bluuebunny/crossref_metadata_2025 huggingface dataset:
Flexible Fibreoptic Intubation in Swine – Improvement for Resident Training and Animal Safety Alike
Authors: Ruemmler Robert , Ziebart Alexander , Ott Thomas , Dirvonskis Dagmar , Hartmann Erik Kristoffer
Published: May 2020

Background
Efficient airway management to facilitate tracheal intubation encompasses essential skills in anaesthesiologic and intensive care. The application of flexible fibreoptic intubation in patients with difficult airways has been identified as the recommended method in various international guidelines. However, providing the opportunity to adequately train residents can be challenging. Using large animals for practice during ongoing studies could help to improve this situation, but there is no recent data on fibreoptic intubation in swine available.
Methods
30 male German landrace pigs were anesthetized, instrumented and randomized into two groups. The animals were either intubated conventionally using direct laryngoscopy or a single-use flexible video-endoscope. The intervention was carried out by providers with 3 months experience in conventional intubation of pigs and a brief introduction into endoscopy. Intubation attempts were supervised and aborted, when SpO2 dropped below 93%. After three failed attempts, an experienced supervisor intervened and performed the intubation. Intubation times and attempts were recorded and analysed.
Results
Flexible fibreoptic intubation showed a significantly higher success rate in first attempt endotracheal tube placement (75% vs. 47%) with less attempts overall (1.3 ± 0.6 vs. 2.1 ± 1.3, P = 0.043). Conventional intubation was faster (42s ± 6 s vs. 67s ± 10 s, P < 0.001), but showed a higher complication rate and more desaturation episodes during the trial.
Conclusions
Flexible fibreoptic intubation in swine is feasible and appears to be a safer and more accessible method for inexperienced users to learn. This could not only improve resident training options in hospitals with animal research facilities but might also prevent airway complications and needless animal suffering.
The Impact of the COVID-19 Pandemic on Final Year Medical Students in the United Kingdom: A National Survey
Authors: Choi Byung , Jegatheeswaran Lavandan , Minocha Amal , Alhilani Michel , Mutengesa Ernest
Published: May 2020

BACKGROUND
The COVID-19 global pandemic has resulted in unprecedented public health measures. This has impacted the UK education sector with many universities halting campus-based teaching and examinations. The aim of this study is to identify the impact of COVID-19 on final year medical student examinations and placements and how it might impact on confidence going into foundation training.
METHODS
An anonymous, self-administered survey of final year medical students from 33 UK medical schools.
RESULTS
441 students from 32 out of the 33 UK medical schools responded. 38% of respondents had their final OSCEs cancelled while 47% had already completed their final OSCEs before restrictions. 50% of assistantship placements were postponed while 77% of electives were cancelled. Respondents feel less confident entering FY1 as a result, but the majority agree that the measures taken to amend their curricula were necessary. Respondents also agree that assisting in hospital during the outbreak would be a valuable learning opportunity.
CONCLUSIONS
The impact on medical student education has been significant. The majority feel less prepared for FY1 but understand the necessity of these measures. Despite this, many are willing to assist in hospitals earlier than expected.
Analysis of β-catenin Association with Obesity in African Americans with Premalignant and Malignant Colorectal Lesions
Authors: Shokrani Babak , Brim Hassan , Hydari Tahmineh , Afsari Ali , Lee Edward , Nouraie Mehdi , Sherif Zaki , Ashktorab Hassan
Published: May 2020

Purpose: African Americans (AA) are at high risk for Colorectal Cancer (CRC). Studies report a 30-60 % increase in CRC risk with physical inactivity, obesity and metabolic syndrome. Activation of the WNT/ β-catenin (CTNNB1) signaling pathway plays a critical role in colorectal carcinogenesis. Accumulating evidence also indicates a role of WNT-CTNNB1 signaling in obesity and metabolic diseases. Aim: To examine the association between obesity, β-Catenin expression and colonic lesions in African Americans. Methods: We reviewed the pathology records of 152 colorectal specimens from 2010-2012 (46 CRCs, 74 advanced adenoma and 32 normal colon tissues). Tissue Microarrays (TMA) were constructed from these samples. Immunohistochemistry (IHC) for CTNNB1 (β-catenin; clone β-Catenin-1) was performed on the constructed TMAs. The IHC results were evaluated by 2 pathologists and the nuclear intensity staining was scored from 0-4. BMI, sex, age, location of the lesion and other demographic data were obtained. Results: Positive nuclear staining in normal, advanced adenoma and CRC was 0%, 24% and 41%, respectively (P <0.001). CRC was associated with positive status for nuclear CTNNB1 intensity (adjusted OR: 3.40, 95%CI=1.42%-8.15%, P=0.006 for positive nuclear staining) compared to non-CRC samples (Normal or advanced adenoma). Nuclear staining percentage has a good diagnostic ability for CRC (AUC: 0.63, 95%CI=0.55%- 0.71%). Overweight and obese patients (BMI>25) did not show a significant (p=0.3) expression of positive status for nuclear CTNNB1 (17% positive in normal weight vs. 27% positive in overweight/obese). The association between nuclear intensity and CRC was not different between normal and overweight patients (P for interaction = 0.6). The positive nuclear CTNNB1status in CRC stage III and IV (35% of all CRC) was not different from stage I and II (50%. vs. 36%, respectively, P = 0.4). Conclusion: In our study, advanced adenoma and CRC were associated with activation of β-catenin in physically fit, overweight and obese patients. Thus, participation of the obesity and WNT pathway seem to be independent in African American patients. WNT/β-catenin signaling pathway has a potential to be used as an effector in colon carcinogenic transformation. Whether or not BMI is a modifier of this pathway needs to be investigated further.
Analysis of gastroscopy results among healthy people undergoing a medical checkup: A retrospective study
Authors: Huang Haosu , Rong Yanting , Wang Meng , Guo Zimeng , Yu Yanghua , Long Zhenpu , Chen Xiaoxiao , Wang Hanyue , Ding Junjie , Yan Lu , Peng Jie
Published: May 2020

