bluuebunny/crossref_metadata_2025 huggingface dataset:
CD44, A Marker of Cancer Stem Cells, is Positively Correlated With PD-L1 Expression and Immune Cells Infiltration in Lung Adenocarcinoma
Authors: Zhang Chenyue , Wang Hui , Wang Xia , Zhao Chenglong , Wang Haiyong
Published: October 2020

Background: PD-L1 inhibitors is widely applied in lung adenocarcinoma patients. Tumor cells with high PD-L1 expression could trigger immune evasion. Cancer stem cells (CSCs) can evade from immunesurveillance due to their immunomodulating effects. However, the correlation between CSC and PD-L1 and some immune-related markers is seldom reported in patients with lung adenocarcinoma. Therefore, we aimed to ascertain their association in lung adenocarcinoma patients. Methods: We assessed CD44 expression and its association with PD-L1 in lung adenocarcinoma, using Tumor Immune Estimation Resource (TIMER), which was further validated in our patient cohort. The immune cells infiltration was depicted by CIBERSORT using GEO database. The correlation between CD44 and immune cells was also analyzed. We further evaluated the prognostic role of CD44 in patients with lung adenocarcinoma both using Kaplan-Meier plotter and validated in our patient cohort. Results: Positive association between CD44 and PD-L1 were found in lung adenocarcinoma patients. T cells CD4 memory resting cells and mast cells resting cells varied significantly between patients with CD44 high and those with CD44 low. Furthermore, positive association could be found between CD44 expression and immune cells. Arm-level depletion of CD44 was linked with B cell, CD4+ T cell, neutrophil and dendritic cell infiltration. Patients with higher CD44 levels had worsened overall survival (OS). Conclusions: In summary, these results demonstrate that CD44 was associated with PD-L1 and infiltration of immune cells, and was a negative prognostic factor for predicting worsened OS in lung adenocarcinoma.
A Tall and Thin Boy with a Bad Headache: A Case Report of Homocystinuria
Authors: Wiel Luisa Cortellazzo , Caddeo Giulia , Zanchi Chiara , Gortani Giulia , Faletra Flavio , Bruno Irene , Magnolato Andrea , Barbi Egidio
Published: October 2020

Background: Homocystinuria is a rare inborn error of metabolism, resulting in the accumulation of homocysteine and methionine in tissues, which manifests as disorders of the connective tissues and increased risk of thromboembolism. The latter is the primary cause of morbidity and mortality, and can be prevented by the prompt start of the specific therapy aimed at lowering homocysteine plasma levels.Case presentation: A nine-year-old boy was admitted to the Emergency Department for a severe headache associated with torticollis, dysarthria, difficulty in walking and extreme irritability. His past medical history was relevant for bilateral lens ectopia and epilepsy, associated with a “marfanoid habitus”. A brain CT scan was consistent with cerebral venous thrombosis. The association between the marfanoid habitus and the thromboembolic event raised the suspicion of homocystinuria, which was eventually confirmed by the high levels of serum homocysteine, and the genetic testing. Anticoagulation therapy was started, together with pyridoxine and folate, and eventually betaine and dietary protein restriction, with a consequent satisfactory fall in homocysteine levels, along with clinical recovery.Conclusions: This case enhances the importance of dosing serum homocysteine in every child investigated for a marfanoid habitus, given the impact of the early diagnosis and treatment in the prevention of thromboembolic events.
Clinical Characteristics and Outcomes of Tuberculosis Infection in Adult Patients with MDS
Authors: Ren Yanling , Mei Chen , Ye Li , Zhou Xinping , Xu Gaixiang , Ma Liya , Lu Chenxi , Wang Lu , Yang Haiyang , Luo Yingwan , Zhu Shuanghong , Jiang Lingxu , Jin Jie , Tong Hongyan
Published: October 2020

Background and aim Despite the high incidence of tuberculosis infection (TBI) in patients with hematological diseases, there were few researches on TBI in MDS patients. We retrospectively analyzed the characteristics of MDS patients with TBI in our center to improve the clinical diagnosis and treatment of these patients.Methods Primary MDS patients diagnosed between 2014 and 2019 at the First Affiliated Hospital of Zhejiang University were retrospectively reviewed, TBI was diagnosed by positive culture(s) or acid fast bacilli on modified Ziehl-Neelsen staining on clinical samples as well as compatible symptoms and signs.Results Thirty-four of 1347 MDS patients were diagnosed with TBI, nine patients had blast＜5%, twelve patients were MDS with excess blast-1(MDS-EB1), and the rest 13 patients were MDS with excess blast-2 (MDS-EB2). Ten patients had lower risk (low and intermediate) and 24 patients had higher risk (high and very high) according to revised international scoring system (IPSS-R). Moreover, fifteen patients were classified into synchronous group (defined as TBI occurring within 3 months of MDS diagnosis), and the rest 19 patients were non-synchronous group (defined as TBI developed after MDS more than 3 months). Patients in synchronous group have higher rate of persistent fever (11/15 vs. 7/19, p=0.03), higher risk classification ( 14/15 vs. 8/19, P=0.002 ), and higher tendency to transform to acute myeloid leukemia (AML) (8/15 vs. 4/19, P=0.04 ) than those in non-synchronous group. The median time to AML was significantly shorter in synchronous group (7.68 months vs. 23.83 months, P<0.01). Most patients received regular anti-tuberculosis treatment (ATT)(33/34) and support care(22/34) for MDS, patients received support care were more prone to proceed to AML than those received active therapy such as decitabine (12/22 vs. 2/12, P=0.03). The median OS of all patients in synchronous group was just 14.17 months, while in non-synchronous group, it was 34.07 moths ( P = 0.01). However, treatments for MDS had no effect on OS(P=0.67).Conclusion TBI is not uncommon among patients with MDS, patients with synchronous TBI and MDS progress faster and have shorter OS, which may be associated with genetic susceptibility and lack of active therapy.
Comprehensive Analysis of lincRNA-Related ceRNA Network in Glioblastoma
Authors: Liu Guangdong , Liu Danian , Huang Jingjing , Li Jianxin , Wang Chuang , Liu Guangyao , Ge Shiqiang , Gong Haidong
Published: October 2020

