bluuebunny/crossref_metadata_2025 huggingface dataset:
Research on the improvement of allergic rhinitis in asthmatic children after reducing dust mite exposure: a randomized, double-blind, cross-placebo study protocol
Authors: Chen Ming , Wu YuFen , Yuan Shuhua , Chen Jiande , Li Luanluan , Wu Jinhong , Zhang Jing , Yin Yong
Published: June 2020

Background: Allergic rhinitis (AR) in children has become a major respiratory inflammatory disease with a high incidence that is increasing yearly. In China, 54.93% of children with asthma have AR, which often requires synchronous treatment. House dust mites (HDMs) are common allergens that often cause attacks of AR and asthma. Reducing allergen exposure is one of the most important measures to control and treat AR and asthma attacks. Hestelia Mite Bait, containing 0.1% emamectin, is a new tool for trapping and killing dust mites that can reduce the number of dust mites on mattresses, thereby potentially reducing stimulation by allergens and ultimately improving asthma and rhinitis symptoms. This single-centre, randomized double-blind crossa-placebo trial will explore the improvement of allergic rhinitis in asthmatic children after reducing dust mite exposure.Methods: We will recruit 60 children (aged 3-12 years) who have been diagnosed with allergic rhinitis and asthma and are allergic to dust mites as confirmed by a serum allergen test. Participants will randomly receive the Hestelia Mite Bait intervention for 8 weeks and the placebo intervention for 8 weeks. There will be a 4-week washout period between the two interventions. The primary outcome is the visual analogue scale (VAS) score of AR symptoms; the secondary outcomes include the Rhinitis Control Assessment Test (RCAT) score, Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) score, changes in the dust mite level, drug usage for asthma and AR, Asthma Control Questionnaire-5 (ACQ-5) score, and frequencies of acute asthma attacks, emergency visits, and hospitalization.Discussion: This study will scientifically and objectively evaluate the improvement effects on rhinitis and asthma after reducing dust mite exposure and will provide a convenient means for the prevention and treatment of children's airway allergic diseases in the future.Trial registration: ChiCTR1900024688 (www.chictr.org.cn) registration date: July 21, 2019
Mixed Methods Research on Satisfaction with Basic Medical Insurance for Urban and Rural Residents in China
Authors: Liu Xiaofang , Yang Fang , Cheng Wenwei , Wu Yanyan , Cheng Jin , Sun Weichu , Yan Xiaofang , Luo Mingming , Mo Xiankun , Hu Mi , Lin Qian , Shi Jingcheng
Published: June 2020

Background: There are few studies on satisfaction with integrated basic medical insurance for urban and rural residents (URRBMI), and satisfaction with URRBMI is not very high due to the complexity of its policies and differences among the insured. The aim of the present study was to explore the factors that influence satisfaction with URRBMI in China and to provide scientific suggestions for the government to effectively manage and improve the policy.Methods: An explanatory sequential design in mixed method research was used. Quantitative study adopted a three-stage stratified cluster sampling method to randomly select the guardians of pupils who had participated in the URRBMI (n=1335). A quantitative study was conducted to calculate latent variables’ score and path coefficient between latent variables by SmartPLS3. 0. With public trust, public satisfaction and perceived quality as the target variables, the important-performance analysis (IPA) was used to explore the important but insufficient performance factors, which were the key elements to improve satisfaction of URRBMI. A purposeful sampling strategy was used to get qualitative research subjects from quantitative research subjects according to satisfaction level. A qualitative study was conducted using semi-structured interviews and the thematic analysis method was used to summarize the interview data.Results: Perceived quality to public satisfaction with a total effect of 0.737 (t=41.270, P<0.001), perceived quality to perceived value with a total effect of 0.676 (t=31.964, P<0.001), and public satisfaction to public trust with a total effect of 0.634 (t=31.305, P<0.001) were three strongest paths. IPA showed that public satisfaction and perceived quality were key factors for public trust and that perceived quality was of high importance and low performance for public satisfaction. The policy quality was a determining factor for perceived quality. Qualitative research showed that the most unsatisfactory aspect for the insured was the policy quality. Conclusions: This study found that improving quality is key to improving public satisfaction and public trust of URRBMI. The government should improve the compensation level by broadening the channel of financing for URRBMI fund, rationally formulating reimbursement standards and broadening the scope of the drug catalogue and the medical treatment projects. The government should establish a stable financing growth mechanism and effective ways of health education so as to improve public satisfaction and public trust.
Factors influencing the length of hospital stays during the intensive phase of multidrug-resistant tuberculosis treatment at Amhara Regional State hospitals, Ethiopia: A retrospective follow up study
Authors: Tamirat koku Sisay , Andargie Gashaw , Babel Yaregal Animut
Published: June 2020

