bluuebunny/crossref_metadata_2025 huggingface dataset:
Intramedullary reaming and irrigation and antibiotic-loaded calcium sulfate implantation for the treatment of infection after intramedullary nailing: a retrospective study of 19 cases
Authors: Zhang Hong-An , Zhou Chun-Hao , Meng Xiang-Qing , Fang Jia , Qin Cheng-He
Published: August 2020

Background: The incidence of intramedullary infection is increasing with increased use of intramedullary fixation for long bone fractures. However, appropriate treatment for infection after intramedullary nailing is unclear. The purpose of this study was to report the results of our treatment protocol for infection after intramedullary nailing: intramedullary nail removal, local debridement, reaming and irrigation, and antibiotic-loaded calcium sulfate implantation with or without segmental bone resection and distraction osteogenesis. Methods: We retrospectively reviewed the records of patients with an infection after intramedullary nailing treated from 2014 to 2017 at our center. Patients with follow-up of less than 24 months, received other treatment methods, or those with serious medical conditions were excluded from the analysis. Patients met the criteria were treated as described above, followed by distraction osteogenesis in 9 cases to repair bone defect. The infection remission rate, infection recurrence rate, and post-operative complication rates were assessed. Results: A total of 19 patients were included in the analysis. All of patients had satisfactory outcomes with an average follow-up of 38.1 ± 9.4 months (range, 24 to 55months). Eighteen patients (94.7%) achieved infection remission; 1 patient (5.3%) developed a reinfection that resolved after repeat debridement. Nine patients with bone defects (average size 4.7 ± 1.3 cm; range, 3.3 to 7.6 cm) were treated with bone transport which successfully restored the length of involved limb. The mean bone transport duration was 10.7 ± 4.0 months (range, 6.7 to 19.5 months). The majority of patients achieved full weight bearing and became pain free during the follow-up period. Postoperative complications mainly included prolonged aseptic drainage (7/19; 36.8%), re-fracture (1/19; 5.3%) and joint stiffness, which were successfully managed by regular dressing changes and re-fixation, respectively. Conclusion: Intramedullary nail removal, canal reaming and irrigation, and antibiotic-loaded calcium sulfate implantation (with or without distraction osteogenesis) is effective for treating infections after intramedullary nailing.
The effects of family, society and national policy support on treatment adherence among newly diagnosed tuberculosis patients: a cross-sectional study
Authors: Chen Xu , Du Liang , Wu Ruiheng , Xu Jia , Ji Haoqiang , Zhang Yu , Zhu Xuexue , Zhou Ling
Published: August 2020

Background

Non-adherence to tuberculosis (TB) treatment is the most important cause of poor TB outcomes, and improving support for TB patients is a primary priority for governments, but there has been little research on the effects of family, social and national policy support factors on TB treatment adherence. The current study evaluated treatment adherence among newly diagnosed TB patients in Dalian, north-eastern China, and determined the effects of family, society, and national policy support factors on treatment adherence.

Methods

A cross-sectional survey was conducted among newly diagnosed TB patients treated at the outpatient department of Dalian Tuberculosis Hospital from September 2019 to January 2020. Data were collected using a questionnaire that measured medication adherence, family support, social support, and national policy support and so on. Differences between groups were assessed using Chi-square tests and Fisher’s exact tests. Ordinal logistic regression analysis was used to determine the predictors of adherence.

Results

A total of 481 newly diagnosed TB patients were recruited, of whom 45.7% had good adherence, and 27.4% and 26.8% had moderate and low adherence, respectively. Patients who had family members who frequently supervised medication (OR:0.34, 95% CI:0.16-0.70), family members who often provided spiritual encouragement (OR:0.13, 95% CI:0.02-0.72), a good doctor-patient relationship (OR:0.61, 95% CI:0.40-0.93), more TB-related knowledge (OR:0.49, 95% CI:0.33-0.72) and a high need for TB treatment policy support (OR:0.38, 95% CI:0.22-0.66) had satisfactory medication adherence. However, patients who had a college degree or higher (OR:1.69, 95% CI:1.04-2.74) and who suffered adverse drug reactions (OR:1.45, 95% CI:1.00-2.11) were more likely to have lower adherence.

Conclusions

Our findings suggested that non-adherence was high in newly diagnosed TB patients. Patients who had family members who frequently supervised medication and provided spiritual encouragement and a good doctor-patient relationship and TB-related knowledge and a high need for policy support contributed to high adherence. It is recommended to strengthen medical staff training and patient and family health education and to increase financial support for improving adherence.
Inequality, Chronic Undernutrition, Maternity, and Diabetes Mellitus as the determinant of anemia among ever-married women in Bangladesh.
Authors: Islam GM
Published: August 2020

