bluuebunny/crossref_metadata_2025 huggingface dataset:
Estimating transmission dynamics and serial interval of the first wave of COVID-19 infections under different control measures: A statistical analysis in Tunisia from February 29 to May 5, 2020
Authors: Talmoudi Khouloud , Safer Mouna , Letaief Hejer , Hchaichi Aicha , Harizi Chahida , Dhaouadi Sonia , Derouiche Sondes , Bouaziz Ilhem , Gharbi Donia , Najar Nourhene , Osman Molka , Cherif Ines , Mlallekh Rym , Ben-Ayed Oumaima , Ayedi Yosr , Bouabid Leila , Bougatef Souha , Ben-Alaya Nissaf Bouafif ép , Chahed Mohamed Kouni
Published: August 2020

Background: Describing transmission dynamics of the outbreak and impact of intervention measures are critical to planning responses to future outbreaks and providing timely information to guide policy makers decision. We estimate serial interval (SI) and temporal reproduction number (Rt) of SARS-CoV-2 in Tunisia. Methods: We collected data of investigations and contact tracing between March 1, 2020 and May 5, 2020 as well as illness onset data during the period February 29-May 5, 2020 from National Observatory of New and Emerging Diseases of Tunisia. Maximum likelihood (ML) approach is used to estimate dynamics of Rt. Results: 491 of infector-infectee pairs were involved, with 14.46% reported pre-symptomatic transmission. SI follows Gamma distribution with mean 5.30 days [95% CI 4.66-5.95] and standard deviation 0.26 [95% CI 0.23-0.30]. Also, we estimated large changes in Rt in response to the combined lockdown interventions. The Rt moves from 3.18 [95% CI 2.73-3.69] to 1.77 [95% CI 1.49-2.08] with curfew prevention measure, and under the epidemic threshold (0.89 [95% CI 0.84-0.94]) by national lockdown measure.Conclusions: Overall, our findings highlight contribution of interventions to interrupt transmission of SARS-CoV-2 in Tunisia.
Lipidomic profiling reveals distinct differences in plasma lipid composition in overweight or obese adolescent students
Authors: Yang Longyan , Yin Ruili , Wang Xiaojing , Yu Ke
Published: August 2020

Introduction: The relationship between dyslipidemia and obesity has been widely reported, but the global lipid profiles associated with the development of obesity still need to be clarified. An investigation into the association between the lipidomic plasma profile and adolescent obesity may provide new insights into the development of obesity. Methods: Mass spectrometry coupled with liquid chromatography was applied to detect the global lipidome in the fasting plasma from 90 Chinese adolescents, including 30 obese adolescents, 30 overweight adolescents, and 30 adolescents with a normal body mass index (BMI). All participants underwent anthropometric measurements by using InBody. Clinical biochemical indicators were measured by Cobas Elecsys.Results: Both qualitative and quantitative analyses revealed a gradual change in plasma lipid features among obese students, exhibiting characteristics close to overweight students, but differing significantly from normal students. Compared with normal and overweight students, levels of triglyceride (TG), 18-hydroxycortisol, isohumulinone A, and 11-dihydro-12-norneoquassin were up-regulated in the obese group, while phosphatidylcholine (PC), phosphatidylethanolamine (PE), lysoPC (LPC), lysoPE (LPE), and phosphatidylinositol (PI) were significantly down-regulated in the obese group. Then, we conducted Venn diagrams and selected 8 significant metabolites from the 3 paired comparisons. Most of the selected features were significantly correlated with the anthropometric measurements.Conclusions: This study demonstrated evidence for a relationship between the eight significant metabolites with obese adolescents. These lipid features may provide a basis for evaluating risk and monitoring the development of obesity.
Seasonal Variation in Gut Microbiota Composition: Comparative Analysis of Siberian Musk Deer (Moschus moschiferus) and Forest Musk Deer (Moschus berezovskii)
Authors: Su Rina , Erdenedalai Myagmarsuren , Dalai Menggen , Batkhuu L , Chi Chimedragchaa , Hasi Surong
Published: August 2020

Background: Musk deer is famous for its secretion of musk, but due to various factors that the musk deer population has dropped sharply and it is difficult to expand herd sizes.In light of the rapid development of animal husbandry and scientific technology, as well as the urgent need for wildlife conservation, research on the gut microbiota of musk deer is warranted. The gut microbiota is a complex ecosystem that is regulated by many factors, such as dietary, environmental, host factors, and seasonal changes. Results: We studied the gut microbiota in Siberian and Forest musk deer using high-throughput sequencing of the V3–V4 region of the 16S rRNA gene. Fecal samples were collected during two seasons to determine associations between community diversity, composition, and seasonal factors. The results showed that the Firmicutes and Bacteroidetes were the predominant phyla in Siberian and Forest musk deer , their relative abundance was significantly different with species and seasonal factors. The Siberian musk deer population sampled in this study had a wider feeding range and no dietary limitations. Affected by the type of food sources and the feed intake , the microbial α-diversity is higher in summer than winter. Conclusions: The gut bacterial composition of these two musk deer is significantly different, and the abundance between core bacteria is affected by seasonal factors. This study is the first to analyze the composition of the gut microflora in Siberian musk deer, and these results provide a foundation for improving feeding for musk deer populations and further studies investigating the environmental impact of musk deer.
Hill-based dissimilarity indices and null models for analysis of microbial community assembly
Authors: Modin Oskar , Liébana Raquel , Saheb-Alam Soroush , Wilén Britt-Marie , Suarez Carolina , Hermansson Malte , Persson Frank
Published: August 2020

