bluuebunny/crossref_metadata_2025 huggingface dataset:
First in Russia Multistage Fracturing Job with Sand Screen Completion in Poorly Consolidated Formation
Authors: Konopelko Aleksey , Shirobokov Anton , Pustovalov Mikhail , Melnikov Maxim , Bakin Mikhail
Published: October 2020

Multistage fracturing is widely used in Western Siberia for stimulation of a wide variety of formations from "Ryabchik" (relatively shallow highly layered sandstone formation in the Samotlor Field) to Achimov (a high pressure, high temperature formation of tight sandstone). One of the formation groups that is not typically stimulated by fracturing is a Pokur formation series. A typical Pokur reservoir is an unconsolidated heavy oil bearing sandstone reservoir of Cennomanian age, and the reason for not using fracturing on these formations is the numerous geological and technological risks.

This paper focuses on the first successful experience of multistage fracturing of the Pokur reservoir with a completion system equipped with both sand screens and frac sleeves in the Vostochno-Messoyakhskoe Field.

This paper is a continuation of papers SPE-187682 and SPE-191477. The results of pilot projects described in these papers enabled a high-tech and complex operation of multistage fracturing in complicated well conditions of Pokur reservoirs with a completion system optimized for these conditions. This application required high caliber engineering along with careful planning and preparation to be successful.

Despite the high number of completion systems that combine both sand screen and frac sleeve technology available on the market, successful implementation of such systems was previously impossible. The reasons for this were equipment design limitations, high complexity of screens and sleeves operation, and high cost due to foreign origin of the equipment. These limitations we overcome through optimization of the permanent and service equipment deployed. Localization of the products significantly reduced the cost of tools.
Proppant Transport Capabilities of High-Viscosity Friction Reducers at Relatively Low Rates: Advanced Modeling and Field Validation
Authors: Abdrazakov Dmitriy , Juldugulov Yeltay , Kruglov Ruslan , Pavlova Svetlana , Vereschagin Sergei , Chuprakov Dimitry , Ivanov Valentin
Published: October 2020

High-viscosity friction reducers (HVFR) have been actively studied and implemented recently in fracturing as a proppant carrier fluid in unconventional reservoirs due to advantages over crosslinked fluids and linear gels. The vast majority of the known studies are performed in unconventional jobs, where pumping rates are significantly higher than in conventional fracturing treatments. A study was designed to answer the question how an HVFR can be used effectively in conventional treatments deep wells.

The analysis was based on a propped fracturing case study in a deep live annulus well completed with relatively small inside diameter (ID) fracturing string. High friction, significant depth, low reservoir permeability, and abnormal pressure indicate that HVFR can be a replacement for the conventional heavy crosslinked gel under certain conditions. Thorough laboratory testing was performed to optimize the recipe of the HVFR for the given conditions. After analysis of the injection and calibration tests, the obtained HVFR efficiency, friction, and downhole behavior were used to optimize the main treatment. The fracturing was performed successfully, placing 26 tons of proppant into the fracture.

Analysis of the treatment was performed in an advanced fracturing simulator with multi-physics model that is capable of modeling the complex proppant transport and redistribution processes within the fracture. Simulation results revealed that towards the end of the treatment, the increased concentration of the proppant resulted in accelerated proppant settling at the fracture bottom, leading to the step-like pressure-out. Treatment results and post-treatment simulations revealed that at given rates (15 to 17 bbl/min) and HVFR efficiency (∼21%), the carrying capacity of the HVFR is enough to place 26 tons of proppant at maximum concentration of 3.5 to 4.0 PPA with 28 to 30% pad percentage. The calibrated model showed that the created fracture has an effective half-length of about 75 m, fracture height of 50 m, and dimensionless fracture conductivity approximately equal to 4.5. A new fracture flowback optimization software was used to estimate the set the limits for drawdown during cleanup; the amount of the predicted proppant flowback (<100 kg) was proved by the top-of-proppant tag.
Tickborne disease awareness and protective practices among U.S. Forest Service employees from the Upper Midwest, USA
Authors: Schotthoefer Anna , Stinebaugh Kathryn , Martin Michael , Munoz-Zanzi Claudia
Published: October 2020

Background: People with occupations that require them to spend time working outdoors in suitable tick habitats are predicted to be at an increased risk for tick-borne diseases (TBDs). However, few studies have assessed the risks of outdoor employees in the United States.Methods: We conducted a cross-sectional survey to collect data on exposure to ticks and TBD infections among U.S. Forest Service employees in a high TBD incidence region of northern Wisconsin, and to examine employee knowledge, attitudes, and practices (KAPs) regarding TBDs to help guide future education and prevention programs. Chi-square contingency tables, calculations of odds ratios, and logistic regression models were used to identify associations among self-reported employee factors, the proportion of correctly answered knowledge questions, their ranked concern for TBDs, adherence to practicing preventive behaviors, and willingness to pay for protective measures. Results: Ninety-five employees completed the survey. Nearly all respondents (97%) reported recent tick exposure, with 27% reporting encountering 10 or more ticks per week during peak tick season. Employee knowledge of TBD was high (median score: 80% correct). Fifty-nine percent of respondents had high concern for TBDs, and there was high adherence to conducting body checks for ticks (83% reported always doing them), but only moderate use of tick repellents (24% reported always and 60% reported occasionally using). High concern for TBD (adjusted odds ratio (aOR) = 6.32 [95% confidence intervals: 1.97 – 20.28]), a history of TBD diagnosis (aOR = 5.88 [1.41-24.55]), and older age (≥ 46 years) (aOR = 3.29 [1.00 – 10.84]) were positively associated with high practice adherence. Respondents suggested they would be willing to pay for personal protective methods and get a hypothetical vaccine for Lyme disease, but not community-wide efforts to control ticks. Conclusions: Our study provides evidence that U.S. Forest Service employees in Wisconsin represent a high risk group for TBD, and despite relatively high TBD knowledge and engagement in tick protection activities, efforts are needed to reduce their risks for tick bites. More generally, our findings suggest that studies to better understand the factors related to the adoption and effectiveness of public health interventions are needed.
Smoking and Incidence of Insomnia: a systematic review and meta-analysis of cohort studies
Authors: Hu Nan , Wang Chunyi , Liao Yan , Dai Qichen , Cao Shiyi
Published: October 2020

