bluuebunny/crossref_metadata_2025 huggingface dataset:
Expressiveness of SNOMED CT for wound Care – Mapping a Standardised item Set for Leg Ulcers to SNOMED CT
Authors: Hüsers Jens , Przysucha Mareike , Nolte Lisa , Paul Anne , Matysek Philipp , John Swen , Hübner Ursula
Published: December 2020

Background: Chronic health conditions are on the rise and are putting high economic pressure on health systems as they require well-coordinated prevention and treatment. Among chronic conditions, chronic wounds such as cardiovascular leg ulcers have a high prevalence. The interdisciplinary and multiorganisational character of wound care demands interoperable information exchange that can be achieved by using international semantic standards such as SNOMED CT. This study, therefore, aimed to investigate the expressiveness of SNOMED CT in this medical domain, and thereby its clinical usefulness and the potential need for its extension.Methods: In this study, a consented wound care item set, the National Consensus for the Documentation of Leg Wounds (NKDUC), was mapped to the international reference terminology SNOMED CT. In order to derive the relevant items of the wound domain, an information model was developed that served as the foundation for the mapping. The mapping itself was guided by the procedural formalism of ISO TR 12300. As a result, the reliability, equivalence and coverage rate were determined.Results: The developed information model revealed 268 items to be mapped. Conducted by three health care professionals, the mapping resulted in “moderate” reliability (K=0.512). Regarding a symmetric match, the coverage rate of SNOMED CT was 67.2% overall, and 64.3% specifically for wounds. Conclusion: The results show acceptable reliability values. The overall coverage rate shows that two-thirds of the items found a symmetric map, which is a substantial portion of the source item set. As the differences in the coverage rates between different wound care sections demonstrate, some areas, such as “general medical condition” and “wound assessment”, in particular, were covered better than other areas (“wound status”, “diagnostics” and “therapy”). These deficiencies can be mitigated either by post-coordination or the inclusion of new terms in SNOMED CT. In general, this study adds another puzzle piece to the general knowledge about SNOMED CT in terms of its clinical usefulness and its need for further extensions.
Bioremediation of Clay With High Oil Content and Biological Response After Restoration
Authors: Li Xiaokang , Li Jinling , Qu Chengtun , Yu Tao , Du Mingming
Published: December 2020

The clay with high oil content form soil lumps, which is hard for microbes to repair. In this paper, the bioremediation + biostimulation was applied to improve the bioremediation effect of the soil with high oil content, that modified by local cow dung and sandy soil, the ecological toxicity of the soil after restoration was further analyzed. After 53 days of bioremediation, the degradation efficiency with respect to the total petroleum hydrocarbon (TPH) content reached 76.9% ± 2.2%; the soil bacterial content reached 4.9 × 107 CFU/g soil and the results were better than those in the natural attenuation M1group of experimental soils. The relative abundances of petroleum-degrading bacteria added to M5 remained high (Achromobacter 9.44%, Pseudomonas 31.06%, and Acinetobacter 14.11%), and the proportions of some other indigenous bacteria (Alcanivorax and Paenibacillus) also increased. The toxicity of the bioremediated soil was reduced by seed germination and earthworm survival experiments.
Investigation of West Nile Fever Seroprevalence and Associated Risk Factors among Horses in Egypt
Authors: selim Abdelfattah , Megahed Ameer , Kandeel Sahar , Alanazi Abdullah
Published: December 2020

Determination of the seroprevalence and risk factors associated with West Nile Fever (WNF) in horses is essential for adoption of effective prevention strategies. Our objective was therefore to determine the seroprevalence and identify the risk factors associated with West Nile virus (WNV) infection in the most densely horse populated provinces in Egypt. A cross-sectional study was conducted on 930 horses distributed over five provinces in the Nile Delta of Egypt in 2018. The randomly selected horses from geographical studied areas were serologically tested for WNF, and the horses’ information was obtained from owners. Four variables (geographic location, breed, gender, and age) were used for risk analysis. A total of 156 (16.8%) serum samples were serologically positive for WNV. The highest prevalence of WNV infection was between mixed breed (21.5%), male (26.4%) horses with age ≥ 15 years (68.1%). Age showed the highest risk for the infection with WNV (OR = 4.3, 95% CI 3.0 to 6.2). Gender and breed also showed important risk factors for WNF infection in horses (OR = 2.4, 95% CI 1.6 to 3.7; OR = 1.9, 95% CI 1.2 to 2.8, respectively). However, geographic location seems to have no impact on the seroprevalence of WNV infection among horses in the Nile Delta of Egypt. Our findings strongly recommend intensive surveillance and implementation of effective control and prevention strategies against WNF especially in male of mixed breed horses with ages ≥ 15 years.
Nonlinear Relationship between Sleep Duration and Non-suicidal Self-injurious Behaviour among Chinese Adolescents
Authors: Tang Ying , Wan Yuhui , Xu Shaojun , Zhang Shichen , Hao Jiahu , Tao fangbiao
Published: December 2020

Background

Previous researches showed a positive association between short sleep duration and non-suicidal self-injury (NSSI) among adolescents, but few studies have described the effects of oversleeping and weekend catch-up sleep duration on NSSI. The present study aims to explore the nonlinear relationship between sleep duration and NSSI among Chinese adolescents.
Methods

China’s National Adolescent Health Surveillance data from 2014 to 2015 were collected from 15,713 students in four provinces within China. A self-report questionnaire was used to assess sleep duration and 12-month NSSI. Binomial logistic regression models were used to examine the associations of NSSI with sleep duration. The locally estimated scatter plot smoothing (LOESS) method was used to help explore the associations of total NSSI number with sleep duration, and binomial regression analysis was used to help test this relationship.
Results

