bluuebunny/crossref_metadata_2025 huggingface dataset:
Gene Biomarker Prediction in Glioma by Integrating scRNA-seq Data and the Gene Regulatory Network
Authors: Qin Guimin , Ma Yuying , Yang Yuhan , Yin Yu , Liu Xiyang , Wang Liming
Published: August 2020

Background: Although great efforts have been made to study the occurrence and development of glioma, the molecular mechanisms of glioma are still unclear. Single-cell sequencing technology provides a new perspective for researchers to explore the pathogens of tumors to further help make treatment and prognosis decisions for patients with tumors.Methods: In this study, we proposed an algorithm framework to explore the molecular mechanisms of glioma by integrating single-cell gene expression profiles and gene regulatory relations. First, since there were great differences among malignant cells from different glioma samples, we analyzed the expression status of malignant cells for each sample, and then tumor consensus genes were identified by constructing and analyzing cell-specific networks. Second, to comprehensively analyze the characteristics of glioma, we integrated transcriptional regulatory relationships and consensus genes to construct a tumor-specific regulatory network. Third, we performed a hybrid clustering analysis to identify glioma cell types. Finally, candidate tumor marker genes were identified based on cell types and known glioma-related genes.Results: We got six identified cell types using the method we proposed and for these cell types, we performed functional and biological pathway enrichment analyses. The candidate tumor marker genes were analyzed through survival analysis and verified using literature from PubMed.Conclusions: The results showed that these candidate tumor marker genes were closely related to glioma and could provide clues for the diagnosis and prognosis of patients with glioma. In addition, we found that four of the candidate tumor marker genes (NDUFS5, NDUFA1, NDUFA13, and NDUFB8) belong to the NADH ubiquinone oxidoreductase subunit gene family, so we inferred that this gene family may be strongly related to glioma.
Up-regulated lncRNA-PVT1 Expression in Peripheral Blood Mononuclear Cells of Patients with Coronary Artery Disease is Correlated with Decreased Interleukin-10 Production
Authors: Miladpour Behnoosh , Seghatoleslam Atefeh , kalani mehdi , Erfani Mehran , Nowrouzi-Sohrabi peyman
Published: August 2020

Background: Plasmacytoma variant translocation 1 (PVT1) is a newly discovered long non-coding RNA (lncRNA), and it has not been previously studied in the inflammatory responses of peripheral blood mononuclear cells (PBMCs) of patients with coronary artery disease (CAD). Methods: This cross-sectional study was conducted in 15 CAD patients and 15 non-CAD (NCAD) individuals. PVT1 expression in PBMCs of the participants was measured, using real-time PCR. Interleukin (IL)-10, IL-22 and MMP-9 in the plasma and supernatant of the cultured PBMCs in the presence or absence of lipopolysaccharide (LPS) was assessed, using flowcytometry and ELISA.Results: An increased expression of PVT1 was observed in untreated PBMCs of CAD patients compared to the NCAD group. There was a significant up-regulation of PVT1 after LPS treatment in PBMCs of both groups. Plasma matrix metalloproteinase-9 (MMP-9) levels were found to be higher in CAD patients compared to the controls. The level of IL-10 and IL-22 production from the non-treated PBMCs of CAD was significantly lower compared to the NCAD group. In the total examined population, PVT1 expression was negatively correlated with IL-10 secretion. The results also showed a significant negative correlation between PVT1 expression and IL-10 produced by untreated cells. Conclusions: PVT1 expression is increased in PBMCs of CAD patients and this increased expression could be associated with decreased IL-10 production from PBMCs of these patients.
Estimation of COVID-19 under-reporting in the Brazilian States through SARI
Authors: Paixão Balthazar , Pedroso Marcel , Baroni Lais , Salles Rebecca , Escobar Luciana , de Sousa Carlos , Saldanha Raphael , Soares Jorge , Coutinho Rafaelli , Porto Fabio , Ogasawara Eduardo
Published: August 2020