BackgroundLong intergenic non-coding RNAs (lincRNAs) are capable of regulating several tumours, while competitive endogenous RNA (ceRNA) networks are of great significance in revealing the biological mechanism of tumours. Currently, there is a dearth of studies on the ceRNA network of lincRNAs in glioblastoma (GBM), which we aimed to assess in the present study. MethodsWe obtained GBM and normal brain tissue samples from TCGA, GTEx, and GEO databases, and performed weighted gene co-expression network analysis and differential expression analysis on all lincRNA and mRNA data. Subsequently, we predicted the interaction between lincRNAs, miRNAs, and target mRNAs. Univariate and multivariate Cox regression analyses were performed on the mRNAs using CGGA data, and a Cox proportional hazards regression model was constructed. ResultsAccording to the Cox model, we assembled a ceRNA network consisting of 23 lincRNAs, 14 miRNAs, and 13 mRNAs. Gene Set Enrichment Analysis was carried out on four lincRNAs with obvious differential expressions and relatively few studies in GBM. ConclusionWe identified four lincRNAs that have the most research values for GBM and obtained the ceRNA network. Our research is expected to facilitate in-depth understanding and study of the molecular mechanism of GBM, and provide new insights into targeted therapy and prognosis of the tumour.
​Short-term changes in and preoperative factors affecting vaulting after posterior chamber phakic Implantable Collamer Lens implantation
Authors: Zhu Qiujian , Chen Wen-Jing , Zhu Wei-Jian , Xiao Hai-Xiang , Zhu Man-Hui , Ma Lie , Yuan You , Song E.
Published: October 2020

Background: To describe the very early changes in vault in the first month after Implantable Collamer Lens (ICL) implantation and to evaluate the effect of preoperative biometric factors on vault.Methods: A total of 83 eyes from 83 subjects with complete data who met follow-up requirements were recruited in this retrospective study between May 2019 and March 2020. We quantitatively assessed postoperative vault at 2 hours, 1 day, 1 week, and 1 month following implantation. Associations between postoperative vault and age, ICL size, spherical equivalent (SE), axial length (AL), central corneal thickness (CCT), flat K, steep K, mean K, anterior chamber depth (ACD), crystalline lens thickness (LT), white-to-white (WTW) diameter obtained by three devices, horizontal and vertical sulcus-to-sulcus (STS) diameter, bright and dark pupil sizes (BPS and DPS) and DPS-BPS were investigated using Spearman’s correlation analysis and stepwise multiple regression analysis.Results: The mean vault values at 2 hours, 1 day, 1 week, and 1 month after ICL implantation were 672.05 ± 30.72, 389.15 ± 28.33, 517.23 ± 30.76 and 530.12 ± 30.22 μm, respectively. There were significant differences in vault values between 2 hours, 1 day and 1 week after the operation. ICL size (β = 0.942; p < 0.001), followed by horizontal STS (β = -0.517; p < 0.001), crystalline LT (β = -0.376; p < 0.001) and vertical STS (β = -0.257; p = 0.017), significantly influenced vault at 1 month after the operation. The multiple regression equation was expressed as follows: central vault (μm) = -1369.05+ 657.121 × ICL size- 287.408 × horizontal STS - 432.497 × crystalline LT - 137.33 × vertical STS (adjusted R2 = 0.643).Conclusions: After ICL implantation, vault decreased and then increased, but it did not return to the vault value at 2 hours after surgery. ICL size, horizontal and vertical STS and crystalline LT were key factors for predicting postoperative vaulting.
Factors Affecting Final Functional Outcomes in Open-Globe Injuries and Use of Ocular Trauma Score in Nepalese population
Authors: Shrestha Saurav Man , Anthony Casey Leigh , Grant Justin A. , Thapa Madhu , Shrestha Jyoti Baba , Khatri Anadi , Hoskin Annette K. , Agrawal Rupesh
Published: October 2020

