bluuebunny/crossref_metadata_2025 huggingface dataset:
What Matters for Patients? A Mixed Method Study of the Importance and Consideration of Patient Demands
Authors: waelli mathias , Minvielle Etienne , Acero Maria Ximena , Aribi Khouloud Ben , Lalloue Benoit
Published: April 2020

BackgroundA patient-centred approach is increasingly the mandate for healthcare delivery, especially with the growing emergence of chronic conditions. A relevant but often overlooked obstacle to delivering person-centred care is the identification and consideration of all demands based on individual experience, not only disease-based requirements. Mindful of this approach, there is a need to explore how patient demands are expressed and considered in healthcare delivery systems. This study aims to: (i) understand how different types of demands expressed by patients are taken into account in the current delivery systems operated by Health Care Organisations (HCOs); (ii) explore the often overlooked content of specific non-clinical demands (i.e. demands related to interactions between disease treatments and everyday life). MethodWe adopted a mixed method in two cancer centres, representing exemplary cases of organisational transformation: (i) circulation of a questionnaire to assess the importance that patients attach to every clinical (C) and non-clinical (NC) demand identified in an exploratory inquiry, and the extent to which each demand has been taken into account based on individual experiences; (ii) a qualitative analysis based on semi-structured interviews exploring the content of specific NC demands.ResultsFurther to the way in which the questionnaires were answered (573 answers/680 questionnaires printed) and the semi-structured interviews (36) with cancer patients, results show that NC demands are deemed by patients to be almost as important as C demands (C = 6.53/7 VS. NC = 6.13), but are perceived to be considered to less of an extent in terms of pathway management (NC = 4.02 VS C = 5.65), with a significant variation depending on the type of non-clinical demands expressed. Five types of NC demands can be identified: demands relating to daily life, alternative medicine, structure of the treatment pathway, administrative and logistic assistance and demands relating to new technologies.ConclusionsThis study shows that HCOs should be able to consider non-clinical demands in addition to those referring to clinical needs. These demands require revision of the healthcare professionals’ mandate and transition from a supply-orientated system towards a demand-driven approach throughout the care pathway. Other sectors have developed hospitality management, mass customisation and personalisation to scale up approaches that could serve as inspiring examples.
Simultaneous Right-Sided Nephrectomy with Orthotopic Liver/Kidney Transplantation - An Alternative Method for Patients with Autosomal Dominant Polycystic Liver and Kidney Disease
Authors: Felgendreff Philipp , Tautenhahn Hans-Michael , Lux Sascha , Dondorf Felix , Aschenbach Rene , Rauchfuß Falk , Settmacher Utz
Published: April 2020

Background: In patients suffering from autosomal dominant polycystic liver and kidney disease (ADPLKD), organ transplantation often poses a technical challenge due to the large volume of both organs. To simplify the transplantation procedure by improving the exposure of anatomical structures, we introduce a novel surgical technique.Methods: Seven patients with ADPLKD were evaluated for simultaneous liver and kidney transplantation at the Jena University Hospital. The modified transplantation approach included hepatectomy and right-sided nephrectomy. After reperfusion of the liver graft, orthotopic kidney transplantation to the right-sided hemiabdomen was performed.Results: Preoperatively, the median liver volume and right kidney volume were morphologically determined by CT to be 9343 ml (± 3698.56) and 2770 ml (± 1128.78). The mean operation time was 342.43 minutes (± 68.77). Postoperatively, the patients were treated 6.28 days (± 2.50) in the intensive care unit and were discharged from the surgical ward approximately 28 days (± 5.66) after the operation with normal graft function.Conclusion: The modified simultaneous liver and kidney transplantation technique is an effective alternative surgical transplantation method for patients with ADPLKD. The new transplantation technique simplifies the transplantation procedure by improving the exposure of anatomical structures.
Analysis of Medico-Social Factors for Job Retention Among Patients Presenting With Haematological Malignancy (Adamentine): Results of a ‘Pilot Study’
Authors: CLIN Bénédicte , Heutte Natacha , Boulanger Mathilde , Troussard Xavier , Cornet Edouard , Damaj Ghandi Laurent , Bouvier Véronique , Guizard Anne-Valérie , Launoy Guy , Licaj Idlir
Published: April 2020

Objective
The aim of this study was to describe return to work determinants in patients with haematological malignancy.
Results
This medico-social pilot study included patients with haematological malignancy in the département of Calvados, aged 18 to 55 years, diagnosed between 1st January and 31st December 2010 and alive at 1st January 2015. Patients were identified via consultation of the Lower Normandy haematological malignancy Registry. They completed a specially developed self-questionnaire, in addition to validated questionnaires for anxiety-depression, quality of life and fatigue. Of the patients contacted, 50% accepted to participate. The mean age at diagnosis was 49.8 years, and the majority of patients (79.2%) was professionally active at the time of diagnosis. Only 64.9% of subjects had stopped work due to illness. The psychological impact (demonstrated anxiety) was significantly greater in men (p = 0.01). The majority of subjects returned to work after treatment (80.7%) and among them, the mean duration of absence from work was 16.1 months. Only 52.6% of subjects had informed their occupational physician and 56.7% had benefited from a pre-return visit.
Sequence analysis and protein interactions of Arabidopsis CIA2 and CIL proteins
Authors: Sun Chih-Wen , Yang Chun-Yen
Published: April 2020