Background: High-throughput amplicon sequencing of marker genes, such as the 16S rRNA gene in Bacteria and Archaea, provides a wealth of information about the composition of microbial communities. To quantify differences between samples and draw conclusions about factors affecting community assembly, dissimilarity indices are typically used. However, results are subject to several biases and data interpretation can be challenging. The Jaccard and Bray-Curtis indices, which are often used to quantify taxonomic dissimilarity, are not necessarily the most logical choices. Instead, we argue that Hill-based indices, which make it possible to systematically investigate the impact of relative abundance on dissimilarity, should be used for robust analysis of data. In combination with a null model, mechanisms of microbial community assembly can be analyzed. Here, we also introduce a new software, qdiv, which enables rapid calculations of Hill-based dissimilarity indices in combination with null models.Results: Using amplicon sequencing data from two experimental systems, aerobic granular sludge (AGS) reactors and microbial fuel cells (MFC), we show that the choice of dissimilarity index can have considerable impact on results and conclusions. High dissimilarity between replicates because of random sampling effects make incidence-based indices less suited for identifying differences between groups of samples. Determining a consensus table based on count tables generated with different bioinformatic pipelines reduced the number of low-abundant, potentially spurious amplicon sequence variants (ASVs) in the data sets, which led to lower dissimilarity between replicates. Analysis with a combination of Hill-based indices and a null model allowed us to show that different ecological mechanisms acted on different fractions of the microbial communities in the experimental systems.Conclusions: Hill-based indices provide a rational framework for analysis of dissimilarity between microbial community samples. In combination with a null model, the effects of deterministic and stochastic community assembly factors on taxa of different relative abundances can be systematically investigated. Calculations of Hill-based dissimilarity indices in combination with a null model can be done in qdiv, which is freely available as a Python package (https://github.com/omvatten/qdiv). In qdiv, a consensus table can also be determined from several count tables generated with different bioinformatic pipelines.
Composing High-level Stream Processing Pipelines
Authors: Mahapatra Tanmaya
Published: August 2020

The growing number of Internet of Things (IoT) devices provide a massive pool of sensing data. However, turning data into actionable insights is not a trivial task, especially in the context of IoT, where application development itself is complex. The process entails working with heterogeneous devices via various communication protocols to co-ordinate and fetch datasets, followed by a series of data transformations. Graphical mashup tools, based on the principles of flow-based programming paradigm, operating at a higher-level of abstraction are in widespread use to support rapid prototyping of IoT applications. Nevertheless, the current state-of-the-art mashup tools suffer from several architectural limitations which prevent composing in-flow data analytics pipelines. In response to this, the paper contributes by (i) designing novel flow-based programming concepts based on the actor model to support data analytics pipelines in mashup tools, prototyping the ideas in a new mashup tool called aFlux and providing a detailed comparison with the existing state-of-the-art and (ii) enabling easy prototyping of streaming applications in mashup tools by abstracting the behavioural configurations of stream processing via graphical flows and validating the ease as well as the effectiveness of composing stream processing pipelines from an end-user perspective in a traffic simulation scenario.
Gastrointestinal perforation in anti-NXP2 antibody-associated juvenile dermatomyositis: Case reports and a review of the literature
Authors: Xu Yingjie , Ma Xiaolin , Zhou Zhixuan , Li Jianguo , Huo jun , Zhu Jia , Kang Min , Lai Jianming , Li Xiaohui
Published: August 2020

Background: To summarize the characteristics of gastrointestinal (GI) perforation in anti-nuclear matrix protein 2 (NXP2) antibody-associated juvenile dermatomyositis (JDM). Methods: Five patients with GI perforation from a JDM cohort of 120 cases are described. Relevant literature was reviewed.Results: Five patients, including four females and one male, were included in the study. The age of onset of these patients ranged from 3.3 to 9.5 years with the median age of 5.0 years. When these patients were complicated by GI perforation, childhood myositis assessment score (CMAS) ranged from 1 to 5 with the median score of 2. Myositis-specific antibody (MSA) spectrum analysis indicated that the five patients were anti-NXP2 antibody positive. The initial symptoms of GI perforation were progressive abdominal pain and intermittent fever. Two patients also presented with ureteral calculus with hydronephrosis and ureteral stricture. Surgery was performed in four patients. One patient failed to undergo a repair as the perforation was high in position. For the other three patients, perforation repair was successful, of which two patients failed due to recurrent perforation. At 24 months postoperative follow-up, one patient was in complete remission on prednisone (Pred) and methotrexate(MTX) treatment, and her ureteral stricture had disappeared. The other four patients died. Adding these cases with 16 other patients described in the literature, the symptom at onset was progressive abdominal pain, which often occurred within 10 months after JDM was diagnosed. Perforation most commonly occurred in the duodenum, although it also occurred at multiple sites or was recurrent. The mortality rate of GI perforation in JDM was 38% (8/21). Conclusions: All the five perforation cases in our study subjected to MSA analysis were anti-NXP2 antibody positive. The symptom at onset was abdominal pain. The most common site of perforation was the duodenum in the retroperitoneum, and the lack of acute abdominal manifestations prevented early diagnosis. GI perforation may be a fatal complication in JDM, and early diagnosis is very important. More research is needed to determine the pathogenesis and predictive factors of GI perforation in JDM.
Preoperative predictors of enucleation time during en bloc ‘no-touch’ holmium laser enucleation of the prostate
Authors: Lin Chun-Hsuan , Li Ching-Chia , Wu Wen-Jeng , Wen Sheng-Chen
Published: August 2020