Background: The length of hospital stay is the duration of hospitalization and reflects disease severity and resource utilization indirectly. Generally, tuberculosis considered as an ambulatory disease able to be treated at DOTs clinics, however, hospitalization remains an important component for clinical stabilization of patients. Hence, this study aimed to identify factors influencing the length of hospital stay during the intensive phase of multidrug-resistant tuberculosis treatment at Amhara Regional State hospitals, Ethiopia.Methods: An institution-based retrospective follow-up study was conducted at three hospitals, namely the University of Gondar comprehensive specialized, Borumeda, and Debremarkos referral from September 2010 to December 2016 (n=432). Data were extracted from hospital admission/discharge logbooks and individual patient medical charts. Logistic regression analysis was used to identify factors associated with longer hospital stays during the intensive phase of multidrug-resistant tuberculosis treatment.Result: Most patients (93.5%) had a pulmonary form of multidrug-resistant tuberculosis and 26.2% had /TB/HIV co-infections. The median length of hospital stay was 62 (interquartile range 36 to 100) days. The pulmonary form of tuberculosis (Adjusted odds ratio [AOR], 3.47, 95% confidence interval [CI]; 1.31 to 9.16), functional status of bedridden (AOR= 2.88, 95%CI; 1.29 to 6.43), and reported adverse drug effects (AOR=2.11, 95%CI; 1.35 to 3.30) were significant predictors of extended hospital stays.Conclusion: The study revealed that the length of hospital-stay differed significantly between the hospitals. The pulmonary form of tuberculosis decreased functional status at admission and reported adverse drug reactions were determinants of longer hospital stays. This underscores the importance of early case detection and prompt treatment of adverse drug effects.
The most stable pinning configurations in transverse supracondylar humerus fracture fixation in children: A novel three-dimensional finite element analysis of a pediatric bone model
Authors: Kamara Allieu , Ji Xianglu , Liu Chuang , Liu Tianjing , Wang Enbo
Published: June 2020

Background: This study aimed at finding out the effect of exit height of pins, pin trajectory and pin number on the stability of cross and lateral pinning configurations used in the fixation of extension-type supracondylar humerus fracture (SHF) in children, through finite element analysis of a novel pediatric humerus bone model. Methods: Distal humerus model consisting of the ossific nucleus of the capitellum (ONC) and distal cartilage of a 6-year-old boy was developed via three-dimensional finite modeling. Various cross and lateral pinning fixation models with either two or three pins were simulated on an extension-type, transverse SHF and tested in six loading directions. Results: Two-cross pins and 2-lateral pins were respectively more stable in rotation and compression loadings, while 3-cross pins were the most stable in all loading directions. The cross pins exiting at the upper border of the distal metaphyseal-diaphyseal junction (MDJ) had the best stiffness among the 2-cross pins, while the lateral pins with a mid-ONC distal pin provided the best stiffness among the 2-lateral pins. A third pin however, going through the olecranon fossa led to improved stability of the 2-lateral pins in flexion, extension, internal and external rotations. Conclusion: In the fixation of extension-type, transverse supracondylar humerus fractures, 2-cross pins are only superior to 2-divergent lateral pins in rotational loadings. Two-cross pins exiting at the upper border of the MDJ provides the best stability, whereas 2-lateral pins with a distal pin going through the middle third of the ONC provides the best stability against compression forces for these fractures. Three-cross pins however offer the best stability against both compression and rotation forces. This study offers important clues in the preoperative evaluation and management of extension-type supracondylar fractures in children.
Article Functional MYB transcription factor gene HtMYB2 is associated with anthocyanin biosynthesis in Helianthus tuberosus L.
Authors: Gao Jieming , Sun Xuemei , Zong Yuan , Yang Shipeng , Wang Lihui , Liu Baolong
Published: June 2020

Background: Tuber color is an important trait for Helianthus tuberosus L. (Jerusalem artichoke). Usually, purple tubers with high anthocyanin content are more nutritious than white tuber. But, the molecular mechanism underlying it is unknown. Results: In the current study, high-throughput RNA-sequencing was used to compare the transcriptomes between plants with tubers with red or white epidermis. Compared with the white-skinned tubers of cultivar QY3, anthocyanin biosynthesis structural genes had greater expression in the red-skinned tubers of cultivar QY1, indicating that the anthocyanin biosynthesis pathway was activated in ‘QY1’; quantitative PCR confirmed this difference in expression. HtMYB2 (Unigene44371_All) was the only MYB transcription factor，homologous to the MYB transcription factor regulating anthocyanin biosynthesis, expressed in the red tuber epidermis of ‘QY1’. The anthocyanin concentration in the root, stem, leaf, flower, and tuber epidermis of ‘QY1’ was higher than in ‘QY3’, especially tuber epidermis. Correspondingly, HtMYB2 had greater expression in these tissues of ‘QY1’ than in ‘QY3’. The expression of HtMYB2 was associated with anthocyanin accumulation in the different tissues. Overexpression of HtMYB2 activated the anthocyanin biosynthesis pathway, accumulating the pigment in leaves of transgenic tobacco, supporting the model that HtMYB2 regulated anthocyanin biosynthesis. Further experiments found that HtMYB2 had the same coding sequence and genomic sequence in ‘QY1’ and ‘QY3’, but that there were several single nucleotide polymorphisms and one insertion–deletion (indel) mutation of 21 nucleotides in the promoter region between the two alleles. The deletion of three nucleotides “AAA” made the promoter of ‘QY1’ predicted to contain one more possible promoter region. A specific primer, based on the indel, could differentiate between cultivars with red or white tuber epidermis. The genetic variation in HtMYB2 was associated with the tuber skin color in a natural population.Conclusions: RNA-seq can successfully isolate the candidate gene (HTMYB2) controlling anthocyanin biosynthesis in purple epidermis of Jerusalem artichoke tuber. HTMYB2 can regulate anthocyanin biosynthesis in plants and is closely related to the formation of purple phenotype in tubers. This study should be useful in understanding the genetic mechanism underlying different tuber skin colors and in breeding new H. tuberosus cultivars with different tuber skin colors.
In Vitro Hypoxia Responsiveness of [18F]FDG and [18F]FAZA Retention: Influence of Shaking Versus Stagnant Conditions, Glass Versus Polystyrene Substrata and Cell Number Down-Scaling
Authors: Busk Morten , Horsman Michael R , Overgaard Jens , Jakobsen Steen
Published: June 2020