About 68.5% of adolescents reported sleeping less than 8 h on weeknights while 37.8% slept more than 10 h per night during weekends. The 12-month prevalence rate of NSSI was 29.4%. Compared to the weekend catch-up sleeping for 0–1 hours, those who slept < 0 hours (adjusted Odd Ratio (aOR) = 1.38, 95% Confidence Interval (95% CI): 1.16–1.64) had higher risk of NSSI. Males who reported ≥ 3 hours of weekend catch-up sleep were significantly increased odds of NSSI (aOR = 1.20, 95%CI: 1.01–1.42). Notably, the positive U-shape association was observed between the entire sleep duration and total NSSI number.
Conclusions

The findings reveals that the nonlinear relationship between sleep duration and non-suicidal self-injurious behaviour among Chinese adolescents. Therefore, it is necessary to be vigilant and screen for sleep duration among adolescents in NSSI treatment or prevention.
Bioprospecting Fungal Glycosyl Hydrolases: Multi-locus Phylogenetic Analysis and Enzyme Activity Profiling for Enhanced Biomass Valorization
Authors: Rastogi Meenal , Shrivastava Smriti , Shukla Pratyoosh
Published: December 2020

Lignocelluloses comprise of celluloses and hemicelluloses which can be effectively depolymerized to obtain fermentable sugars using diverse microbial enzymes, for subsequent conversion to various value-added products. Present study reports the bioprospecting of industrially significant microorganisms and their characterization to attain xylanases with high catalytic efficiency. Four potential xylanolytic fungi were identified through distinct primary and secondary screening process of 294 isolates from samples containing plant degrades. Morphological characterization and multigene analysis (ITS rDNA, 18S rDNA, nLSU rDNA, β-tubulin and actin gene) confirmed them Aspergillus niger AUMS56, Aspergillus tubingensis AUMS60, Aspergillus niger AUMS64 and Aspergillus fumigatus AUKEMS24 and their crude xylanase activities through submerged fermentation using corncob were 18.9, 32.29, 30.68 and 15.82 U ml-1, respectively. AUMS60 and AUMS64 have highest catalytic activity of 1429 U g-1 and 1243 U g-1, respectively, all having pH and temperature optima of 6.0 and 60°C respectively, where AUMS60 produced single xylanase (Xyn60; 36 kDa) and AUMS64 secreted 2 probable isozymes (Xyn64A and Xyn64B; 33.4 and 19.8 kDa). Maximum saccharification efficiency of AUMS60 and AUMS64 were 51.1% (13 h) and 52.2% (24 h) showing enhanced catalytic activity with various cations. Present research reports potential xylanases from indigenous fungi, providing opportunity for development of bio-catalysts concoction (novelty established) for enhanced saccharification of complex lignocelluloses finding specific industrial applications for production of value-added components.
Intraperitoneal Bladder Stones Following Transurethral Cystolithotripsy: A Case Report
Authors: Hsiao Yu-Tse , Lien Wan-Ching
Published: December 2020

Background:Bladder stones are common diseases, constituting 5% of urinary stones. However, iatrogenic bladder rupture with intraperitoneal bladder stones is a rare complication after a transurethral cystolithotripsy (TUCL).Case presentation:A 73-year-old male was sent to the emergency department (ED) with presentations of dyspnea and hematuria after receiving a transurethral cystolithotripsy(TUCL) with laser. Upon arrival, his vital signs were relatively stable. An abdominal X-ray showed a radiopaque lesion within the pelvis. Physical examinations showed diffuse abdominal tenderness with muscle guarding. The initial focused assessment of sonography for trauma (FAST) was positive. Computed tomography (CT) revealed bladder rupture with intraperitoneal bladder stones. The patient received conservative supportive care with antibiotics and foley drainage and was discharged 3 weeks later smoothly.Conclusion:For emergency physicians, bladder rupture should be taken into consideration in patients with intraperitoneal bladder stones following TUCL. Computed tomography remains a standard of diagnosis although ultrasonography is a convenient screening tool for ascites.
Magnitude of Surgical Site Infection and its Associated Factors among Patients who Underwent a Surgical Procedure at Debre Tabor General Hospital, Northwest Ethiopia
Authors: Walelign Mequanint Bezie , Demissie Tadesse Wuletaw , Dessalegn Abaynew Honelign
Published: December 2020

Background: Surgical site infections are commonest nosocomial infections and responsible for considerable morbidity and mortality as well as increased hospitalizations and treatment cost related to surgical operations.Objective: The aim of this study was to determine the magnitude and factors associated with surgical site infections at surgical ward of Debre Tabor General Hospital, Northwest Ethiopia.Method: Institution based cross sectional study was conducted on patients who underwent a surgical procedure at Debre Tabor General Hospital in 2020. The sample size was determined using single population proportion formula. Data were entered and analyzed using SPSS version 21 software. Bivariate and multivariate logistic regressions analysis were employed. Odds ratio and its 95% confidence interval were taken to test the association between the dependent and independent variables. P-value of less than 0.05 will be considered as statistically significant. Result: In this study, a total of 191 patients have participated in the study yielding a response rate of 100%. The mean age of the respondents was 2.5 (SD ±0.68) years. The most age group 115(60.2%) resides at the age group greater than 40 years. More than one half(62.3) of the surgical clients were females. Most of the clients were farmers(32.5%) and un able to read and write(41.9) based on the occupation. The magnitude of surgical site infection in this study was found to be 11.5% (95% CI: 7.8%, 15.9%).The factors existance of comorbidity and antibiotic prophylaxis given were found to be significantly assoiated with magnitude of surgical site infection.Conclusion: The magnitude of surgical site infection in this study was high. Proper management of patients with co-morbidity especially those with diabetes mellitus, proper administration of anesthesia and delivering intravenous antimicrobial prophylaxis before surgery as ordered would significantly reduce the incidence of surgical site infection.
Efficacy and Safety of Tocilizumab in Patients with COVID-19 : A Systematic Review and Meta-Analysis.
Authors: Li Zhenlu , Che Qianqiu , Li Mao , Liu Jianping , Du Rao , Yue Chao , Zhang Ling , Li Hongwei , Zhao Liming , Hu Weiming , Lu Huimin , Xiong Junjie
Published: December 2020