Background: A previous screening of Arabidopsis thaliana for mutants exhibiting dysfunctional chloroplast protein transport identified the chloroplast import apparatus ( cia ) gene. The cia2 mutant has a pale green phenotype and reduced rate of protein import into chloroplasts, but leaf shape and size are similar to wild-type plants of the same developmental stage. Microarray analysis showed that nuclear CIA2 protein enhances expression of the Toc75 , Toc33 , CPN10 and cpRPs genes, thereby up-regulating protein import and synthesis efficiency in chloroplasts. CIA2-like (CIL) shares 65% sequence identity to CIA2, suggesting that CIL and CIA2 are homologous proteins in Arabidopsis. Here, we further assess the protein interactions and sequence features of CIA2 and CIL. Results: Subcellular localizations of truncated CIA2 protein fragments in our onion transient assay demonstrate that CIA2 contains two nuclear localization signals (NLS) located at amino acids (aa) 62-65 and 291-308, whereas CIL has only one NLS at aa 47-50. We screened a yeast two-hybrid (Y2H) Arabidopsis cDNA library to search for putative CIA2-interacting proteins and identified 12 nuclear proteins, including itself, CIL, and flowering-control proteins (such as CO, NF-YB1, NF-YC1, NF-YC9 and ABI3). Additional Y2H experiments demonstrate that CIA2 and CIL mainly interact with flowering-control proteins via their N-termini, but preferentially form homo- or hetero-dimers through their C-termini. Moreover, sequence alignment showed that the N-terminal sequences of CIA2, CIL and NF-YA are highly conserved. Therefore, NF-YA in the NF-Y complex could be substituted by CIA2 or CIL. Conclusions: We show that Arabidopsis CIA2 and CIL can interact with CO and NF-Y complex, so not only may they contribute to regulating chloroplast function but also to modulating flower development.
Predicting developmental dysplasia of the hip in at-risk newborns
Authors: Roposch Andreas , Protopapa Evangelia , Malaga-Shaw Olivia , Gelfer Yael , Humphries Paul , Ridout Deborah , Wedge John H.
Published: April 2020

Background: The development of developmental dysplasia of the hip can be attributed to several risk factors and often in combination with each other. When predicting the likelihood of developing this condition, clinicians tend to over and underestimate its likelihood of occurring.Therefore, the study aim is to determine among at-risk newborns how to best predict developmental dysplasia of the hip (DDH) within 8 weeks post-partum.Methods: Prospective cohort study in secondary care. Patient population included newborns at-risk for DDH – we assessed 13,276 consecutive newborns for the presence of DDH risk factors. Only newborns with at least one of the predefined risk factors and those showing an abnormal examination of the hip were enrolled (n=2,191). For the development of a risk prediction model we considered 9 candidate predictors and other variables readily available at childbirth. The main outcome measure was ultrasonography at a median age of 8 weeks using consensus diagnostic criteria; outcome assessors were blinded. Results: The risk model includes four predictors: female sex (OR=5.6; 95% CI: 2.9-10.9; P<0.001); first degree family history of DDH (OR=4.5; 95% CI: 2.3-9.0; P<0.001), birthweight >4000g (OR=1.6; 95% CI: 0.6-4.2; P=0.34), and abnormal examination of hip (OR=58.8; 95% CI: 31.9, 108.5; P<0.001). This model demonstrated excellent discrimination (C statistic=0.9) and calibration of observed and predicted risk (P=0.35). A model without the variable ‘hip examination’ demonstrated similar performance.Conclusion: The risk model quantifies absolute risk of DDH within 8 weeks postpartum in at-risk newborns. Based on clinical variables readily available at the point of childbirth, the model will enhance parental counselling and could serve as the basis for real time decisions prior to discharge from maternity wards.
The Importance of Utilizing Pragmatics in EFL/ESL Context
Authors: Fatah Younis Salih , Ibrahim Noor Mala Bt
Published: April 2020

Pragmatics research in the last few years has gained eminence under the impact of Soler and the succeeding paradigms of Communicative Competence. Amid the diverse components of communicative competence, a great number of L2 studies have attended to the concept of pragmatic competence, that deals with both pragmalinguistic and sociopragmatic knowledge. Hence, pragmatics interlanguage research is concerned with the pragmatic competence and pragmatic performance of L2 learners; though, teaching pragmatics to Non-native Speakers, particularly EFL learners, is a prickly subject. Hence, pragmatic competence has been noticeably absent from ELT curricula, notwithstanding the fact that it has been guaranteed a place in diverse models of Communicative competence. This is mainly due to the hindrances of teaching and learning pragmatics in the ESL/EFL classes. Hence, the study primarily aims at discoursing challenges and lacunas in teaching and learning pragmatics within the confines of EFL classrooms drawing on the existing published literature and proffers recommendations to overcome these problems. Thus, the paper concentrates on these central and prominent fields: the EFL/ESL setting, ELT materials, and available to teach learners, teacher competence, and evaluating pragmatic ability.
Titanium Dioxide Coated Graphene Nanosheets as a Reinforcement in Aluminum Matrix Composites Based on Pressure Sintering Process
Authors: Guo Zheng-Hua , Wu Qingjie , Li Ning , Jiang Li-Hong , He Wen , Tan Guo-Hui
Published: April 2020