BackgroundDue to its impact, COVID-19 has been stressing the academy to search for curing, mitigating, or controlling it. However, when it comes to control, there are still few studies focused on under-reporting estimates. It is believed that under-reporting is a relevant factor in determining the actual mortality rate and, if not considered, can cause significant misinformation. Therefore, the objective of this work is to estimate the under-reporting of cases and deaths of COVID-19 in Brazilian states using data from the InfoGripe on notification of Severe Acute Respiratory Infection (SARI). MethodologyThe methodology is based on the combination of data analytics (event detection methods) and time series modeling (inertia and novelty concepts) over hospitalized SARI cases. The estimate of real cases of the disease, called novelty, is calculated by comparing the difference in SARI cases in 2020 (after COVID-19) with the total expected cases in recent years (2016 to 2019). The expected cases are derived from a seasonal exponential moving average. ResultsThe results show that under-reporting rates vary significantly between states and that there are no general patterns for states in the same region in Brazil. The states of Minas Gerais and Mato Grosso have the highest rates of under-reporting of cases. The rate of under-reporting of deaths is high in the Rio Grande do Sul and the Minas Gerais. ConclusionsOur work presents the estimation of the under-reporting rates of COVID-19 in Brazilian states. This work can be highlighted for the combination of data analytics and time series modeling. Our calculation of under-reporting rates based on SARI is conservative and better characterized by deaths than for cases.
LncRNA SNHG15 facilitates development of breast cancer (BC) by upregulating c-Myc through sponging miR-451
Authors: Du Jiang , Zhong Hong , Ma Binlin
Published: August 2020

Background: Emerging evidences suggested that LncRNA SNHG15 functioned as an oncogene to promote breast cancer (BC) progression, but the detailed mechanisms are still not fully delineated.Methods: The expression levels of the associated genes were examined by using the Real-Time qPCR and Western Blot. Dual-luciferase reporter gene system was performed to validated the potential targeting sites. Cell counting kit-8 and colony formation assay were used to measure cell proliferation, and trypan blue staining and Annexin V-FITC/PI double staining assay were performed to determine cell viability and apoptosis. Cell invasion and migration were examined by transwell and wound scratch assay, respectively. The tumor-bearing mice models were established, and immunohistochemistry (IHC) was conducted to examine expression and localization of Ki67 protein in tumor tissues.Results: Here we identified that LncRNA SNHG15 upregulated c-Myc to facilitate BC progression by sponging miR-451 in a competing endogenous RNA (ceRNA)-dependent manner in vitro and in vivo. Mechanistically, LncRNA SNHG15 and c-Myc were upregulated, while miR-451 was downregulated in BC cells and clinical tissues, compared to their normal counterparts. As expected, the Pearson correlation analysis results indicated that miR-451 negatively correlated with LncRNA SNHG15 and c-Myc, and LncRNA SNHG15 was positively relevant to c-Myc in BC tissues. Next, we validated that LncRNA SNHG15 sponged miR-451 to upregulate c-Myc in BC cells. Further gain- and loss-function experiments evidenced that LncRNA SNHG15 promoted, while miR-451 inhibited malignant phenotypes, including cell proliferation, viability, migration, invasion and epithelial-mesenchymal transition (EMT) in BC cells. Interestingly, the inhibiting effects of LncRNA SNHG15 ablation on BC progression were abrogated by both silencing miR-451 and overexpressing c-Myc.Conclusions: Collectively, the present study evidenced that targeting LncRNA SNHG15/miR-451/c-Myc signaling cascade was novel to hamper BC progression, and the potential underlying mechanisms were also uncovered, which broadened our knowledge in this field, and provided potential biomarkers for BC diagnosis and treatment.
Appraisal of the diagnostic procedures of acute pancreatitis in the guidelines
Authors: Yi Ke-Qian , Yang Ting , Yang Yan-Min , Lan Guo-Li , An Li-Ya , Qi Yu-Xing , Fan Hong-Bo , Chen Xiong-Zhi , Sun Da-Li
Published: August 2020