Background
The association of upper gastrointestinal diseases with sex, age and Helicobacter pylori infection in asymptomatic healthy people is unclear.The aim of this study was to retrospectively determine the associations of upper gastrointestinal disease in asymptomatic healthy people with sex, age and H. pylori infection.
Methods
A retrospective study was conducted on 2923 patients from a health examination center in Xiangya Hospital between September 2015 and September 2019. Data on sex, age, H. pylori infection and gastroscopy results were collected.
Results
Among 2923 asymptomatic patients who underwent gastroscopy, 2911 patients (99.59%) had abnormal results. The top three results were chronic gastritis, peptic ulcer, and duodenitis. Inflammation of the gastric mucosa in chronic gastritis was more severe in the H. pylori-positive group. The incidence of peptic ulcer decreased with increasing age and was higher in males, patients aged < 30 years and H. pylori-positive patients.The incidence of polyps was higher in females than in males, and the incidence in individuals aged ≥ 60 years was higher than that in those aged < 60 years.
Conclusion
The incidence of upper gastrointestinal diseases is high in asymptomatic healthy people undergoing a check-up and is associated with sex, age and H. pylori infection.Gastroscopy should be considered part of a routine health check.
Prognostic Value of Lymph Node to Primary Tumor Standardized Uptake Value Ratio in Unresectable Esophageal Cancer
Authors: Chen Po-Jui , Yap Wing-Keen , Chang Yu-Chuan , Tseng Chen-Kan , Chao Yin-Kai , Hsieh Jason Chia-Hsun , Pai Ping-Ching , Lee Ching-Hsin , Yang Chan-Keng , Ho Albert Tsung-Ying , Hung Tsung-Min
Published: May 2020

Background Unresectable esophageal cancer harbors high mortality despite chemoradiotherapy. Better patient selection for more personalized management may result in better treatment outcomes. We presume the ratio of maximum standardized uptake value (SUV) of metastatic lymph nodes to primary tumor (NTR) in 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography/computed tomography (FDG PET/CT) may provide prognostic information and further stratiﬁcation of these patients. Methods The patients with non-metastatic and unresectable esophageal squamous cell carcinoma (SCC) receiving FDG PET/CT staging and treated by chemoradiotherapy were retrospectively reviewed. Receiver operating characteristic (ROC) analysis was performed to determine the optimal cut-off value for NTR. Kaplan-Meier method and Cox regression model were used for survival analyses and multivariable analyses, respectively.Results From 2010 to 2016, 96 eligible patients were analyzed. The median follow-up time was 10.2 months (range 1.6 to 83.6 months). Using ROC analysis, the best NTR cut-off value was 0.46 for prediction of distant metastasis. The median distant metastasis-free survival (DMFS) was significantly lower in the high-NTR group (9.5 vs. 22.2 months, p = 0.002) and median overall survival (OS) (9.5 vs. 11.6 months, p = 0.013) was also signiﬁcantly worse. Multivariable analysis revealed that NTR was an independent prognostic factor for DMFS (hazard ratio [HR] 1.81, p = 0.023) and OS (HR 1.77, p = 0.014).Conclusions High pretreatment NTR predicts worse treatment outcomes and could be an easy-to-use and helpful prognostic factor to provide more personalized treatment for patients with non-metastatic and unresectable esophageal SCC.
Epidemiological profile of meningitis following pentavalent vaccination in Iran
Authors: Heidari Saber , Karami Manoochehr , Zahraei Seyed Mohsen , Sedighi Iraj , Zavareh Fatemeh Azimian
Published: May 2020

Background

Ensuring the effectiveness of the Haemophilus influenza type b (DTwP-Hib-HepB) vaccine in reducing meningitis is an essential approach in evaluating the effectiveness of the vaccine. The study aimed to address the epidemiology of meningitis following pentavalent vaccination in Iran.
Methods

In this descriptive study, data from meningitis patients from 21st March 2011 to 21st July 2018 were extracted from the National Notifiable Diseases Surveillance System. This information was divided into two equal periods before the pentavalent vaccine introduction (21st March 2011 to 17th November 2014) and after the introduction (18th November 2014 to 21st July 2018). Descriptive statistics indices, including frequency, percentages, tables, and graphs, were used to describe the study population.
Results

The number of patients in the study period was 53,174 cases. More than 55% of patients were under five years old. Males (63.34%) were more than females (36.06%). From the clinical point of view, 90.56% had a fever, 57.87% vomited, 53.78% had a headache, and 26.27% had neck stiffness. The death rate was reduced to 2.1%; also, the proportion of confirmed cases caused by Haemophilus influenzae type b was 6.7% before the pentavalent vaccine introduction. The corresponding value following vaccine introduction equals to 3.6%. The proportion of children under five has decreased from 4.4–1.9%. This value indicates a 46.2% decrease in the meningitis of all ages and a 57% decrease in children under five due to Haemophilus influenzae vaccination.
Conclusions