Graphene nanoplatelets (GNPs) reinforced 7075 aluminum (Al) nanocomposites were successfully synthesized using the powder metallurgy method. A novel method for optimizing interfacial bonding by coating titanium dioxide (TiO 2 ) on the surface of GNPs was proposed in this manuscript. The effects of GNPs on mechanical properties and microstructure of the aluminum matrix nanocomposites, both with and without TiO 2 coating layers, have been investigated. Experimental results showed that the corresponding mechanical properties of the nanocomposites were further improved when the GNPs have TiO 2 coating layers, compared with the addition of pure GNPs. The yield strength, ultimate tensile strength, and microhardness of the nanocomposites reinforced with TiO 2 -coated GNPs increased by 22.9%, 25.9%, and 20.1%, respectively, in comparison to those of the matrix. The further improvement of the mechanical properties could be attributed to the existence of the coating layer, which optimizes the interface bonding between the reinforcement and the matrix, thereby improving the effectiveness of load transfer.
Implementation of the TaperGuard™ endotracheal tube in an unselected surgical population to reduce postoperative pneumonia
Authors: Martini Ross P , Yanez N Daid , Treggiari Miriam , Tekkali Praveen , Soelberg Cobin , Aziz Michael F
Published: April 2020

Background: Endotracheal tube (ETT) designs to decrease the risk of ventilator associated pneumonia (VAP) include supraglottic suctioning, and/or modifications of the cuff shape. The TaperGuard™ ETT has a tapered, polyvinylchloride cuff designed to reduce microaspiration around channels that form with a standard barrel-shaped cuff. We compared risk of postoperative pneumonia using the TaperGuard™ ETT and the standard ETT in surgical patients requiring general anesthesia with endotracheal intubation.Methods: We used an interrupted time-series design to compare endotracheal intubation using the TaperGuard™ ETT (intervention cohort), and a historic cohort using the standard ETT (baseline cohort), among surgical patients requiring hospital admission. We compared the incidence of postoperative pneumonia in the intervention and baseline cohorts. Data were collected from the electronic health record and linked to patient-level data from National Surgical Quality Improvement Project. Additionally, we performed secondary analyses in a subgroup of patients at high risk of postoperative pneumonia.Results: 15,388 subjects were included; 6,351 in the intervention cohort and 9,037 in the baseline cohort. There was no significant difference in the incidence of postoperative pneumonia between the intervention cohort (1.62%) and the baseline cohort (1.79%). The unadjusted odds ratio (OR) of postoperative pneumonia was 0.90 (95% CI: 0.70, 1.16; p=0.423) and the OR adjusted for patient characteristics and potential confounders was 0.90 (95% CI: 0.69, 1.19; p=0.469), comparing the intervention and baseline cohorts. There was no a priori selected subgroup of patients for whom the use of the TaperGuard™ ETT was associated with decreased odds of postoperative pneumonia relative to the standard ETT. Hospital mortality was higher in the intervention cohort (1.5%) compared with the baseline cohort (1.0%; OR 1.46, 95% CI: 1.09, 1.95; p=0.010).Conclusions: The broad implementation of the use of the TaperGuard™ ETT for intubation of surgical patients was not associated with a reduction in the risk of postoperative pneumonia. In the setting of a low underlying postoperative pneumonia risk and the use of recommended preventative VAP bundles, further risk reduction may not be achievable by simply modifying the ETT cuff design in unselected or high-risk populations undergoing inpatient surgery. ClinicalTrials.gov ID NCT02450929
The aceE involves in mycolic acid synthesis and biofilm formation in Mycobacterium smegmatis
Authors: Chen Suting , Teng Tianlu , Wen Shuan , Zhang Tingting , Huang Hairong
Published: April 2020

Background: The integrity of cell wall structure is highly significant for the in vivo survival for mycobacteria. However, the mechanisms underlying the biosynthesis of mycobacterial cell wall remain poorly understood. aceE encodes the E1 component of pyruvate dehydrogenase (PDH)complex. This study aimed to know the functional role of aceE gene in cell wall biosynthesis in M. smegmatis.Results: We observed that the colony morphology of aceE-deficient mutants(aceE-mut)was quite different from the wild-type(WT) strain during the transposon library screening of M.smegmatis, smaller and smoother on the solid culture medium. Notably, the aceE-mut lost its ability of growing aggregately and biofilm forming, which are two very important features of mycobacteria.The morphological changes of the aceE-mut strain were further confirmed by electron microscopy that presented shorter, smoother and thinner images in contrast withWT strain.Additionally, the analysis of mycolic acid(MA)using LC-MS indicated deficiency of alpha-MA and epoxy-MA in aceE-mut strain whereas complementation of the aceE-mut with a wild-type aceEgene restored the composition of MA. Conclusions: Overall, this study indicates that aceE gene plays a significant role in the mycolic acid synthesis and affects the colony morphology and biofilm formation of M.smegmatis.
Comparative transcriptomic profiling of myxomatous mitral valve disease in the Cavalier King Charles Spaniel
Authors: Corcoran Brendan , Markby Greg , Macrae Vicky , Summers Kim
Published: April 2020