Objectives: The purpose of this study was to comprehensively assess the heterogeneity of procedures in the diagnostic guidelines for acute pancreatitis and to identify gaps limiting knowledge in diagnosing this disease.Methods: A systematic search of a number of databases was performed to determine the guidelines for the diagnosis of acute pancreatitis in patients with severe pancreatitis. The guidelines for the diagnosis of severe pancreatitis were evaluated by AGREE II. The Measurement Scale of Rate of Agreement (MSRA) was used to assess the guidelines (2015-2020) and extract evidence supporting these recommendations for analysis.Results: Seven diagnostic guidelines for acute pancreatitis were included. Only the 2019 WSES Guidelines for the Management of Severe Acute Pancreatitis and the Japanese Guidelines for the Management of Acute Pancreatitis: Japanese Guidelines 2015 had a total score of more than 60%, which is worthy of clinical recommendation. The average scores of the Scope and Purpose domain and the Clarity and Expression domain were the highest at 71.62% and 75.59%, respectively, while the average score of the Applicability area was the lowest at 16.67%. The included guidelines were further analysed to determine the heterogeneity of the diagnosis of acute pancreatitis. The main reasons for the heterogeneity were the citation of low-quality evidence, the presence of far too many indicators for the classification of acute pancreatitis, unclear depictions of the standard, and poorly comprehensive recommendations for the diagnosis of the aetiology in the primary diagnosis of acute pancreatitis, the severity classification, the aetiological diagnosis, and the diagnosis of comorbidities.Conclusions: The quality of different diagnostic guidelines for severe pancreatitis is uneven. The recommendations are largely based on low-quality evidence, and the guidelines still have much room for improvement to reach a high level of quality. The diagnostic procedures for acute pancreatitis vary widely in different guidelines. There are large differences between them, and resolving the abovementioned reasons would be a very wise choice for guideline developers to revise and upgrade the guidelines in the future.
Mitochondrial DNA Mutations Associated with Essential Hypertension in Xin Jiang Han Chinese Population
Authors: Jiang Wenxi , Lü Qiang , Li Ronghui , Wang Panpan , Shan Guangle , Jia Xiaodong , Gu Mingliang
Published: August 2020

Background: Genetic factors contribute to essential hypertension (EH) etiology, however, causal genes haven’t been identified. Mitochondrial dysfunction is common in EH. However, evidence supporting mitochondrial DNA (mtDNA) mutation involved in EH in Chinese Han is lacking. We aimed to characterize relationship between mtDNA mutation and EH in China.Methods: Totally 216 individuals including 151 EH patients and 65 controls from Chinese Han population in Xinjiang were sequenced for whole mtDNA genome. Novel variations and haplogroups were identified for each mtDNA sequence. Frequencies of gene mutations were compared between cases and controls, and functional changes of mtDNA genes associated with EH were predicted.Results: Haplogroups of Chinese Han population in Xinjiang were consistent with those in northern China. No association of mitochondrial haplogroup with EH was observed. Nine novel variations and three EH-associated mutations were identified. Variants in mutation m.12361A>G, m15662A>G and m.1598G>A were predicted to affect functions of ND5, CYTB and 12S rRNA, respectively.Conclusions: Our results have provided a new clue for mitochondrial genetic characteristics in etiology of EH in Chinese Han population in Xinjiang.
Heterogeneity of Borderline Personality Disorder Symptoms in Help-seeking Adolescents
Authors: Cavelti Marialuisa , Lerch Stefan , Ghinea Denisa , Fischer-Waldschmidt Gloria , Resch Franz , Koenig Julian , Kaess Michael
Published: August 2020

Background
The heterogeneous presentation of borderline personality disorder (BPD) represents a clinical challenge. There is an ongoing scientific debate whether the heterogeneity can best be understood in terms of qualitative (categorical) or quantitative (dimensional) differences between individuals. The present study examined the latent structure of BPD in adolescents.
Methods
Five-hundred and six outpatients aged 12 to 17 years with risk-taking and/or self-harming behavior were assessed at baseline and one-year follow-up. Latent class analysis (corresponding with the categorical approach), factor analysis (corresponding with the dimensional approach), and factor mixture models (allowing for both categorical and dimensional aspects) were applied to the DSM-IV BPD criteria.
Results
The best fitting model distinguished between a majority class with high probabilities for all BPD criteria (“borderline group”) and a minority class with high probabilities for the impulsivity and anger criteria only (“impulsive group”). Sex significantly affected latent class membership, and both a latent factor and age explained within-class variability. The borderline group primarily consisted of females, frequently reported adverse childhood experiences, scored high on the emotion dysregulation and inhibitedness personality traits, and was associated with internalizing psychopathology. In contrast, the impulsive group primarily consisted of males, scored high on the dissocial behavior personality trait, and was associated with externalizing psychopathology. After one year, the two groups showed similar clinical improvement.
Conclusions
The study provides evidence for two distinct subgroups of adolescents with BPD features that resemble the subtypes of the ICD-10 emotionally instable personality disorder. More research is needed to further investigate the diagnostic stability of the two groups over time and potential differential treatment indications.
Following cytotoxic nanoconjugates from injection to halting the cell cycle machinery and its therapeutic implications in oral cancer
Authors: Hamid Hend Mohamed Abdel , Darwish Zeinab El Sayed , Elsheikh Sahar Mohamed , Mourad Ghada , Donia Hanaa , Afifi Marwa
Published: August 2020