Background: Open globe injury (OGI) is one of the most devastating form of ocular trauma. The aim of the study is to identify the epidemiology and predict visual outcomes in traumatic open globe injuries using ocular trauma score (OTS) and correlate with final visual acuity (VA) at 3 months. Methods: Patients older than 5 years, presenting to B.P. Koirala Lions Centre for Ophthalmic Studies (BPKLCOS) from March 2016- March 2017 with OGI that met inclusion criteria were evaluated. Patient profile, nature and cause of injury, and time to presentation were recorded. Patients were managed accordingly and followed up to 3 months. An OTS score for each patient was calculated and raw scores were categorized accordingly. The VA after 3 months were compared to the predicted OTS values. Results: Seventy-three eyes of 72 patients were examined. 76% were male, and the mean age was 26.17 years (median, 23.5 years). The mean time from injury to presentation was <6 hours (30 patients, 41%). Thirty-seven eyes (51%) had zone I trauma, followed by twenty eyes (27%) with zone II, and sixteen eyes (22%) with zone III trauma. Sixty-five patients (90%) were managed surgically, and fifty (68%) received intravitreal antibiotics with steroid. When compared, the projected VA as per OTS were able to predict actual final visual outcomes in 60% of the eyes with OGI of various zones (p<0.05). Conclusion: OTS can be an accurate predictive tool for final visual acuity even with a short follow up period of 3 months; with poor presenting visual acuity, delayed presentation, posterior zones of injury, need for intravitreal injections, endophthalmitis, and globe rupture associated with poorer prognosis.
Failure of labor induction in Tigray region, Ethiopia: a retrospective record review study
Authors: Abraha Teklehaymanot Huluf , Kasahun Wondwossen Wollie , Fisseha Gezienesh Kahsay
Published: October 2020

Background: Failed induction of labour is defined as when there is failure to generate regular contractions (i.e, every 3 minute) and cervical change after artificial membrane rupture and at least 24 hour of oxytocin use However, the magnitude of failed induction labor in Tigray is not well documented. Therefore, the objective of this study was to assess the magnitude and factors associated with failed induction of labor in the study area. Methods: We conducted institution-based- retrospective record review study of all inductions of labor conducted from April 9, 2017- April 8, 2018(n=380) in Axum St.Mary hospital, Tigray, Ethiopia. Data were entered and analyzed using SPSS version 21 software. The data were cleaned before analysis. Descriptive statistics such as frequency and mean were used to describe the study participants. For the multivariable logistic, binary logistic regression a two tailed p-value <0.05 was performed to show statistical significant. Results: The magnitude of failure of labor induction was found 11.8% (95% CI: 8.7-15.3%). The multivariable binary logistic regression analysis showed that primi-parity (AOR=4.31, 95% CI; 1.22-15.18) and poor Bishop Score (AOR=10.67, 95%CI: 1.31-86.87) were significantly associated with failed induction of labor. Conclusion and recommendation: The failed of labor induction was found high in the study area. The health care providers should assess and document the status of the cervix (using the Bishop score) to determine the probability of success and to select the appropriate method of induction. In addition, they need to consider induction of women with an unfavorable cervix is associated with high failure and a higher caesarean section.
A case report of greater saphenous vein thrombosis in a patient with coronavirus (COVID-19) infection
Authors: Hesam-Shariati Negin , Fatehi Poya , Fathi Fardin , Abouzaripour Morteza , Shariati Mohamad Bakhtiar Hesam
Published: October 2020

In December 2019, the World Health Organization (WHO) announced a series of pneumonia cases caused by an unknown origin, discovered in Wuhan, China. A dangerous virus called SARS-Cov-2 (severe acute respiratory syndrome coronavirus 2) caused a disease named acute respiratory syndrome, which was later popularly called coronavirus infection (COVID-19). Patients with acute COVID-19 are at high risk for thrombosis in various blood vessels due to over-coagulation, blood stasis, and endothelial damage. To date, very little research has been done on the number and side effects of thromboembolic disorders in patients with COVID-19. In this study, we report a case with COVID-19, who was hospitalized in one of the hospitals in Sanandaj, Iran. There were symptoms of fever, chills, muscle aches, cough, and tachycardia. Laboratory tests such as CRP, ESR, Ferritin CLIA, LDH and D-Dimer were observed in this patient at a high level. Doppler ultrasound of this patient revealed an abnormal finding, thrombosis in the right greater saphenous vein. This suggests that COVID-19 may lead to other side effects through damage to blood vessels.
Drivers of food choices among households in Kersa District, Eastern Ethiopia
Authors: Assefa Nega , Tolera Abebe , Dessie Yadeta , Abraham Aklilu , Demissie Lemma , Teji Kedir , Madzorera Isabel , Canavan Chelsey R , Fawzi Wafaie
Published: October 2020

Introduction: Most individuals in low and middle income countries do not meet nutritional requirements. This can be at least partially attributed to poor diet quality, which is impacted by both external and personal food environment factors. Personal food choice factors among socio-economically disadvantaged groups of Ethiopia are not well researched. Objective: This study aimed to assess food choice factors in eastern Ethiopia. Methods: A cross-sectional quantitative study was conducted among 1196 households in Kersa, Eastern Ethiopia with women age 18-49 years. Confirmatory factor analysis models were used to estimate factors that influence food choice. Cronbach’s alpha for internal reliability coefficients were tested. Results: A majority of respondents were employed in agricultural work and a quarter of the families were poor. Women were primarily responsible for household food procurement. Factors that play a role in food choice included food price, convenience, quality, household preference, household food production and market advertisement. Conclusion: Improving nutritional knowledge and diversifying food availability may help to improve food choices and dietary intake in this rural part of eastern Ethiopia.
Lung segmentectomy assisted by highly selective independent segmental ventilation
Authors: Shi Xiaoshun , Ye Jing , Chen Junyong , Zhai Jianxue , Liu Xiguang , Lu Di , Ni Zhen , Wu Hua , Cai Kaican
Published: October 2020

