bluuebunny/crossref_metadata_2025 huggingface dataset:
Quantitative EEG as a biomarker in mild cognitive impairment with Lewy bodies
Authors: Schumacher Julia , Taylor John-Paul , Hamilton Calum A. , Firbank Michael , Cromarty Ruth A. , Donaghy Paul C. , Roberts Gemma , Allan Louise , Lloyd Jim , Durcan Rory , Barnett Nicola , O’Brien John T. , Thomas Alan J.
Published: June 2020

Objectives: To investigate using quantitative EEG (1) differences between patients with mild cognitive impairment with Lewy bodies (MCI-LB) and MCI with Alzheimer’s disease (MCI-AD) and (2) its utility as a potential biomarker for early differential diagnosis. Methods: We analyzed eyes-closed, resting state, high-density EEG data from highly phenotyped participants (39 MCI-LB, 36 MCI-AD, and 31 healthy controls). EEG measures included spectral power in different frequency bands (delta, theta, pre-alpha, alpha, and beta), theta/alpha ratio, dominant frequency, and dominant frequency variability. Receiver operating characteristics (ROC) analyses were performed to assess diagnostic accuracy. Results: There was a shift in power from beta and alpha frequency bands towards slower frequencies in the pre-alpha and theta range in MCI-LB compared to healthy controls. Additionally, dominant frequency was slower in MCI-LB compared to controls. We found significantly increased pre-alpha power, decreased beta power, and slower dominant frequency in MCI-LB compared to MCI-AD. EEG abnormalities were more apparent in MCI-LB cases with more diagnostic features. There were no significant differences between MCI-AD and controls. In the ROC analysis to distinguish MCI-LB from MCI-AD, beta power and dominant frequency showed the highest area under the curve values of 0.71 and 0.70, respectively. While specificity was high for some measures (up to 0.97 for alpha power and 0.94 for theta/alpha ratio), sensitivity was generally much lower. Conclusions: Early EEG slowing is a specific feature of MCI-LB compared to MCI-AD. However, there is overlap between the two MCI groups which makes it difficult to distinguish between them based on EEG alone.
The combined usage of Matrine and Osthole inhibited endoplasmic reticulum apoptosis induced by PCV2
Authors: Xu Yinlan , Sun Panpan , Wan Shuangxiu , Guo Jianhua , Zheng Xiaozhong , Sun Yaogui , Fan Kuohai , Yin Wei , Sun Na , Li Hongquan
Published: June 2020

Background: Porcine circovirus type 2 (PCV2) is an important DNA pathogen commonly in pig farms, which can cause immunosuppression and induce apoptosis. To evade clearance by the host immune system, PCV2 constantly builds up complex mechanisms or mutates genes, it is difficult to eradicate complex PCV2 infection by relying on vaccine immunity and one compound. At present, there is no literature report on the effective prevention and treatment of PCV2 infection by the combined a of two or more compounds through multiple pathways and multiple targets. We have previously demonstrated the anti-PCV2 effect of Matrine in vitro, but its mechanism has not been further studied. Many literatures have proved that Osthole has a variety of pharmacological activities. Therefore, this study explored the synergistic antiviral effect of Matrine combined with Osthole and the synergistic anti-apoptosis mechanism in the same pathway and targets.Results: It was first demonstrated that Osthole alone had anti-PCV2 effect and the synergistic anti-PCV2 effect combined with Matrine was better than Matrine and Osthole alone by qPCR, IFA and Western blot results. Subsequently, demonstrated that the reduction of endoplasmic reticulum PERK apoptosis induced by PCV2 was mainly contributed the mechanism of anti-PCV2 using these two extracts by Annexin V-FITC/PI, JC-1 and Western blot results. Finally, it was further demonstrated that Matrine combined with Osthole could inhibit the expression of Cap in cap-transfected PK-15 cells, thus inhibiting Cap-induced PERK apoptosis. In this study, Ribavirin was used as the positive control.Conclusions: It was proved that the synergistic anti-PCV2 effect of Matrine combined with Osthole was significantly better than that of Matrine and Osthole alone. And the two ombined, with Cap and GRP78 as potential targets of anti-PCV2, further inhibited PERK apoptosis induced by PCV2 infection by directly inhibiting the expression of PCV2 Cap protein. The results formed a basis for further studies on the mechanism of anti-PCV2 in vivo using Matrine combined with Osthole and developing new anti-PCV2 compounds with Cap and GRP78 as therapeutic targets.
Measuring ecological preference for growth of the most influential weeds in weed community structure associated with agronomic and horticultural crops in Nile Delta, Egypt
Authors: Mahgoub Alaa M.M.A.
Published: June 2020