Background: Both smoking and insomnia are worldwide problems and this study aims to investigate the impact of smoking on the incidence of insomnia. Methods: PubMed, EMBASE and OVID were searched through March, 2020. Cohort studies reporting the effect of smoking on the incidence of insomnia were included. We quantitatively analyzed the basic framework and study characteristics, and then pooled estimate effects with 95% confidence intervals (CIs) of outcomes of each included studies using fixed-effects meta-analyses. Results: This systematic review included six cohort studies involving 12445 participants. Quantitatively summarized results suggested smoking could significantly increase the incidence of insomnia (OR: 1.07, 95%CI: 1.02,1.13). Regular smoking was significantly associated with incidence of insomnia (OR=1.07, 95% CI:1.01,1.13). As for occasional smokers and ex-smokers, the pooled analysis didn’t indicate a significant association (occasional smoker: OR=2.09, 95% CI:0.44,9.95; ex-smoker; OR=1.02, 95% CI:0.67,1.54). Subgroup analysis by age, gender ratio and region showed statistically significant relationship between smoking and incidence of insomnia in specific groups. Conclusions: Integrated longitudinal observational evidence identified smoking as a significant risk factor of insomnia. Considering the limited amount of available studies, more high-quality and prospective cohort studies of large sample sizes are needed to explore details of this association.
Empowering Healthcare Volunteer’s through Participatory Action Research in a Comprehensive Healthcare Center
Authors: Vizeshfar Fatemeh , Momennasab Marzieh , Yektatalab Shahrzad , Iman Mohamad Taghi
Published: October 2020

Background: healthcare volunteers act as the link between the society and the healthcare system and are a symbol of people's participation in health maintenance and promotion. Despite the important role of health volunteers in the health system, it seems they experience several problems. The aim of this study was empowering health volunteers by determining and relining their problems through a participatory approach.Methods: This participatory action research was done through two continuous cycles of reflection and acting for change over 20 months, in a comprehensive health center in Fars province, Southern Iran. 25 health volunteers, two instructors, and academic researchers as facilitator participated in this study. In the first cycle, the participants discovered the challenges of health volunteers prioritized them and an action plan was designed. Immersion and implementation of the plans were done. At the end of this cycle evaluation was done with the participants’ cooperation. The second cycle began with reflecting on the results of the first cycle and final evaluation was done. Results: Qualitative content analysis in the first phase led to the emergence of four major categories, including inefficiency of volunteers training, inefficiency of attraction and maintenance of volunteers, and being unknown to people and the major theme was named “unfertilized capacity”. After the implementation of the operational plan, the participants learned through reflection and immersing in action. Finally, quantitative content and data analysis showed improvement of knowledge and performance, satisfaction, effectiveness of programs and improvement in volunteer’s competence.Conclusions: Clarification of the volunteers’ roles, and supporting volunteers to improve their knowledge and skills with coherent planning based on their educational needs, are appropriate management plans to attract and retain volunteers. By presenting their services to the society, they will be empowered and motivated to continue.
Iodine Nutritional Status and Thyroid volume of School-Aged Children in Wuhan, central of China
Authors: Chen Fang , Wu Kai , Yang Yan , Xu Mingxing
Published: October 2020

Background/Aims:

Iodine deficiency is a public health problem over the world. China has achieved the iodine deficiency disorders (IDD) elimination goal through a mandatory universal salt iodization (USI) program. The aim of this study is to assess the current iodine nutritional status and thyroid volume of school-aged children in Wuhan, central of China.
Methods

The cross-sectional study was conducted among 8–10 years old children from 5 districts in Wuhan. A total of 1000 students were investigated. Salt iodine concentrations, urine iodine concentrations were determined using the standardized methods recommended by WHO/ICCIDD. An ultrasonography of thyroid and anthropometric measurements were performed in all subjects.
Results

The median urinary iodine concentration(MUI) of students was 247.50 µg/L with interquartile range of 147.00 to 384.00 µg/L. Two districts were classified as regions with adequate iodine nutrition, two districts as regions above the requirement, and one district as a region excessive according to the MUI. The prevalence of goiter was 3.0% and 7.8% according to Chinese national and WHO reference values, respectively, and the difference was not observed among different iodine nutrition groups(P༞0.05). The median thyroid volume(Tvol) of all students was 2.56 ml and the P97 of thyroid volume of both male and female in our study was generally higher than that reported by WHO/ICCIDD in 2007 as a function of age and BSA. The Tvol was in significant association with age, height, weight and BSA by Spearman’s correlation analysis(P < 0.001),and the result of multivariate linear regression analysis showed that only BSA were found to have a significant effect on thyroid volume after log conversion (t = 13.437, P < 0.001).
Conclusion