Background: Anemia is a public health concern at a global level. This study aims to delineate the association between household economic inequalities, along with other confounders, and anemia among reproductive age group women in Bangladesh.Methods: A cross-sectional population sample comprising of 5920 reproductive age group women aged between 15–49 years was selected, and the analyses were performed through the application of proportional odds models.Results: The respondents from low and medium socioeconomic status (SES) households vs. richest households were 1.90 (95% CI, 1.65–2.17; p<.01) and 1.41 (95% CI, 1.12–1.78; p<.01) times more likely to suffer from anemia. The likelihood of being anemic reduces for the low and medium SES groups vs. high SES group when sociodemographic variables are added (OR, 1.69, 95% CI, 1.43–1.99 and OR, 1.35, 95% CI, .07–1.70; p<0.01, respectively). After adding the variables of diabetes and maternity status, the association between having anemia belonging to low and medium SES vs. high SES becomes weaker (OR,1.36, 95% CI,0.85–2.15 and OR, 1.15, 95% CI, 0.6–2.19; p>.05, respectively). Moreover, the strength of the association between anemia and the subjects with pregnant and lactating vs. the subjects without these conditions was reduced after factoring body mass index (BMI).Conclusions: BMI, pregnancy, and diabetes mellitus were observed to be significantly associated with anemia, and the strength of the association was low with anemia and socioeconomic inequality.
Seasonal Variation in the Onset of Acute Calcific Tendinitis of Rotator Cuff
Authors: Furuhata Ryogo , Matsumura Noboru , Yoshiyama Akira , Kamata Yusaku , Takahashi Masaaki , Morioka Hideo
Published: August 2020

Background

Calcific tendinitis of the rotator cuff is a disorder that causes acute onset of shoulder pain when spontaneous resorption of the calcification occurs. However, factors that trigger calcium resorption have not been clarified. The present study aimed to investigate the association between the onset of calcium resorption in calcific tendinitis and the season of onset.

Methods

We retrospectively reviewed 195 patients ( female, 116; male, 79; mean age, 62.6 ± 14.2 years; median age, 62 [52, 73] years) diagnosed with the postcalcification stage of calcific tendinitis, which was defined as acute calcific tendinitis in this study, between 2006 and 2018. The onset date of acute calcific tendinitis for each patient was collected from clinical notes. We evaluated the incidence of acute calcific tendinitis in each season and month. Furthermore, we investigated the correlation between the incidence of acute calcific tendinitis and the mean monthly temperature or humidity levels for each year.

Results

The most common season of acute calcific tendinitis onset was summer (35.4%), followed by spring (24.6%), autumn (24.1%), and winter (15.9%) ( P = 0.002). Monthly analyses showed the highest peak of onset was in July (15.4%) and the lowest peak was in February (3.1%) ( P = 0.022). The incidence of acute calcific tendinitis had a weak association with mean monthly temperature (R 2 = 0.066; P = 0.001) but was not associated with mean monthly humidity levels (R 2 = 0.018; P = 0.099).

Conclusions

This study provides new information on seasonal variation of acute calcific tendinitis onset. The results of this study indicated that the onset of calcium resorption occurs most frequently in the summer in Japan; however, the reasons for seasonal variation remain unclear, and further studies will be needed.
Revision surgery for instrumentation failure after total en bloc spondylectomy: a retrospective case series
Authors: Shinmura Kazuya , Kato Satoshi , Demura Satoru , Yokogawa Noriaki , Yonezawa Noritaka , Shimizu Takaki , Oku Norihiro , Kitagawa Ryo , Handa Makoto , Annen Ryohei , Murakami Hideki , Tsuchiya Hiroyuki
Published: August 2020

Background: There have been several reports of instrumentation failure after 3-column resections such as total en bloc spondylectomy (TES) for spinal tumours; nevertheless, clinical outcomes of revision surgery for instrumentation failure after TES are seldom reported. Therefore, this study assessed the clinical outcomes of revision surgery for instrumentation failure after TES. Methods: This study employed a retrospective case series in a single centre and included 61 patients with spinal tumours who underwent TES between 2010 and 2015 and followed for >2 years. Instrumentation failure rate, back pain, neurological deterioration, ambulatory status, operation time, blood loss, complications, bone fusion after revision surgery, and re-instrumentation failure were assessed. Data were collected on back pain, neurological deterioration, ambulatory status, and management for patients with instrumentation failure, and we documented radiological bone fusion and re-instrumentation failure in cases followed for >2 years after revision surgery. Results: Of the 61 patients, 26 (42.6%) experienced instrumentation failure at an average of 32 (range, 11−92) months after TES. Of these, 23 underwent revision surgery. The average operation time and intraoperative blood loss were 204 min and 97 ml, respectively. Including the six patients who were unable to walk after instrumentation failure, all patients were able to walk after revision surgery. Perioperative complications of reoperation were surgical site infection (n = 2) and delayed wound healing (n = 1). At the final follow-up, bone fusion was observed in all patients. No re-instrumentation failure was recorded. Conclusion: Bone fusion was achieved by revision surgery using the posterior approach alone.
­­­An Integrated Autophagy-Related Gene Signature Predicts Prognosis in Human Endometrial Cancer
Authors: Zhang Jun , Wang Ziwei , Zhao Rong , An Lanfen , Zhou Xing , Zhao Yingchao , Wang Hongbo
Published: August 2020

Background

Globally, endometrial cancer is the fourth most common malignant tumor in women and the number of women being diagnosed is increasing. Tumor progression is strongly related to the cell survival-promoting functions of autophagy. We explored the relationship between endometrial cancer prognoses and the expression of autophagy genes using human autophagy databases.