The studying of the performance of weeds and weed assemblages associated with different crops through phytosociological researches derives its importance mainly from weeds adverse impact on crop productivity. Hopefully, the current study is beneficial for developing a sustainable long term weed control and soil management strategy. The objective of the present work is to measure three ecological preferences: crop diversification, soil type and crop seasonality. A sample area was selected comprising farmland of Nile Delta and its adjoining east and west territories, Egypt. Sixty-four sites in 12 governorates comprising 30 agroecosystems were monitored. 150 species were designated as most influential weed-species out of 555 species recorded. Ecological preference for species for crop seasonality was evident through the results of Agglomerative hierarchical clustering (AHC). Three weed communities or weed assemblages’ groups (WAG) were identified. Their diversity evaluated and their linear correlation strength was determined. The fidelity measurements showed that 60-species have fidelity to WAG A; 46 to WAG B; 44 to WAG C. Measuring the ecological preference of species for crop diversification and soil type indicated that the growth activity of 36-species was more affected by crop diversification; 63-species preferential for growth in fine grained soil (FGS) and 87-species in coarse grained soil (CGS). By employing Redundancy analysis (RDA) with variation partitioning (VP), the variability in species frequency in WAG that can be explained by ecological preference of species for the three ecological preferences was determined and variation was partialized out to estimate their partial, linear effect. In fact, weed control is a recalcitrant issue and the current study revealed that a portion of the solution is in a successful crop diversification plan. The successful selection for a competitive crop that can be taken seriously as an adequate weed controlling mechanism in a crop rotation technique will cause the strongest population reduction of harmful weeds on infested farmland, especially in relevance for crops grown for organic certification.
Metformin inhibits cervical cancer cell proliferation by modulating PI3K/Akt-induced major histocompatibility complex class I-related chain A gene expression
Authors: Xia Chenglai , Liu Chang , He Zhihong , Cai Yantao , Chen Jinman
Published: June 2020

Background:Recent studies have shown that the classic hypoglycemic drug metformin inhibits tumor growth; however, the underlying mechanism remains unclear. We previously showed that metformin disrupts the sponge effect of long non-coding RNA MALAT1/miR-142-3p to inhibit cervical cancer cell proliferation. In this study, we interrogated the ability of metformin to modulate the anti-tumor immune response in cervical cancer. Methods:The cell counting kit-8 assay was used to detect the viability of cervical cancer cells. Flow cytometry assays were performed to measure cell apoptosis and cell cycle. Lactate dehydrogenase (LDH) cytotoxicity assay was used to detect NK Cell Cytotoxicity. Relative protein levels were determined by immunoblotting and relative gene levels were determined by quantitative real-time PCR. Tumor Xenograft Modeling was used to evaluate the effect of metformin in vivo.Results: Metformin inhibited cervical cancer cell proliferation, cervical cancer xenograft growth, expression of PCNA, p-PI3K and p-Akt. Moreover metformin induced cervical cancer cell apoptosis and caused cancer cell cycle arrest. In addition, metformin upregulated the expression of DDR-1 and p53 in human cervical cancer cells. Furthermore, metformin also regulated the mRNA and protein expression of MICA and HSP70 on the surface of human cervical cancer cells via the PI3K/Akt pathway, enhancing NK cell cytotoxicity. Conclusions: In conclusion, our results suggest that metformin may be used as immunopotentiator to inhibit cervical cancer progression and may be considered a viable candidate for combination therapy with immunotherapy.
Infiltration of immune competent cells into primary tumors and their surrounding connective tissues in mice
Authors: Metzen Marlon , Bruns Michael , Deppert Wolfgang , Schumacher Udo
Published: June 2020

Background: Due to the fact that a close physical contact between NK- and T-cells and cancer cells themselves is necessary to kill cancer cells, we wanted to study the distribution of immunocompetent cells in syngeneic and xenograft tumor models with immunodeficiency of the specific (T- and B-cells) immune system. Because of this approach we focused on the cells of the innate immune system. Methods: Paraffin wax embedded primary breast cancers from the syngeneic mouse WAP-T model and from xenografted tumors of breast, colon, melanoma, ovarian, neuroblastoma, pancreatic, prostate and small cell lung cancer were investigated for the infiltration of immunocompetent cells. The percentage of the labelled cells was semiquantitatively recorded and attributed to the following locations: adjacent adipose tissue, the tumor capsule, the intra-tumoral septae and the malignant cells themselves. The following markers were used: CD45 as a pan-leukocyte marker, BSA-I as a marker for dendritic cells, CD11b as a marker for NK cells and CD68 for macrophages. Results: Xenograft tumors: in relation to the localisation of CD45, CD11b positive, NK and dendritic cells, the highest score was found in the adjacent adipose tissue, followed by lesser infiltration in the malignant tissue. The detected numbers of CD45 positive cells differed between the tumor entities: few infiltrating cells in breast, small cell lung cancer and in neuroblastoma, a moderate infiltration in colon cancer, melanoma and ovarian cancer and strongest in prostate and pancreatic cancer.Syngeneic tumors: the highest score of CD45, CD11b positive, NK and dendritic cells were observed in the tumor capsule, followed by a lesser degree of infiltration of the cancer tissue itself.Conclusions: Our findings show in several neoplastic entities that the majority of immune competent cells are not directly located at the malignant cells but are present in the surrounding tumor stroma and connective tissue capsule. Hence the tumor stroma represents a considerable barrier for lymphocytes to come in direct contact with the malignant cells. Therefore strategies should be employed to make the tumor stroma more penetrable for immune cells in order to increase their efficacy.
Pelvic Rotation Parametersrelated to in-brace Correction in Patients With Idiopathic Scoliosis
Authors: li kepeng , Miao Jun , Jing-an Zhang
Published: June 2020