Background.
All dogs develop myxomatous mitral valve disease by the end of their life, but the Cavalier King Charles Spaniel (CKCS) has a heightened susceptibility, frequently resulting in death at a young age and suggesting that there is a genetic component to the condition in this breed. Transcriptional profiling can reveal the impact of genetic variation through differences in gene expression levels. The aim of this study was to determine whether expression patterns were different in CKCS diseased mitral valves compared to valves from non-CKCS dogs.
Results.
Gene expression patterns in three groups of canine valves resulted in distinct separation of normal valves, CKCS diseased valves and diseased valves from other breeds; the latter were more similar to the normal valves than were the CKCS valves. CKCS valve gene expression patterns were quite different from those in the other dogs, both affected and normal. Patterns in all diseased valves (CKCS and other breeds) were also somewhat different from normal non-diseased samples. Analysis of differentially expressed genes showed enrichment in GO terms relating to cardiac development and function and to calcium signalling canonical pathway in the genes down-regulated in CKCS, compared to normal valves and to diseased valves from other breeds. F2 (prothrombin) (CKCS valves compared to normal) and MEF2C pathway activation (CKCS valves compared to non-CKCS) had the strongest association with the gene changes. A large number of DEGs in the CKCSs were associated with cardiomyocytes including CASQ2, TNNI3 and RYR2.
Conclusion.
Transcriptomic profiling identified gene expression changes in CKCS diseased valves that were not present in age and disease severity-matched non-CKCS valves. These genes are associated with cardiomyocytes, coagulation and extra-cellular matrix remodelling. Identification of genes that vary in the CKCS will allow exploration of genetic variation to understand the aetiology of the disease in this breed, and ultimately development of breeding strategies to eliminate this disease from the breed.
Electrochemical assessment of pigment-binding-pigment interactions in oil paint deterioration: a case study on indigo and Prussian blue
Authors: Doménech-Carbó Antonio , Doménech-Carbó María Teresa , Osete-Cortina Laura , Donnici Margherita , Guasch-Ferré Nuria , Gasol-Fargas Rosa M. , Iglesias-Campos Manuel Ángel
Published: April 2020

The degradation of synthetic oil paint film specimens containing indigo and Prussian blue pigments and pictorial samples from the Sant Francesc de Paula painting from the museum of Cardedeu (Catalonia, Spain) has been studied by voltammetry of immobilized particles. This technique, combined with SEM-EDX, ATR-FTIR and CG-MS techniques permits to propose a dual scheme for the degradation of the pigments when submitted to natural, UV and UV solar light aging. Under ‘ordinary’ conditions, Prussian blue acts as a radical scavenger moderating the production of ROS produced in the binding media by the action of UV radiation, resulting in the formation of Berlin green and indigo adducts with radicals. In the case of localized areas of the Sant Francesc de Paula paint, strong degradation occurs where Prussian blue acts as a promoter of the indigo oxidation to isatin, thus resulting in a considerable chromatic shift.
Utilization of epinephrine-soaked gauzes to address bleeding from osteotomy sites in non-tourniquet total knee arthroplasty: a retrospective cohort study
Authors: Liu Hongzhi , Liu Zhaohui , Zhang Qidong , Guo Wanshou
Published: April 2020

Background Abandoning tourniquet was commenced because of the complications of tourniquet extensively used for the control of hemorrhage in total knee arthroplasty (TKA). Bleeding management is critical to acquire a relative bloodless arthrotomy interface for maximize cement fixation in non-tourniquet TKA. The purpose of this study was to investigate hemostatic and hemodynamic effects of epinephrine-soaked gauzes in cemented TKAs. Methods A retrospective cohort study of 101 patients in two groups was performed. The first group (n = 51) underwent unilateral TKA with our procedures of epinephrine use, the second group (n = 50) had the same protocol with tourniquet and no epinephrine utilization. Surgical field visualization was assessed by grading scale for difficulty of intraoperative visualization due to blood and number of surgical field clearances. Perioperative blood loss were recorded. Hemodynamic parameters were observed in the epinephrine group. Results There was statistically significant difference (p < 0.01) on surgeon-rated difficulty in visualization in the epinephrine group between before and after use of epinephrine, and no statistically significant differences (p = 0.96) between two groups before cementing. No statistically significantly result on numbers of surgical field clearances between two groups (p = 0.25) was reached. Significant difference in hidden blood loss, was observed in two groups (p = 0.04). The hemodynamic effects of epinephrine may be under control. Conclusion The procedure of epinephrine soaked gauzes, as a prudent adjunct, may be effective to reduce blood loss and obtain bloodless bone sections in non-tourniquet TKAs, regardless of hemodynamics.
Dietary Habits and its Association with Metabolic Syndrome in a large sample of Iranian adults: a population-based study
Authors: Lorzadeh Elnaz , Sangsefidi Zohreh Sadat , Mirzaei Masoud , Hosseinzadeh Mahdieh
Published: April 2020

Background

Central obesity, insulin resistance, dyslipidemia and hypertension are the core components of metabolic syndrome (MetS) which is coincident with unhealthy dietary habits in the Middle-Eastern countries. The aim of this study was to explore the association between dietary habits and MetS of adult population living in Yazd Greater Area, Iran.
Methods

This is a cross-sectional study which uses the data of a population-based cohort study on Iranian adults, known as Yazd Health Study (YaHS). The relationship between dietary habits and metabolic syndrome among adults (n = 2896) were analyzed using multiple logistic regression method.
Results

The prevalence of the MetS among the participants was 32.2%. Outcomes from logistic regression examining show that breakfast consumption has a significant inverse effect on the occurrence of MetS after adjustment for age, education level, physical activity statue, history of chronic diseases and smoking (odds ratio (OR) = 0.38, 95% confidence interval (CI) = 0.14, 0.97). This effect remains significant even after adjustment for body mass index (BMI) and reveals that odds of having MetS is 69% lower in breakfast consumers in contrast to non-consumers (OR = 0.31, 95% CI = 0.11, 0.87). However, no significant relationship was observed between other dietary habits including consumption of sweetened drinks, sugar cubes, and fast foods and MetS after adjustment for all potential confounders
Conclusions