The present study indicated that the iodine nutrition among school-aged children in Wuhan was generally adequate with a relatively low goiter rate, while some of them have excess iodine nutrition. Thyroid volume in our study was higher than the reference of WHO and showed a significant correlation with BSA. So further researches were needed to evaluate the thyroid function in children with iodine excessive and the applicability of WHO reference in goiter diagnose. It was also highly recommended to establish the local reference values for thyroid volume that might be applicable to precisely define goiter prevalence in Wuhan.
The BAG2 and BAG6 Genes are Involved in Multiple Abiotic Stress Tolerance in Arabidopsis Thaliana
Authors: Arif Muhammad , Li Zitong , Luo Qiong , Li Luhua , Shen Yuequan , Men Shuzhen
Published: October 2020

Background: The BAG (Bcl-2 associated athanogene) family is a multi-functional group of proteins that perform functions ranges from apoptosis to environmental stress tolerance. The BAG proteins are found in yeast, plants and animals. In plants, especially in Arabidopsis thaliana (Arabidopsis), BAG proteins were found to play roles both in abiotic and biotic stresses tolerance including heat, cold, salt, drought, and pathogens. However, the function of Arabidopsis BAG2 remains largely unknown. Whereas BAG6 was found to play important roles in plants response to biotic stresses, it remains unknown whether BAG6 is involved in plants tolerance to abiotic stresses.Results: In this study, we have characterized functions of the Arabidopsis BAG2 and BAG6 genes. Promoter:GUS analysis results show that both BAG2 and BAG6 genes are expressed in various tissues in Arabidopsis thaliana. Expression of both BAG2 and BAG6 genes is induced by salt, mannitol, and heat stress treatments and by the stress-related hormones including ABA, ethylene, and SA, while BAG6 expression is additionally induced by JA. Germination of the bag2 and bag6 single and bag2 bag6 double mutant seeds are less sensitive to ABA than that of the wild type (WT). Both bag2 and bag6 single mutant and bag2 bag6 double mutant show more survival rate than WT in drought treatment but display less survival rate on 45 ℃ heat stress experiment. Consistently, transcription levels of stress-related genes such as RD29A, RD29B and NCED3 are higher in the mutant than that in the WT. Furthermore, these mutants exhibit lower content of reactive oxygen species (ROS) after drought and ABA treatment but higher ROS accumulation after heat treatment than the WT.Conclusion: These results suggest that BAG2 and BAG6 genes are negatively involved in drought stress but play a positive role in heat stress in Arabidopsis.
Paediatric Neurology Patients: Parental Awareness of Adverse Effects of Long-term Corticosteroid Therapy
Authors: Perera UKC , Samarasekara JSEA , Shiwanth HWCK , Mohotti WMD , Sriy KA , Marikar Faiz
Published: October 2020

Background: Corticosteroids are potent medications used to treat in many inflammatory conditions in paediatric neurology practice. Although corticosteroids are beneficial, their adverse effects may be numerous and vary. As parents are the primary caregivers of paediatric patients, assessing their awareness is timely important. Methods: To determine the parental awareness on adverse effects of corticosteroid therapy in Paediatric Neurology Patients in the Neurology Unit at the Lady Ridgeway Hospital, Colombo, Sri Lanka. In this descriptive cross-sectional study, 300 parents of paediatric neurology patients on long-term corticosteroid therapy in the paediatric neurology unit were included. Parents were volunteered for the study and signed informed consent. Ethical approval was obtained from the Ethics Review Committee of the same hospital. Data were collected using content validated, pre-tested self-administered questionnaire during January to March 2020. Results: Of the total parents, the majority were mothers (87%, n=262) and more than 70% (n=211) of them completed their secondary education. Findings demonstrated that parents had average awareness about adverse effects of long-term steroid therapy including child’s susceptibility to infections (69.0%, n=207), increase blood glucose levels (69.7%, n=209), moon face (60.3%. n=181), central obesity (60.3%, n=181), increase blood pressure levels (58.0%, n=174) and (irritability 50.3%, n=151) while poor awareness on adverse effects include buffalo humps (26.7%, n=80) increase fracture tendency (24.3%, n=73), tarry colour stools (24.3%, n=73), vision impairment (24.0%, n=72), glaucoma (17.3%, n=52), cataract (16.0%, n=48 ) and delayed wound healing (23.0%, n=69). According to the findings, overall mean (SD) knowledge percentage on parental awareness of adverse effects was found to be low (38.24 ± 20.57). Conclusion: Since parental awareness of the adverse effects of long-term corticosteroid therapy is inconsistent, special attention is needed to plan and implement appropriate awareness sessions.
WITHDRAWN: Consumer Engagement in Health Care Policy, Research and Services: Methods and Effects.
Authors: Wiles Louise Katherine , Kay Debra , Luker Julie , Worley Anthea , Austin Jane , Ball Allan , Bevan Alan , Cousins Michael , Dalton Sarah , Hodges Ellie , Horvat Lidia , Kerrins Ellen , Marker Julie , McKinnon Michele , McMillan Penelope , de Plaza Maria Alejandra Pinero , Smith Judy , Yeung David , Hillier Susan
Published: October 2020