Background. In vitro experiments using radiolabeled molecules is fundamental for Positron emission tomography (PET) or single photon emission computed tomography (SPECT) tracer development and various metabolic assays, but no consensus on appropriate incubation conditions exists. Specifically, the use of shaking versus non-shaking conditions, cell number to medium volume and the choice of cell plating material may unintentionally influence cellular oxygenation and medium composition. This is problematic when testing the oxygen-dependence of tracers including 18F-fluoro-2-deoxyglucose ([18F]FDG) and hypoxia-selective 2-nitroimidazoles (e.g., 18F-fluoroazomycin-arabinoside, [18F]FAZA) or when doing prolonged experiments. The purpose of this study was to assess the influence of various experimental conditions on tracer retention. Methods. Tumor cells were seeded in a) Glass or standard Polystyrene Petri dishes or as b) discrete droplets in polystyrene Petri dishes or on 9 mm glass coverslips positioned in glass Petri dishes. When confluent, cells were pre-equilibrated for 2h to 21%, 0.5% or 0% O2 and [18F]FDG or [18F]FAZA was added, followed by cell harvest and analysis of radioactivity 1h ([18F]FDG) or 3h ([18F]FAZA) after. Experiments were conducted with/without orbital shaking. Results. The influence of hypoxia on tracer retention varied widely among cell lines, but shaking-induced convection did not influence uptake. In contrast, hypoxia-driven [18F]FAZA, and to some extent [18F]FDG, retention was much lower in cells grown on polyethylene than glass. Scaling-down the number of cells did not compromise accuracy. Conclusions. Tracer retention was similar under stagnant and forced convection conditions suggesting that the former approach may be appropriate even when accurate control of oxygen and tracer availability is required. In contrast, conventional plasticware should be used with caution when studying tracers and drugs that are metabolized and retained or activated at low O2 levels. Downscaling of cell number, by reducing the effective growth area, was feasible, without compromising accuracy.
A knowledge-based intensity-modulated radiation therapy treatment planning technique for locally advanced nasopharyngeal carcinoma radiotherapy
Authors: Bai Penggang , Weng Xing , Quan Kerun , Chen Jihong , Dai Yitao , Xu Yuanji , Lin Fasheng , Zhong Jing , Wu Tianming , Chen Chuanben
Published: June 2020

BackgroundTo investigate the feasibility of a knowledge-based automated intensity-modulated radiation therapy (IMRT) planning technique for locally advanced nasopharyngeal carcinoma (NPC) radiotherapy.Methods140 NPC patients treated with definitive radiation therapy with the step-and-shoot IMRT techniques were retrospectively selected and seperated into a knowledge library (n=115) and a test library (n=25). For each case, in the knowledge library, the patient’s overlap volume histogram (OVH), target volume histogram (TVH) and dose objectives were extracted from the manually generated plan to train a 3-layer neural network (NN) machine learning model. For patients in the test library, their OVH and TVH were then used by the trained model to predict a corresponding set of dose objectives, which were subsequently used to generate automated plans (APs) in Pinnacle planning system via an in-house developed automated scripting system. All APs were obtained after a single step of optimization. Manual plans (MPs) of the same test patients were generated by an experienced medical physicist strictly following the established clinical protocols. The qualities of the APs and MPs were evaluated by an attending radiation oncologist. The dosimetric parameters for planning target volume (PTV) coverage and the organs-at-risk (OAR) sparing were also quantitatively measured and compared.ResultsAPs and MPs had the same rating for more than 80% of the patients (19 out of 25) in the test group. For greater than 80% of the patients, both AP and MP achieved PTV coverage criteria. For each OAR, the number of APs achieving its criterion was similar to that in the MPs. The AP approach significantly improved planning efficiency by reducing the planning duration to about 17% of the MP (9.73±1.80 min vs. 57.10±6.35 min, P<0.001). ConclusionA robust and effective knowledge-based IMRT treatment planning technique for locally advanced NPC is developed. Patient specific dose objectives can be predicted by a trained NN model based on the individual’s OVH and clinical TVH goals. The automated planning scripts can use these dose objectives to efficiently generate APs with largely shortened planning time. These APs had comparable dosimetric qualities when compared to our clinic’s manual plans.
Prediction of deep vein thrombosis by ultrasonography and D-dimer in Asian patients with ischemic stroke
Authors: Ha Sang Hee , Kim Yeon-Jung , Heo Sung Hyuk , Chang Dae-il , Kim Bum joon
Published: June 2020