Background: To evaluate preoperative predictors of enucleation time during en bloc ‘no-touch’ holmium laser enucleation of the prostate (HoLEP)Methods: We enrolled 135 patients with symptomatic benign prostatic hyperplasia (BPH) treated with en bloc ‘no-touch’ HoLEP from July 2017 to March 2019 by a single surgeon. Preoperative, perioperative, and postoperative clinical variables were examined. Stepwise linear regression was performed to determine clinical variables associated with enucleation times. Result: The average (range) enucleation time was 46.1 (12–220) minutes, and the overall operation time was 71 (18–250) minutes. History of antiplatelet agents, history of urinary tract infection (UTI), and increasing specimen weight were each significantly associated with increasing enucleation time. No category IV complications were recorded, and all complications were evenly distributed among the groups according to the HoLEP specimen weight.Conclusion: En bloc ‘no-touch’ HoLEP was found to be an efficient and reproducible surgical method for treating BPH. Prostatic gland size was significantly associated with increased enucleation times. Similarly, history of UTI and antiplatelet agents were correlated with increased operative time.
Study of 10kW molten carbonate fuel cell power generation system and its performance test
Authors: Lu Chengzhuang , Zhang Ruiyun , Li Hao , Cheng Jian , Xu Shisen , Yang Guanjun , Huang Hua
Published: August 2020

High-temperature fuel cells are a power technology that can improve the efficiency of electricity generation and achieve near-zero emissions of carbon dioxide. The present work explores the performance of the 10kW high-temperature molten carbonate fuel cell (MCFC). The key materials of the molten carbonate fuel cell single cell were characterized and analyzed by X-ray diffraction(XRD) and scanning electron microscope (SEM). The results show that the pore size of key electrode material was 6.5 μm and the matrix material is α-LiAlO 2 .The open circuit voltage of the single cell is 1.23 V in experiment. The current density is greater than 100 mA / cm^2 when the operating voltage is 0.7 V. The 10 kW fuel cell stack was constitutive of 80 pieces single fuel cells with area of 2000 cm 2 . The open circuit voltage of the stack reaches above 85 V. The fuel cell stack power and current density can reach 11.7 kW and 104.5 mA/cm^2 when the operating voltage is 56 V. The influence and long-term stable operation of the stack were also analyzed and discussed. The successful operation of 10kW high temperature fuel cell promotes the scale of domestic fuel cell and provides the research basis of fuel cell capacity enhancement and distributed generation in the next step.
Association between circulating microRNAs 486, 146b and 15b and serum betatrophin levels in obese; type 2 diabetic and non-diabetic children
Authors: Mohany khalid Mohammad , Alrugaie Osamah , Alwutayd Osama , Al-Nafeesah Abdullah , Saleem Tahia H.
Published: August 2020

Background: This study tested the association between serum levels of microRNA-486, -146b and -15b and betatrophin in normal and obese children with/without type 2 diabetes mellitus (T2DM).Methods: the study included 120 children; divided into three groups: G1 (50 healthy), G2 (35 obese) and G3 (35 obese with T2DM). The levels of microRNA-486, 146b and 15b and serum betatrophin were measured by their corresponding methods.Results: serum microRNA-486, -146b, -15b and betatrophin levels were significantly high in G3 followed by G2 then G1 (p=0.002, >0.001, >0.001, and >0.001, respectively). Especially in G3, these levels correlated positively with the BMI percentile (r=0.44, 0.58, 0.38, and 0.46, p=0.007, >0.001, 0.021, and 0.005, respectively), serum glucose (r=0.56, 0.49, 0.82, 0.60, and 0.42, p>0.001, 0.003, >0.001, and >0.001, respectively) and HbA1c% (r=0.56, 0.39, 0.66, and 0.42, p>0.001, 0.019, >0.001, and 0.032, respectively) while, showed negative correlations with correlated with serum insulin levels (r=-0.37, -0.42, -0.58, and -0.41, p=0.021, 0.012, >0.001 and 0.013, respectively) and with serum C-peptide levels (r=-0.76, -0.50, -0.35 and -0.42, p>0.001, 0.002, 0.036 and 0.011, respectively). Serum betatrophin levels correlated positively with microRNA-486, -146b and -15b levels in G2 (r=0.35, 0.80, and 0.67, p= 0.036, >0.001, and,>0.001, respectively), and in G3 (r=0.57, 0.36, and 0.38, p >0.001, 0.029 and, 0.023, respectively).Conclusions: Circulating microRNA-486, 146b and 15b increase significantly in obese children with T2DM and these levels correlate positively with serum betatrophin levels. Further studies are required to test the role of targeting of these microRNAs and betatrophin in the timely management of obesity and/or T2DM in children.
Epidemiology and Multidrug Resistance of Strongyle Nematodes in Ordos Merino Sheep
Authors: Eye Ledege , Wuen Jiya , He Xiuling , Buyin Buhe , Hai Ying , HASI Surong
Published: August 2020