This study revealed that eating breakfast has an inverse relationship with metabolic syndrome. Finding out stronger evidence in relation between dietary habits and MetS, more researches especially population-based cohort studies are needed to be conducted.
Beyond clinical food prescriptions and mobile markets: parent views on increasing healthy eating in food-insecure families
Authors: DeWit Emily L. , Meissen-Sebelius Emily M. , Shook Robin P. , Pina Kimberly Ann , De Miranda Evelyn Donis , Summar Michelle J. , Hurley Emily A.
Published: April 2020

Background
Children in food-insecure families face increased barriers to meeting recommendations for fruit and vegetable consumption. Hospitals and pediatric healthcare institutions have attempted to alleviate food-insecurity through various internal programs like food prescriptions, yet little evidence for these programs exist. Consistent with a patient-centered perspective, we sought to develop a comprehensive understanding of barriers to fruit and vegetable consumption and a parent-driven agenda for healthcare system action.
Methods
We conducted six qualitative focus group discussions (four in English, two in Spanish) with 29 parents and caregivers of patients who had screened positive for food-insecurity during visits to a large pediatric healthcare system in a midwestern U.S. city. Out iterative analysis process consisted of audio-recording, transcribing and coding discussions, aiming to produce a) a conceptual framework of barriers to fruit and vegetable consumption and b) a synthesis of participant programmatic suggestions for their healthcare system.
Results
Participants were 90% female, 41% Black/African American and 41% Hispanic/Latino. Barriers to fruit and vegetable consumption in their families fell into three intersecting themes: affordability, accessibility and desirability. Participant-generated intervention recommendations were multilevel, suggesting healthcare systems focus not only on clinic and community-based action, but also advocacy for broader policies that alleviate barriers to acquiring healthy foods.
Conclusion
Parents envision an expanded role for healthcare systems in ensuring their children benefit from a healthy diet. Finding offers critical insight on why clinic-driven programs aimed to address healthy eating may have failed and healthcare organizations may more effectively intervene by adopting a multilevel strategy.
Drawing Insights from COVID-19 Infected Patients With no Past Medical History Using CT Scan Images and Machine Learning Techniques: A Study on 200 Patients
Authors: Sharma Sachin
Published: April 2020

As the whole world is witnessing what novel Coronavirus (COVID-19) can do to the mankind, it presents several unique features also. In absence of specific vaccine for COVID-19, it is essential to detect the disease at an early stage and isolate an infected patient. Till today there is a global shortage of testing labs and testing kits for COVID-19. This paper discusses about the role of machine learning techniques for getting important insights like whether lung Computed Tomography (CT) scan should be the first screening /alternative test for real-time reverse transcriptase-polymerase chain reaction (RT-PCR), Is COVID-19 pneumonia different from other viral pneumonia and if yes how to distinguish it using lung CT scan images from the carefully selected data of lung CT scan COVID-19 infected patients from the hospitals of Italy, China and India having no past medical illnesses i.e. high blood pressure, diabetes and heart disease. The reason for selecting images of the patients having no past illnesses history is that people with medical problems are already known to develop serious illness because of COVID-19 but we wanted to check and analyse condition of those patients (lung condition) which don’t have past medical history using CT scan images.
The comparison of extraction methods of ganjiang decoction based on fingerprint, quantitative analysis and pharmacodynamics
Authors: Wei Yanyan , Jiang Ning , Liu Tuo , Liu Chang , Xiao Wen , Liang Likeng , Li Tongming , Yu Yang
Published: April 2020

Background

Ulcerative colitis (UC) is a chronic nonspecific inflammatory disease of the colon and rectum with unknown etiology, and its symptoms include bloody diarrhea, abdominal pain, and hematochezia. Traditional Chinese medicine compound has a good therapeutic, multi-target effect on UC. Ganjiang decoction (GD), which is a traditional classic prescription in China, contains Zingiberis Rhizoma, Angelicae Sinensis Radix, Coptidis Rhizoma, Phellodendri Chinensis Cortex, Sanguisorbae Radix, Granati Pericarpium, and Asini Colla Corii and could be used to treat symptoms of UC. This study aimed to conduct a preliminary study before GD colon-targeted preparation, to explore the relationship between extraction method and efficacy of GD.

Methods

High-performance liquid chromatography (HPLC) was used for the fingerprinting of five preparation methods of GD. HPLC and gas chromatography were used to quantitatively analyze the important chemical components of GD and compare their differences. Mice with UC induced by dextran sulphate sodium salt received the extracts from the five preparation methods of GD via gavage. Disease activity index (DAI) score, colonic length, relative weight of spleen, pathological analysis results, inflammatory factors, therapeutic effect of the five preparation methods of GD, and their relationship with extraction process were compared.

Results

Cluster analysis revealed that the content of the components extracted by traditional extraction methods was significantly different from the other four methods. The third and fifth preparation methods extracted Coptidis Rhizoma and Phellodendri Chinensis Cortex with 50% ethanol to obtain more alkaloids. In the fourth and fifth methods, more volatile oils were detected by adding Zingiberis Rhizoma and Angelicae Sinensis Radix fine powder. According to DAI score, colonic length, relative weight of spleen, pathological analysis results, and inflammatory factors, the third method showed a good therapeutic effect, while the fifth method had the best therapeutic effect.