Background: The identification of targeted intersegmental plane and resection with adequate surgical margin is one of the crucial steps in anatomical pulmonary segmentectomy, and improvements are still needed.Case presentation: Three cases of intersegmental plane identification using highly selective independent segmental ventilation during segmentectomy are reported. All cases required the cooperation with anaesthesiologist who is able to perform segmental ventilation and double confirmation of branch of segmental bronchus by surgeon. The surgical procedure provides a direct visualization of spare segment inflation and saving time in deflation by the conventional residual segment inflation method. Conclusions: Highly selective independent segmental ventilation can be considered a suitable option for the pulmonary intersegmental plane identification, which could be universally used for lung segmentectomy.
Genome-wide detection of CNV regions and their potential association with growth and fatness traits in Duroc pigs
Authors: Qiu Yibin , Ding Rongrong , Zhuang Zhanwei , Wu Jie , Yang Ming , Zhou Shenping , Ye Yong , Geng Qian , Xu Zheng , Huang Sixiu , Cai Gengyuan , Yang Jie , Wu Zhenfang
Published: October 2020

Background: In the process of pig breeding, the average daily gain (ADG), days to 100 kg (AGE), and backfat thickness (BFT) are directly related to growth rate and fatness. However, the genetic mechanisms involved are not well understood. As an essential source of genetic diversity, copy number variation (CNV) that can affect a variety of complex traits and diseases, has gradually been thrust into the limelight. In this study, we reported the genome-wide CNVs of Duroc pigs by SNP genotyping data of 6,627 Duroc pigs. Moreover, we also performed CNV region (CNVR) based association analysis for growth and fatness traits in two Duroc populations.Results: Our study identified a total of 835 nonredundant CNVRs in American and Canadian Duroc pigs, which covered 226.73 Mb (~ 10.00%) of the pig autosomal genome. Among them, we identified 682 CNVRs in the American Duroc pigs and 424 CNVRs in the Canadian Duroc pigs, and 271 CNVRs were detected in both populations. Experimentally, 77.8% of randomly selected CNVRs were validated by quantitative PCR (qPCR). We also identified 24 significant CNVRs for growth and fatness traits though CNVR-based association analysis. Among these, six and three CNVRs in American and Canadian Duroc pigs were found to be associated with both ADG and AGE traits, respectively. Notably, four CNVRs showed both significant in ADG, AGE, and BFT, indicating that these CNVRs may play a pleiotropic role in regulating pig growth and fat deposition. Besides, further bioinformatics analysis determined a subset of potential candidate genes, such as PDGFRB, INSIG1, GPER1, PDGFA, and LPCAT1.Conclusions: The present study provides a necessary supplement to the CNV map of the Duroc genome through a large-scale population genotyping. Also, the CNVR-based association results provide a meaningful way to elucidate the genetic mechanisms of complex traits. The identified CNVRs can be used as molecular markers for genetic improvement in molecular-guided breeding of modern commercial pigs
Down-Regulated gga-miR-223 Inhibits Proliferation and Induces Apoptosis of MG-infected DF-1 Cells by Targeting FOXO3
Authors: Yin Xun , Wang Yingjie , Sun Yingfei , Han Yun , Sun Huanling , Zou Mengyun , Luo Ronglong , Xiuli Peng
Published: October 2020

BackgroundMycoplasma gallisepticum (MG) is a major poultry pathogen that can induce Chronic Respiratory Disease (CRD) in chickens, causing serious economic losses in poultry industry worldwide. Increasing evidence suggests that microRNAs (miRNAs) act as a vital role in resisting microbial pathogenesis and maintaining cellular mechanism. Our previous miRNAs sequencing data showed that gga-miR-223 expression level significantly decreased in MG-infected chicken lungs. The aim of this study was to reveal the role of gga-miR-223 in MG-induced CRD progression. ResultsWe found that gga-miR-223 was remarkably down regulated and forkhead box O3 (FOXO3) was up-regulated in both MG-infected chicken embryos lungs and the chicken embryonic fibroblast cell line (DF-1) by qPCR. FOXO3 was verified as the target gene of gga-miR-223 through bioinformatics analysis and dual-luciferase reporter assay. Further studies showed that overexpressed gga-miR-223 could promote cell proliferation, cell cycle, and inhibit cell apoptosis by notably promoting the expression of cell cycle marker genes cyclin-dependent kinase 1 (CDK1), cyclin-dependent kinase 6 (CDK6) and Cyclin D1 (CCND1) and inhibiting the expression of apoptosis markers Bcl-2-like 11(BIM), FAS ligand (FASLG) and TNF-related apoptosis-inducing ligand (TRAIL). As expected, FOXO3 knockdown group got similar results. Overexpression of gga-miR-223 observably promoted cell multiplication, cell cycle progression, and inhibited apoptosis of MG-infected DF-1 cells, while inhibited gga-miR-223 had the opposite effect. ConclusionsTaken together, upon MG-infection, downregulated gga-miR-223 could decrease proliferation, cycle progression, and increase apoptosis through directly targeting FOXO3 to exert an aggravating MG-infectious effect.
Recurrence of Positive SARS-CoV-2 RNA in a COVID-19 Patient: Two Case Reports from Saudi Arabia
Authors: Alturaif Sarah , Alharbi Remaaz , Alqurashi Waleed , Alsadoon Abdulaziz , Alabdullatif Meshari
Published: October 2020