Background: Regular whole-flock treatments and long-term use of similar anthelmintics have led to the development of anthelmintic resistance and widespread epidemics of nematodiasis in sheep. This study was performed to understand the prevalence of gastrointestinal nematodes in Ordos Merino sheep and evaluate the efficacy of currently used anthelmintics. Results: Between March 2017 and April 2019, a total of 4014 fresh fecal samples were collected from sheep, and fecal nematode eggs were qualitatively and quantitatively analyzed to understand the prevalence of sheep nematodiasis. The anthelmintic efficacy of currently used drugs was evaluated in naturally infected sheep. Severe infection by gastrointestinal nematodes was observed in the Ordos Merino sheep. The infection rates of the nematodes in 3 consecutive years were 84.3%, 36.9%, and 42.3%. Haemonchus contortus and Nematodirus sp. were the predominant nematode species, with infection rates of 84.3% and 65.6%, respectively, in 2017. Moreover, these species had acquired high resistance to ivermectin, doramectin, albendazole, and levamisole; the fecal egg count reduction percentages were 6.9%, 1.7%, 3.5%, and 79.0%, respectively, after a single administration. Nitroxynil and closantel showed strong anthelmintic efficacy against the predominant species Haemonchus contortus and other nematodes, but they had almost no effect on Nematodirus sp. Conclusions: The prevalence of gastrointestinal nematodes in Ordos Merino sheep and their resistance to commonly used anthelmintics were comprehensively evaluated, and the drugs with high efficacy against the predominant species were identified. The findings of this study will provide a good foundation for the appropriate use of anthelmintics.
Machine learning techniques for mortality prediction in critical traumatic patients: anatomic and physiologic variables from the RETRAUCI study
Authors: Serviá Luis , Montserrat Neus , Badia Mariona , Llompart-Pou Juan Antonio , Barea-Mendoza Jesús , Chico-Fernández Mario , Sánchez-Casado Marcelino , Jimenez-Moragas José Manuel , Mayor-García Dolores María , Cabello Javier Trujillano
Published: August 2020

Background: Interest in models for calculating the risk of death in traumatic patients admitted to ICUs remains high. These models use variables derived from the deviation of physiological parameters and/or the severity of anatomical lesions with respect to the affected body areas. Our objective is to create different predictive models of the mortality of critically traumatic patients using machine learning techniques.Methods: We used 9625 records from the RETRAUCI database (National Trauma Registry of 52 Spanish ICUs in the period of 2015–2019). Hospital mortality was 12.6%. Data on demographic variables, affected anatomical areas and physiological repercussions were used. The Weka Platform was used, along with a ten-fold cross-validation for the construction of nine supervised algorithms: logistic regression binary (LR), neural network (NN), sequential minimal optimization (SMO), classification rules (JRip), classification trees (CT), Bayesian networks (BN), adaptive boosting (ADABOOST), bootstrap aggregating (BAGGING) and random forest (RFOREST). The performance of the models was evaluated by accuracy, specificity, precision, recall, F-measure, and AUC.Results: In all algorithms, the most important factors are those associated with traumatic brain injury (TBI) and organic failures. The LR finds thorax and limb injuries as independent protective factors of mortality. The CT generates 24 decision rules and uses those related to TBI as the first variables (range 2.0–81.6%). The JRip detects the eight rules with the highest risk of mortality (65.0–94.1%). The NN model uses a hidden layer of ten nodes, which requires 200 weights for its interpretation. The BN find the relationships between the different factors that identify different patient profiles. Models with the ensemble methodology (ADABOOST, BAGGING and RandomForest) do not have greater performance. All models obtain high values ​​in accuracy, specificity, and AUC, but obtain lower values ​​in recall. The greatest precision is achieved by the SMO model, and the BN obtains the best recall, F-measure, and AUC.Conclusion: Machine learning techniques are useful for creating mortality classification models in critically traumatic patients. With clinical interpretation, the algorithms establish different patient profiles according to the relationship between the variables used, determine groups of patients with different evolutions, and alert clinicians to the presence of rules that indicate the greatest severity.
Analysis of HSD11B2 as a prognostic marker in Melanoma via TCGA data mining
Authors: Fu Hongyi , Tang Yaqin , Ding Ying
Published: August 2020

Background: Hydroxysteroid 11-Beta Dehydrogenase 2 (HSD11B2) expression has been reported to be present in melanoma. We investigated the association of HSD11B2 with melanoma using publicly available data from The Cancer Genome Atlas (TCGA). Methods: The relationship between clinical pathologic features and HSD11B2 were analysed via Wilcoxon signed-rank test and logistic regression. Clinicopathologic characteristics associated with overall survival in melanoma patients were calculated using Cox regression and the Kaplan-Meier method. Gene Set Enrichment Analysis (GSEA) and gene co-association of HSD11B2 were performed using TCGA data set. Results: Reduced HSD11B2 expression was significantly lower in melanoma patients compared to normal patients (p value = 3.004e-122) and also associated with lower survivability. low HSD11B2 expression in melanoma was also significantly associated with cancer stages T (p value = 0.002) and N (p value < 0.001) and age (p value = 0.003). Genes TFCP2L1, PRR15L, ATP6V1B1, C9orf152, AC009948.1, AL391244.1, WDCP, HNRNPCP2 and GTF2E1 were all shown to be co-associated with changes in HSD1B2 expression. Multiple signalling pathway including cytosolic DNA sensing pathway, JAK STAT signalling pathway, NOD like receptor signalling pathway, T cell receptor signalling pathway and Toll like receptor signalling pathway were differentially enriched in low HSD11B2 expression phenotype. Conclusion: Our study revealed that HSD11B2 expression is closely associated with melanoma development and age, as well as multiple cancer related genes and pathways, thus highlighting HSD11B2 as a potential therapeutic marker of melanoma.
hsa_circ_0000231 promotes colorectal cancer cell growth through upregulation of CCND2 by IGF2BP3/miR-375 dual pathway 
Authors: Zhang Wei , Wang Bo , Yang Yang , Zhang Zhen , Wang Quan , Zhang Haoran , Jiang Kewei , Ye Yingjiang , Wang Shan , Shen Zhanlong
Published: August 2020