Background: Deep vein thrombosis (DVT) is an important complication of ischemic stroke, although the incidence of DVT is regarded as being lower in Asian than in non-Asian patients. Here, we investigated the incidence and factors associated with DVT in Asian patients with ischemic stroke.Methods: Acute ischemic stroke patients received lower extremity ultrasonography (LEUS) to diagnose the presence of DVT. Clinical characteristics and laboratory results, including D-dimer level, were compared between patients with and without DVT. Independent risk factors for DVT were investigated using multivariable analysis. Similar analysis was performed to identify factors associated with elevated D-dimer level (>0.5 mg/dl) in acute ischemic stroke patients.Results: During the study period, 289 patients were enrolled, and 38 (13.1%) showed DVT. Female sex (OR=2.579, 95% CI=1.224–5.432; p=0.013) and a high National Institutes of Health Stroke Scale (NIHSS) score (OR=1.191 95% CI=1.095–1.294; p=0.005) were independently associated with the presence of DVT, although D-dimer level was not. Stroke mechanism, especially cardioembolic stroke (OR=3.777, 95% CI=1.532–9.313; p=0.004; reference: large artery atherosclerosis), NIHSS score (OR=1.087, 95% CI=1.002–1.179; p=0.001) and thrombolysis (OR=12.360, 95% CI 2.456-62.213; p=0.002) were independently associated with elevated abnormal D-dimer levels.Conclusion: The severity of ischemic stroke, but not the D-dimer level, was associated with the presence of DVT in Asian ischemic stroke patients. D-dimer level was influenced by the stroke mechanism. LEUS in patients with severe neurological deficit, rather than screening with D-dimer, may be more beneficial for diagnosing DVT in Asian patients with acute ischemic stroke.
Bioassay and molecular monitoring of insecticide resistance status in Aedes albopictus populations from Greece, to support evidence-based vector control
Authors: Balaska Sofia , Fotakis Emmanouil Alexandros , Kioulos Ilias , Grigoraki Linda , Mpellou Spyridoula , Chaskopoulou Alexandra , Vontas John
Published: June 2020

Background: Aedes albopictus has a well-established presence in southern European countries, associated with recent disease outbreaks (e.g. Chikungunya). Development of insecticide resistance in the vector is a major concern as its control mainly relies on the use of biocides. Data on the species’ resistance status is essential for efficient and sustainable control. To date the insecticide resistance status of Ae. albopictus populations from Greece against major insecticides used in vector control remains largely unknown.Methods: We investigated the insecticide resistance status of nineteen Ae. albopictus populations from eleven regions of Greece. Bioassays were performed against diflubenzuron (DFB), B. thuringiensis var. israelensis (Bti), deltamethrin and malathion. Known insecticide resistance loci were molecularly analysed, i.e. voltage-gated sodium channel (VGSC) mutations associated with pyrethroid resistance; presence and frequency of carboxylesterases 3 (CCEae3a) and 6 (CCEae6a) gene amplification associated with organophosphate (OP) resistance and; chitin synthase-1 (CHS-1) for the possible presence of DFB resistance mutations. Results: Bioassays showed full susceptibility to DFB, Bti and deltamethrin, but resistance against the OP malathion (range of mortality: 55.30-91.40%). VGSC analysis revealed a widespread distribution of the mutations F1534C (in all populations, with allelic frequencies between 6.6% - 68.3%), and I1532T (in 6 populations; allelic frequencies below 22.70%), but absence of V1016G. CCE gene amplifications were recorded in 8 out of 11 populations (overall frequency: 33%). Co-presence of the F1534C mutation and CCEae3a amplification was reported in 39 of the 156 samples analysed by both assays. No mutations at the CHS-1 I1043 locus were detected.Conclusions: The results indicate: (i) the suitability of larvicides DFB and Bti for Ae. albopictus control in Greece, (ii) possible incipient pyrethroid resistance due to the presence of kdr mutations and (iii) possible reduced efficacy of OPs, in a scenario of re-introducing them for vector control. The study highlights the need for systematic resistance monitoring for developing and implementing appropriate evidence-based control programs.Key words: diagnostic, bioassay, arbovirus, vector control, mosquito tiger, insecticide resistance, kdr, Bti, gene amplification
Usefulness of exercise for home blood pressure control in people with diabetes: A study protocol for a crossover randomized controlled trial
Authors: Iwai Keiko , Ushigome Emi , Yokota Isao , Majima Saori , Nakanishi Naoko , Hashimoto Yoshitaka , Okada Hiroshi , Senmaru Takafumi , Hamaguchi Masahide , Asano Mai , Yamazaki Masahiro , Fukui Michiaki
Published: June 2020