Methods

The Cancer Genome Atlas was used to identify autophagy related genes (ARGs) that were differentially expressed in endometrial cancer tissue compared to healthy endometrial tissue. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes were referenced to identify important biological functions and signaling pathways related to these differentially expressed ARGs. A prognostic model for endometrial cancer was constructed using univariate and multivariate Cox, and Least Absolute Shrinkage and Selection Operator regression analysis. Endometrial cancer patients were divided into high- and low-risk groups according to risk scores. Survival and receiver operating characteristic (ROC) curves were plotted for these patients to assess the accuracy of the prognostic model. Using immunohistochemistry the protein levels of the genes associated with risk were assessed.

Results

We determined 37 ARGs were differentially expressed between endometrial cancer and healthy tissues. These genes were enriched in the biological processes and signaling pathways related to autophagy. Four ARGs (CDKN2A, PTK6, ERBB2and BIRC5) were selected to establish a prognostic model of endometrial cancer. Kaplan–Meier survival analysis suggested that high-risk groups have significantly shorter survival times than low-risk groups. The area under the ROC curve indicated that the prognostic model for survival prediction was relatively accurate. Immunohistochemistry suggested that among the four ARGs the protein levels of CDKN2A, PTK6, ERBB2 and BIRC5 were higher in endometrial cancer than healthy endometrial tissue.

Conclusions

Our prognostic model assessing four ARGs (CDKN2A, PTK6, ERBB2, and BIRC5) suggested their potential as independent predictive biomarkers and therapeutic targets for endometrial cancer.
Association between sitting time and non-alcoholic fatty liver disease in South Korean population: a cross-sectional study
Authors: Joo Jae Hong , Kim Hwi Jun , Park Eun-Cheol , Jang Sung-In
Published: August 2020

Background: To examine the association between sitting time and non-alcoholic fatty liver disease among South Koreans aged ≥20 years. Methods: Data from the 2016–2018 Korea National Health and Nutrition Examination Survey were used for the analysis. Non-alcoholic fatty liver disease was diagnosed according to a hepatic steatosis index of >36. Sitting time was categorized into as Q1, Q2, Q3, and Q4 using the age-adjusted quartile with Q4 being the longest sitting hour. Multiple logistic regression analysis was used to examine the association between sitting time and non-alcoholic fatty liver disease in South Korean population. Results: A total of 13,518 participants were enrolled. The odds for having NAFLD in Q1, Q2, Q3, and Q4 (sitting hours) were 1.07 (CI: 0.88-1.31), 1.16 (CI: 1.96-1.41), and 1.34 (CI: 1.11-1.61), respectively. The odds ratio increased in magnitude with longer hours of sitting time (test for trend: P-value = 0.0002). Conclusion: Advising physical exercises and discouraging sedentary activities may help to alleviate NAFLD among the South Korean population.
Ultrasound Microbubbles-mediated Microrna-505 Regulates Cervical Cancer Cell Growth via AKT2
Authors: Xu Leilei , Zhang Qin , Li Changhua , Hua Fu , Liu Xiaoping
Published: August 2020

The authors have withdrawn this preprint due to erroneous posting.
Contact pressure distribution of the hip joint during closed reduction of developmental dysplasia of the hip: A Patient-Specific Finite Element Analysis
Authors: Zhang Zhiqiang , Li Hai , Sui Dashan , Qin Haiyi , Zhang Ziming
Published: August 2020

Background

Developmental dysplasia of the hip (DDH) is the most common deformity of the lower extremity in children, and the etiology remains unclear. The biomechanical change during closed reduction (CR) focused on cartilage contact pressure (CCP) has not been studied. Thereby, we try to provide insight into biomechanical factors potentially responsible for CR treatment success and complications by using finite element analysis (FEA) for the first time.

Methods

Finite element models of one patient with DDH were established based on the data of MRI scan on which cartilage contact pressure was measured. During CR, CCP between the femoral head and acetabulum in different abduction and flexion angles were tested to estimate the efficacy and potential risk factors of avascular necrosis (AVN) following CR.

Results

A 3D reconstruction by the FEA method was performed on a sixteen-month-old girl with DDH on the right side. The acetabulum of the involved side showed a long, narrow, and "plate-shaped" deformity, whereas the femoral head was smaller and irregular compared with the contralateral side. With increased abduction angle, the stress of the posterior acetabulum increased significantly, and the stress on the lateral part of the femoral head increased as well. The changes of CCP in the superior acetabulum were not apparent during CR. There were no detectable differences in terms of pressure on the femoral head.