Background and aim Circular RNAs (circRNAs) have emerged as vital regulators of the initiation and progression of diverse kinds of human cancers. This study aimed to investigate the role of circRNAs in colorectal cancer (CRC). Methods The expression profiles of circRNAs in five pairs of CRC tissues and adjacent normal tissues were analyzed using microarray. Quantitative real-time polymerase chain reaction, in situ hybridization, and BaseScope Assay were used to determine the level and prognostic values of hsa_circ_0000231. Then, in vitro and in vivo functional experiments were performed to investigate the effects of hsa_circ_0000231 on cell proliferation. Mechanistically, fluorescence in situ hybridization, dual-luciferase reporter assay, and RNA pull-down and RNA immunoprecipitation experiments were performed to confirm the interaction between hsa_circ_0000231 and Insulin-like growth factor 2 mRNA-binding protein 3(IGF2BP3) or has_miR-375. Results The expression of hsa_circ_0000231 was upregulated in CRC primary tissues, which indicated poor prognosis of patients with CRC. The results demonstrated that hsa_circ_0000231 could promote CRC cell proliferation as well as tumorigenesis in vitro and in vivo. The mechanistic analysis showed that hsa_circ_0000231 might, on the one hand, act as a competing endogenous RNA of miR-375 to promote cyclin D2 (CCND2) and, on the other hand, bind to the IGF2BP3 protein to prevent CCND2 degradation. Conclusion The findings suggested that hsa_circ_0000231 facilitated CRC progression by sponging miR-375 or binding to IGF2BP3 to modulate CCND2, implying that has_circ_0000231 might be a potential new diagnostic and therapeutic biomarker of CRC.
Effects of Tocilizumab in COVID-19 patients: a cohort study
Authors: Vu Christine A. , Deronde Kailynn J , Vega Ana D , Maxam Meshell , Holt Gregory , Natori Yoichiro , Zamora Jose Gonzales , Salazar Veronica , Boatwright Renata , Morris Stephen R , Corvino Daniela de Lima , Betances Anmary Fernandez , Colucci Leah , keegan James , Lopez Andy , Rezk Andrew Hany , Rodriguez Yvette , Doblecki Susanne , Zerda David De La , Abbo Lilian M
Published: August 2020

Background
Due to the lack of proven therapies, we evaluated the effects of early administration of tocilizumab for COVID-19. By inhibition of the IL-6 receptor, it has been proposed that tocilizumab may help to mitigate the hyperinflammatory response associated with progressive respiratory failure.
Methods
A retrospective, observational study was conducted on hospitalized adults who received intravenous tocilizumab for COVID-19 between March 23, 2020 and April 10, 2020.
Results
Most patients were male (66.7%), Hispanic (63.3%) or Black (23.3%), with a median age of 54 years. Tocilizumab was administered at a median of 8 days (range 1–21) after initial symptoms and 2 days (range 0–12) after hospital admission. On the day of administration, the median PaO2/FiO2 was 166 (range 33–523) and 50 patients (83.3%) had ARDS. By day 30, 36 patients (60.0%) demonstrated clinical improvement, 9 (15.0%) died, 33 (55.0%) were discharged alive, and 18 (30.0%) remained hospitalized. Successful extubation occurred in 13 out of 29 patients (44.8%). Infectious complications occurred in 16 patients (26.7%) at a median of 10.5 days. There was an increase in PaO2/FiO2 and an initial reduction in CRP that was not sustained beyond day 10.
Conclusions
Majority of patients demonstrated clinical improvement and were successfully discharged from the hospital alive after receiving tocilizumab. Similar to previous studies, infectious complications were not uncommon. A rebound effect with CRP was observed, which may suggest the need for higher or subsequent doses to adequately manage cytokine storm. Based on our findings, we believe that tocilizumab may have a role in the treatment of COVID-19, however randomized controlled studies are urgently needed.
Analysis of Long Noncoding RNA and mRNA Profiling in Peripheral Blood Mononuclear Cells of Human Immunized With Rabies Virus Vaccine by RNA Sequencing
Authors: Zhao Pingsen , Hou Kaijian , Zeng Peibin , Yang Songtao , Xia Xianzhu
Published: August 2020

Background
Rabies is still a lethal disease caused by rabies virus (RABV), and it remains a global health threaten. The epigenetic landscape of host in response to immunization with rabies virus vaccine is not yet elucidated. Evidences reveal that long noncoding RNA (lncRNA) play an important role for control of viral infection, but the expression profile of lncRNA in human immunized with rabies virus vaccine remains unclear.
Methods
lncRNA and mRNA profiles were investigated in four volunteers vaccinated with RABV vaccine by RNA sequencing.
Results
33 lnRNAs and 427 mRNAs were differentially expressed in RABV vaccine immunized volunteers. The gene oncology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) were used to analysis the functional annotation, and the result suggested the lncRNAs involved in signaling pathways related to host immune induced by the RABV vaccine.
Conclusions
To the best of our knowledge, it is the first time to report the transcriptomic landscape of lncRNAs in human immunized with RABV vaccine. Our study mimics the host response of human to RABV infection and suggests that lncRNAs might be of a potential therapeutic target in anti-rabies virus strategies.
Evaluating Quality of Life in Families With Williams Syndrome Patients
Authors: MORALEDA ESTHER , Arana Mario , López Patricia
Published: August 2020