Background Tocilizumab (TCZ) is an anti-interleukin-6 antibody that has been used to treat patients with 2019 coronavirus disease (COVID-19). Numerous retrospective studies have shown beneficial treatment efficacy. Several recent randomized clinical trials have questioned the efficacy of TCZ in patients with COVID-19. Therefore, we performed an updated systematic review and meta-analysis to explore the effectiveness and safety of tocilizumab recently used for treating patients with COVID-19. Methods Randomized clinical trials (RCTs) and comparative studies that compared the outcomes between TCZ and standard of care (SOC) were analysed. PubMed, EMBASE, and the Cochrane Library (inception to November 20, 2020) were systematically searched. Primary outcomes included mortality and the rate of requirement for mechanical ventilation (MV). In addition, several subgroup analyses stratified by disease severity, publication type and TCZ administration were performed. Results Three RCTs, twenty-one cohort studies and nine case-control studies including 11,206 patients were finally included. The TCZ group included 2,794 patients (24.93%) and the SOC group included 8,412 patients (75.07%). The mortality rate (>14 days) of the TCZ group, 29.63% (590/1,991), was lower than the SOC group, 41.51% (2,380/5,734) (OR 0.64, 0.57 to 0.73; p <0.00001). However, no significant difference in-14-day mortality rates was observed between the two groups (13.53% vs 22.92%, p = 0.21). Meanwhile, the rate of MV was significantly decreased in the TCZ group compared with the SOC group (OR 0.42, 0.22 to 0.83; p = 0.01). According to the results of the subgroup analysis stratified by disease severity, TCZ only reduced the mortality rate for critical patients with COVID-19 compared with SOC (OR 0.60, 0.52 to 0.71; P < 0.00001), particularly for patients in the intensive care unit (ICU) or patients requiring MV. No statistically significant increase was recognized in the rates of secondary infections or thrombosis between the two groups. Conclusions This systematic review and meta-analysis found that the addition of tocilizumab to the SOC might reduce mortality after 14 days in patients with COVID-19, particularly critical patients requiring MV. More extensive RCTs with longer follow-up periods are needed to validate these findings.
Conventional Suture With Prolonged Timing of Drainage is as Good as Quilting Suture in Preventing Seroma Formation at Pectoral Area After Mastectomy
Authors: Huang Juan , Wang Shouman , Wu Yuhui , Hai Jian , Mao Jie , Dong Xue , XIAO ZHI
Published: December 2020

BackgroundThe aim of this study was to compare conventional suture with prolonged timing of drainage with quilting suture on the formation of seroma at pectoral area after mastectomy (ME) with sentinel lymph nodes biopsy (SLN) or axillary lymph nodes dissection (ALND) for breast cancer.Methods388 consecutive breast cancer patients were retrospectively analyzed and categorized into three group. Patients in group 1 were with quilting suture, group 2 with conventional suture and 13-15 days drainage in situ, and group 3 with conventional suture and 20-22 days drainage. The primary outcome was the incidence of Grade 2 and 3 seroma at anterior pectoral area within one month postoperatively. Cox regression was used for analysis.ResultsThe incidence of Grade 2 and 3 seroma was comparable among groups (9.5% vs. 7.9% vs. 5.3%, p = 0.437), as well as late Grade 2 and 3 seroma among groups (4.3% vs. 2.9% vs. 1.5%, p = 0.412). Old age, high body mass index and hypertension were independently risk factors for Grade 2 and 3 seroma.ConclusionsProlonged timing of drainage to 13-15 days in conventional suture was long enough to decrease the incidence of Grade 2 and 3 seroma as lower as that in quilting suture group at pectoral area within one month after mastectomy.
WITHDRAWN: Improved Physical Fitness Induced by Physiotherapist-led Exercise in Patients With Permanent Atrial Fibrillation Disappears and Health-related Quality of Life Is Impaired After Detraining – A 3 Months Follow-up
Authors: Borland Maria , Bergfeldt Lennart , Cider Åsa , Rosenkvist Agneta , Jakobsson Marika , Olsson Kristin , Lundwall Adam , Andersson Lars , Nordeman Lena
Published: December 2020