Conclusions

Severe dislocation (IHDI grade III and IV) in children showed a high mismatch between the femoral head and acetabulum. Increased abduction angle corresponded with high contact pressure, which might relate to avascular necrosis, whereas increased flexion angle was not. Enhanced pressure on the lateral part of the femoral head might increase the risk of AVN.
Dynamic changes of lipid profile in severe hypertriglyceridemia-induced acute pancreatitis patients under double filtration plasmapheresis: a retrospective observational study
Authors: Zheng Huijun , Wang Donghai , Wang Xiaoling , Lin Yongjun , Lu Zhihua , Chen Yueliang , Feng Guo , Yang Na
Published: August 2020

Background: To investigate the dynamic change of lipid profile under double filtration plasmapheresis (DFPP) in severe hypertriglyceridemia-induced acute pancreatitis (sHTGP) patients and ascertain the association between these changes and the clinical prognosis.Methods: sHTGP patients admitted within 72h after disease onset were included, and all the patients received DFPP within 24h after admission. Lipid profile were detected on admission, consecutive 4 days after DFPP and at discharge.Results: There were 47 sHTGP patients enrolled in this study. At admission, all the parameters of lipid profile changed significantly except for low density lipoprotein. In the first day after DFPP, the serum level of TG, cholesterol and very low density lipoprotein declined significantly, while the high-density lipoprotein (HDL) as well as apoprotein A1 elevated obviously (P < 0.05). TG maintained the downward trend in the following three days and the other parameters kept steady. Linear regression analysis showed that HDL was negatively correlated with the duration of hospitalization among three adjusted models (P = 0.043, P = 0.029, P =0.025 respectively).Conclusion: There was distinct fluctuation of the lipid profile upon the burst of sHTGP and the parameters changed significantly in the first day after DFPP. Among these parameters, HDL may serve as a biomarker for disease prognosis in patients with sHTGP.
Quality of life of patients living with psoriasis: a qualitative study
Authors: Godoy Natalia , Meneguin Silmara , Pollo Camila Fernandes , Miot Helio Amante , Oliveira Cesar Messias
Published: August 2020

Background
Psoriasis is a multifactorial inflammatory disease prevalent in dermatology. We aimed to understand the perceptions of patients living with psoriasis in relation to their quality of life and to identify aspects to improve it.
Methods
This is qualitative research carried out in a dermatology outpatient clinic of the São Paulo State University (UNESP) medical school, Botucatu, Brazil, with 81 psoriasis patients. The interviews were transcribed and analysed using the Discourse of the Collective Subject method (DCS).
Results
Quality of life was linked to well-being, happiness, leisure, good food and financial stability. However, disease symptoms, social and clothing restrictions, impairment of professional activities and the absence of a cure, negatively influenced their perceptions. Suggestions for improvements included an increase of public awareness, stress reduction, disease acceptance and multidisciplinary care.
Conclusion
The meanings of quality of life revealed by the participants are subjective, multidimensional, linked to moments experienced by them and to the health-disease process. Public health policies promoting reduction in social stigma and stress as well as multidisciplinary approaches towards care can contribute to improvements of QoL in psoriasis.
Dual burden: the experience of depression among women living with HIV in Ethiopia- a qualitative study
Authors: Yousuf Abdilahi , Musa Ramli , Md. Muhammad Lokman , Arifin Siti Roshaidai Mohd
Published: August 2020

Background

Depression and HIV are common comorbid and their symptoms are inter-related. Depression remains disproportionately more prevalent among women who live in low-income countries and HIV circumstances, it is vastly ignored or not identified. Thus, little is known about the experience of depression by women living with HIV. The purpose of this study is to explore the experience of depression among women living with HIV.
Method:

A qualitative study was carried out and this research is a part of the larger mixed-method study. A face-to-face interview was conducted among women who attend Antiretroviral Therapy (ART) and who were eligible after depression screening. An interview guide was used for the data collection and the data was analyzed with the application of N-Vivo (version 11.0). Hence, a total of twenty-one women were recruited in this study.
Results

Women described their experience as stressful life events, lack of participation of social activities, concern over community acceptance, negative self-perception, feelings of hopelessness, including dealing with emotional suffering. However, this finding has revealed, in the course of the multifaceted nature of HIV and depression comorbidity, women’s experience was not constant instead it remained dynamic determined by the different psychosocial and clinical dimensions of the illnesses.
Conclusion

This study has elaborated that HIV positive women’s experience with depression was merely related to their psychosocial aspects, internalized personal attributes, disease traits regarding their life with comorbid diseases; HIV, and depression. Hence, future interventions should focus on the integration of mental health services in the HIV clinical setup.
Distinct Characteristics of Correlation Analysis at the Single-Cell and the Population Level
Authors: Wu Guoyu , Li Yuchao
Published: August 2020

Background:Correlation analysis is widely used in biological studies to infer molecular relationships within biological networks. Recently, single-cell analysis has drawn tremendous interests, for its ability to obtain high-resolution molecular phenotypes. It turns out that there is little overlap of co-expressed genes identified in single-cell level investigations with that of population level investigations. However, the nature of the relationship of correlations between single-cell and population levels remains unclear. In this manuscript, we aimed to unveil the origin of the differences between the correlation coefficients at the single-cell level and that at the population level, and bridge the gap between them. Results:Through developing formulations to link correlations at the single-cell and the population level, we illustrated that aggregated correlations could be stronger, weaker or equal to the corresponding individual correlations, depending on the variations and the correlations within the population. When the correlation-within is weaker than the individual correlation, the correlation at the population level is stronger than that at the single-cell level. Through a bottom-up approach to model interactions between molecules in a signaling cascade or a multi-regulator controlled gene expression, we surprisingly found that the existence of interaction between two components could not be excluded simply based on their low correlation coefficients, suggesting a reconsideration of connectivity within biological networks which was derived solely from correlation analysis. We also investigated the impact of technical random measurement errors on the correlation coefficients for the single-cell level and the population level. The results indicate that the aggregated correlation is relatively robust and less affected.Conclusions:Because of the heterogeneity among single cells, correlation coefficients calculated based on data of the single-cell level might be different from that of the population level. Depending on the specific question we are asking, proper sampling and normalization procedure should be done before we draw any conclusions.
The Effect of Skill-based Sexual Enhancement Counseling Program in Quality of life in Women with Multiple Sclerosis–a quasi-experimental study
Authors: Sayari Negin , Vakilian Katayon , Khalajinia Zohre , Hejazi Seyyed Amir , Vahedian Mostafa
Published: August 2020