Conclusions

The results showed that the difference of the five extracts of GD in the efficacy of DSS-induced UC in mice was closely related to the extraction method. Our study improved the extraction process of GD and provided a foundation for the process of enteric-soluble preparations and a new idea for traditional Chinese medicine compound preparation.
A comparative study on normal and obese mice indicates that the secretome of mesenchymal stromal cells is influenced by tissue environment and physiopathological conditions
Authors: Ayaz-Güner Şerife , Alessio Nicola , Acar Mustafa B. , Aprile Domenico , Özcan Servet , Bernardo Giovanni Di , Peluso Gianfranco , GALDERISI Umberto
Published: April 2020

BackgroundThe term mesenchymal stromal cells (MSCs) designates an assorted cell population comprised of stem cells, progenitor cells, fibroblasts, and stromal cells. MSCs contribute to the homeostatic maintenance of many organs through paracrine and long-distance signaling.Tissue environment, in both physiological and pathological conditions, may affect the intercellular communication of MSCs. MethodsWe performed a secretome analysis of MSCs isolated from subcutaneous adipose tissue (sWAT) and visceral adipose tissue (vWAT), and from bone marrow (BM), of normal and obese mice.ResultsThe MSCs isolated from tissues of healthy mice share a common core of released factors: components of cytoskeletal and extracellular structures; regulators of basic cellular functions, such as protein synthesis and degradation; modulators of endoplasmic reticulum stress; and counteracting oxidative stress. It can be hypothesized that MSC secretome beneficially affects target cells by the horizontal transfer of many released factors. Each type of MSC may exert specific signaling functions, which could be determined by looking at the many factors that are exclusively released from every MSC type.The vWAT-MSCs release factors that play a role in detoxification activity in response to toxic substances and drugs. The sWAT-MSC secretome contains proteins involved in in chondrogenesis, osteogenesis, and angiogenesis. Analysis of BM-MSC secretome revealed that these cells exert a signaling function by remodeling extracellular matrix structures, such as those containing glycosaminoglycans. Obesity status profoundly modified the secretome content of MSCs, impairing the above-described activity and promoting the release of inflammatory factors.ConclusionWe demonstrated that the content of MSC secretomes depends on tissue microenvironment and that pathological condition may profoundly alter its composition.
Prediction of Lymph Node Metastasis by Tumor-Infiltrating Lymphocytes in T1 Breast Cancer
Authors: Takada Koji , Kashiwagi Shinichiro , Asano Yuka , Goto Wataru , Kouhashi Rika , Yabumoto Akimichi , Morisaki Tamami , Shibutani Masatsune , Takashima Tsutomu , Fujita Hisakazu , Hirakawa Kosei , Ohira Masaichi
Published: April 2020

Purpose:Lymph node metastasis is more likely in early-stage breast cancer with lower tumor-infiltrating lymphocyte (TIL) density. Therefore, we investigated the correlation between TILs and lymph node metastasis in cT1 breast cancer patients undergoing surgery and the usefulness of TILs in predicting sentinel lymph node metastasis (SLNM) in cT1N0M0 breast cancer.Methods:We investigated 332 breast cancer patients who underwent surgery as the first-line treatment after preoperative diagnosis of cT1. A positive diagnosis of SLNM as an indication for axillary clearance was defined as macrometastasis in the sentinel lymph node (SLN) (macrometastasis: tumor diameter > 2 mm). Semi-quantitative evaluation of lymphocytes infiltrating the peritumoral stroma as TILs in primary tumor biopsy specimens prior to treatment was conducted.Results:For SLN biopsy (SLNB), a median of 2 (range, 1–8) SLNs were pathologically evaluated. Sixty cases (19.4%) of SLNM (macrometastasis: 46, micrometastasis: 16) were observed. Metastasis was significantly greater in breast cancers with tumor diameter > 10 mm than in those with diameter \le 10 mm (p = 0.016). Metastasis was significantly associated with lymphatic invasion (p <0.001). These two clinicopathological factors correlated with SLNM even in patients diagnosed with cN0 (tumor size; p = 0.017, lymphatic invasion; p = 0.002). Multivariate analysis for SLNM predictors revealed lymphatic invasion (p = 0.008, odds ratio [OR]=2.522) and TILs (p < 0.001, OR = 0.137) as independent factors.Conclusions:Our results suggest a correlation between lymph node metastasis and tumor immune-microenvironment in cT1 breast cancer. TIL density may be a predictor of SLNM in breast cancer without lymph node metastasis on preoperative imaging.
Clinical Efficacy and Safety of Apatinib for Maintenance Treatment in Patients with Advanced Esophageal Squamous Cell Carcinoma
Authors: Liu Guohui , Wang Chunbo , E Mingyan
Published: April 2020

