Li Alexander J. , Qin Kevin H. , Hu Daniel A. , Wang Eric J. , Tucker Andrew Blake , He Fang , Huang Linjuan , Wang Hao , Liu Qing , Ni Na , Shi Deyao , Zhao Xia , Wan Yafang , Li Tian , He Tong-Chuan , Liao Pu
Published: January 2021

Background Acute myeloid leukemia (AML) is caused by multiple genetic alterations in the hematopoietic progenitors, and molecular genetic analysis has provided useful information for AML diagnosis and prognosis. However, an integrative understanding of the prognostic value of specific copy number variation (CNV) and CNV-modulated gene expression has been limited. Methods We conducted an integrative analysis of CNV profiling and gene expression using data from the TARGET and TCGA AML cohorts. The CNV data from TCGA were analyzed using the GISTIC and all CNV data by genes on every patient were obtained. CNV survival analysis and mRNA survival analysis were conducted with the Multivariate Cox proportional hazards regression model using R software with “survminer” and “survival” packages. KEGG cancer panel genes were extracted from the cancer-related pathways from Kyoto Encyclopedia of Genes and Genomes (KEGG). The R package “circlize” was used for mapping the CNV genes to chromosomes. Results From this investigation, we observed distinct CNV patterns in the AML risk groups as well as the expression of 251 genes significantly modulated by CNV in both cohorts. There were 102 CNV genes (located at 7q31-34, 16q24) associated with clinical outcomes in AML, which were identified in the TARGET cohort and validated in the TCGA cohort, three of which being miRNA genes (MIR29A, MIR183, MIR335) that overlapped with a KEGG cancer panel. Five genes were identified whose expression was modulated by CNV and significantly associated with clinical outcomes, and among them, the deletion of SEMA4D and CBFB were found to potentially have protective effects against AML. The result was also validated with patient marrow samples. Moreover, the distribution of CNV in these five CNV-modulated genes was independent of the risk groups, which suggests that they are independent prognosis factors. Conclusion Overall, this study identified 102 CNV genes and five CNV-modulated gene expression that is crucial for developing new modes of prognosis evaluation and target therapy for AML.