bluuebunny/crossref_metadata_2025 huggingface dataset:
A precise navigation device for fixation of patella fractures with modified K-wire tension band: design and application
Authors: Wang Fuming , Xiong Haolan , Long Xiaotao , Li Yang , Chen Xiaohua , Wang Gang
Published: July 2020

Background Traditionally, the technique of modified tension band wires (MTBW) has been the most commonly used surgical procedure. The purpose of this study is to design a precise navigation device that can obtain a standard position of K-wires for (MTBW), and to compare the precise MTBW (P-MTBW) by a navigation device with the conventional MTBW (C-MTBW) by hands in a retrospective study.Methods The device is designed by solidworks2012 software (USA), which can provide a precise guidance for obtaining a parallel K-wires. In addition, it can set the distance between two k-wires and the level of k-wires below patellar anterior surface. From June 2014 to August 2018, a total of 112 patients are employed in this retrospective study. The patients are divided into P-MTBW group and C-MTBW group according to the surgical technique with or without the precise navigation device. We need to record and analyze the operation time and the number of fluoroscopy, postoperative internal fixation imaging, knee function and complications.Results There were 54 patients in P-MTBW group and 58 patients in C-MTBW group. There were statistically significant differences(P＜0.001) in the operation time between P-MTBW group (39.5±4.7; range, 32–49 minutes) and C-MTBW group (53.7±6.8; range, 42–71 minutes). The number of intraoperative fluoroscopy was significantly less (P＜0.001) in P-MTBW group(4.2±1.4) versus that of C-MTBW group (8.3±2.7). According to Iowa knee score, there was no significant difference (P=0.268) in function between the two groups. According to our own evaluation criteria for MTBW, anyone in the P-MTBW group was excellent and 26 patients were excellent, 20 patients were good and 2 patients were fair in the C-MTBW group.Conclusion The navigation device can reduce operation time and intraoperative fluoroscopy frequency. P-MTBW fixation is an accurate and effective surgical procedure for patella fractures.
Risk factors Affecting the 1-year Outcomes of Minor Ischemic Stroke: Results from Xi’an Stroke Registry Study of China
Authors: Liu Zhongzhong , Lin Wenjuan , Lu Qingli , Wang Jing , Liu Pei , Lin Xuemei , Wang Fang , Shi Yaling , Wang Qing , Liu Guozheng , Wu Songdi
Published: July 2020

Background: The incidences of stroke recurrence, disability, and all-cause mortality of patients with minor ischemic stroke (MIS) remain problematic. The aim of the present was to identify risk factors associated with adverse outcomes at 1-year after MIS in the Xi’an region of China. Methods: The cohort of this prospective cohort study included MIS patients aged 18–97 years with a National Institutes of Health Stroke Scale (NIHSS) score of ≤ 3 who were treated in any of four hospitals in Xi’an region of China between January and December 2015. The 1-year rates of stroke recurrence, disability, and all-cause mortality were evaluated. Multivariate logistic regression analysis was performed to assess the association between the identified risk factors and clinical outcomes. Results: Among the 1,121 patients included for analysis, the rates of stroke recurrence, disability, and all-cause mortality at 1 year after MIS were 3.4% (38/1121), 9.3% (104/1121), and 3.3% (37/1121), respectively. Multivariate logistic regression analysis identified age, current smoking, and pneumonia as independent risk factors for stroke recurrence. Age, pneumonia, and alkaline phosphatase were independent risk factors for all-cause mortality. Independent risk factors for disability were age, pneumonia, NIHSS score on admission, and leukocyte count. Conclusions: The 1-year outcomes of MIS is not optimistic in the Xi’an region of China. Early identification of risk factors for poor clinical outcomes, attention to high risk populations, and targeted interventions contribute to reducing the risk for poor clinical outcomes of patients at 1 year after onset of MIS.
Identification and Prognostic Analysis of Hub Genes in Bladder Cancer
Authors: Yi Haoran , Liu Lingzi , Song Huajie , Zhu Hengcheng
Published: July 2020

Background:Bladder cancer(BC) is one of the most common tumors worldwide. Its incidence and mortality rate rank first in urological malignancies. Due to the lack of credible predictors, most patients are not timely diagnosed and treated. Moreover, in the past 30 years, the clinical treatment of BC had seen little progress, and the 5-year survival rates of patients were flat.Therefore,identifying novel potential markers or therapeutic targets are urgently required for the diagnosis and prognosis of BC.Methods: The BC gene expression chip data （GSE121711）were downloaded from the GEO database and the BLCA RNA-seq data were downloaded from the TCGA database. The differentially expressed genes (DEGs) were identified by R software using limma package and the edgeR package, and obtained the overlapped DEGs from two databases. Then, the Gene Ontology(GO) function analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis of overlapped DEGs were performed through DAVID database, and the protein–protein interaction(PPI) network was constructed to screen Hub genes for regulatory protein expression in BC. Expression and prognostic analysis of the hub genes were performed by UALCAN and Kaplan-Meier plotter.Results: A total of 372 overlap DEGs were obtained, of which 93 were up-regulated and 279 were down-regulated. These genes were mainly associated with the function and pathway enrichment such as glycosaminoglycan binding, vasculature development, Cell cycle, Proteoglycans in cancer. The protein-protein interaction network analysis obtained 12 hub genes. Among these hub genes，HMMR，NCAPG2，SMC4, TROAP were closely related to the survival rate of bladder cancer patients revealed that these genes might be the key genes play an important role in the occurrence and progression.Conclusion:Therefore, our current studies demonstrated thatHMMR, NCAPG2, SMC4, TROAP are potential prognostic biomarkers for BC.In the future, these may also become clinical therapeutic targets.
Health Assessment Questionnaire-Disability Index (HAQ-DI) use in modelling disease progression in diffuse cutaneous systemic sclerosis: an analysis from the EUSTAR database
Authors: Allanore Yannick , Bozzi Sylvie , Terlinden Augustin , Huscher Doerte , Amand Caroline , Soubrane Christina , Siegert Elise , Czirjak Laszlo , Carreira Patricia E , Hachulla Eric , Zanatta Elisabetta , Li Mengtao , Airò Palo , Mendoza Fabian A , Rosato Edoardo , Distler Oliver
Published: July 2020