BACKGROUND: To identify the pelvic parameters affecting in-brace correction (IBC) in patients with idiopathic scoliosis (IS). METHODS: Patients with IS receiving Chêneau brace treatment in our scoliosis center from January 2019 to November 2019 were retrospectively analyzed. Pelvic rotation parameters, including Pelvic incidence (PI), Sacral slope (SS), pelvic tilt (PT), L/R ratio, were collected. Other radiographic data, such as Risser sign, coronal and sagittal balance, curve location, kyphosis, lordosis of each patient was also recorded to analyze their correlations with IBC. Correlation analyses were performed to identify the classified variables influencing IBC. The principal component analysis was used to extract common factors of radiographic parameters to eliminate interaction effects. The linear regression equation was established using principal components, the variables influencing IBC were identified.RESULTS: A cohort of 44 patients with IS (36 girls and 8 boys) were included in the present study. The mean IBC was 49.87% (range, 3%∽100%). IBC of lumbar IS was negatively correlated with apical rotate factor (ARF, B=-0.385), mainly consisted of pelvic coronal plane rotation (PCPR, 0.449), cobb angle (CA,0.575), apical vertebral rotation (AVR, 0.918), and pelvic rotate factor (PRF, B=-0.387), mainly consisted of PT (0.861), PI (0.728), PCPR (-0.570). The regression equation of lumbar IS had statistical significance (F=6.500, P=0.005，R2=0.317). Whereas statistically significance was not found in the regression equation of thoracic IS (F=2.913, P=0.106). The remaining parameters were not related to IBC.CONCLUSIONS: For lumbar IS, ARF and PRF have negative effects on IBC, Coronal and sagittal rotation of the pelvis is related to IBC.
The K nearest neighbor algorithm for imputation of missing longitudinal prenatal alcohol data
Authors: Sania Ayesha , Pini Nicolò , Nelson Morgan E. , Myers Michael M. , Shuffrey Lauren C. , Lucchini Maristella , Elliott Amy J. , Odendaal Hein J. , Fifer William P.
Published: June 2020

Background — Missing data are a source of bias in many epidemiologic studies. This is problematic in alcohol research where data missingness may not be random as they depend on patterns of drinking behavior. Methods — The Safe Passage Study was a prospective investigation of prenatal alcohol consumption and fetal/infant outcomes (n=11,083). Daily alcohol consumption for the last reported drinking day and 30 days prior was recorded using the Timeline Followback method. Of 3.2 million person-days, data were missing for 0.36 million. We imputed missing exposure data using a machine learning algorithm; “K Nearest Neighbor” (K-NN). K-NN imputes missing values for a participant using data of other participants closest to it. Since participants with no missing days may not be comparable to those with missing data, segments from those with complete and incomplete data were included as a reference. Imputed values were weighted for the distances from nearest neighbors and matched for day of week. We validated our approach by randomly deleting non-missing data for 5-15 consecutive days. Results — We found that data from 5 nearest neighbors (i.e. K=5) and segments of 55 days provided imputed values with least imputation error. After deleting data segments from a first trimester data set with no missing days, there was no difference between actual and predicted values for 64% of deleted segments. For 31% of the segments, imputed data were within +/-1 drink/day of the actual. Conclusions — K-NN can be used to impute missing data in longitudinal studies of alcohol use during pregnancy with high accuracy.
Metabolomic analysis of biosynthesis mechanism of ε-polylysine produced by Streptomyces diastatochromogenes
Authors: Wang Ziyuan , Guo Fengzhu , Dong Tianyu , Tan Zhilei , Abdelraof Mohamed , Cui Jiandong , Jia Shiru
Published: June 2020

The authors have withdrawn this preprint due to author disagreement.
Reduced translation efficiency due to novel splicing variants in 5′ untranslated region and identification of novel cis-regulatory elements in canine and human BRCA2
Authors: Yoshikawa Yasunaga , Morimatsu Masami , Kozuma Hajime , Sugawara Kaori , Orino Koichi
Published: June 2020

Background
Breast cancer 2, early onset (BRCA2) is a tumor suppressor gene. The protein encoded by this gene plays an important role in homologous recombination (HR)-mediated DNA repair. Deleterious mutations in BRCA2 and downregulation of its expression have been associated with tumorigenesis in dogs and humans. Thus, regulation of BRCA2 expression level is important for maintaining homeostasis in homologous recombination.
Results
In this study, the mechanisms that regulate the expression of BRCA2 were proposed. Novel splicing variants were identified in the 5′ untranslated region (UTR) of canine and human BRCA2 in canine testis, canine ovary, and canine and human cultured cell lines. In cultured cells, the ratio of BRCA2 splicing variants at 5′ UTR was altered by serum starvation. These novel splicing variants, excluding one of the canine splicing variants, were found to reduce the translational efficiency. Additionally, the DNA sequence in human BRCA2 intron 1 harbored novel cis-regulatory elements. Three silencer and two enhancer cis-regulatory elements were identified in human BRCA2 intron 1.
Conclusions
This study demonstrates that BRCA2 expression level is regulated via 5′ UTR splicing variants and that the BRCA2 intron 1 region harbors cis-regulatory elements.
Dynamic changes of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio predicts breast cancer prognosis
Authors: Kim Ju-Yeon , Jung Eun Jung , Kim Jae-Myung , Lee Han Shin , Kwag Seung-Jin , Park Ji-Ho , Park Taejin , Jeong Sang-Ho , Jeong Chi-Young , Ju Young-Tae
Published: June 2020