Background: Williams Syndrome is a developmental disorder characterized by a variable intellectual disability. People with Williams Syndrome need the intervention of several clinical and educational specialists throughout their life. However, little is known about the impact produced by this disability in their immediate environment, especially in families. The purpose was to know the level of quality of life described by families with Williams Syndrome.Methods: The sample was made up of 33 families belong to Spanish Williams Syndrome Association who were evaluated using the Kidslife Scale. Theirs children and adolescents were between 4 and 20 years old. Eight main quality of life dimensions were evaluated: emotional well-being, physical well-being, material well-being, personal development, interpersonal relations, social inclusion, self-determination and rightsResults: The obtained data indicated that the degree and presence of intellectual disability themselves did not homogeneously influence people’s quality of life, but many variables could alter their quality of life to a greater or lesser extent. There are no significant differences between quality of life areas but significant differences appeared for level of dependence in the self-determination subarea (p<.05). Conclusions: These results led us to analyse the social and emotional implications for families and their environment.
Characteristics of human papillomavirus infection among women with cervical cytological abnormalities in the Zhoupu District, Shanghai City, China, 2014–2019
Authors: Li Ping , Liu Qing , Li Wei , Liu Zhou , Xing Baoling , Wu Suqin , Zhou Zhaoli , Sun Liping , Ren He , Li Hengfeng , Li Huaping
Published: August 2020

Background: Human papillomavirus (HPV) infection is currently the main cause of cervical cancer and precancerous lesions in female patients. By analyzing 6-year patient data from Shanghai Zhoupu Hospital in China, we retrospectively analyzed the epidemiological characteristics of women to determine the relationship between HPV genotype and cytological test results.Methods: From 2014 to 2019, 23,724 cases of cervical shedding were collected from Zhoupu Hospital in Shanghai, China. By comparing the results of HPV and ThinPrep cytology test (TCT), the HPV infection rate of patients was retrospectively analyzed. HPV genotyping using commercial kits can detect 21 HPV subtypes (15 high-risk and 6 low-risk). According to the definition of the Bethesda system, seven types of cervical cytology results are involved.Results: 3,816 among 23,724 women, nearly 16.08%, were infected with HPV. The top three highest HPV prevalence rates were high-risk type infection, including HPV52 (3.19%), 58 (2.47%) and 16 (2.34%). The number of single-type HPV infections (3,480 (91.20%)) was much larger than the number of multi-type ones (336 (8.8%)). Single-type infections were mainly in women aged 50-60 (16.63%) and women under 30 (15.37%), while multi-type infections were more common in women over 60 (2.67%). By analyzing the long-term trends, between 2014 and 2019, HPV52, 58, and 16 subtypes changed significantly, and the HPV positive rate also changed significantly during this period.Among 4,502 TCT positive women, 15 (4.04%), 125 (2.64%) ,159 (1.54%), 4,202(17.71%) and 1(0.004%) had atypical squamous cells (ASC), high-grade squamous intraepithelial lesions (HSIL), low-grade squamous intraepithelial lesions (LSIL), atypical glandular cells (AGC) and cervical adenocarcinoma, respectively. The HPV infection rates were 66.08%, 63.99%, 115.20%, 119.50%, and 31.72% for NILM, AGCs, HSILs LSILs and ASCs, respectively.Conclusions: HPV and TCT screening were very important steps in the secondary prevention of cervical cancer. Through the tracking and analysis of HPV and TCT results in this study, it can provide valuable information for Shanghai's HPV screening and prevention strategies, and provide references for clinical decision-making in the treatment of cervical cancer and precancerous lesions.
A Head-To-Head Comparative Study of Covid-19 Patients Between Epicenter and Peripheral Areas of Pandemic From China
Authors: Wang Gang , Luo Feng Min , Liu Dan , Liu Jia Shen , Wang Ye , Chen Hong , Tian Pan Wen , Fan Tao , Tang Li , Yu He , Wang Lan , Feng Mei , Ni Zhong , Wang Bo , Song Zhi Fang , Wu Xiao Lin , Wang Hong Jun , Tong Xiang , Xue Miao , Lei Xian Ying , Long Bo , Jia Chao , Xiao Jun , Shang Juan , Xiong Nian , Luo Jian Fei , Liang Zong An , Li Wei Min
Published: August 2020