Background: Atrial fibrillation negatively impact physical fitness and health-related quality of life in patients. We recently showed that physiotherapist-led exercise-based cardiac rehabilitation improves physical fitness in patients with permanent atrial fibrillation, however little is known about the effect of detraining after finishing an exercise period. The purpose of the study was to examine the impact of 3 months of detraining on physical fitness, physical activity level and health-related quality of life among patients with permanent atrial fibrillation, after ending a randomized comparison of physiotherapist-led exercise-based cardiac rehabilitation versus physical activity on prescription.Methods: Prospective 3-month follow-up study after a randomized multi-centre study. Of the 87 patients completing the intervention study, 80 (92%) participated in the detraining part (22 women; age 74 ± 5 years), 38 from the physiotherapist-led exercise-based cardiac rehabilitation group and 42 from the physical activity on prescription group. All patients were asked to refrain from organised exercise during the 3-months period of detraining. The primary outcome measure was maximal exercise capacity using an exercise tolerance test. Secondary outcomes measures were muscle function, physical activity level, and health-related quality of life using a muscle endurance tests, Short Form-36, and physical activity assessments (questionnaire and accelerometer), as in the intervention study. We used the Mann-Whitney U-test and X2 test to analyse differences between the groups, and Cohen’s d to determine the effect size. A mixed effect model analysis was used to identify predictors of change in physical fitness.Results: Compared to the physical activity on prescription, physiotherapist-led exercise-based cardiac rehabilitation showed a significantly decreased exercise capacity (−9 ± 11 vs. −2 ± 12 W, P < .0001), reduction in shoulder flexion repetitions (−4 ± 8 vs. 2 ± 7 repetitions, P = .001), and reduced health-related quality of life in the Short Form-36 dimension Role Emotional (−13 ± 39 vs. 6 ± 27 points, P = .006). Conclusion: In elderly patients with permanent atrial fibrillation detraining negatively impacted previously achieved improvements from physiotherapist-led exercise-based cardiac rehabilitation in physical fitness and reduce health-related quality of life. The importance of continued exercise is emphasized and should be part of the strategy. Retrospectively registred in ClinicalTrials.gov Identifier: NCT02493400. First posted July 9, 2015
The Association Between Variants in PLA2R and HLA-DQA1 and Renal Outcomes in Patients With Primary Membranous Nephropathy in Western China
Authors: Fan Shulei , Wang Qiuxia , Wang Amanda Y , Zhang Ping , Zhong Xiang , Chen Shasha , Li Guisen , Wang Li , Wang Wei
Published: December 2020

Background：Both Genome-wide associations and our previous study have shown that single nucleotide polymorphisms (SNPs) of M-type phospholipase A2 receptor (PLA2R) and human leukocyte antigen complex class II HLA-DQα-chain 1 (HLA-DQA1) gene were identified to be associated with primary membranous nephropathy (PMN). However, whether these SNPs affect clinical manifestation and renal outcome for PMN patients is poorly defined. Here, we evaluated whether there is an association between these SNPs and clinical manifestations and renal outcomes of PMN in a western Chinese cohort.Methods: Seven SNPs within PLA2R and one SNP in HLA-DQA1 were selected in our study. Clinical data from 314 patients with PMN were collected and the relationship between the genotype and phenotype was evaluated. A total of 186 patients had follow-up data. We assessed the treatment responses and renal outcomes between patients with these gene polymorphisms after a median follow-up of 18.6 months. Results: Eight SNPs were not associated clinical manifestations of PMN patients (Pc<0.05). rs3828323 T allele was marginally significantly associated with hypertension (P=0.008, Pc=0.064, OR=1.821). After treatment for PMN, urea (OR=1.184, 95%CI:1.030-1.361, P=0.017) was a risk factor for non-remission of the disease, eGFR (OR=0.984, 95%CI:0.970-0.998, P=0.028) and albumin (OR=0.922, 95%CI:0.880-0.966, P=0.001) were protective factors for non-remission of the disease. We also identified that PMN patients with CT/TT genotype for rs3828323 achieved higher cumulative survival rate than patients with CC genotype.Conclusions：Rs3828323 may influence hypertension and renal outcome in patients with PMN. Further research is needed to explore the mechanism for this genotype-disease phenotype association.
HLF is a Potential Prognostic Biomarker in Head and Neck Squamous Cell Carcinoma Based on Bioinformatic Analysis and Experimental Validation
Authors: Fang Wei , Wan Di , Chen Jun , Ma Weiqun , Luo Zhen , Yang Xiaoqin
Published: December 2020

BackgroundHead and neck squamous cell carcinoma (HNSCC) is one of the most frequent cancers worldwide, with an increasing incidence. However, the underlying molecular mechanisms of HNSCC are poorly understood.MethodIn this work, 5 original datasets (GSE23558, GSE13601, GSE30784, GSE9844, GSE78060) of Head and neck squamous cell carcinoma (HNSCC) were selected from Gene Expression Omnibus (GEO) database. To identify differentially expressed genes (DEGs) in HNSCC and adjacent tissues. The common DEGs were acquired by Venn diagram. The sensitivity and specificity of HLF were determined by Receiver operating characteristic curves (ROC). Then, In order to further confirm the relationship between HLF and HNSCC patient’s prognosis, the expression and survival analysis of HLF was performed by Gene Expression Profiling Interactive Analysis (GEPIA), Cell culture, reverse transcription polymerase chain reaction (RT-PCR), western blotting and immunohistochemical staining.ResultsSeventeen DEGs were screened from five sets of HNSCC functional gene expression series in GEO datasets. The low expression of HLF was indicated might be correlated with poor prognosis of HNSCC patients based on the bioinformatics analysis. According to the results of Cell culture, RT-PCR, western blotting, immunohistochemical staining, it was confirmed that the low level of HLF expression correlated with poor prognosis of HNSCC patients.ConclusionThe study effectively revealed useful information about the relationship of the low level of HLF expression and HNSCC. In summary, we identified HLF as a potential prognostic biomarker and therapeutic target for HNSCC.
Measuring Productivity and Efficiency of Traditional Chinese Medicine Hospitals From 2009 to 2016: A Bootstrap-Data Envelopment Analysis
Authors: Liu Xinliang , Chen Rui , Wu Shaopeng , Wang Quan , Wang Jian , Li Jianan , Li Hao
Published: December 2020