Background We aimed to determine whether neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are more useful predictors after initial intention to treat than at the time of diagnosis.Methods We collected the medical records of 533 patients. The results of the peripheral blood sampling before the primary treatments were labeled as initial cohort, and those obtained between 24 and 36 months after initial treatment were defined as the 2nd cohort. Delayed metastasis has been defined as distant metastasis 2 years after treatment, and survival outcome was estimated and compared across groups.Results Median follow-up duration was 74 months (24–162 months), and 53 patients experienced delayed metastasis. In univariate analysis, metastasis-free survival, patient age at diagnosis, tumor size, lymph node metastasis, HER-2 status, initial NLR and PLR, and 2nd NLR and PLR were found to be significantly associated with delayed metastasis. However, in multivariate analysis, only the 2nd NLR and PLR were found to be significantly associated with delayed metastasis, excluding initial NLR and PLR. Metastasis-free survival was analyzed through the pattern changes of NLR or PLR. The results revealed that patients with continued low NLR and PLR values at pre- and post-treatment (low initial values and 2nd values) showed a significantly better prognosis than those with a change in value or continued high NLR and PLR.Conclusions We identified that patients with persistent high NLR and PLR after initial treatment have significant worse prognosis in terms of late metastasis. Therefore, these results suggest that NLR and PLR are more useful in predicting prognosis post-treatment.
Is 99mTechnetium Pertechnetate Thyroid Uptake accurate in Thyrotoxicosis Evaluation?
Authors: al-muqbel kusai , Tashtoush Reema , Mayyas Fadia , Marashdeh Wael , Tashtoush Amr , AbuGhanmi Raya , Kareem Ali Abdel
Published: June 2020

BackgroundThis study aimed to evaluate the 99mTc thyroid uptake (TcTU) in terms of (1) normal mean and range, (2) level of uncertainty in thyrotoxic patients and (3) effectiveness of adding radioiodine uptake in patients with uncertain TcTU values.MethodsPatients referred for TcTU test were included and categorized into groups: euthyroid, Graves’ disease, toxic nodular goiter and subacute thyroiditis. Mean and range of TcTU were obtained separately for each group. Second radioiodine uptake test was performed in patients who had uncertain TcTU (overlap with normal range). Results209 patients were included (54 euthyroid, 112 Graves’ disease, 29 toxic nodules and 17 subacute thyroiditis patients). Normal mean and range of TcTU were 1.5 +/- 1.1% and 0.17-4.8%, respectively. Mean TcTU was high in hyperthyroid patients and was extremely low in subacute thyroiditis patients, however, uncertain values was noted in about 30% of the patients. TcTU was uncertain in 39 hyperthyroid patients and in 10 subacute thyroiditis patients, while second radioiodine uptake was high in the former and extremely low in the latter.Test sensitivity was 68%, specificity was 100%, positive predictive value (PPV) was 100%, negative predictive value (NPV) was 52% and accuracy was 76%. ConclusionTcTU major disadvantage is the uncertainty seen in third of patients degrading test sensitivity and accuracy. We managed to overcome this uncertainty by adding second radioiodine thyroid uptake test. Accordingly, single visit TcTU was accurate and sufficient in about two thirds of patients while the remainder required second radioiodine uptake to reach accurate diagnosis.
Factors that impact the adoption of clinical decision support systems (CDSS) in healthcare settings for evidence-based decision making
Authors: LAKA MAH , MILAZZO ADRIANA , MERLIN TRACY
Published: June 2020

Background: Clinical decision support systems (CDSS) are designed to promote evidence-based patient care and shared-decision making in healthcare settings. Despite these benefits, adoption and long-term use of the systems remain limited. There is a need to identify different factors that influence CDSS adoption in healthcare settings.Objective: The Unified Theory of Acceptance and Use of Technology (UTAUT) model was applied to determine different factors that influence the adoption of CDSS in healthcare settings.Methods. A cross-sectional online survey examining clinicians’ perceptions about CDSS implementation in hospital and primary care settings in Australia was undertaken from June - October 2019. Multivariate logistic regression was used to examine the association of UTAUT moderators (age, gender and experience) and care settings (hospital and primary care) with perceived benefits, barriers and facilitators to CDSS adoption.Results: Access to information required for evidence-based decision making, and improvements in quality and safety of patient care were the most common perceived benefits of CDSS. Mapping of different barriers and facilitators to the UTAUT model indicated that ease of use (effort expectancy), perceived benefit (performance expectancy) and a facilitating environment greatly influence the adoption of CDSS. Respondents indicated that systems providing a better fit between relevance, content and timeliness greatly facilitates uptake. Adoption of CDSS also depends on the ability of an organisation to create a facilitating environment that can help address the lack of users’ trust in these systems. The type of healthcare setting was found to be a significant predictor of lack of confidence in the content within CDSS, threat to professional autonomy, and time constraints as barriers to CDSS implementation. Therefore, setting dynamics as well as user-specific requirements need to be considered to improve the acceptability and use of CDSS. Conclusion: Our study has explored different factors that may help address implementation challenges for CDSS. By combining internal factors of users’ inclination and perceptions about the system’s perceived benefits, coupled with external factors of system design requirements, training and support, and stakeholders’ consultations, our findings highlight the need for a holistic implementation framework to enable effective CDSS adoption.
Epidemiology, Hot Spots and Socio-Demographic Risk Factors of Alcohol Consumption in Indian Men and Women: Analysis of National Family Health Survey-4, A Nationally Representative Cross Sectional Study
Authors: Paulson Winnie , Karuppusamy Balasubramani , Chellappan Savitha , Behera Sujit Kumar , Nina Praveen Balabaskaran
Published: June 2020