Background: There has been little information on difference of epidemiology, clinical characteristics and outcomes between epicenter and peripheral areas of Covid-19 pandemic. Methods: Based on Sichuan & Wuhan collaboration research group for Covid-19, we established two retrospective cohorts reflecting the epicenter and peripheral area of pandemic. Epidemiology, clinical characteristics and outcomes of patients were compared. Multivariate regression analyses were used to estimate adjusted odds ratios (aOR) to identify clinical variables associated with outcomes.Results: Upon March 12, 2020, Wuhan cohort consisted of 710 patients using random sampling, and 474 consecutive cases constituted Sichuan cohort. Sichuan cohort had more upper airway symptoms, while Wuhan cohort is elder, has more lower airway symptoms and comorbidities. Wuhan cohort had higher risk of death (aOR=7.64), ICU admission (aOR=1.66), delayed time from illness onset to hospital and ICU admission (aOR=6.29 and aOR=8.03) and prolonged duration of viral shedding (aOR=1.64). Conclusions: Worse outcomes in the epicenter would be explained by delayed time from illness onset to hospital and ICU admission associated with elevated systemic inflammation reflecting organ dysfunction and prolonged duration of virus shedding except for age and comorbidities. It indicates potentially clinical implications of Covid-19 that early supportive care would achieve better clinical outcome.
Association of Cardio-Metabolic Risk Factors and Basic and Instrumental Activities of Daily Living Among Elderly People;Bushehr Elderly Health Program
Authors: Khalagi Kazem , Ansarifar Akram , Fahimfar Noushin , Sanjari Mahnaz , Gharibzdeh Safoora , Sharifi Farshad , Shafiee Gita , Heshmat Ramin , Nabipour Iraj , Larijani Bagher , Ostovar Afshin
Published: August 2020

Background: Iran's population is aging. One of the most common problems in Iranian public health is the high prevalence of cardio-metabolic risk factors. The purpose of this study was to investigate the relationship between cardio-metabolic and demographic risk factors and disability in people 60 years and older in Iran.Methods: Data from the Bushehr Elderly Health (BEH) program was used in the analysis. Demographic characteristics, as well as the history of diabetes and other chronic diseases, and smoking were measured using standardized questionnaires. Anthropometric measurements and laboratory tests were performed under standard conditions. Dependency was determined by the questionnaires of basic activities of daily living (BADL) and instrumental activities of daily living (IADL) using Barthel and Lawton scales respectively. Multiple logistic regression was used in the analysis.Results: Mean (Standard Deviation) of the participants’ age was 69.34 (6.4) years (range: 60 and 96 years), and 48.06% of the participants were men. After adjusting for potential confounders, being older, being female (OR (95%CI): 2.33 (1.89 - 2.86)), having a lower education level, a history of diabetes mellitus (OR: 1.43 (1.17 -1.74)) and past smoking (OR: 1.25 (1.00 - 1.55)), and no physical activity (OR: 1.54 (1.23 - 1.87)) were significantly associated with dependency in IADL. Also, being older and female (OR: 2.38 (1.85 - 3.03)), having a lower education level, no physical activity (OR: 2.17 (1.61 - 2.86)) and low daily intake of calories were associated with dependency in BADL.Conclusion: Age, gender, education level and physical activity are risk factors of the dependency in both of BADL and IADL in the elderly people. Diabetes mellitus and past smoking are risk factors of the dependency in IADL, and low HDL cholesterol and low daily intake of calories are risk factors of the dependency in BADL.
A Novel Anatomic Titanium Mesh Cage for Reducing the Subsidence Rate After Anterior Cervical Corpectomy: A Finite Element Study
Authors: Wang Yuhang , Zhao Qinpeng , Zhang Yongyuan , Zhang Haiping , He Baorong , Yan Liang , Hao Dingjun , Wang Biao
Published: August 2020

Background: Fusion with a titanium mesh cage (TMC) has become popular as a conventional method after cervical anterior corpectomy, but postoperative TMC subsidence has often been reported in the literature. We designed a novel anatomic cervical TMC to reduce the postoperative subsidence rate. This finite element study aims to investigate the anti-subsidence performance of a novel anatomic TMC and provide a theoretical basis for clinical application. Methods: According to the test process specified in the ASTM F2267 standard, three-dimensional finite element analysis was used to compare the anti-subsidence characteristics of a traditional TMC (TTMC) and novel TMC (NTMC). Abaqus software was used for the mesh, and the modulus of elasticity, Poisson's ratio and other material coefficients of each part were input into the model. Solidworks software was used to establish the TTMC and NTMC models and construct the two three-dimensional finite element models of TMC subsidence testing mentioned above. Through analysis, the relationships between the stiffness of the intervertebral body fusion device (Kd) and the stiffness of the polyurethane foam blocks (Ks) of the TTMC and NTMC were derived, respectively. Results: After fitting the linear segment, the Kd values of the TTMC and NTMC were 37314 N/mm and 89124 N/mm, respectively. After calculation, the Ks values of the TTMC and NTMC were 653.83 N/mm and 995.95 N/mm, respectively. The Kp values of the TTMC and NTMC were calculated to be 665.5 N/mm and 1007.2 N/mm according to the formula. Conclusion: The reported novel anatomic titanium mesh cage (NTMC) significantly improved the anti-subsidence performance after ACCF, which was approximately 51.3% higher than that of the traditional titanium mesh cage.
Cancer Incidence and Mortality in the U.S. Astronaut Corps, 1959-2017
Authors: Reynolds Robert , Little Mark P , Day Steven M , Charvat Jacqueline , Blattnig Steve , Huff Janice L , Patel Zarana S
Published: August 2020