Background: Patients with diffuse cutaneous systemic sclerosis (dcSSc) have a poor prognosis. The importance of monitoring subjective measures of functioning and disability, such as the Health Assessment Questionnaire-Disability Index (HAQ-DI), is important as dcSSc is rated by patients as worse than diabetes or hemodialysis for quality of life impairment. This European Scleroderma Trials and Research (EUSTAR) database analysis was undertaken to examine the importance of impaired functionality in dcSSc prognosis. The primary objectives were to identify predictors of death and HAQ-DI score progression over 1 year. HAQ-DI score, major advanced organ involvement, and death rate were also used to develop a comprehensive model to predict lifetime dcSSc progression.Methods: This was an observational, longitudinal study in patients with dcSSc registered in EUSTAR. Death and HAQ-DI scores were, respectively, analyzed by Cox regression and linear regression analyses in relation to baseline covariates. A Markov model was developed to estimate/predict natural progression of dcSSc over a patient’s lifetime.Results: The analysis included dcSSc patients with (N = 690) and without (N = 4132) HAQ-DI score assessments from the EUSTAR database. Baseline HAQ-DI score, corticosteroid treatment and major advanced organ involvement were predictive of death on multivariable analysis; a 1-point increase in baseline HAQ-DI score multiplied the risk of death by 2.7 (p < 0.001) and multiple advanced major organ involvement multiplied the risk of death by 2.8 (p < 0.05). Multivariable analysis showed that baseline modified Rodnan Skin Score (mRSS) and baseline HAQ-DI score were associated with HAQ-DI score progression at 1 year (p < 0.05), but there was no association between baseline organ involvement and HAQ-DI score progression at 1 year. HAQ-DI score, major advanced organ involvement, and death were successfully used to model long-term disease progression in dcSSc.Conclusions: HAQ-DI score and major advanced organ involvement were comparable predictors of mortality risk in dcSSc. Baseline mRSS and baseline HAQ-DI score were predictive of HAQ-DI score progression at 1 year, indicating a correlation between these endpoints in monitoring disease progression. It is hoped that this EUSTAR analysis may change physician perception about the importance of the HAQ-DI score in dcSSc.
Association Between Growth Differentiation Factor 5 rs143383 Genetic Polymorphism and the Risk of Knee Osteoarthritis Among Caucasian but Not Asian: A Meta-analysis (PROSPERO CRD42020168180)
Authors: lei peng , Jin Song , Lu Jiping , Ouyang Chao , Gou Jiang , Xie Zhongyu , Shen Huiyong , Wang Peng
Published: July 2020

Background. A few months ago, the Bioscience Reports journal showed that Growth Differentiation Factor 5 (GDF5) rs143383 genetic polymorphism increases the susceptibility of knee osteoarthritis (KOA), but previous studies’ results have debates about available data. Considering the availability of more recent data, we focus on clarifying the relationship of KOA and GDF5 rs143383 genetic polymorphism by a meta-analysis of case-control trial data.Methods. The eligible studies from the time of database established to Oct. 2019 were collected from PubMed, Springer, Cochrane library, Web of Science, China National Knowledge Infrastructure (CNKI), Wan Fang library.Odds ratios (OR) and 95% confidence intervals (CI) were used to estimate the association between these polymorphisms and KOA risk. The meta-analysis was completed by STATA 18.0 software. Results. A total of 196 studies were collected, 16 of them including in final meta-analysis (7997 cases and 12684 controls). There was significant association between GDF 5 rs143383 polymorphism and KOA in all genetic models (for Allele model (C versus T): OR = 0.84 (95% CI = 0.76-0.91); dominate model (CC+CT versus TT): OR = 0.80(95% CI = (0.72-0.90); recessive model (CC versus CT+TT): OR= 0.79 (95% CI = 0.68-0.92); heterozygote model (CT versus CC+TT): OR = 0.89 (95% CI=0.80-0.97 ); homozygous model (CC versus TT): OR = 0.71 (95% CI=0.60-0.85). In the subgroup analysis by ethnicity, we obtained the results is no significant among Asians.Conclusion. GDF5 rs143383 genetic polymorphism increases the risk of KOA among Caucasians; CC genotype and C allele are protective factors for the susceptibility of KOA among Caucasians.
Performance of Model Based Multifactor Dimensionality Reduction Methods for Epistasis Detection by Controlling Population Structure
Authors: Abegaz Fentaw , Lishout Francois van , John Jestinah M. Mahachie , Chiachoompu Kridsadakorn , Bhjardwa Archana , Duroux Diane , Gusareva Elena S. , Wei Zhi , Hakonarson Hakon , Steen Kristel Van
Published: July 2020