Background The rapid spread of the COVID-19 pandemic which took a place in Wuhan, China and diffused globally required the international public health to take a coordinated international response. As other coronaviruses were described, SARS-CoV-2 was thought to be an immunizing, monophasic disease. Herein, we reported first two COVID-19 cases registered in Saudi Arabia whose nasopharyngeal swabs turned positive for SARS-CoV-2 ribonucleic acid (RNA) after recovery.Case presentation First patient who is symptomatic with recurrence of positive SARS-CoV-2 RNA occurred 115 days after the first symptomatic infection and did not develop protective immune response. Second patient who is asymptomatic during the recurrence of positive SARS-CoV-2 RNA occurred 60 days after the first symptomatic infection in an apparently immunocompetent patient.Conclusion These findings highlight the recurrence of positive SARS-CoV-2 after recovery even if SARS-CoV-2 antibodies were developed.
Persistent infection with SARS-CoV-2 – first direct evidence
Authors: Liu Tao , Tao Huangheng , Peng Jianping , Zhou Fuling , Liu Tongzu , Wang Xinghuan
Published: October 2020

Whether persistent infections with SARS-CoV-2 exist is still unknown. This study reported a case with COVID-19 who still got positive RT-PCR test results for SARS-CoV-2 in his throat swabs about 4 months post symptom onset. This case is potentially the first direct evidence of persistent infection with SARS-CoV-2.
Implementation, Spread and Impact of The Patient Oriented Discharge Summary (PODS) Across Ontario Hospitals: A Mixed Methods Evaluation
Authors: Hahn-Goldberg Shoshana , Huynh Tai , Chaput Audrey , Krahn Murray , Rac Valeria , Tomlinson George , Matelski John , Abrams Howard , Bell Chaim , Madho Craig , Ferguson Christine , Turcotte Ann , Free Connie , Hogan Sheila , Nicholas Bonnie , Oldershaw Betty , Okrainec Karen
Published: October 2020

BACKGROUND: Traditional discharge processes lack a patient-centred focus. This project studied the implementation and effectiveness of an individualized discharge tool across Ontario hospitals. The Patient Oriented Discharge Summary (PODS) is an individualized discharge tool with guidelines that was co-designed with patients and families to enable a patient-centred process. METHODS: Twenty one acute-care and rehabilitation hospitals in Ontario, Canada engaged in a supported community of practice and worked over a period of 18 months to implement PODS. An effectiveness-implementation hybrid design using a triangulation approach was used with hospital-collected data, patient and provider surveys, and interviews of project teams. Key outcomes included: reach within and spread outside target populations, change in patient-centred processes, patient and provider experience, understanding of discharge instructions, and healthcare utilization. Statistical methods included linear mixed effects models and generalized estimating equations. RESULTS: Of 65,221 discharges across hospitals, 41,884 patients (64%) received a PODS. There was variation in reach and implementation pattern between sites, though none of the between site covariates was significantly associated with implementation success. Both high participation in the community of practice and scoring highly on quality of PODS were associated with higher implementation success. PODS improved family involvement during discharge teaching (7% increase, p=0.026), use of teach-back (11% increase, p<0.001) and discussion of help needed (6% increase, p=0.041). Although unscheduled healthcare utilization decreased with PODS implementation, it was not statistically significant.CONCLUSIONS: This project highlighted the system-wide adaptability and ease of implementing PODS across multiple patient groups and hospital settings. PODS demonstrated an improvement in patient-centred discharge processes linked to quality standards and health outcomes. A community of practice and high quality content may be needed for successful implementation.
Ureteral Calculi Associated with High-Altitude Polycythemia: A Case Report and Literature Review
Authors: Yang Min , Wuren Tanna , Ma Kexiong , Ge Ri-Li , Ji Linhua , Cui Sen
Published: October 2020

Background: High-altitude polycythemia (HAPC) is a common disease in high-altitude areas characterized by excessive erythrocyte proliferation and severe hypoxemia. Recently, the incidence of ureteral calculi has a rising trend. However, cases of ureteral calculi associated with high-altitude polycythemia have not been reported. Case Presentation: We present the cases of two patients with HAPC who were born in the lowlands and worked in high altitudes and were admitted to the hospital with acute severe pain in the ureter as the first symptom. Urological examinations confirmed the presence of a ureteral stone. Interestingly, the biochemical tests showed elevated serum uric acid levels and the calculous component analysis suggested anhydrous uric acid. Recently, extensive research has demonstrated a significant correlation between hyperuricemia and high-altitude polycythemia. Therefore, we speculated that the occurrence of ureteral calculi among immigrants to the plateau might be related to hyperuricemia associated with high-altitude polycythemia. Conclusions: This case report and literature review highlights that the prevention of ureteral calculi in patients with polycythemia who immigrate to the plateaus from high-altitude areas should be considered. Additionally, the serum uric acid levels and urine pH should be monitored regularly.
Use of Lipid Parameters to Identify Healthy Men at a Higher Risk of Arterial Stiffness Progression
Authors: Sang Yu , Cao Ming , Wu Xiaofen , Ruan Lei , Zhang Cuntai
Published: October 2020