BackgroundAlcohol consumption is a serious health crisis in India that needs urgent attention. An estimated 160 million Indians consume alcohol. Despite the widespread alcohol use across India, there is no information on the alcohol hot spots. Along with hot spots, understanding the Socio-Demographic Indices (SDI) affecting alcohol consumption in Indian men and women will help guide public health policies on alcohol use. MethodsData from National Family Health Survey-4 carried out from 2015-2016 with a sample size of 103 411 men and 699 686 women were used for the analysis. Epidemiology of alcohol use was mapped by Geographic Information System, and hot spots were identified by spatial statistics (Getis-OrdGi*). Bivariate analyses and binary logistic regression were used to analyse SDI. ResultsIndia has three major alcohol hot spots: (1) North East (NE) states, (2) Eastern Peninsular states formed by Chhattisgarh, Odisha, Jharkhand and Telangana, and (3) Southern states of Tamil Nadu and Kerala. Among these hot spots, the districts of Tamil Nadu, Telangana and Assam fall under high risk category. Hot spot analysis strongly correlated with region-wise analysis of SDI. South (Men aOR - 1.0, 95% CI: 39.1 - 42.1) and NE India (Men aOR - 0.6, 95% CI: 38.4 - 42.6; Women aOR - 2.05, 95% CI: 6.4 - 7.5) have higher odds of alcohol use. Schedule tribe men (aOR-1.67, 95% CI: 1.53-1.82) and women (aOR-5.99, 95% CI: 4.71-7.63) have higher odds of alcohol consumption. Compared to other religions, Muslim men (aOR: 0.11) and women (aOR: 0.06) consume less alcoholConclusionsHot spots and, high risk districts of alcohol consumption identified in this study can guide public health policies for targeted intervention. Except for religion and social category, other socio-economic factors have a low to moderate effect on alcohol consumption. India does not have concrete anti-alcohol policies at the national level. Alcohol use is at the discretion of individual states and union territories, and appears to be the major determinant of alcohol use in India. Stringent anti-alcohol policies strictly enforced across India is the key to control alcohol use.
A Conceptual Model of Functional Health Literacy to Improve Chronic Airway Disease Outcomes
Authors: Poureslami Iraj , Fitzgerald J. Mark , Tregobov Noah , Shum Jessica , Akhtar Alizeh , Kassay Saron , Starnes Kassandra , McMillan Austin , Mahjob Maryam
Published: June 2020

Background: Current conceptual models of health literacy (HL) illustrate the link between HL skills and health outcomes. However, these models fail to recognize and integrate certain elements of disease management, health system factors, and socio-demographic factors into a comprehensive framework. This article summarizes the process of developing a Chronic Airway Disease Management and Health Literacy (CADMaHL) conceptual model.Methods: The proposed CADMaHL model is developed within the following six stages: (1) Systematic review of HL measurement tools. (2) Patient-oriented focus group sessions. (3) HL and health professions (key-informants) interviews. (4) Attain perspectives and feedback of respirologists. (5) Develop a HL measurement tool for chronic airway disease (CAD) patients (e.g., asthma and COPD), pilot test, and tool modification. (6) Tool validation with asthma and COPD patients. Results: Throughout the study process, patient population groups, an advisory panel of HL experts, clinician scientists, and researchers reviewed the information acquired. This review process enabled us to organize the CADMaHL model into 6 primary modules, including INPUT, consists of four HL core components (access, understand, communicate, evaluate) and numeracy skill; OUTPUT, includes use/application of the obtained information; OUTCOME, covers patient empowerment in performing self-management practices by applying HL skills; ASSESSMENT, comprises HL assessment tools and strategies; IMPACT, includes mediators between HL and health outcomes; and CROSSCUTTING FACTORS, consists of diverse socio-demographics and health-system factors with applicability across the HL domains.Conclusions: We developed and validated the proposed HL tool using the CADMaHL model. We anticipate that the model may inform development of interventions aiming to improve HL and disease management outcomes of CAD patients, by properly identifying and mitigating HL gaps among these patient population groups.
Incidence, prediction, and the long-term outcome of solid pseudopapillary tumor of the pancreas with malignant behaviors: a pooled-analysis
Authors: Li Yifei , Wang Shijie , Li Yifan , Zhou YanMing
Published: June 2020