Background: Traditional Chinese Medicine (TCM) Hospitals are the dominant agents to provide TCM services in China. How to improve the productivity and efficiency of TCM hospitals is quite pivotal for the hospital managers and policy-makers to realize the optimal use of TCM resources. The purpose of this study was to estimate the productivity and efficiency of TCM hospitals with the Bootstrap-Malmquist-Data Envelopment Analysis (DEA) from 2009 to 2016 to provide empirical evidence for hospital managers and policy-makers to improve the management and quality of TCM service.Methods: The data of the individual tertiary public TCM hospitals were collected from official Yearbooks of Traditional Chinese Medicine of China (2010-2017). Bootstrap-Malmquist-DEA was employed to measure the productivity and efficiency of the TCM hospitals from 2009 to 2016. SPSS 23.0 version statistical software was used to conduct the descriptive analysis of the input and output indicators. R 3.2.1 version statistical software was applied to calculate the productivity and efficiency of the TCM hospitals with FEAR package. The statistical significant was set at P < 0.05.Results: The annual average growth rates for each input and output indicator were 6.61% (health professionals), 8.15% (actual open beds), 7.08% (outpatients and inpatients) and 12.50% (discharged patients) respectively from 2009 to 2016. Except the TFPC between 2014 and 2015, more than half of the TCM hospitals had TFPC scores over 1.000, indicating increased productivity. The overall annual geo-means of the scores of the TFPC and its decomposition index were 1.0379 (TFPC), 1.0167 (TEC), 1.0209 (TC), 1.0212 (PTEC), and 0.9955 (SEC) respectively from 2009 to 2016.Conclusions: The overall annual rate of the total factor productivity of the tertiary public TCM hospitals was slightly increased. The technological progress was the main driver to improve the total factor productivity. The decreased TE was more affected by the decreased SE. The TCM hospitals need to pay attention to the development and innovation of the TCM technology, thereby improving the competitiveness. The TCM hospitals managers should pursuit the high quality, high efficiency and low cost of the TCM medical services.
GCKR Common Functional Polymorphisms are Associated with Metabolic Syndrome and its Components: A 10-Year Retrospective Cohort Study in Iranian Adults
Authors: Zahedi Asiyeh Sadat , Akbarzadeh Mahdi , Sedaghati-khayat Bahareh , Seyedhamzehzadeh Atefeh , Daneshpour Maryam S
Published: December 2020

Background: Some previous studies reported that common functional variants (rs780093, rs780094, and rs1260326) in the glucokinase regulator gene (GCKR) were associated with metabolic syndrome despite the simultaneous association with the favorable and unfavorable metabolic syndrome components. We decided to examine these findings, to our knowledge for the first time, in Iranian adults. We investigated the association of the GCKR variants with incident MetS in mean follow-up times for nearly ten years.Methods: Analysis of this retrospective cohort study was performed among 5666 participants of the Tehran Cardiometabolic Genetics Study (TCGS) at 19-88 years at baseline. Linear and logistic regression analyses were used to investigate the metabolic syndrome (JIS criteria) association and its components with rs780093, rs780094, and rs1260326 in an additive genetic model. Cox regression was carried out to peruse variants' association with the incidence of metabolic syndrome in the TCGS cohort study.Results: In the current study, we have consistently replicated the association between the T-allele of GCKR SNPs and higher triglyceride levels and lower fasting blood sugar levels (p<0.05) in the Iranian population. The CT genotype of all three variants was associated with lower HDL-C levels. The proportional Cox adjusted model regression resulted that TT carriers of rs780094, rs780093, and rs1260326 were associated with 20%, 23%, and 21% excess risk metabolic syndrome incidence, respectively (p<0.05).Conclusions: Elevated triglyceride levels had the strongest association with GCKR selected variants among the metabolic syndrome components. Despite the association of these variants with decreased fasting blood sugar levels, T alleles of the variants were associated with metabolic syndrome incidence; so whether individuals are T allele carriers of the common functional variants, they have a risk factor for the future incidence of metabolic syndrome.
Lipid Profile and Blood Glucose Level of Hypertensive Population in Rural Regions of West China.
Authors: Fan Lihong , Hu Xiaojing , Li You , Bai Tiao , Pan Longfei , Tian Hua , Wang Yifan , Lu Qun , Ma Aiqun , Tian Hongyan
Published: December 2020