Background: Dyslipidemia contributes to the development and progression of arterial stiffness. We aimed to confirm the superiority of the serum lipids and their calculated ratios in predicting arterial stiffness progression.Methods: Total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and brachial-ankle pulse wave velocity (baPWV) of 612 healthy males (47.0 ± 10.5 years) were measured at baseline. Values for non-HDL-C, TC/HDL-C, TG/HDL-C, LDL-C/HDL-C, and non-HDL-C/HDL-C were calculated. BaPWV was re-performed after 4.1 years follow-up. A baPWV cutoff of 1400 cm/s was used to diagnose arterial stiffness.Results: Over the follow-up period, the mean baPWV value increased from 1330 cm/s to 1400 cm/s, and 309 individuals increased/persisted with high baPWV (outcome 1). Among the 430 subjects who were free of arterial stiffness at baseline, 90 arterial stiffness events occurred (outcome 2). Only logTG (OR 1.65 [95% CI: 1.14-2.40] for outcome 1; 2.08 [1.24-3.52] for outcome 2) and logTG/HDL-C (1.56 [1.15-2.13] for outcome 1; 1.69 [1.10-2.62] for outcome 2) were significantly associated with arterial stiffness progression after adjusting for confounding factors. Adding logTG or logTG/HDL-C to age and blood pressure improved the accuracy of risk predictions for arterial stiffness progression. These associations remained significant when lipids were analyzed as categorical variables.Conclusions: Baseline serum TG and TG/HDL-C were independently associated with increases in/persistently high baPWV and incident arterial stiffness, and they performed more effectively than other lipid variables in identifying healthy men at a higher risk of arterial stiffness progression.
Different Doses of Erenumab for Preventive Treatment of Episodic Migraine: A Systematic Review and Network Meta-Analysis
Authors: Yang Yanbo , Chen Mingjia , Wang Zilan , Sun Yue , Jiang Fan , Chen Zhouqing , Wang Zhong
Published: October 2020

Background Erenumab is a novel monoclonal calcitonin gene–related peptide receptor antibody that is used for the preventive treatment of migraine.Objectives To evaluate overall safety and efficacy and dose-response relationship of erenumab in patients with episodic migraine and patients with prior migraine treatment failures.Methods We searched randomized clinical trials on PUBMED, EMBASE database, and Cochrane Library database. A pair-wise meta-analysis and Bayesian network analysis were performed.Results For efficacy outcomes, the network meta-analysis suggests that compared with erenumab 70 mg, participants received erenumab 140 mg reported significantly decreased MSMD and increased 50% response rate, and erenumab was most likely to be ranked first for MMD, MSMD and 50% response rate. For safety outcomes, the network meta-analysis has found no significant difference between the 70 mg group and the 140 mg group measured by AE and SAE. For patients with ≥2 treatment failures, 140mg erenumab group, patients with ≥2 treatment failures reported significantly reduced MMD and MSMD, increased 50%, and 75% response rate, compared with placebo. For safety outcomes, no significant difference was found between 140 mg erenumab group and the placebo group.Conclusion Erenumab was effective in patients with episodic migraine. 140 mg erenumab was associated with better efficacy outcomes without increased risk for developing adverse events compared with 70 mg erenumab, and 140 mg erenumab was effective in patients with prior migraine treatment failures.Registration number: CRD42020198985
Using Weighted Gene Co-Expression Network Analysis to Identify Key Genes Related to the Onset of Preeclampsia
Authors: Shen Xinyang , Wang Zhijian , Zeng Zhirui , Huang Zhenqin , Huang Xiaowei , Zhang Lizi , Pan Shumin , Xie Lijia , Li Jiaqi , Chen Lu , Yue Xiaojing
Published: October 2020

Background: Preeclampsia is a form of hypertension in pregnancy, which induced by complicated factors. However, the pathogenesis of the disease is unclear. The present study was aimed to discover the critical biomarkers associated with the occurrence and development of preeclampsia. Methods：Gene data profile GSE75010 was downloaded from the Gene Expression Omnibus (GEO) database and used as discovery cohort to establish a WGCNA network determining significant modules which associated with clinical traits. Subsequently, functional enrichment analysis, pathway analysis and protein-protein interaction (PPI) network construction were performed on the core genes in significant modules to identify hub genes. Then, gene data profile GSE25906 was used as verified cohort to determine their diagnostic value of hub genes. The protein expression levels of these hub genes in preeclampsia and control placental tissues were verified using immunohistochemistry method. Finally, GSEA was performed to analyze their enrichment pathways. Results: Total 33 co-expression modules were identified after the establishment of WGCNA, of which 4 gene modules were identified as significant modules because they were related to multiple (>3) clinical traits. Total 75 core genes in significant modules were analyzed, and results showed that they were mainly enriched in adaptive immune response (Gene Ontology term) and platelet activation (Kyoto Encyclopedia of Genes and Genomes term). Finally, a total of 5 genes including TYROBP, PLEK, LCP2, HCK, ITGAM were identified as hub genes which scored high in PPI network and had high diagnostic value. Furthermore, the protein level of these 5 genes in placental tissues of preeclampsia was lower than that of the control group. Moreover, these 5 genes were all enriched in 17 pathways, including autoimmunity pathway. Conclusions：These 5 genes (TYROBP, PLEK, LCP2, HCK, ITGAM) may be closely related to the pathogenesis of preeclampsia, which may also help the diagnosis and therapy of preeclampsia.
A North-South-South Partnership in Higher Education to Develop Health Research Capacity in the Democratic Republic of Congo: the Challenge of Finding a Common Language
Authors: Horwood Christiane , Mapumulo Sphindile , Haskins Lyn , John Vaughn , Luthuli Silondile , Tylleskär Thorkild , Mutombo Paulin , Engebretsen Ingunn M. S. , Ali Mapatano Mala , Hatløy Anne
Published: October 2020