Background: Microscopic malignancy or gross metastasis of solid pseudopapillary tumor of the pancreas were considered to be malignant behaviors. The clinical status of solid pseudopapillary tumors of the pancreas with malignant behaviors (SPTM) are unclear. This study was to perform a review and pooled-analysis to determine the incidence and predictors of SPTM, and explore the survival and prognostic factors.Methods: A registered meta-analysis (PROSPERO: CRD42020163788) was performed. Studies reporting on SPTM and follow-up information were identified between 1960 and 2020 by searching PubMed, Scopus, and Embase. The search process followed the PRISMA guidelines.Results: A total of 98 articles were included in this study, including 22 articles reporting the incidence of SPTM, and 159 SPTM cases containing survival information in 77 articles. Pooled estimates showed that the incidence of SPTM in solid pseudopapillary tumors of the pancreas was 22% [95% CI：19~24%], and tumor size ≥5 cm (OR: 2.03，95%CI: 1.28~3.22) was the only risk factor for predicting the occurrence of SPTM. The 5-, and 10-year survival rates of SPTM patients after complete surgical resection were 92% and 77%, respectively. Larger tumors (diameter ≥5cm) (p=0.046), lymphovascular invasion (p=0.005), lymph node metastasis (p=0.02), cellular atypia (0.018), Ki67 index ≥5% (p=0.001), tumor recurrence (p=0.004), recurrent time <5 years (p=0.005) and positive margin (p=0.003) were prognosis unfavorable factors for survival. Additionaly, lymphovascular invasion (OR:8.25, 95% CI:2.26-30.1), lymph node metastasis (OR:25.28, 95% CI:3.01-211.74), extrapancreatic invasion (OR:9.07, 95% CI:2.36-34.84), cellular atypia (OR:16, 95% CI:3-85.3), and Ki67 ≥5% (OR: 7.88, 95%CI: 1.53~40.51) increased the risk of recurrences of resected SPTM. Conclusion: Tumor size is an important factor in predicting the occurrence of SPTM before operation, and complete surgical resection can provide SPTM patients a expected long-term survival. Proved clinicopathological factors by current research will help to determine prognosis and recurrence, and close follow-up of five years or more after operation is essential.
Relationship between School Gardening and Self-Efficacy on Weekly Fruit & Vegetable Intake
Authors: Kafeero Hussein Mukasa , Kavuma David , Mbabazi Scovia
Published: June 2020

Background: The study was designed to understand the relationship between school gardens and student’s self-efficacy and its effect on weekly intake of fruits and vegetables. The survey used two Ugandan secondary schools; one having a well established school garden with all students having equal opportunities to participate in the growing, harvesting and consumptions of fruits and vegetables.Methods: The study followed a cross-sectional study design employing quantitative research methods. The target population comprised of late adolescents 18–25 years attending the two-selected secondary school; one in Kampala and another in Luwero districts. The school in Luwero district engaged students in gardening activities while the school in Kampala did not. Self-administered structured questionnaire was given to students to answer questions in line with the specific objectives. Quantitative data was analyzed by t-test, Mann Whitney U test, Pearson Rank Correlation, Odds ratio and Chi-square.Results: The students exposed to gardening had a higher self-efficacy (p = 0.03217) towards weekly consumption of fruits and vegetables with slightly higher scores of fruits and vegetable weekly intake as compared to those not exposed (OR = 1.0370). However, the weekly consumption of fruits and vegetables was low among both groups as compared to the World Health Organization (WHO), Food and Agricultural Organization (FAO) and United States Department of Agriculture (USDA) recommendation of ≥ 35 servings per week (≥ 5 servings per day) for both fruits and vegetables. The students in the exposed group were more confident in consuming fruits and vegetables rather than a snack (p = 0.008), ice cream (p = 0.004), three times a day (p < 0.0001) compared to the control group.Conclusion: School garden based intervention can significantly improve student’s self-efficacy towards fruit & vegetable dietary intake increasing the weekly consumption of fruits and vegetables.
The non-targeted metabolomic profiling of liver reveals the molecular perturbations underlying clonorchiasis
Authors: Zhang Xiaoli , Wang Ruifeng , Sun Beibei , Chen Rui , Hu Xinyi , Gao Yannan , Duan Shanshan , Fang Jing , Wang Ping , Zhao Xinshu , Han Su
Published: June 2020

Background: Clonorchiasis is a common food-borne parasitic disease worldwide. However, the molecular mechanisms of host-parasite interaction has not been illustrated. Given the parasite could influence host metabolism, the hepatic metabolic profiling will be useful for exploring the pathogenic mechanism of clonorchiasis.Results: The global hepatic metabolic profile of male Wistar rats at 4 and 8 weeks post infection with Clonorchis sinensis were investigated using liquid chromatography-mass spectrometry (LC-MS) metabolomics analysis. Multivariate analysis including principal components analysis and partial least squares discriminant analysis, were applied to clearly separated the metabolites of infected and control rats. These metabolites included lipids, hormones, peptides, alkaloids and amino acids. Metabolic pathways, such as purine and pyrimidine metabolism, primary bile acid biosynthesis and glycerophospholipid metabolism were perturbed during the infection process.Conclusions: These findings showed significant systemic metabolic perturbations of the liver in clonorchiasis. It also provided a new insight into the pathogenesis from the metabolic level, which might be helpful for making treatment strategies and prevention of clonorchiasis.
MazEF-rifampicin Interaction Suggests a Mechanism for Rifampicin Induced Inhibition of Persisters
Authors: Alexander Cyrus , Guru Ankeeta , Mallick Sunanda , Mahanandia Nimai Charan , Subudhi Bharat Bhushan , Beuria Tushar Kant
Published: June 2020