Background: Multiple sclerosis (MS) is one of the world’s most common neurologic disorders and the leading cause of neurologic disability in young adults. This study aimed to investigate skill-based sexual enhancement counseling on Quality of Life (QLI) of women with Multiple Sclerosis.Methods: the present study is a quasi-experimental design with two groups. Forty-two patients with multiple sclerosis and their spouses (N=88) voluntarily participated in this study based on the inclusion and exclusion criteria. After obtaining the written consent forms, the couples were randomly assigned in two groups. The subjects in the intervention group (N=22 couples) received the skill-based sexual enhancement counseling program in six sessions (each for 90 minutes). The control group just received routine medical procedure during this period. Both groups completed three stages of pretest-posttest, and the standard MSQOL54 questionnaire 3 months later. Data were analyzed by SPSS-20 using descriptive and inferential statistics (repeated measures ANOVA, chi-square, Friedman and t-test).Results: The results showed that the participants' overall quality of life in the intervention group in pretest was 55.32±9.140 which increased to 73.89± 13.39 in posttest and to 92.59±20.45, 3 months later. Also, the physical quality of life showed a significant difference between the two groups 3 months after the intervention (P <0.05). There was a significant difference between the two groups in psychological quality of life, too. The subscales of physical and mental QLI such as sexual satisfaction, sexual function, emotional wellbeing, social function and energy in post-test and follow-up were significantly different (P<0.05).Conclusions: According to the findings, skill-based sexual enhancement counseling program is effective in quality of life enhancement. Therefore, it is recommended to health care providers to use enhancement program alongside the other rehabilitation and medical services to improve the patients' quality of life.
Tibial spurs (pes anserinus bony spurs) in children and adolescents: a case series of 21 patients
Authors: Matsunobu Tomoya , Maekawa Akira , Fukushima Suguru , Nabeshima Akira , Iwamoto Yukihide
Published: August 2020

Background: Icicle-like bony spurs that originate from the proximal medial surface of the tibia in young persons have been referred to by various names in the literature. This tibial spur, called pes anserinus bony spurs (PABSs), can present as exostoses, but lacks a cartilage cap which is characteristic feature of osteochondroma. To date, there are only two small case series about the tibial spur, and little information is available. The aim of this study was to describe the characteristics of PABSs in children and adolescents. Methods: This retrospective study analysed patients diagnosed with PABSs on an orthopaedic oncology service from 2013 to 2020. Additionally, in order to estimate the prevalence of PABSs in children and adolescents, we retrospectively reviewed knee X-rays of patients who visited our hospital for other reasons from 2008 to 2020. Results: Thirteen male and 8 female patients with PABSs, with a mean age of 11.7 years, were evaluated. Bilateral spurs were observed in 7 of the 21 patients. Among 28 PABSs in 21 patients, 6 were incidentally identified. Radiological evaluation showed that the average PABS length was 10.6 mm. There was a statistically significant difference in the spur length between incidentally detected PABSs and symptomatic PABSs at the first visit. The prevalence rate of PABSs among children and adolescents was 0.94%. Computed tomography examinations showed that no PABSs occurred at the site of the tendinous insertion of the pes anserinus. Surgical resection was performed in only 2 patients, both of whom were high-performing athletes. Conclusions: This is the first study to describe the clinical and radiological features of PABSs in detail and to report their prevalence in children and adolescents. Although longer PABSs are symptomatic, most PABSs are non-problematic and surgical resection of PABSs should be considered only if pain persists despite conservative treatment.
Perspectives of health practitioners and the key population on predictors of relapse in physical activity and dietary behavior: a concept mapping study
Authors: Roordink Eline , Steenhuis Ingrid H.M. , Kroeze Willemieke , Chinapaw Mai J.M. , Stralen Maartje M. van
Published: August 2020

Background

To prevent people from relapsing into unhealthy habits, insight into predictors of relapse in physical activity and dietary behavior is needed. Therefore, we aimed to explore predictors of relapse in physical activity and dietary behavior from the perspectives of health practitioners and the key population (i.e. adults who recently lost weight and experienced relapse).
Methods

We used concept mapping to collect data among five groups of health practitioners (N = 39) and three key population groups (N = 21). First participants’ ideas on potential predictors were collected. Subsequently, these ideas were individually sorted by relatedness and rated on importance. Concept maps were created for each group using principal component analysis and cluster analysis.
Results