Background
In genome-wide association studies the extent and impact of confounding due population structure has been well recognized. Inadequate handling of such confounding is likely to lead to spurious associations, hampering replication and the identification of causal variants. Several strategies have been developed for protecting associations against confounding, the most popular one being based on Principal Component Analysis. In contrast, the extent and impact of confounding due to population structure in gene-gene interaction association epistasis studies is much less investigated and understood. In particular, the role of nonlinear genetic population substructure in epistasis detection is largely under-investigated, especially outside a regression framework.
Methods
In order to identify causal variants in synergy, to improve interpretability and replicability of epistasis results, we introduce three strategies based on model-based multifactor dimensionality reduction approach for structured populations namely: MBMDR-PC, MBMDR-PG and MBMDR-GC.
Results
Simulation results comparing the performance of various approaches show that in the presence of population structure MBMDR-PC and MBMDR-PG consistently better control type I error rate at the nominal level than MBMDR-GC. Moreover, our proposed three methods of population structure correction outperform MDR-SP in terms of statistical power.
Conclusion
We demonstrate through extensive simulation studies the effect of various degrees of genetic population structure and relatedness on epistasis detection and propose appropriate remedial measures based on linear and nonlinear sample genetic similarity.
Circular RNA expression profiles in the development of acute chronic liver failure in hepatitis B virus-infected patients
Authors: Lian Jiangshan , Lin Feiyan , Lu Yinfeng , Hao Shaorui , Yu Jiong , Cai Huan , Zhang Xiaoli , Gu Yuqing , Yang Yida , hu lufeng
Published: July 2020

Hundreds of millions of people worldwide suffer from chronic hepatitis B (CHB), which is thus among the most serious public health problems. CHB can lead to serious acute chronic liver failure (ACLF). Since ACLF has a very high mortality rate, prediction of ACLF risk is a critical issue in clinical practice. To investigate the development of ACLF from CHB, circular RNA (circRNA), a novel type of endogenous non-coding RNA, was examined in healthy control (HC) subjects and CHB and ACLF patients using high-throughput RNA sequencing technology. Differentially expressed circRNAs were selected and analyzed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) biological pathway analyses, circRNA-miRNA co-expression networks, and statistical analyses.The results showed that a total of 21,101 circRNAs were identified in HC, CHB and ACLF subjects. Compared with the HCs, 4 up-regulated and 14 down-regulated circRNAs were identified in ACLF subjects, which exhibited a consistent trend of change in the three groups. GO analysis revealed that regulation of lymphocyte activation and macrophage tolerance induction were the most important biological processes in ACLF progression. KEGG pathway analysis revealed that primary immunodeficiency and NOD-like receptor signaling pathways were the most enriched terms. The circRNA-miRNA co-expression network and statistical analyses showed that circRNA_07734, circRNA_08533, and circRNA_16083 were the most important circRNAs in the process of ACLF. In conclusions, immune dysfunction and immunodeficiency may be critical in the development of ACLF, which results in aberrant expression of circRNAs, especially circRNA_07734, circRNA_08533, and circRNA_16083.
Accelerating R&D for Emerging Infectious Diseases: Lessons Learnt From Ebola
Authors: Li Chao , Chen Jingyi , Ma Jiyan , Huang Yangmu
Published: July 2020

Objective: The R&D explosion for Ebola virus disease (EVD) during the 2014-2016 outbreak led to the successful development of high-quality vaccines performed by China and the U.S. This study aims to compare the R&D activities of Ebola-related medical products in two countries, as a way to present the influential factors of R&D for emerging infectious disease (EID) and to provide suggestions for timely and efficient R&D response to the COVID-19 pandemic.Methods: In this comparative study, R&D activities were analyzed in terms of research funding, scientific research outputs, R&D timeline, and government incentive and coordinated mechanisms. Quantitative analysis was performed using data retrieved from national websites, clinical trial registries and databases.Qualitative semi-structured interviews were conducted to explore perspectives of fifteen key informants from EID field, especially of those involved in Ebola product development. Findings: The funding gap between China and the U.S. was significant before 2014 and narrowed after the Ebola outbreak. Both research teams started basic studies prior to the Ebola outbreak; however, the U.S. got FDA approval for clinical trials 5 months earlier than China. The underlying gap reveals the lack of participation and support by private sectors, the stagnant transformation platform, and the inadequate government incentives in China. Conclusion: R&D pre-planning and resource deployment mechanisms are crucial for EID preparedness and response. Funding should be allocated to support diversified R&D institutions for coping with the risks. Building private and public collaboration, and strengthening government support for clinical trials may accelerate the translation of basic research.
Identification ACTA2 and KDR as Key Proteins for Prognosis of PD-1/PD-L1 Blockade Therapy in Melanoma
Authors: Wang Yuchen , Li Zhaojun , Zhang Zhihui , Chen Xiaoguang
Published: July 2020