The results of the study indicate the effectiveness of the vaccine due to changes in meningitis caused by Haemophilus influenzae type b after vaccination compared with no vaccination. Therefore, it is advisable to continue the full immunization coverage with the pentavalent vaccine.
Endothelin-1 upregulates activin receptor-like kinase-1 expression via Gi/RhoA/Sp-1/Rho kinase pathways at transcriptional and post-transcriptional levels in human pulmonary arterial endothelial cells
Authors: Sugimoto Koichi , Yokokawa Tetsuro , Misaka Tomofumi , Kaneshiro Takashi , Yamada Shinya , Yoshihisa Akiomi , Nakazato Kazuhiko , Takeishi Yasuchika
Published: May 2020

BackgroundsPulmonary arterial hypertension (PAH) is a disease with poor prognosis that is characterized by pulmonary vasoconstriction and organic stenosis due to abnormal proliferation of pulmonary vascular cells. It has been demonstrated that endothelin (ET)-1 induces pulmonary vasoconstriction through activation of RhoA. Moreover, we previously demonstrated that Gi, a heterotrimeric G protein, functions upstream of RhoA activation. A gene mutation of activin receptor-like kinase (ACVRL)-1 is recognized in idiopathic or heritable PAH patients. However, little is known about the association between ET-1 and ACVRL-1. In the present study, we investigated the effect of ET-1 on ACVRL-1 expression and aimed to delineate the involvement of the Gi/RhoA/Rho kinase pathway.MethodsET-1 was added to culture medium of human pulmonary arterial endothelial cells (PAECs), and ACVRL-1 expression levels were analyzed using western blotting and quantitative polymerase chain reaction. The promoter activity of ACVRL-1 was evaluated by dual luciferase assay. Before adding ET-1 to the PAECs, pretreatment with pertussis toxin (PTX) or exoenzyme C3 transferase (C3T) was performed for the inhibition of Gi or RhoA, respectively. Rho kinase was inhibited by Y27632. Active form of RhoA (GTP-RhoA) was assessed by pull-down assay.ResultsACVRL-1 expression was increased by ET-1 in the PAECs. Pull-down assay revealed that ET-1 rapidly induced a GTP-loading of RhoA. The ET-1-induced RhoA activation was suppressed by pretreatment with PTX or C3T. Further, PTX, C3T, and Y27632 suppressed the ET-1-induced ACVRL-1 expression. The activity of ACVRL-1 promotor and the lifespan of ACVRL-1 mRNA was increased by ET-1. Sp-1, which is one of the transcriptional factors of ACVRL-1, peaked 15 min after adding ET-1 to the PAECs. PTX and C3T prevented the increase of Sp-1 induced by ET-1.ConclusionThe present study demonstrated that ET-1 increases ACVRL-1 expression at the transcriptional and post-transcriptional levels in human PAECs via the Gi/RhoA/Rho kinase pathway with involvement of Sp-1.
The association between Dietary total antioxidant capacity with Rheumatoid Arthritis in adults: A case-control study
Authors: Nezamoleslami Shokufeh , Nezamoleslami Saeed , Ghiasvand Reza , Boozari Behnoosh , Sohouli Mohammadhassan
Published: May 2020

Objective

Dietary total antioxidant capacity (TAC) has been assumed as a useful tool to assess the relationship between the cumulative antioxidant food capacity and several chronic disorders. However, the relationship between the total antioxidant capacity of the diet (TAC) and the risk of RA has not been previously examined. The aim of this study was to evaluate the association between DTAC and risk of RA in a case-control study.
Methods

This case-control study was carried out among 100 patients with RA and 200 healthy subjects aged 18–55 years. Dietary data were collected using a validated 147- items quantitative food frequency questionnaire. DTAC was calculated based on the ferric reducing-antioxidant power (FRAP) values that reported by US Department of Agriculture.
Results

The mean age and BMI of the study participants were 49.4 years and 25.6 Kg.m2.. The energy, protein, fiber, MUFA, n-3 fatty acid, vitamin B9, vegetable, and fruit were significantly increased across tertiles of DTAC. Also, Compared with participants in the lowest tertile of DTAC, those in the highest terrtile had a significantly lower OR for rheumatoid after adjustment for BMI; physical activity; waist circumference; smoking; and dietary intake energy and fat (model 3: OR, 0.19; 95% CI, 0.07–0.51; p for trend, 0.001).
Conclusions

Our findings showed that a high DTAC was associated with a reduced risk of RA in adult, suggesting that promoting a naturally elevated antioxidant capacity might help prevent the development of RA. Further prospective studies should be conducted in this regard.
REBACIN® is an optional intervention for persistent high-risk human papillomavirus infection: a retrospective analysis of 364 patients
Authors: Yang Ying , Hu Ting Wen Yi , Ming Xiu , Yang E , Li Zhengyu
Published: May 2020

Background: Persistent high-risk human papillomavirus (hrHPV) infection is a crucial cause of cervical cancer, for which optimal pharmacological intervention remains unavailable. This study aimed at evaluating the therapeutic efficacy of REBACIN® in patients with persistent hrHPV infection.Methods: This study is a combination of a retrospective analysis and a meta-analysis. The retrospective analysis included 364 patients who were persistently infected with HPV for at least twelve months, between September 2015 and February 2019, and only received REBACIN® intervention. HPV DNA typing, HC2 hrHPV DNA, and ThinPrep cytologic tests were performed before and after REBACIN® intervention, to evaluate the therapeutic efficacy. The meta-analysis included trials evaluating the therapeutic efficacy of interferons.Results: After a follow-up period of three to six months, the overall effective rate of REBACIN® was 74.73% (272/364), which was higher than that of interferon (61.50%). The efficacy of REBACIN® was correlated with HPV type (OR: 0.549, 95% CI: 0.367–0.822, P < 0.05) and pretreatment cytology (OR: 0.358, 95% CI: 0.173–0.739, P < 0.05).Conclusions: REBACIN® is potently efficacious at clearing persistent hrHPV infection; hence, it can serve as an optional intervention for persistent hrHPV infection.
Machine learning prediction on number of patient due to conjunctivitis based on air pollutants: A preliminary study
Authors: Cheng Yong-ran , Feng Zhan-hui , Zhou Meng-Yun , Wang Nan , Wang Ming-Wei , Ye Lan , Chen Juan
Published: May 2020