BackgroundTo assess the effects of consumer engagement in health care policy, research and services.MethodsWe updated a review published in 2006 and 2009 and revised the previous search strategies for key databases (The Cochrane Central Register of Controlled Trials; MEDLINE; EMBASE; PsycINFO; CINAHL; Web of Science) up to February 2020. Selection criteria included randomised controlled trials assessing consumer engagement in developing health care policy, research, or health services. The International Association for Public Participation, Spectrum of Public Participation was used to identify, describe, compare and analyse consumer engagement. Outcome measures were effects on people; effects on the policy/research/health care services; or process outcomes.ResultsWe included 23 randomised controlled trials with a moderate or high risk of bias, involving 136,265 participants. Most consumer engagement strategies adopted a consultative approach during the development phase of interventions, targeted to health services. Based on four large cluster-randomised controlled trials, there is evidence that consumer engagement in the development and delivery of health services to enhance the care of pregnant women results in a reduction in neonatal, but not maternal, mortality. From other trials, there is evidence that involving consumers in developing patient information material results in material that is more relevant, readable and understandable for patients, and can improve knowledge. Mixed effects are reported of consumer-engagement on the development and/or implementation of health professional training. There is some evidence that using consumer interviewers instead of staff in satisfaction surveys can have a small influence on the results. There is some evidence that consumers may have a role in identifying broader range of health care priorities that are complementary to those from professionals. There is some evidence that consumer engagement in monitoring and evaluating health services may impact perceptions of patient safety or quality of life.ConclusionsThere is growing evidence from randomised controlled trials of the effects of consumer engagement on the relevance and positive outcomes of health policy, research and services. Health care consumers, providers, researchers and funders should continue to employ evidence-informed consumer engagement in their jurisdictions, with embedded evaluation. Systematic review registrationPROSPERO CRD42018102595.
Out-of-clinic and Self-managed Abortion in Bangladesh: A Qualitative Study of Menstrual Regulation Providers
Authors: Crouthamel Bonnie , Pearson Erin , Tilford Sarah , Hurst Samantha , Paul Dipika , Aqtar Fahima , Silverman Jay , Averbach Sarah
Published: October 2020

Background: In Bangladesh, abortion is illegal except to save a woman’s life, though menstrual regulation (MR) is permitted. MR involves the use of manual uterine aspiration or Misoprostol (with or without Mifepristone) to induce menstruation up to 10-12 weeks from the last menstrual period. Despite the availability of safe and legal MR services, abortions occur outside of the legal system and are associated with high complication rates. Methods: Qualitative semi-structured interviews (SSIs) were conducted with 25 trained MR providers from urban tertiary care facilities in six different cities in Bangladesh. SSIs explored providers’ attitudes about the practice of unsanctioned MR/abortion providers and self-managed MR/abortion, their experiences treating patients who sought abortion services out-of-clinic, barriers/facilitators to safe MR/abortion, and MR/abortion definitions.Results: There were three predominant yet overlapping themes: (i) logistics of obtaining MR/PAC/abortion, (ii) provider attitudes, and (iii) overcoming barriers to safe MR. Lack of consensus among trained providers revealed challenges for defining MR/abortion and gestational age cutoffs. Increasing post-abortion care (PAC) services may be due to patients purchasing Mifepristone/Misoprostol from pharmacists who do not provide adequate instruction, or patients may be directed to untrained providers by brokers, who intercept patients entering the hospitals/clinics and receive a commission from unsanctioned clinics for bringing patients. Perceived barriers to accessing in-clinic MR include distance, family influence, brokers, lack of knowledge, and provider attitudes toward MR.Conclusions: Providers in urban tertiary care facilities in Bangladesh see primarily the complicated MR/PAC cases, and the safety of out-of-clinic/self-managed abortion is unknown. Lack of standardization among providers of MR definition/gestational age cutoffs may affect patient care and MR access. MR safety may be improved by eliminating brokers. A harm reduction approach to improve MR/abortion care provided by pharmacies may improve safety and access. Policy makers should consider increasing training of frontline health workers, such as Family Welfare Visitors (FWVs) to provide evidence-based information about Mifepristone/Misoprostol.
Short- and long-term recurrence of early-stage invasive ductal carcinoma in middle-aged and old women with different treatments: A nationwide population-based cohort study
Authors: Wu Ying-Jhen , Kao Yuan , Hsu Chien-Chin , Lin Hung-Jung , Wang Jhi-Joung , Weng Shih-Feng , Huang Chien-Cheng
Published: October 2020

Background

Most new cases and the highest mortality rates of breast cancer occur among middle-aged and old women. The recurrence rate of early-stage invasive ductal carcinoma (IDC) among women aged ≥ 50 years and receiving different treatments remains unclear.
Methods

Therefore, this study was conducted to determine these rates. We used Surveillance, Epidemiology, and End Results (SEER) data for this nationwide population-based cohort study. All women aged ≥ 50 years and diagnosed with early-stage IDC between 2000 and 2015 were identified and divided into three treatment groups, namely, breast conservation therapy (BCT), mastectomy alone (MAS), and mastectomy with radiation therapy (MAS + RT). The recurrence rates of IDC among these groups were then compared.
Results