Background: The coexistence of hypertension and diabetes mellitus significantly increases the risk of macrovascular complications in patients with diabetes. Blood pressure at home is important because it is more strongly associated with target organ damage and total mortality than clinic blood pressure measurements. Regular moderate aerobic exercise has antihypertensive effects. This study aims to examine the effect of aerobic exercise therapy on blood pressure at home in patients with diabetes. Methods: In this crossover randomized controlled trial, 110 patients with type 2 diabetes will be randomly assigned to two groups: an exercise preceding group and an exercise lagging group. During the exercise period, patients will be instructed to walk either 30 minutes twice each day or 60 minutes once each day for at least three days per week. During the non-exercise period, patients will be permitted to perform physical activity associated with activities of daily life. Patients will be followed up for 56 days. The primary outcome will be the mean nocturnal blood pressure from day 24 to 28 during the exercise period compared to that during the non-exercise period. The secondary outcome will include variation in nocturnal blood pressure, mean blood pressure values and variation of morning and evening blood pressure from day 24 to 28 in the exercise period compared to the non-exercise period, body weight, body mass index and bioelectrical impedance analysis. Biochemical tests such as hemoglobin A1c level, blood glucose level, serum lipid profile, renal function, uric acid levels, liver function tests and urinary albumin excretion level will also be measured.Discussion: This randomized controlled trial will provide critical information regarding the effectiveness of moderate exercise on nocturnal blood pressure reduction. If successful, the results of this randomized controlled trial may increase exercise motivation in people with diabetes and may lead to improvement or prevention of target organ damage and overall mortality.Trial registration: Trial registration: University Hospital Medical Information Network, UMIN 000035973. Protocol version number: R000040969. Registration date: February 22, 2019. Recruitment began: June 19, 2019. The estimated date of completion of recruitment: March 31, 2021. URL: http://www.umin.ac.jp
Intervention fidelity and its determinants of focused antenatal care package implementation, in South Wollo Zone, Northeast Ethiopia.
Authors: Tessema Asressie Molla , Gebeyehu Abebaw , Mekonnen Solomon , Alemu Kassahun , Tigabu Zemene
Published: June 2020

Background: Studies show home and community-based implementation of intervention packages have significantly reduced neonatal mortality particularly in resource constrained settings. However, due to evidence-practice gap, thousands of neonates are still losing their lives every day mostly from preventable causes. This study aimed to assess focused antenatal care package intervention fidelity and its determinant factors in South Wollo Zone, Northeast Ethiopia. Methods: A cross-sectional study design was employed and a total of 898 mothers who gave birth in the last six months prior to data collection were included. Also sixteen health extension workers who were working in the health posts (n=10) selected for facility audits were included. Interview and self-administered questionnaires were used to collect data from mothers and health extension workers, respectively. Facility audits were used to assess the availability and functionality of required drugs and supplies for the health posts. Mothers were asked whether or not the required level of care were provided to them. Health extension workers were provided self-administered questionnaires to assess socio-demographic characteristics, reception of trainings, facilitation strategies and ability to classify danger signs. A multilevel linear regression analysis was performed to identify the individual and organizational levels factors influencing focused antenatal care package intervention fidelity. Results: The overall weighted average focused antenatal care package intervention fidelity was 49.78% (95% CI: 47.73 – 51.83). Of these, 62.02% (95% CI: 59.71 – 64.32) was provided by health extension workers and 56.57% (95% CI: 53.94 – 59.19) by skilled providers (nurses, midwifes, health officers or medical doctors). The overall antenatal care coverage was 83.7% (95% CI: 81.28 – 86.12); 34.97% (95% CI: of 31.56 – 38.39) of them received at least four antenatal visits and 6.12% (95% CI: 4.40-7.83) received all the recommended components of focused antenatal care. Previous pregnancy-related medical problems, paternal education, and implementation of supportive/facilitation strategy were found to be significant facilitators of focused antenatal care package intervention fidelity.Conclusion: Focused antenatal care package intervention fidelity in the study area was low, which may contribute to the stagnation of neonatal mortality reduction. Improving the implementation of facilitation strategies is highly required to produce a positive result in neonatal mortality reduction.
Comparison of three treatment methods for simple bone cyst in children
Authors: Zhang Ke Xue , Chai Wei , Zhao Jia Jia , Deng Jun Hao , Peng Zhan , Chen Ji Ying
Published: June 2020

Background
To evaluate the efficacy of the elastic stable intramedullary nail (ESIN), the injection of autologous bone marrow (ABM) and the combination of ESIN and ABM in the treatment of children simple bone cyst.
Methods
83 children with simple bone cyst were analyzed retrospectively. 28 cases were treated with ABM. 28 cases were treated with ESIN. 27 cases were treated with ABM combined with ESIN. All cases were diagnosed through X-ray plains, CT or MRI scans. For the suspicious ones, pathological biopsy was performed for an accurate diagnosis. X-ray examination were carried out for the postoperative follow-up. Capanna criteria for bone cyst was used for the postoperative evaluation of the three methods.
Results
All the cases accomplished the follow-up. The effective rate of ABM + ESIN group was significantly higher than that of the ABM group (P < 0.05), and the cure rates of ESIN group and ABM + ESIN group were higher than that of ABM group (P < 0.05, respectively). The cure time in ESIN group was lower than that of the other two groups (P < 0.05, respectively). The times for admission were 2.0 ± 0.0 in ESIN group, 5.7 ± 1.9 in ABM group and 4.7 ± 2.4 in ABM + ESIN group (P < 0.05 when compared with each other).
Conclusion
The method of ABM combined with ESIN for children bone cyst has the highest effective and curative rate.For individual method, ESIN has a higher effective rate and curative rate than that of ABM with the lowest time of admission.
Knowledge, Attitudes and Practices (KAP) towards pandemic COVID-19 among Syrians
Authors: Ahdab Sanaa Al
Published: June 2020