Background: Globally, increasing numbers of higher education institutions (HEIs) in non-English-speaking countries have adopted English as a medium of instruction (EMI), because of the perception that this provides opportunities to attract high calibre students and academic staff, and engage with the international research community. We report an evaluation of a North-South-South collaboration to develop health research capacity in Democratic Republic of Congo (DRC) by establishing a postgraduate programme in nutritional epidemiology at the Kinshasa School of Public Health (KSPH), where English was adopted as the medium of instruction. We report experiences and perceptions of stakeholders, facilitators and students about using EMI.Methods: In-depth qualitative interviews were conducted between October-December 2019 among purposively sampled stakeholders (8), facilitators (11) and students (12) involved in the programme from all three partner institutions (University of Kinshasa; University of KwaZulu-Natal, South-Africa; University of Bergen, Norway). Interviews were conducted in participants’ language of preference (English or French), audio-recorded, transcribed verbatim and translated into English when required. Analysis employed a thematic approach. Results: Most participants viewed EMI positively, reporting that studying in English created opportunities to access relevant literature, improve interactions with the scientific community and advance their careers. As a result of adopting EMI, some students had opportunities to present research findings at international conferences, and publish their research in English. English-speaking researchers from partner institutions were able to participate in supervision of students’ research. However, inadequate English competency, particularly among students, was challenging, with some students reporting being unable to understand or interact in class, which negatively affected their academic performance. Further, EMI created barriers at KSPH among academic staff who were not proficient in English, leading to lack of integration with other postgraduate programmes. Participants suggested additional English language support for EMI.Conclusion: Partnerships between HEIs are a powerful tool to develop research capacity in low income countries and improve research outputs and evidence-based decision-making. EMI was able to develop the common ground required to establish a collaboration between HEIs where several languages were spoken. However, investing in wide-ranging supports to develop English proficiency is essential to ensure that challenges do not outweigh the benefits.
School-Based Interventions Targeting Double Burden of Malnutrition and Educational Outcomes of Adolescents in Low- and Middle-Income Countries: Protocol for a Systematic Review
Authors: Shinde Sachin , Wang Dongqing , Fawzi Wafaie W
Published: October 2020

BackgroundAdolescence is a period of rapid physical growth and transition between childhood to adulthood. However, in many developing countries, nutritional and epidemiological transitions are contributing to surging overnutrition, which, together with prevalent undernutrition, is resulting in the double burden of malnutrition (DBM) among adolescents. Schools as social systems have tremendous but mostly underutilized capacity to facilitate change and address a range of nutritional and associated educational concerns of adolescents and young people. The main objective of this systematic review will be to synthesize the evidence on school-based nutrition interventions that aimed to address the DBM, and the associated educational outcomes among adolescents from low- and middle-income countries (LMICs).MethodsComprehensive literature searches will be conducted in multiple electronic databases, including the Medline (through PubMed), Embase, CENTRAL (through Cochrane Library), CINAHL, and Google Scholar. We will include randomized controlled trials (RCTs), controlled before-after studies, and non-randomized controlled trials examining the effects of nutrition interventions on DBM and educational outcomes among adolescents (10−19−years−old) in LMICs. Two reviewers will independently screen all citations and full-text articles and abstract data. The quality of the included studies will be assessed with the Cochrane Collaboration’s tool for assessing the risk of bias for RCTs and the Risk Of Bias In Non-randomized Studies of Interventions tool for controlled before-after studies and non-randomized controlled trials. DiscussionTo maximize the power of schools as a platform to reinforce the mutually beneficial relationship between adolescent nutrition and education, it is imperative to develop and implement integrated interventions connecting schools, adolescents, parents, communities, and the health care system. The results of this systematic review will provide a comprehensive state of current knowledge on the effectiveness of school-based interventions to enable future research that maximizes the impact and efficiency of integrated approaches to tackle multiple forms of malnutrition among school-going and out-of-school adolescents.Systematic review registrationPROSPERO ID: 211109 (under review)
Challenge of treating cancer amid the COVID-19 pandemic: case of skeletal muscle metastasis from primary carcinoma of the lung mistaken as sarcoma
Authors: Casas Maria Gloria Elisha , Rosario Mamer , Battad Geoffrey , Mercado Adrienne Camille , Hermogenes Trisha Ann , Hernandez Alvin , Dy-Ledesma Janelyn , Alomesen Avelino , Valera Juancho Lorenzo , Dy Arnel Christian
Published: October 2020