Background

Accurate prediction of the number of patients with conjunctivitis plays an important role in providing adequate treatment at the hospital, but such accurate predictive model currently does not exist. The current study sought to use machine learning (ML) prediction based on past patient for conjunctivitis and several air pollutants. The optimal machine learning prediction model was selected to predict conjunctivitis-related number patients.
Methods

The average daily air pollutants concentrations (CO, O3, NO2, SO2, PM10, PM2.5) and weather data (highest and lowest temperature) were collected. Data were randomly divided into training dataset and test dataset, and normalized mean square error (NMSE) was calculated by 10 fold cross validation, comparing between the ability of seven ML methods to predict the number of patient due to conjunctivitis (Lasso penalized liner model, Decision tree, Boosting regression, Bagging regression, Random forest, Support vector, and Neural network). According to the accuracy of impact prediction, the important air and weather factors that affect conjunctivitis were identified.
Results

A total of 84977 cases to treat conjunctivitis were obtained from the ophthalmology center of the Affiliated Hospital of Hangzhou Normal University. For all patients together, the NMSE of the different methods were as follows: Lasso penalized liner regression: 0.755, Decision tree: 0.710, Boosting regression: 0.616, Bagging regression: 0.615, Random forest: 0.392, Support vectors: 0.688, and Neural network: 0.476. Further analyses, stratified by gender and age at diagnosis, supported Random forest as being superior to others ML methods. The main factors affecting conjunctivitis were: O3, NO2, SO2 and air temperature.
Conclusion

Machine learning algorithm can predict number of patients due to conjunctivitis, among which, the Random forest algorithm had the highest accuracy. Machine learning algorithm could provide accurate information for hospitals dealing with conjunctivitis caused by air factors.
The Dual Effect of CD28 on The Prognosis of Lung Cancer Based On Nomograms: A Comprehensive Analysis of The Tumor Immune Microenvironment
Authors: sun dantong , Tian Lu , Bian Tiantian , Zhao Han , Tao Junyan , Feng Lizong , Liu Qiaoling , Hou Helei
Published: May 2020

Background
Lung cancer has ranked first in China in recent years, and TIME-related molecules may serve as biomarkers for the prognosis of lung cancer. Nomograms are widely used tools for the evaluation of prognosis in malignancies. We performed this study to construct nomograms based on TIME for predicting the prognosis of lung cancer.
Methods
Univariate and multivariate analyses were performed to estimate prognosis. TIME-related variables and basic clinical characteristics were included in the nomograms. Discrimination and calibration were used for the internal validation of the nomograms. Patients in our center and in the TCGA database were involved in the construction of the nomograms.
Results
Both LUAD and lung cancer patients with a higher expression of CD28 had a shorter DFS (P = 0.0011; P = 0.0001) but a longer OS (P = 0.0001; P = 0.0282). Nomograms for the DFS of young LUAD patients and the OS of LUAD and lung cancer patients were constructed. The established nomograms provide an easy way to estimate prognosis. Patients may obtain not only probabilities for disease progression and 1-year, 3-year or 5-year survival but also a precise and individualized follow-up regimen.
Conclusion
TIME-related variables are closely associated with the prognosis of lung cancer patients, especially young LUAD patients. CD28, which has a dual effect on lung cancer prognosis, may be a novel biomarker for not only the prognosis of lung cancer but also sensitivity to immunotherapy. Nomograms based on TIME may be a novel way to predict the prognosis of lung cancer.
Preliminary result of carbon-ion radiotherapy using the spot scanning method for prostate cancer
Authors: Takakusagi Yosuke , Kato Hiroyuki , Kano Kio , Anno Wataru , Tsuchida Keisuke , Mizoguchi Nobutaka , Serizawa Itsuko , Yoshida Daisaku , Kamada Tadashi
Published: May 2020

Background
Carbon-ion radiotherapy (CIRT) for prostate cancer was initiated at Kanagawa Cancer Center in 2015. The present study analyzed the preliminary clinical outcomes of CIRT for prostate cancer.
Methods
The clinical outcomes of 253 patients with prostate cancer who were treated with CIRT delivered using the spot scanning method between December 2015 and December 2017 were retrospectively analyzed. The irradiation dose was set at 51.6 Gy (relative biological effectiveness) delivered in 12 fractions over 3 weeks. Biochemical relapse was defined using the Phoenix definition. Toxicities were assessed according to CTCAE version 4.0.
Results
The median patient age was 70 (47–86) years. The median follow-up duration was 35.3 (4.1–52.9) months. According to the D’Amico classification system, 8, 88, and 157 patients were classified as having low, intermediate, and high risks, respectively. Androgen deprivation therapy was administered in 244 patients. The biochemical relapse-free rate in the low-, intermediate-, and high-risk groups at 3 years was 87.5%, 88.0%, and 97.5%, respectively (P = 0.036). Grade 2 acute urinary toxicity was observed in 12 (4.7%) patients. Grade 2 acute rectal toxicity was not observed. Grade 2 late urinary toxicity and grade 2 late rectal toxicity were observed in 17 (6.7%) and three patients (1.2%), respectively. Diabetes mellitus and previous transurethral resection of the prostate were significantly associated with late grade 2 toxicity in univariate analysis. The predictive factor for late rectal toxicity was not detected.
Conclusion
The present study demonstrated that CIRT using the spot scanning method for prostate cancer produces favorable outcomes.
Assessment of Regional Left Ventricular Myocardial Strain in Patients with Left Anterior Descending Coronary Stenosis Using Computed Tomography Feature Tracking
Authors: Han Xiaoyu , Cao Yukun , Ju Zhiguo , Lu Jia , Li Na , Li Yumin , Liu Tong , Shi Heshui , Gu Jin
Published: May 2020