Background: Programmed cell death protein 1 (PD-1) /programmed cell death ligand 1 (PD-L1) blockade is an important therapeutic strategy for melanoma, despite its low clinical response. It is important to identify genes and pathways that may reflect the clinical outcomes of this therapy in patients. Methods: In this study, we analyzed clinical dataset GSE96619, which contains clinical information from five melanoma patients before and after anti-PD-1 therapy (five pairs of data). Two of the five patients responded to the anti-PD-1 treatment, whereas the other three patients did not respond to the treatment. We used MetaboAnalyst to identify differentially expressed genes (DEGs). The significant GO terms and KEGG pathway enrichment analysis of the identified DEGs were performed by using DAVID. The STRING v10 online tool was used to construct and visualize the PPI network. Validation the expression of hub genes in the B16F10 subcutaneous xenograft model Results: We identified 704 DEGs using these five pairs of data, and then the number of DEGs was narrowed down to 286 in patients who responded to treatment. Next, we performed KEGG pathway enrichment and constructed a DEG-associated protein-protein interaction network. Smooth muscle actin 2 (ACTA2) and tyrosine kinase growth factor receptor (KDR) were identified as the hub genes, which were significantly downregulated in the tumor tissue of the two patients who responded to treatment. To confirm our analysis, we demonstrated similar expression tendency to the clinical data for the two hub genes in a B16F10 subcutaneous xenograft model. Conclusions: This study demonstrates that ACTA2 and KDR are valuable responsive markers for PD-1/PD-L1 blockade therapy.
The Change of Soluble Programmed Cell Death-Ligand 1 (sPD-L1) in Glioma Patients Receiving Radiotherapy and Its Impact on Clinical Outcome
Authors: Ding Xing-chen , Wang Liang-liang , Zhu Yu-fang , Yang Jia , Yu Jin-ming , Hu Man
Published: July 2020

Background: It has been proved that the levels of soluble programmed death-ligand 1 (sPD-L1) are associated with prognosis in extracranial malignancies. However, the expression of sPD-L1 in glioma patients receiving radiotherapy (RT) still remains unclear.The purpose of this study is to evaluate the concentration of sPD-L1in the plasma of glioma patients before and after RT, and to explore its relationship with clinical outcomes.Methods: Between October 2017 and September 2018, the glioma patients treated with RT (30 ± 10 Gy, 2 Gy/f) were enrolled and the blood samples were collected before and after RT. We quantified the sPD-L1 levels by enzyme-linked immunosorbent assay (ELISA). The isocitrate dehydrogenase-1 (IDH-1) promoter status and Ki-67 expression were evaluated by immunohistochemistry. The murine models of glioma were used to address whether circulating sPD-L1 molecules are directly targeted by the anti-PD-L1 antibody. The associations between sPD-L1 and clinical features were assessed with Pearson or Spearman correlation. The progression-free survival (PFS) and overall survival (OS) were determined by Kaplan-Meier method.Results: Sixty glioma patients were included, with the median age 52-year-old. The proportion of grade I, II, III, IV were 6.7%, 23.3%, 28.4% and 41.6%, respectively. The baseline sPD-L1 levels were significantly associated with tumor grades, IDH-1 mutation status and Ki-67 expression. Using 14.35 pg/mL as the cutoff, significantly worse PFS and OS were both observed in patients with higher baseline level of sPD-L1 (P = 0.027, 0.008, respectively). RT significantly increased the mean level of sPD-L1 (P < 0.001). Further analysis showed that increased level of sPD-L1 in IDH-1 mutation patients was higher than that in wide-type ones. Furthermore, the murine models of glioma indicate that sPD-L1 can be blocked by anti-PD-L1 antibody. Conclusion: This study reported that sPD-L1 might be a potential biomarker to predict the outcome in glioma receiving RT. The elevated level of sPD-L1 after RT suggested that the strategy of combination with immune checkpoint inhibitors and RT might be promising for glioma, especially for patients with IDH-1 mutation.
Temporal and Spatial Characteristics Endogenous Hormone Regulation During Male Cone Development of Dacrydium pectinatum
Authors: Lu Wenju , Li Zhaoji , Song Xiqiang , Wang Jian , Ren Mingxun , Yang Donghua , Huo Shaojie , Zhao Ying , Liang Haiying
Published: July 2020

Background: Dacrydiumpectinatum de Laubenfels is a perennial gymnosperm dominant in tropical montane rain forests. Due to severe damages by excessive deforestation, typhoons, and other external forces, the population of the species has been significantly reduced. Furthermore, natural regeneration is poor. In order to better understand the reproductive process in D. pectinatum, we examined the morphological and anatomical changes during the development of male cone and analyzed the endogenous hormone dynamics.Results: Our study indicates that D. pectinatum male buds become distinguishable in April in tropical montane rain forests, while microspore sac forms in September and pollen mother cell forms and divides in December. Pollen grains mature and disperse in the following February. A mature male cone averages 8.5 mm in length. Level of GA, IAA, ABA and JA and their ratios fluctuated during late August to late November when sporogenous tissues were actively differentiated.Conclusions: The differentiation of sporogenous tissues is accompanied by variations in levels of endogenous hormones (GA, ABA, IAA, and JA) and their balances. The new insights about the cone development in D. pectinatum lay the foundation for future cone induction with hormones and study of factors contributing to the species’ low rate of seed germination.
Association between body mass index and fragility fracture in postmenopausal women: a cross-sectional study using Korean National Health and Nutrition Examination Survey 2008-2009 (KNHANES IV)
Authors: Kim Jihan , Lee Sami , Kim Sung Soo , Lee Jong-Pyo , Kim Jong Sung , Jung Jin Gyu , Yoon Seok Jun , Kim Kyu Pil , Park Chan-Keol , Kim Yong-Hwan
Published: July 2020