Background. The authors report on an extremely rare case of skeletal muscle metastasis from primary lung cancer that involved the radial nerve and humerus, which was “overtreated” with wide tumor resection and frozen autograft reconstruction upon misdiagnosis of sarcoma by intraoperative frozen section, amid pressure of expediting hospital care during the COVID-19 pandemic. Case presentation. A 61-year-old male living outside Metro Manila presented with painful mass in his left distal arm during the enhanced community quarantine, and requested admission upon testing negative for COVID-19. Imaging studies suggested a diagnosis of soft tissue sarcoma involving the radial nerve and humerus, and intending to prevent nosocomial SARS-CoV-2 infection of patient, treatment was expedited by foregoing biopsy and opting for intraoperative frozen section prior to resection. Frozen section findings suggested malignancy intraoperatively, and we proceeded with wide tumor resection and frozen autograft reconstruction of the humerus using plates and screws. However, permanent sections revealed metastatic carcinoma from primary non-small cell lung cancer, with PET scan confirming lung mass in the right apical lobe. Conclusion. The report concludes that establishment of a definite tumor diagnosis by final histopathological analysis is indispensable, even when planning for emergent surgery in the time of COVID-19 pandemic.
Evaluation of SARS-CoV-2 clearance period in patients with COVID-19: a systematic review and meta-analysis
Authors: Okita Yasutaka , Morita Takayoshi , Kumanogoh Atsushi
Published: October 2020

Background: There is insufficient consensus on the viral shedding period in each background of patients with coronavirus disease 2019 (COVID-19).Methods: We conducted a comprehensive systematic review and meta-analysis according to the PRISMA guidelines. PubMed and Web of Science were searched for original studies reporting the viral shedding period in patients with COVID-19. A random effects model was used to calculate the mean number of days from the onset. Subanalysis was performed focusing on age, sex, severity, locality, and treatment.Results Of 55 studies identified, 12 met the selection criteria. The viral shedding period tended to be longer in sputum (19.03 days) than in nasopharynx (14.58 days). The viral shedding period in nasopharynx tended to be longer in severe patients (23.65 days) than in nonsevere patients (12.67 days). It also tended to be longer in patients treated with steroid (21.24 days) than in patients treated without steroid (12.20 days). This period tended to be longer in Asia (16.07 days) than in Europe (12.57 days). Age, sex, and anti-viral drugs did not affect the viral shedding period.Conclusions Severity, steroid usage, and locality may affect the viral shedding period.
Nanopore sequencing and de novo assembly of a misidentified Camelpox vaccine reveals putative epigenetic modifications and alternate protein signal peptides
Authors: Saud Zack , Hitchings Matthew D. , Butt Tariq M.
Published: October 2020

DNA viruses can exploit host cellular epigenetic processes to their advantage; however, the epigenome status of most DNA viruses remains undetermined. Third generation sequencing technologies allow for the identification of modified nucleotides from sequencing experiments without specialized sample preparation, permitting the detection of non-canonical epigenetic modifications that may distinguish viral nucleic acid from that of their host, thus identifying attractive targets for advanced therapeutics and diagnostics. We present a novel nanopore de novo assembly pipeline used to assemble a misidentified Camelpox vaccine. Two confirmed deletions of this vaccine strain in comparison to the closely related Vaccinia virus strain modified vaccinia Ankara make it one of the smallest non-vector derived orthopoxvirus genomes to be reported. Annotation of the assembly revealed a previously unreported signal peptide at the start of protein A38 and several signal peptides that were found to differ from those previously described. Putative epigenetic modifications around various motifs have been identified and the assembly confirmed previous work showing the vaccine genome to most closely resemble that of Vaccinia virus strain Modified Vaccinia Ankara. The pipeline may be used for other DNA viruses, increasing the understanding of DNA virus evolution, virulence, host preference, and epigenomics.
Discussion on the Cenozoic tectonic evolution and dynamics of southern Tibet
Authors: Liu Demin , Yang Weiran , Guo Tieying , Ru Jiangtao , Xiong Aimin
Published: October 2020

Opening-closing tectonics is a new idea for exploring the global tectonics, which holds that every tectonic movement of all materials and geological bodies on earth is characterized by opening and closing. The opening-closing tectonic view can be used to explain some geological phenomena developing in continents which cannot be reasonably explained by the theory of plate tectonics. Based on the available basic geological data and combining with the opening-closing view, we analyzed the divisions and characteristics of tectonic units in South Tibet, and propose that Tibet can be divided into gravitational detachment and detachment fault zones, which are superimposed thrust fault zones and reconstructed normal fault zones, respectively. Although the mainstream opinion believed that the Tibetan Plateau is formed by collision-compression orogenesis, field investigation revealed the existence of the Rongbu Temple normal fault in the 1970s. We consider that the Rongbu Temple normal fault and the Main Central Thrust were formed earlier than the South Tibet detachment fault, and the former two faults constitute the two boundaries of the southern Tibet extrusion structure. The South Tibet detachment fault partially superimposes on the Main Central Thrust and manifests a relatively high angle in following the Rongbu Temple normal fault north of the Chomolangma. We suggest that the three fault systems are the products of different periods and tectonic backgrounds. The tectonic units, such as klippes and windows identified by previous researchers in southern Tibet, belong to thrust fault system but usually have no obvious extrusion or thrust characteristics; however, they are characterized by missing strata columns as younger strata overlapping the older ones. These klippes and windows should be the results of later gravitational decollement and must be characterized as extensions and slips, respectively. Based on opening-closing theory, we suggest that since the Cenozoic the study area had undergone multistage development, which can be divided into the oceanic crust expansion (opening) and subduction (closing) and the continental collision (closing) and intracontinental extension (opening) stages. Geothermal energy from the deep earth, gravitational potential energy from the earth’s interior, and additional stress energy from tectonic movements, all played a key role in the multistage tectonic evolutionary process.