In total 43 predictors were identified, of which the majority belonged to the individual domain compared to the environmental domain. Although the majority of perceived predictors were mentioned by both stakeholder groups, both groups had different opinions regarding the importance of predictors. Also, few predictors were mentioned by all practitioner groups, but not by the key population, and vice versa. Practitioners indicated change in daily structure, stress, lack of effective coping skills, habitual behavior, and lack of self-efficacy regarding losing weight as most important recurrent (i.e. mentioned in all practitioner groups) predictors. The key population indicated lifestyle imbalance or experiencing a life event, lack of perseverance, negative emotional state, abstinence violation effect, decrease in motivation and indulgence as most important recurrent predictors.
Conclusions

Both stakeholder groups predominantly rated individual factors as most important perceived predictors of relapse. The finding that both groups differed in opinion regarding importance of predictors or identified different predictors, may provide an opportunity to enhance lifestyle coaching by ensuring it is patient-centered and tailored.
Association of Serum Bilirubin Levels With Sarcopenia in Patients With Type 2 Diabetes: a Cross-Sectional Study in China
Authors: Wang Chuan , Jin Chen , Liu Jidong , Yin Xiaofei , Wu Chuanlong , Liu Jinbo
Published: August 2020

Background: The prevalence of sarcopenia increased in type 2 diabetes mellitus (T2DM). Elevated oxidative stress and inflammation played important roles in the pathogenesis of diabetic sarcopenia. Bilirubin had been confirmed to possess potential anti-oxidative activity. This study aimed to explore the relationship between bilirubin and sarcopenia in patients with T2DM. Methods: A total of 251 patients (124 men and 127 postmenopausal women) with T2DM aged ≥ 50 years were recruited. Levels of serum total bilirubin (TBIL), direct bilirubin (DBIL) and indirect bilirubin (IBIL) were measured. Muscle mass was measured by dual-energy X-ray absorptiometry (DXA). The relationships between serum bilirubin levels and appendicular skeletal muscle mass index (SMI) were assessed using a Pearson correlation analysis and multiple linear regression analysis in men and women, respectively. Multiple logistic regression analysis was used to evaluate the association of the highest quartile of serum bilirubin levels with sarcopenia.Results: TBIL (r =0.211, p = 0.019) and IBIL (r =0.249, p = 0.005) were positively associated with SMI in men, but not in women. After multiple adjustment in multiple linear regression analysis, TBIL (p = 0.023) and IBIL (p = 0.012) were also significantly associated with SMI in men. In multiple logistic regression analysis, the highest quartile of IBIL showed a decreased OR for sarcopenia (OR=0.243, P = 0.009) in men. Conclusions: Both of TBIL and IBIL were positively associated with muscle mass in men with T2DM. IBIL might have a stronger protective effect on the occurrence of sarcopenia in men with T2DM.
Cardiovascular Outcomes of Antidiabetes Medications by Race/Ethnicity: a systematic review and meta-analysis
Authors: Cai Xiaoling , Dagogo-Jack Sam , Lin Chu , Yang Wenjia , Ji Linong
Published: August 2020

Background: The consistency of cardiovascular risk reduction by antidiabetes medications across racial and ethnic groups remains unclear. The aim of this study was to analyze racial/ethnic patterns in the results of cardiovascular outcomes trials of antidiabetes medications in people with type 2 diabetes.Method: PubMed and Cochrane library databases were searched from the inception dates to December 2019. Cardiovascular outcome trials in type 2 diabetes that randomized participants to active or control treatment and reported results by race/ethnic groups or region were included.Results: A total of 16 studies were included in this meta-analysis. Among White participants, active antidiabetes medication, compared with control treatment, significantly decreased the composite cardiovascular outcomes (OR=0.90, 95% CI 0.86-0.94, p<0.05). Among Asian participants, active antidiabetes medication, compared with control treatment, also significantly decreased the composite cardiovascular outcomes (OR=0.82, 95%CI 0.76-0.90, p<0.05). Among Black participants (OR=0.96, 95% CI 0.69-1.32, p=0.79) and subjects from other groups (mostly Hispanics or Pacific Islanders) (OR=0.92, 95% CI 0.81-1.04, p=0.16), active anti-diabetes medication resulted in nominal but non-significant decreases in the composite cardiovascular outcomes, compared with the control treatment.Conclusions: Antidiabetes drugs demonstrated cardiovascular safety in people with type 2 diabetes from all racial/ethnic groups studied, but achieved significant composite cardiovascular risk reduction only in White and Asian participants, perhaps due to differences in sample size and power.
Alternative Polyadenylation in Response to Temperature Stress Contributes to Gene Regulation in Trees
Authors: Yan Chao , Wang Yupeng , Lyu Tao , Hu Zhikang , Ye Ning , Liu Weixin , Li Jiyuan , Yao Xiaohua , Yin Hengfu
Published: August 2020