The BCT group had a lower short-term recurrence risk than the MAS and MAS + RT groups (hazard ratio [HR]: 1.00 vs. 2.90 [95% CI: 1.36–2.66] vs. 2.07 [95% CI: 0.97–4.44]); however, the BCT group also had a higher long-term recurrence risk than MAS and MAS + RT groups (HR: 1.00 vs. 0.30 [95% CI: 0.26–0.35] vs. 0.43 [95% CI: 0.30–0.63]). The high long-term recurrence rate of the BCT group was especially prominent at the 10- and 15-year follow-ups.
Conclusion

The results provide valuable evidence of the most reliable treatment strategy for this population. Further studies including more variables and validation in other countries are warranted to confirm our findings.
Hepatoprotective Effect of Qushihuayu Formula on Non-Alcoholic Steatohepatitis Induced by MCD Diet in Rat
Authors: Lan Qingping , Ren Zhitao , Chen Yan , Cui Guozhen , Cheong Choi I. , Yu Hon Ho , Lee Simon Ming-Yuen
Published: October 2020

Background:NASH is developed from NAFLD and there is no proven pharmaceutical therapy for patients. Traditional Chinese medicine formula of Qushihuayu(QSHY) shows strong advantage because of their various bioactive compounds in curing NAFLD and NASH.Methods:Male Wistar rats with six weeks old received methionine-choline- supplemented diet (MCS) diet for 8 weeks as the blank control. Another 7 rats received MCD diet for 6 weeks first and MCS&MCD (1:1) mixture diet for the last 2 weeks as the model group. QSHY Pre-treatment, low dosage, medium dosage and high dosage groups were received the same diet as the model group. Except for pre-treatment group (1 week in advanced of other groups), all QSHY treatment groups received QSHY formula by gavage every day since the MCD diet started.Results:QSHY formula decreased the serum ALT and AST levels, lipid droplets, inflammation foci, FAS and α-SMA protein expression than MCD diet group. MAPK pathways phospharylation are markedly depressed by QSHY formula. Moreover, QSHY formula enhanced PPAR-γ and p-p65 translocating into nucleus. The administration of QSHY increased hepatic mRNA levels of Transcription Factor 1 alpha (HNF1A), Hepatocyte Nuclear Factor 4 alpha (HNF4A) and Forkhead box protein A3 (FOXA3) which play a pivotal role in Hepatic stellate cell (HSCs) reprogramming.Conclusion:These findings suggest that QSHY formula exerts a hepatoprotective effect against steatosis and fibrosis presumably via depressed MAPK pathways phosphorylation, reinforcement of PPAR-γ and p-p65 translocating into nucleus and enhanced HSCs reprogramming.
The Value of Ultrasound Diagnosed Axillary Lymph Node in Avoiding Axillary Surgery in Early Breast Cancer Patients
Authors: Liu Na , Yang Liu , Wang Xinle , Wang Meiqi , Li Ruoyang , Song Zhenchuan
Published: October 2020

Background: Axillary lymph node dissection can be avoided in early stage breast cancer patients with negative sentinel lymph node biopsy. However, the possibility of avoiding axillary surgery in patients without axillary lymph node metastasis (ALNM) by preoperative imaging is still under exploration. Thus, the objectives of this study were to investigate the high-risk factors of false negative of ALNM diagnosed by preoperative ultrasound (US) and to find out who could be avoided axillary surgery in the US negative ALNM patients.Methods: This study retrospectively analyzed 3,361 patients with primary early breast cancer diagnosed in the Breast Center of the Fourth Hospital of Hebei Medical University from January 2010 to December 2012. All patients had undergone routine preoperative US and then axillary lymph node dissected. This study investigated the clinicopathological features of axillary lymph node (ALN) negative patients diagnosed by preoperative US and its correlation with prognosis. The follow-up data for disease-free survival (DFS) and overall survival (OS) were obtained from 2,357 patients. Results: The sensitivity, specificity and accuracy of axillary US in this cohort were 66.24%, 76.62% and 73.87%. The proportion of patients in the false negative group was higher than that in true negative in the group of age < 50 years old (P = 0.002), tumor size > 2cm (P = 0.008), estrogen receptor (ER) positive (P = 0.005), progesterone receptor (PR) high expression (P = 0.007), nuclear-associated antigen Ki-67 (Ki-67) >20% (P = 0.030), visible vascular tumor thrombus (P < 0.001) and histological grade>2 (P < 0.001). Prognostic analysis of false negative and true negative ultrasonographic diagnosis of ALN metastasis: when ALNM was not found by preoperative ultrasound, there was no significant difference in patients with ALNM≤3 compared with patients without lymph node metastasis in patients of age ≥ 50 years old, tumor size ≤ 2cm, Ki-67 ≤ 20%, or histological grade ≤ 2. Conclusion: The surgery of ALN may be avoided for the preoperative US diagnosed ALNs negative in early breast cancer patients who had advanced age, small tumor size, low expression of Ki-67 and low histological grade.
Clinical Characteristics and Prognosis of Ovarian Clear Cell Carcinoma: A 10-Year Retrospective Study
Authors: Zhu Chenchen , Zhu Jing , Qian Lili , Liu Hanyuan , Shen Zhen , Wu Dabao , Zhao Weidong , Xiao Weihua , Zhou Ying
Published: October 2020