Background
Computed Tomography feature tracking (CT-FT) has emerged as a valuable method for the assessment of cardiac function. However, there have been no study about the usefulness of CT-derived assessments of left ventricular strain on coronary artery disease (CAD). Our aim was to evaluate the regional left ventricular (LV) systolic deformation in patients with left anterior descending coronary (LAD) stenosis using CT-FT.
Methods
Seventy-six patients with LAD stenosis were enrolled. The patients were divided into four groups according to the percentage of LAD stenosis: ≤25% was defined as group I (24 patients), 26–49% as group II (17 patients), 50–74% as group III (21 patients), and ≥ 75% as group IV (14 patients).Thirty-two sex- and age-matched normal subjects were included as controls.
Results
No intergroup differences were found between groups I-IV and the controls in terms of the left ventricular ejection fraction, end-diastolic volume and end-systolic volume. However, the longitudinal strain (LS) of the LAD territory was significantly reduced in groups I-IV compared with the controls (-20.8% and − 18.5% and − 18.6% and − 17.0% vs -23.7%, respectively). The circumferential strain (CS) of the LAD territory was significantly reduced in groups III and IV compared with the controls and groups I and II (-22.4% and − 22.2% vs -25.4% and − 24.1% and − 25.3%, respectively). Compared with non-LAD territory, groups II-IV had significantly increased LS (-19.9% vs -21%; -18.6% vs -21.9%; -16.4% vs -20.1%). The severity of LAD stenosis had a positive correlation with the LS of the LAD territory (r = 0.438, p = 0.002).
Conclusion
CT‑FT can detect decreasing LV systolic function in patients with LAD stenosis. With the increasing severity of LAD stenosis, the LV regional systolic deformation of the LAD territory was reduced.
STAT3 ameliorates cognitive deficits by positively regulating the expression of NMDARs in a mouse model of FTDP-17
Authors: Liu Gong-Ping , Hong Xiao-Yue , Wan Hua-Li , Li Ting , Zhang Bing-Ge , Li Xiao-Guang , Wang Xin , Li Xiao , Liu Qian , Chen Chong-Yang , Yang Ying , Wang Qun , Li Shu-Peng , Yu Hao , Wang Jian-Zhi , Yang Xi-Fei
Published: May 2020

Background In tauopathies, the degree of neurodegeneration and memory impairment positively strongly correlates with the amount of abnormal tau aggregates. Recently, we found that human wild-type tau accumulation activated Signal Transduction and Activator of Transcription-1 (STAT1) to inhibit the transcription of genes coding for synaptic N-methyl-D-aspartate receptors (NMDARs). STAT3 has similar specific DNA binding element GAS as STAT1, however, the role of STAT3 in cognitive deficits induced by tau accumulation has not reported until now.Methods The activity of the transcription factor was analyzed by luciferase reporter assay or electrophoresis mobility shift assay. AAV virus (AAV-Cre, AAV-P301L, AAV-STAT3 or AAV-K410/3R-STAT1) was infused stereotaxically into the hippocampal CA3 regions of STAT3flox/flox or C57 mice. The spatial learning and memory of the animals were assessed by Morris water maze, the contextual fear conditioning and new object recognition test. The synaptic plasticity was measured by electrophysiological recording and the spine density was detected by Golgi staining. RT-PCR and Western blotting were used to detect the mRNA and protein levels.Results We found that P301L-hTau accumulation acetylated STAT1 at lysine 410 and 413 sites to bind with STAT3 in the cytoplasm which inhibited the nuclear translocation and inactivated STAT3, though phosphorylation of STAT3 at Tyr705, which leads to STAT3 nuclear translocation and DNA binding, increased. Knockdown of STAT3 by AAV-Cre in STAT3flox/flox mice mimicked P301L-hTau-induced suppression of NMDARs expression, synaptic and memory impairments. Overexpressing STAT3 rescued P301L-hTau-induced synaptic and cognitive deficits by increasing NMDARs expression. Further study revealed that STAT3 positively regulated NMDARs transcription through direct binding to the specific GAS element of NMDAR1, NMDAR2A and NMDAR2B promoters.Conclusion These findings indicate that accumulated P301L-hTau impairs synaptic plasticity by inactivating STAT3 to suppress NMDARs expression, thereby revealing a novel mechanism for P301L-hTau-associated synapse and cognition deficits.
Modulation of OSCP mitigates mitochondrial and synaptic deficits in a mouse model of Alzheimer’s pathology
Authors: Gauba Esha , Sui Shaomei , Tian Jing , Driskill Christopher , Yu Chunxiao , Jia Kun , Rughwani Tripta , Wang Qi , Sven Kroener , Guo Lan , Du Heng
Published: May 2020