Background Genome-wide change of polyadenylation (polyA) sites (also known as alternative polyadenylation, APA) is emerging as an important strategy of gene regulation in response to stress in plants. But little is known in woody perennials that are persistently dealing with multiple abiotic stresses.Results Here, we performed a genome-wide profiling of polyadenylation sites under heat and cold treatments in Populus trichocarpa. Through a comprehensive analysis of polyA tail sequences, we identified 25,919 polyA-site clusters (PACs), and revealed 3429 and 3139 genes shifted polyA sites under heat and cold stresses respectively. We found that a small proportion of genes possessed APA that affected the open reading frames; and some shifts were commonly identified. Functional analysis of genes displaying shifted polyA tails suggested that pathways related to RNA metabolism were linked to regulate the APA events under both heat and cold stresses. Interestingly, we found that the heat stress induced a significantly more antisense PACs comparing to cold and control conditions. Furthermore, we showed that a unique cis-element (AAAAAA) was predominately enriched downstream of PACs in P. trichocarpa genes; and this sequence signal was only absent in shifted PACs under the heat condition, indicating a distinct APA mechanism responsive to heat tolerance. Conclusions This work provides a comprehensive picture of global polyadenylation patterns in response to temperatures stresses in trees. We show that the frequent change of polyA tail is a potential mechanism of gene regulation responsive to stress, which are associated with distinctive sequence signatures.
M2 Macrophage-based Prognostic Nomogram for Gastric Cancer After Surgical Resection: Original Article
Authors: Hu Jianwen , Ma Yongchen , Ma Ju , Yang Yanpeng , Ning Yingze , Zhu Jing , Wang Pengyuan , Chen Guowei , Liu Yuncun
Published: August 2020

Background: A good prediction model is useful to accurately predict patient prognosis. Tumor–node–metastasis (TNM) staging often cannot accurately predict prognosis when used alone. Some researchers have shown infiltration of M2 macrophages in many tumors, which indicates poor prognosis. This approach has the potential to predict prognosis more accurately when used in combination with TNM staging. The present study aimed to develop and validate a nomogram to predict survival in patients with gastric cancer by combining TNM staging and the degree of M2 macrophage infiltration.Methods: Patients undergoing curative resection for gastric cancer between 2008 and 2013 at our hospital were enrolled and assigned into either the training set or the validation set. M2 macrophage markers were evaluated by immunohistochemical staining. A stepwise method was applied to screen variables associated with patient survival time, and a nomogram was constructed to predict patient survival. Concordance index, calibration curve, and decision curve analysis were used to evaluate the discrimination, calibration, and clinical benefit of the model.Results: A multivariate analysis demonstrated that CD163 expression, TNM staging, age, and gender were independent risk factors for overall survival. Thus, these parameters were assessed to develop the nomogram. In the training, validation, and overall datasets, the concordance index was >0.6. The model showed a high degree of discrimination in all three datasets. The five-year survival calibration curves were a very good fit with standard curves in all three datasets, and the model demonstrated good clinical benefit. The prognostic abilities had threshold probabilities of 10%–38% for one-year survival, 10%–75% for three-year survival, and 35%–80% for five-year survival.Conclusions: We combined CD163 expression in macrophages, TNM staging, age, and gender to develop a nomogram to predict five-year overall survival after curative resection for gastric cancer. This model has the potential to provide further diagnostic and prognostic value for patients with gastric cancer.
Characteristics of Tumor Immune Gene and Immune Cell Infiltration during Keloid Formation
Authors: Liu Hao , Shan Mengjie , Wang Youbin , Song Kexin , Liu Shu , Hao Yan
Published: August 2020

Background: Keloids are benign fibroproliferative skin tumors that can cause disfigurement and disability. Although current research has sought to examine keloids from the perspectives of genetics, inflammation, immunity, and tumorigenesis, their pathological mechanisms remain unclear. Methods: In this study, we used three datasets of tumor immune gene expression profiling from the normal skin tissue of keloid patients (N group), inflammation tissue of keloid patients (I group), and keloid tissue of keloid patients (K group) to describe the occurrence and characteristics of keloid development. Tumor immune-related genes were analyzed, and the differentially expressed genes (DEGs) between the three groups were compared. Gene Ontology (GO) categories and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were carried out to determine the main functions of the differentially expressed genes and keloid-related pathways. Results: We identified several genes that may play an important role in keloid development. These genes are CCR1, SELL, CCR7, CD40LG, CD69, CXCL8, ITGAM, ITGAX, CD86, and CXCL9. GO analysis revealed that there were variations in biological processes (BP) between I group and N group, including regulation of lymphocyte activation and T-cell activation. Similar variations were also found between I group and K group, which may play an important role in keloid initiation and formation. Variations in molecular function (MF) were markedly enriched in cytokine receptor binding and receptor ligand activity. Analysis of the KEGG pathway between I group and N group revealed that DEGs were primarily enriched in cytokine−cytokine receptor interaction and viral protein interaction with cytokine and cytokine receptor. We identified a higher proportion of M2 macrophages in N group than in I group, although the difference was not obvious. M1 macrophage production differed significantly between I group and K group. The proportions of CD8+T cells varied significantly between N group and K group. We traced multiple tumor immune-related hub genes from keloid formation and analyzed immune cell subsets in keloid development. Possible molecular mechanisms were described in this study using bioinformatics. Conclusions: These results provide another possibility to elucidate keloid pathogenesis and therapeutic targets in terms of tumor immune gene expression.
Improved Abdomen Hypodermic Embedding for Salvage of the Amputated Fingertip from Tip to Lunula (Tamai Zone Ⅰ)
Authors: Lu Yiming , Wang Bin , Liu Hongjun , Zhang Naichen , Gu Jiaxiang
Published: August 2020