Background: Persistence is a natural phenomenon whereby a subset of a population of isogenic bacteria either grow slow or become dormant conferring them with the abilityto withstand various stresses including antibiotics.In a clinical setting bacterial persistence often leads to the recalcitrance of various infectionsincreasing the treatment time and costs.Additionally, some studies also indicate that persistence can also pave way for the emergence of resistant strains. In a laboratory setting this persistent phenotype is enriched in nutritionally deprived environments. Consequently, in a batch culture the late stationary phase is enriched with persistent bacteria. The mechanism of persister cell formation and its regulation is not well understood. Toxin-antitoxins (TA) systems have been implicated to be responsible for bacterial persistence and rifampicin is used to treat highly persistent bacterial strains. The current study tries to explore a possible interaction between rifampicin and the MazEFTA system that furthers the former’s success rate in treating persistent bacteria.Results: In the current study we found that the population of bacteria in the death phase of a batch cultureconsists of metabolically inactive live cells resembling persisters, which showed higher membrane depolarization as compared to the log phase bacteria. We also observed an increase in the expression of the MazEF TA modules in this phase. Since rifampicin is commonly used to kill the persisters, we assessed the interaction of rifampicin with MazEF complex. We showed that rifampicin directly interacts with MazEF complex.Conclusion: Our study suggests that the interaction of rifampicin with MazEF complex might play an important role in inhibition of persisters.
Clinical results of arthroscopic tight fibrous band release for adult moderate-to-severe gluteal fibrosis using anterior and posterior portal: a retrospective analysis of 118 consecutive cases
Authors: Li Liang-jun , Yang Ming , Liu Wei-jie , Li Jing-ping , Su Chao , Kuang Shi-da , Xiong Jie-peng , Chou Ke , He Zhi-yong , Gao Shu Guang
Published: June 2020

Background
To evaluate the clinical outcomes of arthroscopic tight fibrous band release in the treatment of adult moderate-to-severe gluteal fibrosis using anterior and posterior portals during medium and long-term follow-ups.
Methods
The data of 138 patients (58 males, 80 females) aged between 18 and 42 years (mean, 28.6 years), presenting with bilateral moderate-to-severe gluteal fibrosis (GF) from October 2013 to August 2019, was retrospectively analyzed. All patients underwent arthroscopic tight fibrous band release using anterior and posterior portals with radiofrequency energy. Under arthroscopic guidance through the posterior portal, we debrided the fatty tissue overlying the contracted band of the gluteal muscle and excised the contracted bands using a radiofrequency device introduced through the anterior portal. The pre- and post-operative gluteal muscle contracture disability (GD) scale and the patient satisfaction rate were compared to evaluate the curative effect of the operation.
Results
The average operation time was 18 min (range, 10–30 min) and the average blood loss was 4 ml (range, 2–10 ml) for unilateral arthroscopic release. Two cases of post-operative minimal hematomas, 2 cases of bruising and 2 cases of local subcutaneous edema were observed as early complications and were cured by conservative treatment. After surgery, all incisions healed in stage I, and no other complications such as wound infection, nerve and blood vessel injury were detected. 118 patients were followed up for 6 to 72 months (mean, 36 months). No lateral instability of the hip was observed and all patients returned to normal gait. The degree of adduction of the hip joint in all these 118 patients was significantly improved relative to their pre-operative conditions. 115 patients (97.5%) were able to crouch with knees close to each other after surgery. 114 patients (96.6%) were able to cross the affected leg completely without any support. The GD scale was improved from 55.5 ± 10.6 before operation to 90.1 ± 5.2 at the last follow-up (p < 0.05). The patient satisfaction rate was 95.8%.
Conclusion
Arthroscopic tight fibrous band release using anterior and posterior portals is minimally invasive for adult moderate-to-severe gluteal fibrosis, with a high success rate, quick recovery after surgery and reliable medium- and long-term effect.
Temporal trends in pre-ART patient characteristics and outcomes before the Test and Treat era in Central Kenya
Authors: Wekesa Paul , McLigeyo Angela , Owuor Kevin , Mwangi Jonathan , Isavwa Linda , Katana Abraham
Published: June 2020

Background
Retention of patients who did not to initiate antiretroviral therapy (ART) has been persistently low compared to those initiated ART. Understanding the temporal trends in clinical outcomes prior to ART initiation is important to inform interventions targeting patients who do not initiate ART immediately after diagnosis.
Methods
A retrospective cohort analysis of known HIV-infected patients who did not initiate ART from healthcare facilities in Central Kenya was done to investigate temporal trends in characteristics, retention, and mortality outcomes. The data were sourced from the Comprehensive Care Clinic Patient Application Database (CPAD) and IQ care electronic patient-level databases for those enrolled between 2004 and 2014.
Results
A total of 13,779 HIV-infected patients were assessed, of whom 30.7% were men.There were statisitically significant differences in temporal trends relating to marital status, WHO clinical stage, and tuberculosis (TB) status from 2004 to 2014. The proportion of widowed patients decreased from 9.1–6.0%. By WHO clinical stage at enrollment in program, those in WHO stage I increased over time from 8.7–43.1%, while those in WHO stage III and IV reduced from 28.5–10.8% and 4.0–1.1% respectively. Those on TB treatment during their last known visit reduced from 8.3–3.9% while those with no TB signs increased from 58.5–86.8%. Trends in 6 and 12 month retention in the program, loss to follow-up (LTFU) and mortality were statistically significant. At 6 months, program retention ranged between 36.0% in 2004 to a high of 54.1% in 2013. LTFU at six months remained around 50.0% for most of the cohorts, while mortality at 6 months was 7.5% in 2004 but reduced to 3.8% in 2014. At 12 months, LTFU was above 50.0% across all the cohorts while mortality rate reached 3.9% in 2014.
Conclusion
Trends in pre ART enrollment suggested higher enrollment among patients who were women and at earlier WHO clinical stages. Retention and mortality outcomes at 6 and 12 months generally improved over the 11 year follow-up period, though dipped as enrollment in asymptomatic disease stage increased.
Post-operative Radiotherapy Did Not Improve the Treatment Outcomes of Intracranial Hemangiopericytoma
Authors: Xiao Jianbiao , Ding Yi , Xu Lanwei , Wang Wei , Chen Fen , Wu Xuehui , Zhou Yangshu , Zhou Qiyuan , Zhang Fengjiao , Li Junpeng , Liang Li , Jen Yee-Min
Published: June 2020