Background
Ovarian clear cell carcinoma (OCCC) is a special pathological type of epithelial ovarian carcinoma (EOC), we conducted this research in order to investigate the clinical characteristics and outcomes of OCCC and to provide additional supporting evidence to aid in the clinical diagnosis and management.
Methods
This was a retrospective study investigating the clinical characteristics and survival outcomes of 87 patients with OCCC treated at our center between January 2010 and March 2020. Survival analysis was also performed on 179 patients with OCCC obtained from the Surveillance, Epidemiology and End Results (SEER) cancer registry database.
Results
The median age of participants was 49.28 ± 9.8 years old, with 74.71% diagnosed at early stage. Median CA125 level was 607.26 IU/mL, with 23.94% having normal CA125 levels. 16 patients (18.39%) had co-existing endometriosis and 8 patients (9.2%) developed venous thromboembolism (VTE). There were 5 patients received suboptimal cytoreduction. 67 patients (77.01%) underwent lymphadenectomy, and only 3 (4.48%) were found to have positive lymph nodes. Patients diagnosed at an early stage had higher 3-year overall survival (OS) and progression-free survival (PFS) rates than those with advanced stage OCCC. CA199 (P = 0.025) and ascites (P = 0.001) were significantly associated with OS, while HE4 (P = 0.027) and ascites (P = 0.001) were significantly associated with PFS. Analysis of data from the SEER database showed that positive lymph nodes is also an independent prognostic factor for OS (P = 0.001).
Conclusions
OCCC often presents at an early stage and young age with a mildly elevated CA125. CA199, HE4, massive ascites and positive lymph node are independent prognostic factors.
Caring for Sexual and Gender Minority Patients: What Factors Explain Self-Reported Competence among Health Care Professional Students?
Authors: Pratt-Chapman Mandi L. , Potter Jennifer
Published: October 2020

Background: Lesbian, gay, bisexual, transgender, queer and intersex people comprise approximately 5% of the U.S. population, yet health care professional student education on sexual and gender minority (SGM) health is sparse. This study explored the degree to which sociodemographic factors and student affiliation with SGM people explained self-reported competence in caring for SGM patients. Methods: Multiple linear regression was used to test the value of an eight-variable exploratory (Full Model) for each of five criterion variables. Independent variables that explained a meaningful amount (≥0.15) of total variance were retained in Reduced Models for parsimony. The criterion variables were: Basic Knowledge, Attitudinal Awareness and Clinical Preparedness (subscales of the Lesbian, Gay, Bisexual, Transgender Development of Clinical Skills Scale); and Beliefs and Behaviors (subscales of the Gay Affirming Practice Scale). Results: Political affiliation, religiosity, and SGM affiliation were predictor variables in half of the Reduced Models. SGM-specific health training hours were included in Reduced Models for Clinical Preparedness and affirming Behaviors. Conclusion: Sociodemographic factors, lived experiences, and amount of training in SGM-specific health matter when it comes to health care professional students’ sense of preparedness in caring for SGM patients.
Trait Mindfulness and College Student Interpersonal Sensitivity: The Mediating Role of Negative Emotions and the Moderating Role of Effectiveness/Authenticity
Authors: Ding Xiaoqian , Zhao Tian , Li Xiaoxi , Yang Zirong , Tang Yi-Yuan
Published: October 2020

Background: College student interpersonal sensitivity has received increased attention in recent years, and trait mindfulness has been found to be a protective factor in interpersonal relationships. However, little is known about the mediating and moderating mechanisms underlying this relation. The aim of this study was to investigate (a) the mediating role of negative emotions in the association between trait mindfulness and interpersonal sensitivity, and (b) the moderating role of the effectiveness/authenticity in the indirect relationship between trait mindfulness and college student interpersonal sensitivity. Methods: This model was examined with 1419 Chinese college students (mean age=18.38 years, SD= 0.86); the participants completed measurements regarding trait mindfulness, negative emotions, the effectiveness/authenticity, and interpersonal sensitivity. Results: The correlation analyses indicated that trait mindfulness was significantly negatively associated with college student interpersonal sensitivity, and the effectiveness/authenticity was significantly negatively associated with college student interpersonal sensitivity. Mediation analyses revealed that negative emotions partially mediated the link between trait mindfulness and interpersonal sensitivity. Moderated mediation further indicated that the relationship between trait mindfulness and negative emotions was more significant for college students with high level of effectiveness/authenticity; the relationship between negative emotions and interpersonal sensitivity was more significant for college students with low level of effectiveness/authenticity.Conclusion: Mindfulness training may help reduce interpersonal sensitivity in college students. When college students have strong effectiveness/authenticity, lower negative emotions may be a protective factor to prevent interpersonal sensitivity.
Sp1-activated Long Noncoding RNA NCK1-AS1 Facilitates Cell Growth of Breast Cancer via Sponging miR-361-5p 
Authors: Jia Hongyao , Wu Di , Zhang Zhiru , Li Sijie
Published: October 2020