Background: To investigate the clinical efficacy,safety and prognostic factors of the therapy that apatinib is used for maintenance treatment in patients with advanced esophageal squamous cell carcinoma. Methods: We select 46 patients with advanced esophageal squamous cell carcinoma treated with radiotherapy and chemotherapy in our hospital from January 2017 to February 2019, all of them were treatment with apatinib. Analysis the clinical efficacy, adverse reactions and prognostic factors. Meanwhile, the expression of patients’VEGFR-2、NF-kB was detected by immunohistochemical SABC method,and the microvessel density and microlymphatic tube density were counted.Analysis of the relationship between indicators and MVD, MLVD counts and the efficacy of apatinib.Results: We found that oral treatment of apatinib in VEGFR-2、NF-kB positive group was better than that in negative group. The partial remission rate of patients was 26.09%; the disease control rate was 67.39%.The main adverse reactions were hypertension (60.87%); hand and foot syndrome (34.77%); proteinuria (36.96%). The degree of adverse reactions was mainly grade 1~2. The median progression-free survival was 3.7 months and the median overall survival was 7.2 months. Log-Rank univariate analysis showed that the degree of adverse reactions and ECOG score were related to OS in patients with advanced esophageal squamous cell carcinoma.Cox multivariate regression analysis showed that the degree of adverse reactions and ECOG score were independent factors affecting OS in patients with advanced esophageal squamous cell carcinoma.Conclusion: Positive expression of VEGFR-2 and NF-kB can be used as a biological reference target for targeted treatment of oral apatinib. Apatinib has a certain clinical effect in the maintenance treatment of advanced esophageal squamous cell carcinoma patients after treatment, with mild adverse reactions and high safety.
Human-mimetic Estimation of Food Volume from a Single-View RGB Image using an AI System
Authors: yang zhengeng , Yu Hongshan , Cao Shunxin , Jia Wenyan , Xu Qi , Yuan Ding , Zhang Hong , Mao Zhi-Hong , Sun Mingui
Published: April 2020

Background: It is well-known that many chronic diseases are associated with unhealthy diet. Although improving diet is critical, adopting a healthy diet is difficult despite its benefits being well understood. Technology is needed that allows assessment of dietary intake accurately and easily in real-world settings so that effective intervention to manage overweight, obesity and related chronic diseases can be developed. In recent years, new wearable imaging and computational technologies have emerged. These technologies are capable of objective and passive dietary assessment with much simplified procedure than traditional questionnaires. However, a critical task is required to estimate the portion size (in this case, the food volume) from a digital image. Currently, this task is very challenging because the volumetric information in the two-dimensional images is incomplete, and the estimation involves a great deal of imagination, beyond the capacity of the traditional image processing algorithms.Method : A novel Artificial Intelligent (AI) system is proposed to mimic the thinking of dietitians who use a set of common objects as gauges (e.g., a teaspoon, a golf ball, a cup, and so on) to estimate the portion size. Specifically, our human-mimetic system "mentally" gauges the volume of food using a set of internal reference volumes that have been learned previously. At the output, our system produces a vector of probabilities of the food with respect to the internal reference volumes. The estimation is then completed by an "intelligent guess", implemented by an inner product between the probability vector and the reference volume vector.Dataset: The datasets utilized for model validation include: 1) two virtual food datasets produced by computer simulation, and 2) two real-world food datasets collected by us.Results: The average relative volumetric errors of our AI method were less than 9% on both virtual datasets, and 11.7% and 20.1% , respectively, on the two real-world food datasets.Discussion: We discuss: 1) the use of AI to estimate the "relative volume" of food in a plate, 2) the case of multiple foods in a plate, and 3) the potential of AI in advancing nutrition science.Conclusion: Our AI system is able to use the same food volume estimation strategy as the human uses.
Prevalence of some virulence genes and antibiotic susceptibility pattern of Pseudomonas aeruginosa isolated from different clinical specimens
Authors: Chand Yamuna , Khanal Santosh , Panta Om Prakash , Shrestha Dipendra , Khadka Dhruba Kumar , Poudel Pramod
Published: April 2020

Background: Pseudomonas aeruginosa is an opportunistic human pathogen and are reported to cause acute and chronic infectious diseases. Due to its high ability to acquire resistance to many antibiotics, it has become a global public health threat. It consists of some virulence genes that may lead to its pathogenicity. The main objective of this cross-sectional study was to detect the virulence genes and antibiotic susceptibility pattern of P. aeruginosa isolated from clinical specimens collected from governmental hospital of Nepal.Methods: A total of 7898 clinical specimens were analyzed for the period of six months from November 2018 to April 2019. The specimens were cultured on Nutrient agar, Blood agar, MacConkey agar, Chocolate agar, Cysteine-Lactose, Electrolyte Deficient agar plates and were incubated at 37°C for 24 hours. All the isolates were identified by standard biochemical tests and further confirmed by growth on Cetrimide agar plate. The antibiotic susceptibility testing was performed by modified Kirby-Bauer disc diffusion method following CLSI guideline. Multiplex-PCR was done to detect the virulence genes oprL and toxA. Statistical analysis was carried out using IBM SPSS Statistic ver. 25 and the p-value was calculated at significance level (0.05%) by using Chi square.Results: Out of these specimens investigated, 87 isolates were tentatively identified to be P. aeruginosa in which 20 (22.98 %) were found to be multidrug resistant. Comparatively, most of the P. aeruginosa were isolated from outpatients 63 (72.41 %) than inpatients 24 (27.58 %), from male 56 (64.36 %) than female 31 (35.63 %) and in age group 60-79 years (41.37 %). AST result showed the highest resistance of 100% with cefixime whereas susceptibilities of 83.9% and 81.6% with polymixin B and tobramycin were noticed respectively. The PCR results showed that all P. aeruginosa isolates carried oprL 87 (100%) and 83 (95.4 %) isolates showed toxA genes. Conclusion: The studies revealed that almost all P. aeruginosa harbors both oprL and toxA genes.
Brain function changes induced by intermittent sequential pneumatic compression in patients with stroke as assessed by functional near-infrared spectroscopy
Authors: Xie Hui , Xu Gongcheng , Huo Congcong , Li Wenhao , Zhao Haihong , Lv Zeping , Li Zengyong
Published: April 2020