BackgroundEffective COVID-19 pandemic management requires adequate understanding of factors that influence behavioral changes. This study aims to assess knowledge attitudes and practices towards COVID-19 among the Syrian population in post-conflict context.MethodThis study is based on a cross sectional, web-based survey, conducted among Syrian of 16 years and above. It contains questions on knowledge, attitudes and practices (KAP) of the Syrians with respect to COVID-19. Participants’ demographic characteristics are recorded and analyzed. The study is conducted during the global outbreak of COVID-19.ResultsAmong the 706 participants, more than 85% respondents are aware of the main symptoms of COVID-19 infection and 56.2% know that the virus can be transmitted from ill to healthy persons even without fever symptoms. The overall achieved knowledge score towards the disease is about 60% while attitudes and practices score higher at 63.5% and 73.75%, respectively. The results from multiple linear regression indicate lower knowledge scores are significantly associated with lower education level (P<0.05), whereas poor preventive practices are common among male, young and unemployed participants with significance levels of P<0.01, P=.000, P<0.01, respectively.ConclusionThe findings of this study suggest that Syrians demonstrate modest knowledge, attitudes and practices towards COVID-19 at the time of its global outbreak. Efforts should be directed towards educating Syrians to improve their practices in the current COVID-19 pandemic, as well as for future epidemics.
Hydroxychloroquine for Post-Exposure Prophylaxis of COVID-19 among naval personnel: study protocol for a randomized controlled trial
Authors: Niriella Madunil Anuk , Ediriweera Dileepa Senajith , De Silva Arjuna Priyadarshin , Premarathna Ranjan , Balasooriya Priyantha , Duminda K D , Malavige Neelika Gathsaurie , Wanigasuriya Kamani , Lekamwasam Sarath , Kularathne S A , Siribaddana Sisira , de Silva Hithanadura Janaka , Jayasinghe Saroj
Published: June 2020

Background: The first case of a corona virus 2019 (COVID-19) infection among Sri Lankan was reported on 11th March, 2020. The situation in Sri Lanka changed with the rapid increase of personnel contracting COVID-19 in a Naval base camp that housed more than 4000 people. This provided a unique opportunity to study the effectiveness of hydroxychloroquine (HCQ) for post-exposure prophylaxis (PEP), while taking stringent, non-pharmacologic, public health measures to prevent spread. Our aim is to answer the question “is HCQ effective and safe for PEP among naval personnel with exposure to COVID-19 positive patients?”Methods/design: This is a placebo-controlled, randomized, clinical trial carried out in quarantine centers of the Sri Lanka Navy, Ministry of Defense, Sri Lanka. Navy personnel who are exposed to a patient with confirmed COVID-19 infection but test negative for the virus on reverse, real-time polymerase chain reaction (rRT-PCR) at recruitment will be randomized, 200 to each arm, to receive HCQ or placebo, and monitored for the development of symptoms or rRT-PCR positivity for severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) virus for 14 days. Discussion: This trial will provide high-quality evidence of the efficacy of HCQ as PEP for COVID-19. The study design is unique due to the circumstances of the outbreak in a confined area among otherwise healthy adults, at a relatively early stage of its spread. Trial registration:This trial was registered in the Sri Lanka Clinical Trails Registry (SLCTR) – SLCTR/2020/011 on 04.05.2020 (https://slctr.lk/trials/slctr-2020-011)
‘Recoupling’ the attentional and motor control of preparatory postural adjustments to overcome Freezing of Gait in Parkinson’s
Authors: Maslivec Amy , Fielding Anna , Wilson Mark , Norris Meriel , Young William
Published: June 2020

Objectives

This study examined if people with Parkinson’s and freezing of gait pathology (FoG) could be trained to increase preparatory weight-shift amplitude, and facilitate step initiation during FoG.

Methods

Thirty-five people with Parkinson’s and FoG attempted to initiate forward stepping either during a FoG event (n=17, FoG-F) or following a voluntary stop (n=18, FoG-NF) in a Baseline condition and two conditions where an increased weight-shift amplitude was trained via: i) Explicit verbal instruction, and ii) Implicit movement analogies.

Results

At Baseline , weight-shift amplitudes were smaller during: i) unsuccessful, compared to successful step initiations (FoG-F group), and ii) successful step initiations in the FoG-F group compared to FoG-NF. Both Verbal and Analogy training resulted in significant increases in weight-shift amplitude in both groups, and a corresponding pronounced reduction in unsuccessful attempts to initiate stepping (FoG-F group).

Conclusions

Hypometric preparatory weight-shifting is associated with failure to initiate forward stepping in people with Parkinson’s and FoG. However, impaired weight-shift characteristics are modifiable through conscious strategies. This current study provides a novel and critical evaluation of preparatory weight-shift amplitudes during FoG events. The intervention described represents an attractive ‘rescue’ strategy and should be further scrutinised regarding limitations posed by physical and cognitive deficits.
A comparative study of multimodal MR in the differential diagnosis of AIDS-related central nervous system lymphoma and infection
Authors: Li Jingjing , Xue Ming , Yan Shuo , Guan Chunshuang , Xie Ruming , Chen Budong
Published: June 2020