Background: The concept of personalized therapy has been proven to be a promising approach. A popular approach is to utilize gold nanoparticles (AuNPs) as drug delivery vectors for cytotoxic drugs and small molecule inhibitors to target and eradicate oral cancer cells in vitro and in vivo. While it is currently accepted that the cytotoxic drug’s mode of action remains the key regulator of the therapeutic outcome and toxicity beside nanocarrier design. None of the leading studies have compared multiple chemotherapeutics to their baseline free drugs nor used multiple nanocarriers to calculate drugs impact versus nanocarriers effect. We hypothesized that similarly constructed nanocarriers play a greater role than only acting as cargo-carriers. If proven, AuNPs may have a therapeutic role beyond bypassing cancer cell membrane and delivering their loaded drugs. We propose that similarly constructed AuNPs can flexibly leverage different conjugated drugs irrelevant to their mode of action enhancing the therapeutic outcome.Methods: We conjugated 5- fluorouracil (5Fu), camptothecin (CPT), and a fibroblast growth factor receptor1-inhibitor (FGFR1i) to gold nanospheres (AuNSs). We followed their trajectories in Syrian hamsters with chemically induced buccal carcinomas.Results: Flow cytometry and cell cycle data shows that 5Fu- and CPT- induced a similar ratio of S-phase cell cycle arrest as nanoconjugates and in their free forms. On the other hand, FGFR1i-AuNSs induced significant sub-G1 cell population compared with its free form. Despite cell cycle dynamics variability, there was no significant difference in tumor cells’ proliferation rate between CPT-, 5Fu- and FGFR1i- AuNSs treated groups. Clinically, FGFR1i-AuNSs induced the highest tumor reduction rates followed by 5Fu- AuNSs. CPT-AuNSs induced significantly lower tumor reduction rates compared with the 5Fu- and FGFR1i- AuNSs despite showing similar proliferative rates in tumor cells.Conclusions: Our data indicates that the cellular biological events do not predict the clinical outcome. Furthermore, our results suggest that AuNSs selectively enhances the therapeutic effect of small molecule inhibitors such as FGFR1i than potent anticancer drugs. Future studies are required to better understand the underlying mechanism.
Dynamic Changes in Circulating Plasma B-type Natriuretic peptide levels and its Influencing Factors in Patients with Hemorrhagic Fever with Renal Syndrome
Authors: Ma Ning , Li Yongguo , Huang Yanxin , Xu Mingyan , Zhao Yue , Song Shupeng , Jiang Lisheng , Lan Yinghua
Published: August 2020

Background: Typically, Hemorrhagic fever with renal syndrome (HFRS) occurs in five sequential stages: Febrile, hypotensive, oliguric, polyuria, and convalescent stage. The pathophysiological process involves the release of inflammatory mediators, the fluctuation of blood volume and the injury of the Multiple organs, and all the factors mentioned above may cause the elevation of the level of plasma B-type natriuretic peptide (BNP). In addition, the physiological effects of BNP in regulating blood volume and promoting angiogenesis may in theory alleviate the pathological state of HFRS. So, this study is to explore the clinical application of BNP in HFRS by dynamically monitoring the BNP levels and analyzing the factors associated with BNP expression.Methods: Eighty-six in-patients with HFRS were divided into the mild, moderate and severe groups according to disease severity. Mixed-effects linear model was used to analyze the differences in BNP expression according to disease severity and disease stage. The factors affecting BNP expression were analyzed using a linear regression model for each disease stage.Results: BNP showed dynamic changes that corresponded with disease progression. The more severe the disease, the overall BNP level was higher. Disease severity, neutrophil count and pulse pressure were independent factors for BNP, while cardiac injury related indicators were not.Conclusions: In HFRS the main factors promoting BNP expression were inflammation and blood volume, rather than heart disease. BNP can be regarded as an index for judging the severity of the disease and guiding body fluid treatment.
How to improve participant compliance in clinical trials: A Scoping Review of process factors
Authors: Yu Mingkun , Lin Ziyi , Liang Changhao , Li Chengze , Zhang Zhijia , Liu Kexin , Li Xun , Liu Jianping , Fei Yutong
Published: August 2020

Background

The reliability of results can be compromised when subsets of participants who remain on a study differ from those who drop out. Although recent studies have investigated approaches for improving compliance, there has been very little investigation of process factors, regardless of the type of literature and the publication date. factors that may influence how and why compliance may be successful (or not).
Aim

To identify process factors that may influence participant compliance retention in clinical trials, and potential approaches to improve the compliance, from published studies, to facilitate future design and implementation of trials.
Methods