Background: The present study examined the relationship between body mass index (BMI) and the risk for fragility fractures in postmenopausal Korean women. Method: Among subjects who participated in the 4th National Health and Nutrition Examination Survey (2008-2009), 2114 women ≥ 40 years of age were included. BMI was based on standards set by the Korean Society for the Study of Obesity, as follows: <18.5 kg/m2, underweight; 18.5 ≤ to <25 kg/m2, normal weight; and ≥25 kg/m2, obese. Subjects were also divided into three groups according to the location of fragility fracture: spine, hip, or wrist. Results: The mean (± SD) rate of fragility fracture was significantly different among the three groups: 5.9±2.9% (underweight), 1.1±0.3% (normal weight), and 3.0±0.7% (obese) (p=0.001). After correcting for age, family history, and treatment history of osteoporosis and rheumatoid arthritis, smoking and drinking status, and level of exercise, multivariable regression analysis revealed that the odds ratio for fragility fracture in the underweight group was 5.51 (95% confidence interval [CI] 1.88–16.13) and 3.19 (95% CI 1.51–6.74) in the obese group. After subdividing fragility fractures into vertebral and non-vertebral, the odds ratio for vertebral fracture in the underweight group was 6.05 (95% CI 1.61–22.68) times higher than that in the normal weight group; in the obese group, the non-vertebral fracture odds ratio was 3.73 (95% CI 1.33–10.44) times higher. Analysis of non-vertebral fractures in the obese group revealed an odds ratio for fracture 8.29 (95% CI 1.04–66.37) times higher for hip fracture and 3.73 (95% CI 1.21–11.43) times higher for wrist fracture. Conclusions: Obesity and underweight increased the risk for fragility fractures in postmenopausal Korean women. As such, it is important for this patient population to maintain bone health through proper weight management, sufficient exercise, and regular examination of bone density.
Seasonal variation of decompensated heart failure admissions and mortality rates in sub-Saharan Africa, Cameroon
Authors: Nganou-Gnindjio Chris Nadège , Epoupa Anais Romanne Awah , Wafeu Guy Sadeu , Njeunje Donald Paulin Tchapmi , Endomba Francky Teddy , Boombhi Jerome , Mfeukeu-Kuate Liliane , Amougou Sylvie Ndongo , Hamadou Bâ , Menanga Alain Patrick
Published: July 2020

Background
Decompensated heart failure (HF) and related deaths are common in cardiology units. Epidemiological data in north hemisphere suggest higher rates during winter.
Objective
We aimed to describe the seasonal variation of decompensated HF admission and mortality rates in a country with equatorial climate.
Methods
We conducted a retrospective cross-sectional study from 2016 to 2018 in cardiology unit of the Yaoundé Central Hospital, collecting data on HF morbidity and mortality from registers and patients’ files. Climate data of the corresponding period were obtained from the meteorology office of the Cameroonian ministry of transports. Analysis of variance and Chi square test were respectively used to compare the continuous and categorical data between seasons. Correlation between continuous data was assess with the Pearson correlation coefficient.
Results
Of the 1,755 patients admitted in the unit during the study period, 636 (36.2%) had decompensated HF, among which 115 (18%) died. Decompensated HF admission, mortality and lethality rates – respectively 38.2%, 6.7% and 17.9%- were higher during long rainy season (p > 0.05). We observed an inverse linear correlation between monthly temperatures and admission rate (r = -0.301; p = 0.070), lethality rate (r = − 0.361; p = 0.030) and mortality rate (r = − 0.385; p = 0.020). There was no significant difference of the distribution of precipitating factors between seasons.
Conclusion
Decompensated HF admissions and deaths increases in rainy season where the temperature is lower. This suggest a need of effective methods to mitigate the effect of cold on cardiovascular diseases.
Decontamination Methods for Respiratory Protection Mask Model N95: A Rapid Review
Authors: Probst Livia Fernandes , Guerrero Ana Tereza Gomes , Cardoso Andréia Insabralde de Queiroz , Grande Antônio José , Croda Mariana Garcia , Venturini James , Fonseca Maria Cristina de Camargo , Paniago Anamaria Mello Miranda , Barreto Jorge Otávio Maia , de Oliveira Sandra Maria do Valle Leone
Published: July 2020

Background: N95 respiratory protection masks are used by healthcare professionals to prevent contamination with infectious microorganisms transmitted by droplets or aerosols. Methods: We conducted a rapid review of the literature analyzing the effectiveness of decontamination methods for mask reuse. The review was carried out in April 2020 using a simplification of the formal systematic review process. A total of 166 articles were retrieved of which 17 laboratory-based studies were selected. Results: Two of the studies only examined the effectiveness of decontamination methods, seven only reported on the maintenance of mask integrity, and eight considered both outcomes. Twelve decontamination methods were included in the studies. Conclusions: Positive results should be considered with caution as they represent a small number of studies, reflect ideal laboratory conditions, and may have limited applicability in realistic situations and for health systems. Nonetheless, five methods appear promising: hydrogen peroxide vapor, ultraviolet irradiation, dry heat, wet heat/pasteurization, and microwave ovens.
Establishment of a Rapid and Stable Transgenic System by Agrobacterium-Mediated Transformation of the Germination Seeds in Diploid Strawberry.
Authors: Gu Xiao-Jiao , Shen Yuanyue
Published: July 2020