Background. Intermittent sequential pneumatic compression (ISPC) can effectively promote blood flow and improve microcirculation. The increase in pressure gradient and blood flow velocity by ISPC has been suggested to be a possible mechanism to improve the microcirculation of patients. However, the effects of ISPC on cerebral oscillations are still unclear.Methods. The tissue concentration of oxyhemoglobin and deoxyhemoglobin oscillations were measured by functional near-infrared spectroscopy under resting and ISPC conditions in 27 right-handed adult patients with stroke. Five characteristic frequency signals (I, 0.6–2 Hz; II, 0.145–0.6 Hz; III, 0.052–0.145 Hz; IV, 0.021–0.052 Hz; and V, 0.0095–0.021 Hz) were identified using the wavelet method. The wavelet amplitude (WA) and laterality index (LI) were calculated to describe the frequency-specific cortical activities.Results. The WA values of the ipsilesional motor cortex (MC) in the frequency intervals III (F = 4.378, p = 0.041), IV (F = 4.281, p = 0.044), and V (F = 5.33, p = 0.025) and those of the contralesional MC in III (F = 10.122, p = 0.002), IV (F = 9.275, p = 0.004), and V (F = 8.373, p = 0.006) were significantly higher when the patients were under the ISPC state than when they were under the resting state. Also, the LI value of the prefrontal cortex (PFC) and MC of the patients decreased more obviously in the ISPC state compared with the resting state despite there was no significant difference.Conclusions. ISPC could induce the activation of bilateral MCs in myogenic and neurogenic innervations and endothelial cell metabolic activities. The decreased LI values in the PFC and MC indicated that the ISPC had a positive effect on these regions’ functional rehabilitation. The ISPC of 0.03 Hz is not suitable for all patients with stroke, and personalized treatment options should be considered in subsequent ISPC intervention. This study provides a method for assessing the effects of ISPC on cerebral oscillations, and the results benefit the optimization of ISPC parameters in the personalized treatment for the functional recovery of patients with stroke.
Identification and characterization of Anopheles larval aquatic habitats at three sites of varying malaria transmission intensities in Uganda.
Authors: Musiime Alex K. , Smith David L. , Kilama Maxwell , Otto Geoffrey , Kyagamba Patrick , Rek John , Conrad Melissa D. , Nankabirwa Joaniter I. , Arinaitwe Emmanuel , Akol Anne M. , Kamya Moses R. , Dorsey Grant , Staedke Sarah G. , Drakeley Chris , Lindsay Steve W.
Published: April 2020

Background: Over the last two decades, there has been remarkable progress in malaria control in sub-Saharan Africa, due mainly to the massive deployment of long-lasting insecticidal nets and indoor residual spraying. Despite these gains, it is clear that in many situations, additional interventions are needed to further reduce malaria transmission. Larval source management (LSM) is a potential supplementary measure that could be used to control malaria. However, prior to its roll-out, knowledge on ecology of larval aquatic habitats is required.Methods: Aquatic habitats colonized by Anopheles vectors were characterised at three sites of low, medium and high malaria transmission in Uganda from October 2011 to June 2016. Larval surveys were conducted along transects in each site and aquatic habitats described according to type and size. Anopheles mosquito larvae and pupae from the described habitats were sampled using standard dipping methods to determine larval densities. Larvae were identified as anopheline or culicine and counted. Pupae were not identified further. Binary logistic regression analysis was used to identify factors associated with the presence of Anopheles larvae in each site.Results: A total of 1,205 larval aquatic habitats were surveyed and yielded a total of 17,028 anopheline larvae, 26,958 culicine larvae and 1,189 pupae. Peaks in larval abundance occurred in all sites in March-May and August-October coinciding with the rainy seasons. Anopheles larvae were found in 52.4 % (n = 251) of aquatic habitats in Tororo, a site of high transmission, 41.9 % (n = 536) of habitats in Kanungu, a site with moderate malaria transmission, and 15.8 % (n=418) in Jinja, a site with low malaria transmission. The odds of finding Anopheles larvae was highest in rice fields compared to pools in both Tororo (odds ratio, OR = 4.21, 95% CI 1.22-14.56, p = 0.02) and Kanungu (OR= 2.14, 95% CI 1.12-4.07, p =0.02). In Kanungu, Anopheles larvae were less likely to be found in open drains compared to pools (OR = 0.15, 95% CI 0.03-0.72, p = 0.02) and river fringe (OR = 0.19, 95% CI 0.07-0.52, p = 0.001). Conclusions: These findings show that Anopheles larvae were common in areas of high and moderate transmission but were rare in areas of low transmission. Although Anopheles larvae were found in all types of water bodies, they were most common in rice fields and less common in open drains and on river fringes. Methods are needed to reduce the aquatic stages of anopheline mosquitoes in human-made habitats, particularly rice fields.
Inside the lungs of COVID-19 disease
Authors: Aguiar Diego , Lobrinus Johannes Alexander , Schibler Manuel , Fracasso Tony , Lardi Christelle
Published: April 2020

In the setting of COVID-19 pandemic, only few data regarding lung pathology induced by SARS-CoV-2 is available, especially without medical intervention interacting with the natural evolution of the disease. We present here the first case of forensic autopsy of a COVID-19 fatality occurring in confinement and in a young female. Diagnosis was made at necropsy and lung histology revealed diffuse alveolar damage, edema and interstitial pneumonia with a geographically heterogeneous pattern, affecting mostly central part of the lungs. This death related to COVID-19 pathology highlights the heterogeneity and severity of central lung lesions when the disease naturally evolves.