Background: To compare the ability of multimodal magnetic resonance(MR) to differentiate acquired immune deficiency syndrome-related(AIDS-related) central nervous system lymphoma (ARL-CNS) from infection.Methods: Clinical data and multiple MR imaging were analyzed retrospectively. Nine cases of ARL-CNS and ten cases with central nervous system infection were included.Results: In conventional MR, there was a statistical significance in whether the lesion involved the paraventricular/corpus callosum. The Fisher values were 0.020 and 0.033 for the lymphoma and infection groups, respectively. In multimodal MR, there were significant differences in the ADC(apparent diffusion coeffecient) values(high/low) and SWI-ITSS grades between two groups, with pvalues of 0.003, 0.001 and 0.001. The sensitivity, specificity and accuracy of conventional MR in the diagnosis of ARL-CNS were 88.9%, 70.0% and 78.9%, respectively. The conventional sequence combined with the DWI/ADC sequence in the diagnosis of ARL-CNS had a sensitivity of 100.0%, a specificity of 60.0% and an accuracy of 78.9%. The sensitivity, specificity and accuracy of the conventional sequence combined with the SWI-ITSS sequence in the diagnosis of ARL-CNS were 100%, 70.0% and 84.2%, respectively.Conclusion: Multimodal MR is of great value in distinguishing ARL-CNS from infection.
Associations of Socioeconomic Factors with Cause-specific Mortality and Burden of Cardiovascular Diseases: Findings from the Vital Registration in Urban Shanghai, China, during 1974-2015
Authors: Zhang Lijuan , Li Qi , Han Xue , Wang Shuo , Li Peng , Ding Yibo , Zhang Tao , Zhao Jia , Chen Yifan , Liu Jiluo , Li Jue , Tan Xiaojie , Liu Wenbin , Zhang Rong , Cao Guangwen
Published: June 2020

Background: Cardiovascular disease (CVD) is the leading cause of mortality worldwide. The effect of socioeconomic factors on cause-specific mortality and burden of CVD is rarely evaluated in low- and middle-income countries, especially in a rapidly changing society.Methods: Original data were derived from the vital registration system in Yangpu, a representative, population-stable district of urban Shanghai, China, during 1974-2015. Temporal trends for the mortality rates and burden of CVD during 1974-2015 were evaluated using Joinpoint Regression Software. The burden was evaluated using age-standardized person years of life loss per 100,000 persons (SPYLLs). Age-sex-specific CVD mortality rates were predicted by using age-period-cohort Poisson regression model.Results: A total of 101,822 CVD death occurred during 1974-2015, accounting for 36.95% of total deaths. Hemorrhagic stroke, ischemic heart disease, and ischemic stroke were the 3 leading causes of CVD death. The age-standardized CVD mortality decreased from 144.5/100,000 to 100.7/100,000 in the residents (average annual percentage change [AAPC] -1.0, 95% confidence interval [CI] -1.7 to -0.2), which was mainly contributed by women (AAPC -1.3, 95% CI -2.0 to -0.7), not by men. Hemorrhagic stroke, the major CVD death in the mid-aged population, decreased dramatically after 1991. The crude mortality of ischemic heart disease kept increasing but its age-adjusted mortality decreased continually after 1997. SPYLLs of CVD death increased from 1974 to 1986 (AAPC 2.1, 95% CI 0.4 to 3.8) and decreased after 1986 (AAPC 1.8, 95% CI -2.3 to -1.3). These changes were in concert with the implementation of policies including extended medical insurance coverage, pollution control, active prophylaxis of CVD including lifestyle promotion, and national health programs. The mortality of CVD increased in those born during 1937-1945, a period of the Japanese military occupation, and during 1958-1965, a period including the Chinese Famine. Sequelae of CVD and ischemic heart disease are predicted to be the leading causes of CVD death in 2029.Conclusions: Exposure to serious malnutrition in early life might increase CVD mortality in later life. Improvements in medical services, pollution control, and lifestyle could decrease CVD death. New strategy is needed to prevent the aging-related CVD death and burden in the future.
Spectrum Sensing in Cognitive Radio Networks: Threshold Value Optimization and Analysis
Authors: KOÇKAYA Kenan , DEVELİ İbrahim
Published: June 2020

Cognitive radio is a technology developed for the effective use of radio spectrum sources. The spectrum sensing function plays a key role in the performance of cognitive radio networks. In this study, we propose an online learning algorithm for the energy detection scheme, which aims to maximizing spectrum detection performance. Optimal threshold value, which is critical for the determination of the absence or the presence of a licensed user, was mathematically expressed in accordance with the balance between probability of detection and probability of false alarm. Performance of the proposed algorithm was tested on non-fading and different fading channels for low signal-to-noise ratio (SNR) regime with noise uncertainty. In conclusion of the simulation studies, improvement in spectrum detection performance according to optimal threshold value selection was observed.
The Individualized Selection of Pancreaticoenteric Anastomosis in Pancreaticoduodenectomy
Authors: Jin Ke-Min , Liu Wei , Wang Kun , Bao Quan , Wang Hong-Wei , Xing Bao-Cai
Published: June 2020