Background To explore the clinical efficacy of a new surgical approach called improved abdomen hypodermic embedding for salvage of the amputated fingertip from tip to lunula (Tamai zone Ⅰ). Methods From September 2015 to June 2017, we treated 18 fingertips from 15 patients with abdomen hypodermic embedding while all the fingertips were completely amputated and failed to vascular anastomose. After 3 weeks, all the fingertips were taken out from abdomen. After 6 months, outcomes were evaluated with DASH score and static two-point finger discrimination. Results 16 fingertips survived completely, 2 fingertips developed partial loss and scar healed by dressing change. All patients were satisfied with the appearance of the fingertips while one woman was not satisfied for ischemic atrophy. The DASH score ranged from 35-46 (average 38), static two-point discrimination was 6--14mm (average 8mm). Conclusions When vascular anastomosis is not feasible in fingertip replantation, improved abdomen hypodermic embedding is a simple and feasible operation for the amputated fingertip from tip to lunula.
Efficacy of dulaglutide to improve Vascular Health indexes in subjects with Type 2 Diabetes: A Randomized Trial
Authors: Tuttolomondo Antonino , Cirrincione Anna , Casuccio Alessandra , Cuore Alessandro Del , Daidone Mario , Chiara Tiziana Di , Maida Carlo , Simonetta Irene , Scaglione Stefania , Pinto Antonio
Published: August 2020

Background: Recent cardiovascular outcome trials have shown significant reductions of major cardiovascular (CV) events with glucagon-like peptide (GLP)-1 receptor agonists. Adjunctive surrogates for cardiovascular risk more recently validated by some studies (23,24) are arterial stiffness and endothelial function indexes. No randomized trials have yet addressed the possible effects of antidiabetic interventional drugs such as GLP1 agonists on endothelial and arterial stiffness indexes as surrogate markers of vascular damageAims: A randomized trial to once-weekly dulaglutide (1.5 mg) added to traditional antidiabetic treatment compared to traditional treatment alone to evaluate some metabolic efficacy endpoints and surrogate vascular efficacy endpoints such as endothelial function and arterial stiffness indexes.Methods: Men and women (aged ≥50 years) with established or newly detected type 2 diabetes whose HbA1c was 9.5% or less on stable doses of up to two oral glucose­lowering drugs with or without basal insulin therapy were eligible. Subcutaneous dulaglutide was initiated at the full dose (1.5 mg/day weekly). Arterial stiffness indexes (pulse wave velocity and augmentation index) and endothelial function index (reactive hyperemia index) were evaluated at baseline and at a three-month and nine-month examination visit. At each visit (at 3 and 9 month follow-up) were also evaluated glycemic variables such as fasting plasma glucose (FPG), HbA1c and lipid variables such as total cholesterol, LDL cholesterol, HDL cholesterol and triglyceride. Results: at a three month follow up subjects treated with dulaglutide in comparison with subjects treated with conventional therapy showed significantly lower serum levels of FBG and significantly lower percentage of HBa1c. At a 9 month follow up subjects treated with dulaglutide in comparison with control subjects treated with conventional therapy showed a significant lowering of diastolic blood pressure, BMI, mean total serum cholesterol, LDL cholesterol, FPGa significantly lower percentage of HBa1C and PWV and higher mean RHI values.Discussion: These findings are consistent with previous studies indicating the strict relationship between cardiovascular risk factors such as systolic blood pressure, total serum cholesterol and LDL levels and cardiovascular events and vascular health surrogate markers.
High rate of increased level of plasma Angiotensin II and its gender difference in COVID-19: an analysis of 55 hospitalized patients with COVID-19 in a single hospital, WuHan, China
Authors: Liu Na , Hong Yan , Chen Ren-Gui , Zhu Heng-Mei
Published: August 2020

Background: 2019 Novel coronavirus disease (COVID-19) is turning into a pandemic globally lately. There were few reports illustrated the expression of Angiotensin II (AngII) in COVID-19. This study aimed to demonstrate the expression of AngII in COVID-19 and how it correlated to the disease.Methods and Results: We enrolled 55 patients with COVID-19 admitted to Renmin Hospital of Wuhan University from January 21st to February 21st, 2020. Demographic data were collected upon admission. COVID-19 nuclear acid, plasma AngII, Renin and aldosterone in the lying position without sodium restriction, and other laboratory indicators were together measured by the laboratory department of our hospital. Of the 55 patients with COVID-19, 34(61.8%) had an increased level of AngII. The severity of COVID-19 and male is positively related with the level of AngII. The level of blood lymphocyte, PCT, ALT, and AST were remarkably severe with those of normal level of AngII (P < 0.05). CD4/CD8 cells ratio was significantly higher than those of normal level of AngII (P < 0.05). The results of binary logistic regression analysis showed that the severity of COVID-19 (OR=4.123) and CD4/CD8 ratio(OR=4.050) were the co-directional impact factor while female(OR=0.146) was inverse impact factor of elevated AngII level.Conclusion: High rate of increased level of AngII and its gender differences were detected in COVID-19 patients. Elevated AngII level were correlated with the severity of COVID-19 and CD4/CD8 ratio.