Six databases and two clinical trial registries were searched on November 29, 2019. Surveys, interviews, retrospective data analyses, theoretical research, reviews and clinical studies aiming at investigating factors influencing participant compliance and potential approaches for improving compliance retention were included. Data synthesis followed an iterative process to develop a list of process factors and potential retention approaches. Results were analysed descriptively, including visualization using word cloud.
Results

181 publications were included in this review, composed of 58 retrospective analysis of RCTs based on 1,132 clinical trials with 177804 participants, 27 implementation researches, 22 theoretical researches, 20 interviews, 18 surveys, 17 randomized controlled trials, 8 literature reviews, 5 systematic review and meta analysis, 3 mixed methods researches, 2 case report and 1 cohort study. We identified 70 process factors that may affect the compliance. The most commonly addressed factors were age, education, economy, trust in clinical trials, supporting from surrounding people, safety concerns and effectiveness. We found 44 potential approaches to improve compliance. Approaches reported most frequently were that researchers should pay attention to the changes on participants' psychological condition, try their best to build good relationships, provide some compensation and educate the participants about compliance.
Conclusion

These factors that may affect the compliance can help researchers predict participants who are less likely to adhere and develop screening tools to find efficiently their suitable participants. These potential approaches that may improve the compliance provide suggestions for improving compliance.
Association between Colic and sleep problems in infancy and subsequent development, emotional and behavioral problems: A Longitudinal study
Authors: Valla Lisbeth , Småstuen Milada Cvancarova , Andenæs Randi , Misvær Nina , Olbjørn Christine , Helseth Sølvi
Published: August 2020

Background: Sleep and Colic problems in infancy have been linked to adverse health outcome, but there is limited knowledge of the association between sleep and colic problems in infancy and subsequent development, emotional and behavior problems in young children. The aim of the present study was to examine whether there is an associations between infants’ crying and sleep problems at 6 months and behavioral and development problems at 18 months, 3 and 5 years Methods: A population-based longitudinal study, using data from the Norwegian Mother and Child Cohort Study conducted at the Norwegian Institute of Public Health from June 1999, to December 2008. A total of 86,724 children were included. Colic and sleep (sleep duration, nocturnal awakenings and easy to put to bed) was assessed by mother-reports. Z-scores were used to assess differences between groups of children (e.g. having colic or not, having a sleep problem or not). Emotional and behavioral problems were measured with items from the Child Behavior Checklist. Development problems were measured with items from The Ages and Stages Questionnaire. Results: Infants with colic scored significantly lower on development at 5 years (B=-0.10, CI [-0.14-; - 0.06]) and higher on internalizing problems both at 18 months (B=-0.06 .CI [-0.09-; - 0.03]) and 3 years (B=-0.05 .CI [0.08-; - 0.01]) than the reference population. Children who awoke frequently (≥ 3 times) and were more difficult to put to bed at 6 months scored significantly lower on development at 18 months and 3 and 5 years, and higher on internalizing behavior problems at 18 months and 3 years (B=0.18 and B=0.16), and children with shorter sleep duration (≤ 10 hours) at 6 months had more internalizing behavior problems at 18 months (B=-0.14. CI [0.07; - 0.02]) and 3 years (B=-0.15 .CI [0.05-; - 0.25]) than the reference population.Conclusions: Colic and disruptive sleep early in life are risk factors for development, emotional and behavioral problems within the first five years of a child’s life. It is important to be aware that disruptive sleep and colic in infancy may have long-term negative consequences.
Target calorie intake achievements for patients treated in the surgical intensive care unit
Authors: Kim Min Kyoon , Choi Yoo Shin , Suh Suk-Won , Kang Hyun
Published: August 2020