BackgroundStrawberry (Fragaria) is regarded as a model plant for both Rosaceae and non-climacteric fruit ripening. Although much progress has been made in the identification of gene function using traditional, stable and transient genetic transformation systems in strawberry, the limitation is, more or less, present. Thus, development of a rapid, efficient, and stable transformation system is required for strawberry research and breeding.ResultsHere, using diploid Hawaii-4 (Fragaria vesca) seeds and a reporter gene of CHLH (the H subunit of magnesium chelatase magnesium chelatase) , we first develop a new, rapid, efficient, and stable transgenic system by the Agrobacterium-mediated seed transformation to silence the reporter gene, obtaining a transformation frequency with 10 % through a series of optimization conditions, including full imbibition and initial germination, shaking infection for 24 h, dark cultivation on MS medium for 3 d at 24 ℃, light culture on MS-Tim medium for 1 week at 24 ℃, and vector construction carried fluorescence label. Taken together, radicle-emergence germination seeds, appropriate Agrobacterium concentration and infection time are critical for successful transformation, obtaining transgenic kanamycin-resistant seedlings within 1 month and T2 generation transgenic plants within 4 months. ConclusionsWe first have successfully established Agrobacterium-mediated transformation of germinating seeds (AMTGS) in diploid strawberry (F. vesca), providing a useful tool for studying non-climacteric fruit ripening and strawberry breeding.
Inhibition of Sphingosine Kinase 2 Down-Regulates ERK/c-Myc Pathway and Reduces Cell Proliferation in Human Epithelial Ovarian Cancer
Authors: Dai Lan , Song Keqi , Wang Wenjing , Liu Yixuan , Di Wen
Published: July 2020

Background: Epithelial ovarian cancer (EOC) is the leading cause of death from female cancers. In our previous study, Sphingosine kinase 2 (SphK2) inhibitor was shown to display anti-EOC activities. The purpose of this study was to further evaluate the expression characteristics and clinical significance of SphK2 in EOC, and to explore the roles and underlying mechanisms of SphK2 in EOC cell survival.Methods: SphK2 expression was examined by Immunohistochemistry and western blot, and its clinical implications and prognostic significance were analyzed. Cellular proliferation assay and mouse xenograft model was established to confirm the roles of SphK2 in vitro and in vivo. Cell cycle analysis, apoptosis assay and western blot were performed to examine cell cycle progression and apoptosis rate. Gene set enrichment analysis (GSEA) and western blot was used to investigate the downstream signaling pathways related to SphK2 function.Results: SphK2 expression level was shown to be associated with stage, histological grade, lymph node metastasis and ascite status. More importantly, high SphK2 expression level was a prognostic indicator of overall survival and relapse-free survival. Moreover, knockdown of SphK2 arrested cell cycle progression and inhibited the proliferation of EOC cells both in vitro and in vivo. Furthermore, ERK/c-Myc, the key pathway in EOC progression, was important for SphK2-mediated mitogenic action in EOC cells.Conclusion: Our findings provided the first evidence that SphK2 played a crucial role in EOC proliferation by regulating ERK/c-Myc pathway. SphK2 may serve as a prognostic marker and potential therapeutic target in EOC.
Pegylated liposomal doxorubicin in patients with epithelial ovarian cancer
Authors: Yuan Zhen , Zhang Ying , Cao Dongyan , Shen Keng , Li Qingshui , Li Guonan , Wu Xiaohua , Cui Manhua , Yue Ying , Cheng Wenjun , Wang Li , Qu Pengpeng , Tao Guangshi , Hou Jianqing , Sun Lixin , Meng Yuanguang , Li Guiling , Li Guozhong , Shi Huirong , Chen Yaqing
Published: July 2020

Objective
To evaluate the efficacy and safety of PLD in treating of in patients with epithelial ovarian, tubal, and peritoneal cancer progression within 12 months after the first-line platinum-based therapy.
Methods
This was an open-label, single-arm and multicenter clinical trial. ORR was the interim primary objective and DCR, AEs and QOL were the secondary objectives. The impact of factors on the efficacy outcomes, the change trend of CA125 and the artificial platinum-free interval were exploratory endpoints.
Results
Totally, 115 patients were enrolled in this study and included in the ITT. Moreover, 101 patients were included in the safety analysis. The median follow-up time was 4 months (IQR 2–6). In ITT, the confirmed ORR was 37.4% (95%CI, 28.4%-46.4%), and the DCR was 65.2% (95%CI, 56.4%-74.1%). The previous response status to platinum-based chemotherapy and baseline CA125 levels were statistically correlated with the ORR. The ORR was significantly higher in the patients with a CA125 decrease after the first cycle than in the patients with a CA125 increase. The most common grade 3 or higher AE was hand-foot syndrome (3 [3.0%] of 101 patients). No statistically significant differences existed between the baseline and the postbaseline questionnaires.
Conclusions
For patients with platinum-resistant and platinum refractory relapse, the use of PLD may be a favorite choice because of the associated satisfactory efficacy, low frequency of AEs and high patient QOL. Moreover, a lower CA125 level at baseline and a reduction in CA125 after the first cycle are predictive factors for a better efficacy.
Sero-epidemiology and associated risk factors of brucellosis among sheep and goat population in the mid southern Nepal: A comparative study
Authors: Gompo Tulsi Ram , Shah Rubina , Tiwari Ishwari , Gurung Yam Bahadur
Published: July 2020