Background: In rural regions of West China, there was almost no intervention on dyslipidemias and abnormal glucose metabolism of individuals with hypertension because of no literature reporting the lipid profile or blood glucose of these patients. This study was designed to investigate the lipid profile and blood glucose level of the hypertensive population in these regions. Methods: A cross-sectional community survey was carried out in Xunyi county of Shaanxi province in West China. The study enrolled 1425 hypertensive patients. The lipid profile and blood glucose levels were assessed. Diet and physical activity were also investigated by questionnaire. Results: 54% of the population had dyslipidemias. The hypercholesterolemia (hyper-TC) and hypertriglyceridemia (hyper-TG) were the main dyslipidemias (hyper-TC:25%; hyper-TG: 33% ). The prevalence of abnormal glucose metabolism was 37%. 16% of the population had hyperglycemia. Despite of low-fat intake, the diet was unbalanced by excess salt consumption and seriously insufficient intake of vegetables, fruits and protein. Conclusion: Dyslipidemias and abnormal glucose metabolism were common in the hypertensive patients in rural areas of West China. They were needed to be invented to reduce the risks of atherosclerotic cardiovascular diseases of hypertensive patients in these regions. Unbalanced diet here may be needed to be modified.
Problems of Lymph Node Dissection in Intrahepatic Cholangiocarcinoma: A Multicenter Retrospective Study Using Inverse Probability of Treatment Weighting.
Authors: Hu Hanjie , Xu Gang , Zhao Hong , Du Sunda , Luo Zhiwen , Cai Jianqiang
Published: December 2020

Background Lymph node dissection (LND) is considered to improve the prognosis of patients with intrahepatic cholangiocarcinoma (ICC). Although the National Comprehensive Cancer Network (NCCN) guidelines recommend routine LND in ICC, the role of LND remains controversial. This study aimed to explore the effect of LND on the prognosis of patients with ICC from two Chinese centers.MethodsPatients were identified in two Chinese academic centers. Inverse probability of treatment weighting (IPTW) was used to reduce bias. Kaplan–Meier curves and Cox proportional hazards models were used to compare overall survival (OS) and disease-free survival (DFS).ResultsOf 251 patients, 189 (75.2%) underwent LND, and 72 (38%) had metastatic lymph nodes. A minimum of 6 lymph nodes were dissected in 67 patients (35.5%). Lymph node metastasis (LNM) was a risk factor with a high hazard ratio. There was no association between LND and OS after IPTW; however, LND may affect the DFS. Tumors in the LNM group were more malignant, and surgical trauma was greater in the LNM group.ConclusionsOnly a few LNDs meet the NCCN guidelines’ requirements. LND did not improve prognosis, with higher surgical trauma. The best approach for LND requires further discussion.
Significance of Preoperative Peripheral Blood Neutrophil-lymphocyte Ratio in Predicting Postoperative Survival in Patients with Multiple Myeloma Bone Disease
Authors: Xu Ziyu , Yao Xingchen , Shi Xiangjun , du xinru
Published: December 2020

Background: By observing the change characteristics of NLR at different stages after operation, to make a preliminary analysis of the effect of operation on the immune status of MM patients and study the prognostic value of peripheral blood NLR in predicting the treatment of multiple myeloma bone disease (MMBD).Method: The clinical data of 82 MMBD patients who underwent operations in our hospital were collected, which to analyze the effect of preoperative peripheral blood NLR on the prognosis of MMBD patients; Peripheral blood lymphocyte percentage was taken as the major observation indicator to analyze the change characteristics of the immune status of MM patients.Results: Data showed that the NLR cut-off values of the NLR≥3 group and NLR≥4 group were significantly correlated with POS. The POS of NLR≥3 patients (14.86±14.28) was significantly shorter than that of NLR＜3 patients (32.68±21.76). The lymphocyte percentage 1 week after operation (19.329±9.083) was significantly lower than that before operation (25.723±11.016). Survival analysis showed that postoperative chemotherapy and preoperative peripheral blood NLR were independent risk factors for POS.Conclusions: NLR was significant for the prediction of the POS of MMBD patients treated with operation, and MMBD patients with high preoperative NLR (NLR≥3) had a poorer prognosis and shorter POS. The immune status of MMBD patients was at a normal low level, and significantly declined after operation.Trial registration: As this was a retrospective study, it did not require ethical approval; all patients had signed informed consent when they received treatment, and all treatment options were voluntary.
Linezolid-Containing Regimen Lowers Mortality of Rifampicin/Multidrug-Resistant Tuberculous Meningitis in Shenzhen, China
Authors: Fang Mu-tong , Su You-feng , Deng Guo-fang , Zhang Pei-ze , Liu Hou-ming , Mao Zhi , Zeng Jian-feng , Li Guo-bao , Yang Qian-ting , Wang Zhong-yuan
Published: December 2020

Background: The morbidity of rifampicin/multidrug-resistant tuberculous meningitis (RR/MDR-TBM) is increasing in many countries and regions in the world. Its mortality is significantly higher than non rifampicin/multidrug-resistant ones (NRR/MDR-TBM ). This article aims to explore the RR/MDR-TBM related risk factors, and compare the different therapeutic effects to the RR/MDR-TBM patients between linezolid-containing anti-tuberculosis regimen and non linezolid regimen in Shenzhen city. Furthermore, we want to find a better therapy for pathogen negative TBM with RR/MDR-TBM related risk factors. Methods: 137 cases with confirmed TBM (pathogen positive), who were hospitalized in the Third People’s Hospital of Shenzhen from June 2014 to March 2020, were enrolled in this study, all patients were divided into RR/MDR-TBM group (12 cases) and NRR/MDR-TBM group (125 cases) according to the GeneXpert MTB/RIF and (or) phenotypic drug susceptibility test of CSF (cerebral spinal fluid). The risk factors related to RR/MDR-TBM were investigated through comparing the clinical and examination features between the two groups.The mortality of RR/MDR-TBM patients treated with different regimens was analyzed to compare their respective therapeutic effects to the RR/MDR-TBM . P<0.05 differences is considered statistically significant. Results: Most of the patients(111/137, 81%) were from southern or southwestern China, and a large proportion(72/137, 52.55%) is migrant workers. 12 cases were RR/MDR-TBM (12/137,8.8%) in all TBM patients while 125 cases were NRR/MDR-TBM(125/137,91.2%). The proportion of previously treated cases in RR/MDR-TBM group was significantly higher than that in NRR/MDR-TBM group (6/12vs12/125, 50%vs10.5%,P<0.01), while there was no significant difference in other clinical and examination features between the two groups. The mortality of RR/MDR-TBM treated with the linezolid-containing regimen was significantly lower than that treated with non linezolid regimen (P=0.045). Conclusions: The main related high-risk factor of RR/MDR-TBM is the history of anti-tuberculosis treatment. Linezolid -containing regimen appears to lower the mortality of RR/MDR-TBM significantly. Therefore, it is recommended that linezolid-containing regimen can be used as a better empirical anti-tuberculosis therapy for pathogen negative TBM previously treated in China.
Impossible Airway: A Case Report
Authors: Hsiao Yu-Tse , Huang Pei-Chuan , Lien Wan-Ching , Chang Wei-Tien
Published: December 2020