Background
The purpose of this study is to analyze the impact of post-operative radiotherapy on the results in patients with intracranial hemangiopericytoma (HPC).
Materials and methods
We retrospectively reviewed 66 intracranial HPC patients between 1999 and 2019 including 29 with surgery followed by radiotherapy (11 with intensity-modulated radiotherapy (IMRT) and 18 with stereotactic radiosurgery (SRS)) and 37 with surgery alone. Chi-squared test was used to compare the clinical characteristic between the groups. The Kaplan-Meier method was used to analyze overall survival (OS) and recurrence-free survival (RFS). Multivariate Cox proportional hazards models were used to examine prognostic factors of survival.
Results
The crude local control rates were 58.6% in the surgery plus post-operative radiotherapy group (PORT) and 67.6% in the surgery alone group (p = 0.453). In the subgroup analysis of the PORT patients, local controls were 72.7% in the IMRT group and 50% in the SRS group (p = 0.228). The median OS in the PORT and surgery groups were 122 months and 98 months, respectively (p = 0.169). The median RFS was 96 months in the PORT group and 72 months in the surgery alone group (p = 0.714). The median OS and RFS of the SRS group were not significantly better than those in the IMRT group (p = 0.256, 0.960). The median RFS were 112 and 72 months for pathology grade II and III patients, respectively (p = 0.001).
Conclusion
PORT did not improve the local control rates nor the survivals. The local control rates after IMRT and SRS were similar even though the IMRT technique had a much higher biological dose compared with the SRS technique. PORT is not indicated for intracranial HPC patients with a complete resection margin.
Effects of Intragastric balloon on obesity in obese Korean women for 6 months post removal
Authors: Pak Hyeon-Ju , Choi Ha-Neul , Lee Hong-Chan , Yim Jung-Eun
Published: June 2020

Background: The prevalence of morbid obesity in Korean women has consistently been increasing, while the overall prevalence rate of obesity in Korean women seems to be stable. In addition to bariatric surgery, intragastric balloons (IGB), as a non-surgical therapy, have been reported to be effective in weight loss. However, the beneficial effects of IGB in Korean women with obesity have not been fully investigated. The aim of this study was to evaluate the changes in fat mass in Korean women with obesity who had undergone IGB treatment for 6 months.Methods: Seventy-four women with obesity (BMI ≥ 25.0 kg/m2) were recruited. Clinical data, including general information, comorbidities with obesity, anthropometric data, and changes in the body fat composition before and after IGB treatment, were obtained from the subjects.Results: Most subjects had one or more comorbidities, such as osteoarthropathy and woman’s disease, and had bad eating behaviors including irregular mealtimes, eating quickly, and frequent overeating. Body composition measurements showed that weight, fat mass and waist-hip circumference ratio decreased significantly at 6 months after IGB treatment. Especially, women with morbid obesity (BMI ≥ 30 kg/m2) showed 33% excess weight loss. There was no significant difference in skeletal muscle mass and mineral contents after IGB treatment.Conclusion: The present study suggested that 6 months of IGB treatment can be a beneficial treatment for obesity without muscle mass and bone mineral loss.
Evaluating the Reliability of CBCT Airway Measurement: A Pilot Study
Authors: Jorgensen Brent L. , Park Jae Hyun , Bay R. Curtis
Published: June 2020

Background

Many studies have analyzed treatment effects on the airway using CBCT scans of the airway as evidence, but no study to date has been published that validates a repeatable protocol for acquiring CBCT airway measurements. Our objective is to evaluate a protocol for standardization of CBCT volume acquisition of the airway.
Methods

Ten participants (6 females and 4 males, median age 30.03 ± 3.53 years) were radiographed 2 times each (T1 and T2, the average time between T1-T2 was 15.8 ± 3.65 days), for a total of 20 CBCT scans. The participants’ head position was placed so that the Frankfort horizontal plane was parallel to the floor. Participants were given specific instructions regarding jaw position, tongue position, swallowing and breathing before each of the 2 scans. Minimum cross-sectional area (MCA) and total volume (TV) of each airway scan were measured between the distal most point of the hard palate (superior limit) and the superior most point of the epiglottis (inferior limit). T1 and T2 were compared to determine the repeatability of our proposed protocol for CBCT airway acquisition.
Results

There was no statistically significant difference between T1 and T2 measurements for TV and MCA. The average difference between T1 and T2 MCA and TV measurements for each participant was 34.18 ± 30.55 mm2 and 2.51 ± 2.05 cc, respectively.
Conclusions

Using our proposed standardization protocol, the measurements of MCA and TV of the airway were reliable to within 34.18 ± 30.55 mm2 and 2.51 ± 2.05 cc, respectively.