Background Brucellosis is a zoonotic disease of animals and humans caused by the Brucella spps. In Nepal, the presence of brucellosis in small ruminants, e.g., sheep and goats, has impacted the farmers' livelihood and people's food safety. A cross-sectional study was conducted at Rupandehi districts of Nepal to the discover the seroepidemiology and associated risk factors of brucellosis in sheep and goat population. Altogether, 19 sheep and 60 goat farms located in the districts' local units were visited, and the owners were interviewed to get the information on animal characteristics, management, and movement patterns. Three hundred fifty-seven serum samples (80 sheep and 277 goat’s samples) were collected from selected herd based on the probability proportional to their sizes. Each serum sample was tested for Rose Bengal Plate Test (RBPT) and ELISA to estimate the seropositivity. Bivariate analysis followed by multivariable logistic regression was applied to calculate corresponding odds ratios of each variable associated with the brucellosis. Results Out of 80 sheep samples, 12 (15%; 95%CI: 8.79%-24.41%, P<0.001) and out of 277 goat samples 3 (1.1%; 0.37%-3.14%, P<0.001) were tested positive to brucellosis. Age of greater than 1.5 years (OR= 6.39, 95%CI: 1.23, 54.67, p= 0.04) was identified as the significant risk factor for brucellosis in sheep population. While in the goat population, none of the variables were identified as the significant risk factors in multivariable regression analysis. However, the goat from the frequent grazing herds had borderline significance (OR = 8.81, 95%CI: 0.44, 174.56, p<0.15). It might be because of the regular movement of sheep herds that get mixed up with the goat populations. Conclusion The study provides evidence that the burden of brucellosis in sheep is significantly higher than goats. The brucellosis control program in sheep should be applied immediately, as the contiguous herds of sheep and goats keep mixing while grazing and selling. Also, the strict biosecurity and biosafety measures should be implemented among the sheepherders to prevent infection of Brucella in them. We suggest further study on both small ruminants and the sheep owners to reveal the transmission dynamics through one health approach.
“We have a ticking time bomb”: A qualitative exploration of the impact of canine epilepsy on dog owners living in England
Authors: Pergande Amy Eliza , Belshaw Zoe , Volk Holger A , Packer Rowena M A
Published: July 2020

Background
Idiopathic epilepsy is a common neurological condition in dogs. Previous research has focused on clinical aspects of seizure management in dogs with idiopathic epilepsy with little attention given to the emotional and logistical challenges for their owners. The current study aimed to explore the impacts of owning a dog with idiopathic epilepsy on owner quality of life and lifestyle, using qualitative methods.
Methods
Owners of dogs with idiopathic epilepsy living in England were recruited via social media and word of mouth, and then selected using purposive sampling to participate in face-to-face semi-structured interviews. Epilepsy management was explored through in-depth accounts of owner experiences and influencing factors. Interviews were recorded and transcribed verbatim and thematic analysis was used to construct key themes.
Results
Twenty-one interviews were completed. Almost all owners had made lifestyle changes in order to care for their dog, including substantial modifications to routines and, in some cases, employment. Many owners discussed a very emotionally close dog-owner bond, and described experiencing frequent feelings of fear, stress and uncertainty regarding their dog’s health. Friends, family and colleagues did not always understand the magnitude of commitment required to care for a dog with idiopathic epilepsy. This, combined with a fear of leaving their dog unsupervised, had social implications in some instances and lead to increased use of the Internet and online groups for peer support.
Conclusions
The commitment required to care for a dog with idiopathic epilepsy, and the lifestyle changes made by their owners, may be far greater than previously estimated. Further consideration of these factors by veterinary professionals and the friends and families of owners of dogs with idiopathic epilepsy could improve owner quality of life, and facilitate the provision of additional support.
Determinants of Low birthweight and Preterm Delivery in the Volta Region of Ghana: Evidence from birth records
Authors: Axame Wisdom Kudzo , Binka Fred Newton , Kweku Margaret
Published: July 2020

Background:Low birthweight and preterm delivery are birth outcomes that can predict the survival, development and long-term health outcomes of newborns. Though advances in medical research have improved birth outcomes these birth outcomes still remain issues of public health concern. This study assessed the determinants of low birthweight and preterm delivery in the Volta region of Ghana.Methods:This retrospective cross-sectional study analyzed data from 680 birth records of all deliveries between October and December, 2018 at the Ho Teaching Hospital in the Volta Region of Ghana. Univariate and multivariate logistic regression models were used to predict determinants of low birthweight and preterm delivery using Stata MP/16.0.Results:Overall, the prevalence of low birthweight was 12.9% and that of preterm delivery was 14.1%. Increasing maternal age (AOR: 0.52; 95% CI: 0.28-0.98), multiparity (AOR: 0.54; 95% CI: 0.30-0.94) and increasing doses of Sulphadoxine pyrimethamine (AOR: 0.43; 95% CI: 0.22-0.84) significantly reduced the odds of low birthweight. However, delivery through caesarean section (AOR: 1.94; 95% CI: 0.1.16-3.27) and hypertension (AOR: 2.06; 95% CI: 1.27-03.33) significantly increased the likelihood of low birthweight. Increasing number of antenatal care visits (AOR: 0.38; 95% CI: 0.18-0.80) and doses of Sulphadoxine pyrimethamine (AOR: 0.43; 95% CI: 0.19-0.97) were significantly associated with decreased odds of preterm delivery while delivery through caesarean section increased the odds of preterm delivery by 2 folds (AOR: 2.14; 95% CI: 1.15-3.99). Conclusion:This study shows maternal age, parity, number of ANC visits, hypertension, SP/IPTp and caesarean section were independent determinants of low birthweight and preterm delivery. These findings add up to literature on the determinants of these adverse birth outcomes particularly in resource-limited environments. Furthermore, this study could serve as a foundation for further research in the study area and for developing public health interventions geared towards reducing the risk and complications of these birth outcomes.
Engineering a Multi Epitope Vaccine Against SARS-CoV-2 By Exploiting Its Non Structural and Structural Proteins
Authors: RAJPUT VIKRANT SINGH , SHARMA RITIKA , KUMARI ANCHALA , VYAS NIDHI , PRAJAPATI VIJAY , GROVER ABHINAV
Published: July 2020