Background Oligomycin-sensitivity conferring protein (OSCP) is a critical subunit of mitochondrial F1Fo ATP synthase. OSCP dysfunction has been observed in Alzheimer’s disease (AD) brains and a mouse model with AD-like brain amyloidosis (5xFAD mice). However, whether OSCP dysfunction constitutes a key mitochondrial defect contributing to synaptic injury in AD-related conditions has not been comprehensively investigated. Methods Here, we used a 5xFAD mouse model with OSCP overexpression in neurons (Thy-1 OSCP/5xFAD mice) and cultured neurons from OSCP overexpressing pups in the study. We performed biochemical, immunohistochemical, live cell imaging and electrophysiological as well as behavioral analyses.Results We found that preserved OSCP expression with reduced interaction of amyloid beta (Aβ) with membrane-bound OSCP in Thy-1 OSCP/5xFAD mice. OSCP overexpression also alleviated F1Fo ATP synthase deregulation and preserved mitochondrial function. Moreover, OSCP modulation conferred resistance to Aβ-mediated defects in axonal mitochondrial dynamics & motility. Consistent with protected neuronal mitochondrial function, OSCP overexpression ameliorated hippocampal synaptic injury in 5xFAD mice as demonstrated by preserved synaptic density and synaptic transmission, reduced complement-dependent synapse elimination, leading to improved spatial learning and memory. Conclusion Our findings show the consequences of OSCP dysfunction in the development of synaptic stress in AD-related conditions and they implicate OSCP modulation as a potential therapeutic strategy.
Patterns of Pediatric Thoracic Penetrating Injuries: a Single Trauma Center Experience – Riyadh, Saudi Arabia
Authors: Alaqeel Suliaman , Howsawi Abdulaziz , Namshan Mohammad Al , Maary Jamila Al
Published: May 2020

Background
Trauma in pediatric age group is a major cause of morbidity and mortality. The causes and magnitude of pediatric trauma differs from region to region. Many studies have focused on blunt injuries but not on penetrating trauma. Our aim is to identify the patterns, and outcome of pediatric thoracic penetrating injuries in a single trauma center.
Methods
We conducted a retrospective chart review of pediatric patients who presented with thoracic penetrating injuries from the year 2001 till 2016 in a level 1 trauma center. Patients aged 18 years or less who presented to our emergency department with thoracic penetrating injury were included. Those transferred from other institutions were excluded
Results
The total number of patients included with penetrating thoracic injuries were 89. Mean age was 15.5 years. One female the rest were males. The most common mechanism of injury is stab wound by knives in 80%, then Gunshot in 12%. Main mode of transport to emergency department was by private vehicles in 75.3%. Type of injuries sustained were pneumothorax 70.7%, hemothorax 25.8%, diaphragmatic injury 5.6%, hemopericardium 4.49%, lung contusion and laceration 7.8%, cardiac injury 4.49%, major vessel injury 3.4%, pneumomediastinum 2.2%, esophageal injury 1.1%, and rib Fractures 1.1%. In the emergency department, endotracheal intubation required in 13.5%, chest tube insertion 73%, blood transfusion for resuscitation 16.8%, emergency thoracotomy 2.2%, pericardiocentesis 1.1%. Surgical intervention was required in 17%. Mean length of hospital stay 3.87 days ± 4.86 SD. 93% of patients did not require intensive care unit admission. Mortality was observed in 3.4% were all had injuries to either heart, aorta or inferior vena cava.
Conclusion
In our institution, thoracic injuries were found uncommon and represent 25% of all penetrating trauma. Most sustained penetrating thoracic injuries can be managed nonoperatively safely. However, prompt resuscitation and intervention are required to identify and manage life-threatening ones.
Pulse oximetry curves in healthy children living at moderate altitude: a cross-sectional study from the Ecuadorian Andes
Authors: Mayorga Vinicio Andrade , Andrade Felipe , Riofrío Pablo , Nedel Fulvio , Martin Miguel , Romero Natalia
Published: May 2020

Background
In populations above 3000 meters above sea level (m a.s.l.) normal values of oxygen saturation (SpO2) above 90% have been reported. Few studies have been conducted in cities of moderate altitude (between 2500 and 3000 m a.s.l.) We set out to describe the range of SpO2 values measured with a pulse oximeter in healthy children between 1 month and 12 years of age living in an Ecuadorian Andean city.
Methods
A cross-sectional study was carried out in Quito, Ecuador, located at 2800 m a.s.l. SpO2 measurement in healthy children of ages ranging from 1 month to 12 years of age living in the city were recorded by pulse oximetry. Age and gender were recorded, and 2.5th and 5th percentile were drawn. Nonparametric tests were used to compare differences in SpO2 values by age and gender.
Results
1378 healthy children were eligible for the study, 719 (52.2%) males. Average SpO2 for the entire population was 94.5% (SD 1.70; 95%CI 94.41–94.59). No differences were observed between SpO2 values by age and gender. The SpO2 2.5 percentile value in the whole was 90%, in children under 5 years of age was 91% and it was 90% in children older than 7.
Conclusions
In cities of moderate altitude, the SpO2 percentile measures developed in healthy children may contribute to an improved decision-making process, especially in cases where resource availability is limited.
Metagenomics insight into microbial dynamics in field-scale remediation of crude oil-polluted soil
Authors: Chikere Chioma Blaise , Tekere Memory , Adeleke Rasheed
Published: May 2020