Background: The mortality following pancreaticoduodenectomy has markedly decreased but remains an important challenge for the complexity of operation and technical skills involved. The present study aimed to clarify the impact of individualized pancreaticoenteric anastomosis and management to postoperative pancreatic fistula.Methods: Data from 529 consecutive pancreaticoduodenectomies were retrospectively analysed from the Hepatobiliary and Pancreatic Surgery Unit I, Peking Cancer Hospital. The pancreaticoenteric anastomosis was determined based on the pancreatic texture and diameter of the main pancreatic duct. The amylase value of the drainage fluid was dynamically monitored postoperatively on days 3, 5 and 7. A low speed intermittent irrigation was performed in selected patients. Intraoperative and postoperative results were collected and compared between the pancreaticogastrostomy (PG) group and pancreaticojejunostomy (PJ) group.Results: From 2010 to 2019, 529 consecutive patients underwent pancreaticoduodenectomy. Pancreaticogastrostomy was performed in 364 patients; pancreaticojejunostomy was performed in 150 patients respectively. The clinically relevant pancreatic fistula (CR-POPF) was 9.8% and mortality was zero. The soft pancreas, diameter of main pancreatic duct≤3mm, BMI≥25, operation time>330min and pancreaticogastrostomy was correlated with postoperative pancreatic fistula significantly. The CR-POPF of PJ was significantly higher than that of PG in soft pancreas patients; the operation time of PJ was shorter than that of PG significantly in hard pancreas patients. Intraoperative blood loss and operation time of PG was less than that of PJ significantly in normal pancreatic duct patients (p<0.05).Conclusions: Individualized pancreaticoenteric anastomosis should be determined based on the pancreatic texture and pancreatic duct diameter. The appropriate anastomosis and postoperative management could prevent mortality.
LncRNA FAM83H-AS1 Promotes Aerobic Glycolysis and Tumor Progression by Regulating miR-4684-5p/ZBTB38 Axis in Esophageal Squamous Cell Carcinoma
Authors: Qian Cuijuan , Xu Zhurong , Chen Luyan , Wang Yichao , Yao Jun
Published: June 2020

Background: Dysregulation of lncRNAs is implicated in esophageal squamous cell carcinoma (ESCC) progression; However, the precise function of lncRNA FAM83H-AS1 in ESCC remains unknown. Methods: FAM83H-AS1, miR-4684-5p and ZBTB38 mRNA expressions were detected via qRT-PCR. ZBTB38, GLUT1 and LDH-A protein expressions were tested via Western blot. Cell proliferation, migration and invasion were evaluated via CCK-8 and transwell assay, respectively. A nude mouse xenograft model was used to investigate the role of FAM83H-AS1 in xenograft ESCC growth. The metabolic shift in ESCC cells was examined via glycolysis analysis. The interaction between FAM83H-AS1, miR-4684-5p and ZBTB38 was analyzed via computational algorithms, RNA pull-down, RIP and dual luciferase reporter assay. Results: We found that FAM83H-AS1 was upmodulated in ESCC cell lines. FAM83H-AS1 knockdown hampered ESCC cell proliferation, migration, invasion and aerobic glycolysis, while FAM83H-AS1 overexpression demonstrated the opposite effects. FAM83H-AS1 knockdown also delayed the tumor growth in vivo. Moreover, FAM83H-AS1 interacted with miR-4684-5p/ZBTB38 axis in ESCC cells. ZBTB38 overexpression or miR-4684-5p inhibition partially reversed the inhibitory effect of FAM83H-AS1 knockdown on cell migration, invasion and aerobic glycolysis in ESCC cells. Conclusion: Our present results indicate FAM83H-AS1 accelerated aerobic glycolysis and tumorigenesis of ESCC by sponging miR-4684-5p and triggering the expression of ZBTB38, providing new insights into mechanism of ESCC progression and therapeutic strategy.
Novel use of pop-up satellite archival telemetry in sawsharks: insights into the movement of the common sawshark Pristiophorus cirratus (Pristiophoridae)
Authors: Burke Patrick J , Mourier Johann , Gaston Troy F , Williamson Jane E
Published: June 2020

Background
Understanding movement patterns of a species is vital for optimising conservation and management strategies. This information is often difficult to obtain in the marine realm for species that regularly occur at depth. The common sawshark (Pristiophorus cirratus) is a small, benthic associated elasmobranch species that occurs from shallow to deep-sea environments. No information is known regarding its movement ecology. Despite this, P. cirrata are still regularly landed as nontargeted catch in the south eastern Australian trawl fisheries. Three individuals were tagged with pop-up satellite archival tags (PSATs) off the coast of Tasmania, Australia, to test the viability of satellite tagging on these small elasmobranchs and to provide novel insights into their movement.
Results
Tags were successfully retained for up to three weeks, but movement results differed on an individual basis. All three individuals displayed a post-release response to tagging and limited vertical movement was observed for up to 5–7 days post-tagging. Temperature loggers on the tags suggest the animals were not stationary but moved horizontally during this time, presumably in a flight response. After this response, continuous wavelet transformations identified diel vertical movements in one individual at cyclical intervals of 12- and 24-hour periods, however, two others did not display as clear a pattern. Temperature was not significantly correlated with movement in the study period. The deepest depths recorded during the deployments for all individuals was approximately 120 meters and the shallowest was 5 meters.
Conclusions
This study demonstrates that sawsharks can be successfully tagged by pop-up satellite archival tags. The data presented here show that sawsharks regularly move both horizontally and vertically in the water column, which was an unexpected result for this small benthic species. Additional research aimed at resolving the trophic ecology will help identify the drivers of these movements and help to better define the ecological, behavioural and physiological roles of these sharks in their ecosystems. These data describe a substantial ability to move in the common sawshark that was previously unknown and provides the first account of movement ecology on the family of sawsharks: Pristiophoridae.