SARS-CoV-2, the causative agent behind the ongoing pandemic exhibits an enhanced potential for infection when compared to its related family members- the SARS-CoV and MERS-CoV; which have caused similar disease outbreaks in the past. The severity of the global health burden, increasing mortality rate and the emergent economic crisis urgently demands the development of next- generation vaccines. Amongst such emergent next generation vaccines are the multi-epitope subunit vaccines, which hold promise in combating deadly pathogens. In this study we have exploited immunoinformatics applications to delineate a vaccine candidate possessing multiple B and T cells epitopes utilizing the SARS-CoV-2 non structural and structural proteins. The antigenicity potential, safety, structural stability and the production feasibility of the designed construct was evaluated computationally. Furthermore, due to the known crucial interactions of human TLR-3 immune receptor with SARS-CoV, the vaccine construct was examined for its binding efficiency using molecular docking and molecular dynamics simulation studies, which resulted in strong and stable interactions. Finally, the immune simulation studies suggested an effective immune response on vaccine administration. Overall, the immunoinformatics analysis advocates that the purposed vaccine candidate is safe and immunogenic and therefore can be pushed as a lead for in vitro and in vivo investigations.
Can Integrated Care Improve the Efficiency of Hospitals? - Research based on 200 Hospitals in China
Authors: Peng Zixuan , Zhu Li , Wan Guangsheng , Coyte Peter C.
Published: July 2020

Backgrounds:

The shift towards integrated care (IC) represents a global trend towards more comprehensive and coordinated systems of care, particularly for vulnerable populations, such as the elderly. When health systems face fiscal constraints, integrated care has been advanced as a potential solution by simultaneously improving health service effectiveness and efficiency. This paper addresses the latter. There are three study objectives: first, to compare efficiency differences between IC and non-IC hospitals in China; second, to examine variations in efficiency among different types of IC hospitals; and finally, to explore whether the implementation of IC impacts hospital efficiency.
Methods

This study uses Data Envelopment Analysis (DEA) to calculate efficiency scores among a sample of 200 hospitals in H Province, China. Tobit regression analysis was performed to explore the influence of IC implementation on hospital efficiency scores after adjustment for potential confounding. Moreover, the association between various input and output variables and the implementation of IC was investigated using regression techniques.
Results

The study has four principal findings: first, IC hospitals, on average, are shown to be more efficient than non-IC hospitals after adjustment for covariates. Holding output constant, IC hospitals are shown to reduce their current input mix by 12% and 4% to achieve optimal efficiency under constant and variable returns-to-scale, respectively, while non-IC hospitals have to reduce their input mix by 26% and 20% to achieve the same level of efficiency; second, with respect to the efficiency of each type of IC, we show that higher efficiency scores are achieved by administrative and virtual IC models over a contractual IC model; third, we demonstrate that IC influences hospitals efficiency by impacting various input and output variables, such as length of stay, inpatient admissions, and staffing; fourth, while bed density per nurse was positively associated with hospital efficiency, the opposite was shown for bed density per physician.
Conclusions

Integrated Care has the potential to promote hospital efficiency by influencing an array of input and output variables. Policies designed to facilitate the implementation of IC in hospitals need to be cognizant of the complex way IC impacts hospital efficiency.
Impaired Effective Functional Connectivity of the Sensorimotor Network in Interictal Episodic Migraineurs Without Aura
Authors: Wei Heng-Le , Chen Jing , Chen Yu-Chen , Yu Yu-Sheng , Guo Xi , Zhou Gang-Ping , Zhou Qing-Qing , He Zhen-Zhen , Yang Lian , Yin Xindao , Li Junrong , Zhang Hong
Published: July 2020

Background: Resting-state functional magnetic resonance imaging (Rs-fMRI) has confirmed sensorimotor network (SMN) dysfunction in migraine without aura (MwoA). However, the underlying mechanisms of SMN causal functional connectivity in MwoA remain unclear. We aimed to explore the association between clinical characteristics and effective functional connectivity in SMN, in interictal patients who have MwoA.Methods: We used Rs-fMRI to acquire imaging data in forty episodic patients with MwoA in the interictal phase and thirty-four healthy controls (HCs). Independent component analysis was used to profile the distribution of SMN and calculate the different SMN activity between the two groups. Subsequently, Granger causality analysis was used to analyze the effective causal connectivity between the SMN and other brain regions.Results: Compared to the HCs, MwoA patients showed higher activity in the bilateral postcentral gyri (PoCG) and supplementary motor areas, but lower activity in left Rolandic operculum/insula. Moreover, MwoA patients showed significantly causal connectivity from the SMN to the left calcarine sulcus, left middle temporal gyrus, right angular gyrus and right precuneus. There was also significant causal connectivity from the left calcarine sulcus, left inferior orbitofrontal cortex, right cuneus, right putamen and left inferior parietal lobule to the SMN. In the interictal period, there was positive correlation between the activity of the left PoCG and headache frequency (r = 0.410, p = 0.013), but negative correlation between the activity of the right PoCG and the impact of headache (r = -0.397, p = 0.016). In addition, the disease duration was directly proportional to the connectivity strength from the left PoCG to the right angular gyrus (r = 0.418, p = 0.011), and from the right PoCG to the left calcarine sulcus (r = 0.377, p = 0.023).Conclusions: These differential, resting-state functional activities of the SMN in episodic MwoA may contribute to the understanding of migraine-related intra- and internetwork imbalances associated with nociceptive regulation and chronification.