Background: The frequency of crude oil pollution has been on the increase following increased exploration, exploitation and production of energy from fossil fuel. Bioremediation has been shown to be eco-friendly and cost-effective method of oil spill remediation. In the Niger Delta, Landfarming has been the most used technique. The aim of this research was to employ metagenomic techniques to understand microbial dynamics during field-scale remediation in the Niger Delta in order to improve and reduce the time of remediation. Results: The surface (0.0 – 0.5m) sample had an extractable TPH value of 6231 mg/kg. The subsurface samples from 1m, 1.5m and 2.0m depths had extractable TPH concentration of 4836 mg/kg, 9112 mg/kg and 7273 mk/kg respectively. Proteobacteria dominated the bacterial community of the oil-polluted soil and comprised mainly of the classes Alphaproteobacteria, Betaproteobacteria and Gammaproteobacteria. Alpha diversity analysis revealed the presence of crude oil in the soil reduced microbial diversity. Principal coordinate analysis showed the microbial structure continually changed following changes in the chemical composition of the soil. Mycobacterium, Burkholderia, Methylobacterium and Bacillus were among the core OTUs detected during the period of remediation. Significant variation in pathway abundance particularly pathways for propanoate degradation, benzoate degradation, naphthalene degradation, fatty acid metabolism, polycyclic aromatic hydrocarbon degradation and degradation of xenobiotics were observed when the unpolluted soil was compared to the samples obtained during remediation. Conclusions: The findings from this study will greatly advance an already preferred landfarming oil spill recovery technique in the Niger Delta.
The Research and Analysis of Bring Perigastric Tumor Deposits into The Staging of Primary Gastric Cancer
Authors: wang xinxin , wang zhaoyang , xie tianyu , li shuo , wu di , guo xin , wang yong , chen lin
Published: May 2020

Background: The current significance of perigastric tumor deposits (TDs) in gastriccancer (GC) for indicating prognosis remains unclear. The aim of this study was to assess the prognostic value of perigastric TDs and a new TNM staging involving TDs for GC.Methods: The pathological data of 6672 patients with GC who underwent gastrectomy or operation of gastric cancer with other diseases between January 1, 2012 and December31, 2017 at Chinese PLA General Hospital were analyzed retrospectively. The patients were divided into tumor deposits positive (TD+) group and tumor deposits negative (TD-) group. The differences between TD+ and TD- were analyzed by binary Logistic regression model. To draw survival curves, we used Kaplan-Meier methods. Multivariate Cox regression model and Log-rank test was used to analyze the data.Results:Perigastric TDs were found to be positive in 339 (5.09%) of the 6672 patients with GC of which 237were males (69.91%) and 102 females (30.09%) (2.32:1). The median age was 59 years (ranging from 27 to 78 years). No significant differences were detected between the two groups. Univariate and multivariate survival analysis both indicated that GC patients with positive TDs had poorer prognosis than those with negative TDs (p<0.05). The 1-, 3-and 5-year overall survival rates of GC patients with TDswere68.3%, 19.6%, and 11.2%, respectively, and weresignificantly poorer than those of the staged matched control group.There was statistical significance between thelocation of TDs and patient survival in patients with gastric cancer (p＜0.05). A new TNM staging was formulated according to the TDs location.When TDs appear on the gastric body,the original T1, T2, T3stages change to T4a, and T4a, T4b change to T4b;whenTDs appear in the lesser curvature, the previous N0, N1, N2, N3 stage change to N3;when the TDs located in the greater curvature or the distant tissue, the patient should be categorized as M1. After using the new stage, the survival curve of patients with TDs was closer to that of patients without TDs in each pTNM staging.Conclusion: 1. Tumor deposits is a bad prognostic factor in patients with primary gastric cancer. 2. The location of tumor deposits is associated with the prognosis of patients with primary gastric cancer.3.The new stage is more suitable for patients with tumor deposits of gastric cancer.
Development and Validation of a Nomogram to Predict Overall Survival for Patients with Metastatic Renal Cell Carcinoma
Authors: Zheng Wenwen , Zhu Weiwei , Yu Shengqiang , Li Kangqi , Ding Yuexia , Wu Qingna , Tang Qiling , Zhao Quan , Lu Congxiao , Guo Chenyu
Published: May 2020

Background: The prognosis of metastatic renal cell carcinoma (RCC) patients vary widely because of clinical and pathological heterogeneity.We aimed to develop a novel nomogram to predict overall survival (OS) for this population.Methods: Metastatic RCC patients were selected from the Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2016. These patients wererandomly assignedto a training set and a validation set at a ratio of 1:1. Significant prognostic factors of survival were identified through Cox regression models and then integrated to form a nomogram to predict 1-, 3- and 5-year OS. The nomogram was subsequently subjected to validationsvia the training and the validation sets. The performance of this model was evaluated by using Harrell’s concordance index (C-index), calibration curve, integrated discrimination improvement (IDI), net reclassification improvement (NRI), and decision curve analysis (DCA). Results: Overall, 2315 eligible metastatic RCC patients were enrolled from the SEER database. A nomogram of survival prediction for patients of newly diagnosed with metastatic RCC was established, in which eight clinical factors significantly associated with OS were involved, including Fuhrman grade, lymph node status, sarcomatoid feature, cancer-directed surgery, bone metastasis, brain metastasis, liver metastasis, and lung metastasis.The new model presented better discrimination power than the American Joint Committee on Cancer (AJCC) staging system (7th edition) in the training set (C-indexes, 0.701 vs. 0.612, P<0.001) and the validation set (C-indexes, 0.675 vs. 0.600, P<0.001). The calibration plots of the nomogram exhibited optimal agreement between the predicted values and the observed values.The results of NRI and IDI also indicated the superior predictive capability of the nomogram relative to the AJCC staging system. The DCA plots revealed higher clinical use of our model in survival prediction.Conclusions: We developed and validated an effective nomogram to provide individual OS prediction for metastatic RCC patients, which would be beneficial to clinical trial design, patient counseling, and therapeutic modality selection.
CHI3L1 Expression is a Prognostic Marker for Patients with Diagnosed Solid Tumors: Evidence from a Systematic Review and Meta-Analysis
Authors: pan jianyuan , Wu Liping , Yin Shiwu , Tang Yongqin , Zhang Jing , Feng Jun , Chen Zhenfei , Mossel Marije
Published: May 2020