Background: Wheezing is a common presentation of asthma and chronic obstructive pulmonary disease (COPD). However, other rare etiologies such as endotracheal tumor should be kept in mind. Case presentation: We report a case of mucoepidermoid carcinoma of carina in which the patient initially presented with wheezing mimicking COPD. Chest roentgenogram showed a soft-tissue density in the tracheal air column. Surgical resection of the tumor was technically hindered by difficulty in airway establishment during anesthesia. Extracorporeal membrane oxygenation (ECMO) was employed to secure adequate blood-gas exchange during operation, after which the tumor was resected smoothly and the patient discharged uneventfully.Conclusions: Endotracheal tumor should be kept in mind when facing a patient presenting with wheezing. Careful auscultation and interpretation of the chest roentgenogram are two important keys for differentiating such lesions from asthma or COPD. If further intervention was hindered by difficulty in airway establishment, ECMO proves effective and safe to “bypass” such an impossible airway and secure the procedures.
Which are factors determining a low COVID-19 mortality in society? High health expenditure and lower exposure of population to air pollution as critical factors for an effective strategy to cope with future pandemics similar to COVID-19
Authors: Mario Coccia
Published: December 2020

One of the problems hardly clarified in the scientific field of Coronavirus Disease 2019 (COVID-19) is inter-related factors associated with a lower mortality of COVID-19 to design effective strategies to cope with unforeseen pandemic crises. The main goal of this study is to explain these factors determining a lower fatality rate of the Coronavirus disease 2019 (COVID-19) in society with a global analysis based on more than 160 countries worldwide. This study reveals a novel finding: countries with a low average COVID-19 mortality have high investments in health sectors as % of GDP (>7.5%), high health expenditures per capita (>$2,300) associated with a lower exposure of population to days exceeding safe levels of particulate matter (PM2.5), reinforcing these factors with a policy response of lockdown. In addition, these countries have lower fatality rates of COVID-19, regardless a higher percentage of population aged more than 65 years in these countries. Overall, then, this study must conclude that an effective strategy to reduce the negative impact of future epidemics similar to COVID-19 has to be based on a reinforcement of healthcare sector to have an efficient organization prearranged to cope with pandemics of new viral agents and to be able to minimize fatality rates in a context of sustainable environment having low air pollution.
Apolipoprotein C1 stimulates the malignant process of renal cell carcinoma via the Wnt3a signaling
Authors: jiang hao , Tang Jing-Yuan , Xue Dong , Chen Yi-Meng , Wu Ting-Chun , Zhuang Qian-Feng , He Xiao-Zhou
Published: December 2020

Background Renal cell carcinoma (RCC) is a clinically common tumor in the urinary system, showing an upward trend of both incidence and mortality. Apolipoprotein C1 (APOC1) has been identified as a vital regulator in tumor progression. This study aims to uncover the biological function of APOC1 in RCC process and the underlying mechanism. MethodsDifferential levels of APOC1 in RCC samples and normal tissues in a downloaded TCGA profile and clinical samples collected in our center were detected by quantitative reverse transcription PCR (qRT-PCR). The prognostic value of APOC1 in RCC was assessed by depicting Kaplan-Meier survival curves. After intervening APOC1 level by transfection of sh-APOC1 or oe-APOC1, changes in phenotypes of RCC cells were examined through CCK-8, colony formation, Transwell assay and flow cytometry. Subsequently, protein levels of EMT-related genes influenced by APOC1 were determined by Western blot. The involvement of the Wnt3a signaling in APOC1-regulated malignant process of RCC was then examined through a series of rescue experiments. Finally, a RCC xenograft model was generated in nude mice, aiming to further clarify the in vivo function of APOC1 in RCC process.ResultsAPOC1 was upregulated in RCC samples. Notably, its level was correlated to overall survival of RCC patients, displaying a certain prognostic value. APOC1 was able to stimulate proliferative, migratory and invasive abilities in RCC cells. The Wnt3a signaling was identified to be involved in APOC1-mediated RCC process. Notably, Wnt3a was able to reverse the regulatory effects of APOC1 on RCC cell phenotypes. In vivo knockdown of APOC1 in xenografted nude mice slowed down the growth of RCC.ConclusionsAPOC1 stimulates the malignant process of RCC via targeting the Wnt3a signaling.
A Qualitative Study of Ghanaian Pediatric Oncology Nurses’ Care Practice Challenges.
Authors: Nukpezah Ruth Nimota , Fomani Fatemeh Khoshnavay , Hasanpour Marzieh , Nasrabadi Alireza Nikbakht
Published: December 2020