Background: Breast cancer (BC) is one of the most lethal and malignant tumors in the world. Accumulating documents have illuminated the vital roles of long noncoding RNAs (lncRNAs) which are closely related to the progression of human cancers, including BC. LncRNA NCK1-AS1 was reported to be an oncogene in some cancers; nevertheless, its functionality is not well elucidated in BC. Methods: NCK1-AS1 expression status was detected in human breast cancer tissues and cell lines by the means of RT-qPCR. The impacts of NCK1-AS1 deficiency on breast cancer cell stemness, viability, proliferation, migration, invasion, and apoptosis were measured in vitro via sphere formation assay, western blot analysis, CCK-8, colony formation, transwell, TUNEL and flow cytometry analysis. Furthermore, luciferase reporter assay, RIP and ChIP were used to verify the mutual effects between molecules.Results: In this study, lncRNA NCK1-AS1 was verified to be elevated in BC tissues and cells. In addition, NCK1-AS1 silencing hampered BC cell growth by inhibiting cell stemness, viability, proliferation, migration and invasion as well as promoting cell apoptosis. Moreover, NCK1-AS1 functioned as a molecular sponge for miR-361-5p and modulated SP1 expression. Rescue experiments signified that SP1 overexpression restored NCK1-AS1 silencing-mediated suppression on BC cell growth. Importantly, SP1 was uncovered to bind with NCK1-AS1 promoter, suggesting a positive feedback loop of NCK1-AS1/miR-361-5p/SP1 in BC cells. Conclusion: Taken together, these findings showed for the first time that NCK1-AS1 served as a carcinogenic gene in BC cells via combining with miR-361-5p to upregulate SP1.
MiR-150-5p-modified Bone Marrow Mesenchymal Stem Cells Derived Exosomes Ameliorate Osteonecrosis of Femoral Head by Promoting Endothelial Cell Angiogenesis
Authors: Fang Shanhong , He Tianmin , Jiang Jiarun , Li Yongfeng , Huang Heling , Chen Peng
Published: October 2020

Background: Osteonecrosis of femoral head (ONFH) is a common ischemic disease that induces femoral head necrosis. The role of exosomes and miRNA in ONFH has been elucidated, however, whether miRNA-modified exosomes improve the therapy of ONFH is not clear.Methods: We screened ONFH-related miRNAs by RNA sequencing in plasma exosomes of ONFH patients and healthy donors. The key miRNA was overexpressed in bone marrow mesenchymal stem cells (BMSC) exosomes. The regulatory functions of miRNA-modified BMSC exosomes in vascular endothelial cells were illustrated through angiogenesis assay and scratch assay.Results: We identified 9 differently expressed miRNAs (DEmiRNAs) in plasma exosomes between ONFH and healthy groups, with 6 up-regulated and 3 down-regulated miRNAs. Function and pathway analysis revealed DEmiRNAs were primarily involved in angiogenesis, cell migration, focal adhesion. Moreover, miR-150-5p was declined in ONFH exosomes and regulated multiple angiogenesis-related pathways. The miR-150-5p-overexpressed BMSC exosomes were successfully obtained and transported miR-150-5p to endothelial cells. Moreover, the miR-150-5p-modified BMSC exosomes promoted the angiogenesis and migration of endothelial cells.Conclusion: Our results elucidate the exosomal miRNA expression profiles in ONFH, and miR-150-5p-modified BMSC exosomes protect against ONFH by promoting angiogenesis, suggesting a new molecular knowledge for the clinical application of ONFH.
Epidermal Growth Factor or Platelet Rich Plasma Combined With Induced Membrane Technique in the Treatment of Segmental Femur Defects: An Experimental Study
Authors: Bilal Ökkeş , Topak Duran , Kınaş Mustafa , Kurutaş Ergül Belge , Kızıldağ Betül , Bahar Abdulkadir Yasir
Published: October 2020

Objective: Extensive bone defects remain a therapeutic challenge necessitating alternative surgical approaches with better outcomes. Can increase the effectiveness of PRP or EGF treatment in surgical treatment of large bone defects with masquelet technique?Aim of this study examined potential therapeutic benefits of the Masquelet technique with induced membranes in combination with platelet rich plasma (PRP) or epidermal growth factor (EGF) in a rat model of segmental femur defect.Methods: Three groups each consisting of 20 Sprague-Dawley rats were defined as follows: EGF group, PRP group, and control group. A femoral bone defect was created and filled with antibiotic embedded polymethyl metacrylate. Half of the animals in each group were sacrificed at week 6 and the pseudo-membranes formed were analyzed. In the remaining half, the cement was removed and the space was filled with autograft. After another six weeks, the structures formed were examined radiologically, histologically and biochemically.Results: At week 6, both PRP and EGF groups had significantly higher membrane CD31, TGF and VEGF levels than controls. At week 12, when compared to controls, PRP and EGF groups had significantly higher membrane CD31 levels and PRP group had significantly higher membrane TGF levels. Regarding bone tissue levels, PRP and EGF groups had significantly higher VEGF levels and EGF group had significantly higher BMP levels. In addition, PRP and EGF groups had higher radiological scores than controls. However, the two experimental groups did not differ with respect to any parameter tested in this study. Conclusion: Both PRP and EGF seems to be associated with histological, biochemical, and radiological improvements in experimental rat model of Masquelet technique, warranting in further clinical studies.
B4C-TiB2 Composite Ceramics with Ultra-High Fracture Toughness Fabricated by Spark Plasma Sintering
Authors: Yan Xingheng , Zhou Xingui , Wang Honglei
Published: October 2020