Background: Accumulating studies have demonstrated YKL-40 associated with the prognosis of several cancers and contributed to the tumor progression through promoting tumor angiogenesis, migration, invasion and metastasis. The objective of this meta-analysis was to investigatethe relationship between YKL-40 and prognosis inpatients with solid tumors and seek for a new prognostic biomarker.Method: Relevant studies were searched in the Medline (PubMed), Web of science, and Embase. Pooled HR of overall survival and disease-free survival (DFS) were calculated to evaluate the strengthof the association between YKL-40 and cancer prognosis by using Stata software 14.0.Results: In total, 30 studies comprising 5160 patients were considered eligible and enrolled into the final meta-analysis. According to the meta-analysis results, higher expression of YKL-40 predicted poorer OS (pooled HR=1.85 CI%=1.58-2.18；P<0.001) and DFS (pooled HR =3.63 95% CI =2.63-5.01; P<0.001).Conclusion: The current evidence suggests that YKL-40 has a predictive effect onsurvival of cancer patients as indexed by DFS and OS. YKL-40 tissue expression is a valuable prognostic biomarker and may be a promising therapeutic target for solid tumors.
Utilization of Long-Lasting Insecticide Treated Net and Associated Factors Among Pregnant Women in Malarious Kebeles in Awabel District, North-West Ethiopia, 2017
Authors: Tariku Mengistie Kassahun , Dagnew Zewdu , Misikir Sewnet Wongiel , Belete Abebe Habtamu
Published: May 2020

Background: Utilization of long-lasting insecticide treated net (LLITN) is one of the main vector control activities. It has a killing, repellent and physical barrier effects against mosquito. Even if priority is given for pregnant women, not all nets owned by household have been utilized by pregnant women. The objective of the study was to assess utilization of Long-lasting insecticidal net and associated factors among pregnant women in malarious kebeles, Awabel woreda, North-West Ethiopia. Methods: A community-based cross-sectional study was conducted from May 1 to June 30, 2017. A systematic random sampling was used to select 422 households. Two days training was given for data collectors and supervisors. Collected data were coded and entered using epi-data version 3.1, then it was exported to Statistical Package for Social Science (SPSS) version 20. After bivariate logistic regression analysis, all variables with a p-value less than or equal to 0.25was entered into multivariable logistic regression and p value < 0.05 considered as significantly associated with the outcome variable. Results: Utilization of LLITN was 33.6%. Factors such as attending antenatal care [adjusted odd ratio (AOR) =1.89; 95% CI; 1.04-3.44], traveling <1 hour to reach health facility AOR=4.41; 95% CI; 2.06-9.43], age [AOR= 3.67; 95% CI; 1.36-9.95], knowledge[AOR=11.68; 95% CI; 5.96-22.89] and having positive attitude [AOR=3.12; 95 CI; 1.66-5.88] were significantly associated with utilization of LLITN. Conclusion: This study showed that low utilization of LLITN. Attending antenatal care (ANC), traveling <1 hour to reach health facility, age , knowledge and attitude had positive association with LLITN utilization. Every concerned body should focus on reducing distance barrier by giving outreach services and increasing ANC, the attitude and knowledge of pregnant women toward malaria and LLITN which increase utilization of LLITN. Key words : LLITN utilization, pregnant women, malarious kebeles, Awable, Ethiopia
Fully automatic three-dimensional MRI analysis for the cartilage and meniscus of the knee: Kanagawa Knee Study
Authors: Aoki Hayato , Ozeki Nobutake , Katano Hisako , Hyodo Akinobu , Matsuda Junpei , Takanashi Kimiko , Suzuki Kenji , Masumoto Jun , Okanouchi Noriya , Fujiwara Takeo , Sekiya Ichiro
Published: May 2020

Objective We have developed a fully automatic three-dimensional MRI analysis software that measures the projected cartilage area ratio (PCAR) to allow for the quantification of the cartilage in the knee. Our objectives for this cross-sectional study were to verify our software’s accuracy and to quantify cartilage and meniscus extrusion. We also examined which cartilage quantification was most affected by age and analyzed the relationship between PCAR and meniscus extrusion. Methods 108 subjects were selected for training, and Dice similarity coefficients were determined from 5 other subjects. This study included 561 subjects between 30–70 years of age. From their knee MRI data, we quantified cartilage thickness, cartilage volume, and PCAR (0.0–1.5 mm) in four regions, including the medial tibial (MT) cartilage. Furthermore, each region was divided into nine subregions. The medial central (mc) subregion was also analyzed. As a quantification for meniscus extrusion, the medial meniscus coverage ratio (MMCR) was also investigated. Results Dice similarity coefficients were 0.911 and 0.892 for the femoral and tibial cartilage and 0.916 and 0.891 for the medial and lateral meniscus. Among 48 cartilage quantifications, the highest absolute value of the correlation coefficient with age was mcMT PCAR 1.0 mm in females and mcMT cartilage thickness in males. In females, mcMT PCAR 1.0 mm was correlated with MMCR, although MMCR was not correlated with age. In males, mcMT PCAR 0.0 mm was correlated with MMCR. Conclusions Our software showed high segmentation accuracy and provided numerous quantifications of cartilage related to age and meniscus extrusion.