Background: Pediatric cancer is a global problem, and some studies have highlighted that nurses caring for these children experience work-related challenges. This makes many children with cancer to be left with terminal diagnoses, unnecessary suffering; and also, job dissatisfaction among the nurses. But no study has explored this phenomenon among pediatric oncology nurses in Ghana. This study aims to explore and understand the challenges that the pediatric oncology nurses experience when caring for children with cancer in Ghana.Methods: An exploratory qualitative research design study was conducted from August 2019 - April 2020. The study was conducted at the Pediatric oncology unit which is located at the Tamale Teaching Hospital (TTH), Ghana. The study was conducted among 14 Ghanaian pediatric oncology nurses who were purposively sampled. The data collection instrument was a face-to-face in-depth semi-structured interview. The interviews were recorded, transcribed verbatim, and analyzed inductively using Elo and Kyngas content analysis approach. The criteria proposed by Guba and Lincoln were used to ensure the validity of the study.Results: The results showed that the challenges that the pediatric oncology nurses experience includes: Time-consuming care, Low Job motivations, Inadequate logistics, Work stress, Reduced labor force, Low knowledge level, Lack of teamwork and the Perception of contracting cancer. Conclusions: The results point to several organizational and personal constraints experienced by the nurses who work at the pediatric oncology ward. There is the need for the administrative managers of hospitals, government and other stakeholders to invest in human, material and financial resources for delivering childhood cancer care services. It is hoped that by addressing these challenges, it would lead to further improvement in the care that is provided to children with cancer.
Quantifying the advantages of conducting a prospective meta-analysis (PMA): a case study of early childhood obesity prevention
Authors: Seidler Anna Lene , Hunter Kylie E , Espinoza David , Mihrshahi Seema , Askie Lisa M
Published: December 2020

Background: For prospective meta-analyses (PMA), eligible studies are identified and the PMA hypotheses, selection criteria and analysis methods are pre-specified before results of any of the studies are known. This reduces publication bias and selective outcome reporting and provides a unique opportunity for outcome standardisation/harmonisation. We conducted a world-first PMA of four trials investigating interventions to prevent early childhood obesity. The aims of this study were to quantitatively analyse the effects of prospective planning on variations across trials, outcome harmonisation and the power to detect intervention effects, and to derive recommendations for future PMA.Methods: We examined intervention design, participant characteristics and outcomes collected across the four trials included in the EPOCH PMA using their registration records, protocol publications and variable lists. The outcomes trials that planned to collect prior to inclusion in the PMA were compared to the outcomes trials collected after PMA inclusion. We analysed the proportion of matching outcome definitions across trials, the number of outcomes per trial, and how collaboration increased the statistical power to detect intervention effects.Results: The included trials varied in intervention design and participants, which improved external validity and the ability to perform subgroup analyses for the meta-analysis. While individual trials had limited power to detect the main intervention effect (BMI z-score), synthesising data substantially increased statistical power. Prospective planning led to an increase in number of collected outcome categories (e.g. weight, child’s diet, sleep), and greater outcome harmonisation. Prior to PMA inclusion, only 18% of outcome categories were included in all trials. After PMA inclusion this increased to 91% of outcome categories. However, whilst trials mostly collected the same outcome categories after PMA inclusion, some inconsistencies in how the outcomes were measured remained (such as measuring physical activity by hours of outside play versus using an activity monitor).Conclusion: Prospective planning led to greater outcome harmonisation and greater power to detect intervention effects, while maintaining acceptable variation in trial designs and populations, which improved external validity. Recommendations for future PMA include more detailed harmonisation of outcome measures, and careful pre-specification of analyses to avoid research waste by unnecessary over-collection of data.
Replicative Verification of Susceptibility Genes Previously Identified from Families with Segregating Developmental Dysplasia of the Hip
Authors: Xu Xiaowen , Wang Binbin , Chen Yufan , Zhou Weizheng , Li Lianyong
Published: December 2020

Background: Developmental dysplasia of the hip (DDH) is a complex hip joint deformity with effects ranging from acetabulum malformation to irreversible hip dislocation. Previous studies suggest a significant association of four variations, teneurin transmembrane protein 3 (TENM3, OMIM * 610083) (chr4:183721398), heparan sulfate proteoglycan 2 (HSPG2, OMIM * 142461 ) (chr1:22201470), ATPase plasma membrane Ca2+ transporting 4 (ATP2B4, OMIM * 108732) (chr1:203682345), and prostaglandin F receptor (PTGFR, OMIM * 600563) (chr1:79002214), with DDH susceptibility in families with segregating DDH. However, the association was not validated in sporadic cases and remains controversial. To confirm the association of the reported variations in these four genes with DDH, we conducted replicative verification in 250 sporadic samples with DDH from a Chinese Han population. Methods: We conducted Sanger sequencing after amplifying the variation sites. The results were compared with the reference sequence from the GRCh37 assembly in UCSC (http://genome.ucsc.edu). Results: Replication analysis of 250 sporadic samples by Sanger sequencing indicated that the four variations, TENM3 (OMIM * 610083, chr4:183721398), HSPG2 (OMIM * 142461, chr1:22201470), ATP2B4 (OMIM * 108732, chr1:203682345), and PTGFR (OMIM * 600563, chr1:79002214), were not associated with the susceptibility to DDH in the Chinese Han population.Conclusions: Further studies should be performed to identify other variations of these four genes that are potentially associated with DDH by whole-exome sequencing and the results should be verified in different populations.