Background: Cancer incidence and mortality are important outcomes in the surveillance of long-term astronaut health. In this research, we compare cancer incidence rates, cancer-specific mortality rates, and cancer case fatality ratios in US astronauts with those in the US general population.Methods: We use standardized incidence ratios and standardized mortality ratios to index the incidence and mortality of various cancers against rates in the US general population, from the US astronaut cohort inception in April 1959 through 31 December 2017. We also compare the lethality of these cancers in astronauts and the general population using the relative case fatality ratio.Results: The astronaut cohort included 338 individuals and over 9600 person-years of follow-up time. The counts of most cancers were under 3, though there were 11 cases of melanoma and 30 cases of prostate cancer. Both prostate and melanoma had statistically significant increases in incidence, though only melanoma had a significant increase in mortality. Lung cancer had a statistically significant deficit of both cases and deaths, while colon cancer had sizable (but not statistically significant) reductions in incidence and mortality. Three cancers showed evidence of detection bias (colon, hematologic, prostate), possibly a result of astronaut health screening protocols. For all cancers combined, astronauts showed a non-significant reduction in incidence and mortality, and a significant reduction in case fatality ratio.Conclusions: Though there were observed increases in both incidence and mortality from melanoma among astronauts, these increases are consistent with those observed repeatedly among aircraft pilots, suggesting this may be associated with ultraviolet radiation or lifestyle factors rather than any astronaut-specific exposure. The increase in prostate cancer incidence is likely explained by detection bias, and the same may be true for hematologic cancers. The lack of statistical significance in the reduction of incidence and mortality for colon cancer may be attributable to relaxed screening practices for astronauts in recent years. As astronaut health surveillance continues and evolves, the growing database will lead to a clearer picture over time. The methods employed here provide a useful structure for ongoing analysis of this unique occupational cohort.
Fibroblast Growth Factor 21 Predicts and Promotes Vascular Calcification in Haemodialysis Patients
Authors: Jiang Liqiong , Yin Qing , Yang Min , Li Min , Pan Mingming , Han Yucheng , Zhao Zhen , Wang Zhi , Zhu Lili , Wei Qing , Tu Yan , Gao Min , Liu Hong , Zhang Xiaoliang , Liu Bi-cheng , Wang Bin
Published: August 2020

Background: Cardiovascular disease (CVD) is the leading cause of death in haemodialysis (HD) patients. Vascular calcification (VC) is dramatically accelerated and is strongly associated with CVD events and mortality in HD patients. VC coexists with osteoporosis in many studies. Fibroblast growth factor 21 (FGF21) as an adipocytokines is a new hypoglycemic strategy and is inversely related to bone mineral density.Methods: To evaluate the contribution of FGF21 to VC in HD patients, we preliminary sreened 802 HD patients of two large HD centers in China. At last 388 HD patients were entered this cross-sectional study. We detected circulating FGF21 levels and measured the whole thoracic aorta calcification scores (TACS) and calcification scores of the three segments of thoracic aorta (TA), including ascending thoracic aorta (ATACS), aortic arch (AoACS), and descending thoracic aorta (DTACS) of our 388 HD patients. In addition, we pre-incubated human aortic endothelial cells (HAECs) with FGF21 in the presence or absence of parathyroid hormone (PTH) in vitro.Results: The median serum FGF21 level in HD patients was 11-fold higher than that in healthy controls. Ln(FGF21) was positively correlated with Ln(TACS+1), Ln(ATACS+1), Ln(AoACS+1) and Ln(DTACS+1) respectively in HD patients. Serum FGF21 was independently associated with TACS and ATACS, AoACS, and DTACS. FGF21 combined with age, calcium and intact parathyroid hormone demonstrated a high area under the curve (AUC=0.84) with optimal sensitivity (84%) and specificity (71%) for the prediction of VC in HD patients. Our vitro results showed that FGF21 enhanced the calcification effect of PTH on HAECs by increasing calcium deposition and endothelial-to-mesenchymal transition (EndMT).Conclusions: Circulating FGF21 was notably higher and was a potential predictor and promoter of VC in HD patients.Trial registration Chinese Clinical Trial Registry, identifier: ChiCTR1900028249. Registered 16 December 2019-Retrospectively registered,http://www.medresman.org.cn/uc/project/projectedit.aspx?proj=5981
Evolution of Medical Students' Perception of the Patient's Right to Privacy
Authors: Terán Alberto Álvarez , Palazuelos Camilo , Dierssen-Sotos Trinidad , Llorca Javier , Gómez-Acebo Inés
Published: August 2020

Background: During clinical rotations, medical students experience situations in which the patients’ right to privacy may be violated. The aim of this study is to analyze medical students' perception of clinical situations that affect patients' right to privacy or intimacy, and to look for the influential factors that may contribute to the infringement on their rights, such as age, gender, academic year or parents’ educational level.Methods: A cross-sectional study was conducted with a survey via “Google Drive”. It consisted of 16 questions about personal information, 24 questions about their experience when rotating and 22 questions about their opinion concerning several situations related to the right to privacy. Results: 129 medical students from various Spanish medical schools participated. Only 31% of 3rd-6th year students declared to have signed a confidentiality agreement when starting their clinical practice, and most students (52%) reported that doctors “sometimes”, “rarely” or “never” introduce themselves and the students when entering the patients’ rooms. Additionally, about 50% of all students reported that they would take a picture of a patient’s hospitalization report without his/her (consent), which would be useful for an assignment. Conclusions: Important mistakes during medical students’ rotations have been observed, as well as general lack of knowledge regarding patient’s right to privacy among Spanish medical students. Men and older students showed better knowledge of current legislation, as well as those whose parents were both college-educated and those in higher academic years. Informative courses and law teaching should be enhanced so that patients’ right to privacy may be better guaranteed.