B4C-TiB2 composite ceramics with ultra-high fracture toughness were successfully prepared via spark plasma sintering using B4C and 30 vol.% Ti3SiC2 as raw materials at different sintering temperatures. The results show that compared with pure B4C ceramics sintered by SPS, the flexural strength and fracture toughness are significantly improved, especially the fracture toughness has been improved by leaps and bounds. When the sintering temperature is 1900 ℃, the B4C-TiB2 composite ceramic has the best comprehensive mechanical properties: hardness, bending strength and fracture toughness are 27.28 GPa, 405.11 MPa and 18.94 MPa·m1/2, respectively. The main two reasons for the ultra-high fracture toughness are the formation of TiB2 three-dimensional network covering the whole composites, and the existence of lamellar graphite at the grain boundary.
Premenstrual Dysphoric Disorder is Associated with the Longer Length from Clitoris to Urethra
Authors: Li Zheng , Xu Meng-jiao , Jin Ying , Zhu Bing-gen
Published: October 2020

Background: Premenstrual dysphoric disorder (PMDD) is a common, recently recognized, psychiatric condition among reproductive women, reflecting abnormal responsivity to ovarian steroids. Moreover, the organizational effects of prenatal sex hormones during the embryonic environment that may determine individual sensitivity to fluctuation of sex hormones, have got attentions, but there have been considerably less of researches on this topic. The aim of this research was to investigate the possible role of prenatal androgen in the PMDD.Methods: Anogenital distance (AGD), the distance between a woman’s clitoris and her urethral meatus (CUMD), left and right 2D:4D ratios were measured in 77 subjects (25 patients with PMDD), as these anthropometric indicators are considered to indirectly reflect prenatal androgen exposures in utero. Results: Patients with PMDD had a longer CUMD than controls (25.03±4.73 vs 22.07 ± 4.30, P=0.008), while there were no significant difference between PMDD group and control group in the AGD and right and left 2D:4D ratios.Conclusion: Atypical high prenatal androgen exposure might predispose individuals to be susceptible to PMDD.
Adaptation of Gut Microbiotas to Transgenic Pigs Secreting β-Glucanase, Xylanase and Phytase
Authors: Mo Jianxin , Li Guoling , Huang Guangyan , Wang Haoqiang , Shi Junsong , Zhou Rong , Cai Gengyuan , Yang Huaqiang , Wu Zhenfang , Zhang Xianwei
Published: October 2020

BackgroundThe gut microbiotas play an important role in digestive function and feed efficiency in pigs. However, the effect of exogenous digestive enzymes on the composition and functional contributions of swine intestinal microbes is unclear. The objective of this study was to investigate the change of gut microbiotas in the transgenic pigs secreting microbial digestive enzymes in their salivary glands.MethodsEGFP marker-free transgenic (MF-TG) pigs were generated by deleted the EGFP coding genes in the transgenic pigs we previously generated. Samples of chyme from the ileum, caecum and colon of five MF-TG and five wild-type (WT) sows were collected for investigating the gut microbiomes via metagenomics analyses.ResultsThe levels of probiotics were abundant in the caecum of MF-TG pigs and higher than those of WT pigs. By contrast, the levels of some harmful microorganisms were higher in the caecum of WT pigs than those of MF-TG pigs. In addition, the microorganisms in the colon of MF-TG pigs had high fractional abundance in DNA (cytosine-5)-methyltransferase 1 and serine-type D-Ala-D-Ala carboxypeptidase, whereas the aspartate carbamoyltransferase regulatory subunit and outer membrane protein pathways were enriched in WT pigs. Moreover, the levels of numerous carbohydrases in the caecum of MF-TG pigs were higher than those of WT pigs. ConclusionsThe results indicated that intestinal microbes can change adaptively to the secretion of transgenic enzymes, thereby forming a benign cooperation with their host.
Sampling in Difficult Settings: A Simulation Study Comparing Several Sampling Methods
Authors: Shannon Harry , Emond Patrick D. , Bolker Benjamin M. , Viveros-Aguilera Román
Published: October 2020

Background: Taking a representative sample to determine prevalence of variables like disease is difficult when little is known about the target population. Several methods have been proposed, including a recent revision of the World Health Organization’s Extended Program on Immunization (EPI) surveys. The original method uses probability proportional to size to sample towns and a nearest neighbour approach to sampling households within towns. The new version samples from relatively small areas and conducts a probability sample of households within those areas. Other techniques sample within towns from circles around randomly identified points (‘Circles’) or from randomly sampled squares in a superimposed grid (‘Square’). We compared these sampling methods in multiple virtual populations using computer simulation.Methods: We constructed 50 virtual populations with varying characteristics. Populations comprised about a million people across 300 towns. We created three more populations with different prevalences of disease but with uniform characteristics across each population. We created a binary exposure variable and allocated disease statuses to individuals assuming different Relative Risks of exposure. We simulated thirteen methods of sampling: simple random sampling; the original EPI method and variants; the Square and Circle methods; and the new EPI method. For each population, each sampling method, and each of three sample sizes per cluster (7, 15, and 30), we simulated 1,000 samples. For most sampling methods, the clusters were towns. We conducted simulations using the same 30 clusters and using a freshly-chosen set of clusters. For each simulation we estimated prevalence and RRs and computed the Root Mean Squared Error for the 1,000 samples.Results: The Circle and Square methods produced almost identical results, so we report only the Square method results. The Root Mean Squared Error for the Square method was almost universally best relative to simple random sampling for estimating prevalence, and generally best when estimating Relative Risks. The revised EPI approach was less good, but generally better than the original EPI. Conclusions: The Square method is recommended as statistically optimal, unless practical considerations favour another approach.