BackgroundAdequate nutritional therapy in critically ill patients is integral to an optimal outcome. This study determined which clinical factors affect the target calorie approach during SICU admission.MethodsConsecutive patients that were provided with nutritional support during their hospitalization in the Chung-Ang university hospital SICU from August 2014 to July 2016 were included in this retrospective study. Data on demographics, supplied calorie amount and method, lengths of stay in the hospital and the intensive care unit, and mortality outcomes when discharged from the SICU were collected and analyzed. ResultsIn 279 patients, 36.9% approached target calorie intake during SICU stay. In multivariate regression analysis, patients’ sex and nasogastric tube insertion were significant factors affecting target calorie approach. (OR 2.00 for female sex, 2.03 for nasogastric tube insertion; p-value 0.012 and 0.024 for each, respectively) When we divide the patients into two groups by SICU stay length, nasogastric tube insertion is more important variable in ≤7days of SICU stay for achieve the target calorie goal. (OR 4.13; p-value 0.006) As higher amounts of calories are supplied to the patients, total lymphocyte count (TLC) and C-reactive protein (CRP) levels improved significantly without changes in mortality.ConclusionExistence of nasogastric tube and patient sex were important clinical factors to reach target calorie supply for SICU patients and their importance is different according to SICU stay length.
Extra-Hepatic Comorbidity Burden Significantly Increases 90-day Mortality in Patients with Cirrhosis and High Model for Endstage Liver Disease
Authors: Coppel Scott , Mathur Karan , Ekser Burcin , Patidar Kavish R , Orman Eric , Desai Archita P , Gomez Eduardo Vilar , Kubal Chandrashekhar , Chalasani Naga P , Nephew Lauren , Ghabril Marwan
Published: August 2020

Background & aims
We examined how extra-hepatic comorbidity burden impacts mortality in patients with cirrhosis referred for liver transplantation (LT).
Methods
Adults with cirrhosis evaluated for their first LT in 2012 were followed through their clinical course with last follow up in 2019. Extra-hepatic comorbidity burden was measured using the Charlson Comorbidity Index (CCI). The endpoints were 90-day transplant free survival ( Cox-Proportional Hazard regression), and overall mortality (competing risk analysis).
Results
The study included 340 patients, mean age 56 ± 11, 63% male and MELD-Na 17.2 ± 6.6. The CCI was 0 (no comorbidities) in 44%, 1–2 in 44% and > 2 (highest decile) in 12%, with no differences based on gender but higher CCI in patients with fatty and cryptogenic liver disease. Thirty-three (10%) of 332 patients not receiving LT within 90 days died. Beyond MELD-Na, the CCI was independently associated with 90-day mortality (hazard ratio (HR), 1.32 (95% confidence interval (CI) 1.02–1.72). Ninety-day mortality was specifically increased with higher CCI category and MELD ≥ 18 (12% (CCI = 0), 22% (CCI = 1–2) and 33% (CCI > 2), (p = 0.002)) but not MELD-Na ≤ 17. At last follow-up, 69 patients were alive, 100 underwent LT and 171 died without LT. CCI was associated with increased overall mortality in the competing risk analysis (Sub-HR 1.24, 95%CI 1.1–1.4 ).
Conclusions
Extra-hepatic comorbidity burden significantly impacts short-term mortality in patients with cirrhosis and high MELD-Na. This has implications in determining urgency of LT and mortality models in cirrhosis and LT waitlisting, especially with an ageing population with increasing prevalence of fatty liver disease.
Preoperative X-ray C2C6AR is Applicable for Prediction of Difficult Laryngoscopy in Patients With Cervical Spondylosis
Authors: Zhou Yang , Han Yongzheng , Li Zhengqian , Zhao Yuqing , Yang Ning , Liu Taotao , Li Min , Wang Jun , Guo Xiangyang , Xu Mao
Published: August 2020

Background: Airway management is one of the most important techniques in clinical anesthesia practice, and inappropriate airway management is related with airway injury, brain hypoxia, and even death. The patients with cervical spondylosis are often confronted with difficult laryngoscopy and are more prone to appear unexpected difficult airway, so it is important to figure out the most valuable predictor of difficult laryngoscopy in these patients.Methods: We randomly enrolled 270 patients undergoing elective cervical spine surgery and analyzed the cervical mobility data in predicting difficult laryngoscopy. The preoperative X-ray radiological indicators were measured by an attending radiologist. Cormack–Lehane scales were assessed during intubation, and patients with a class III or IV view were assigned to the difficult laryngoscopy group.Results: Univariate analysis showed that the hyomental distance (HMD, the distance between the hyoid bone and the tip of the chin) and the hyomental distance ratio (HMDR, the ratio between HMD in the extension position and the one in the neutral position) might not be suitable indicators in patients with cervical spondylosis. Binary multivariate logistic regression (backward-Wald) analyses identified two independent risk factors from the cervical mobility indicators that correlated best as a predictor of difficult laryngoscopy: modified Mallampati test (MMT) and C2C6AR (the ratio of the angle between a line passing through the bottom of the second cervical vertebra and a line passing through the bottom of the sixth cervical vertebra in the extension position over the one in the neutral position). The odds ratio (OR) and 95% CI were 2.292(1.093-4.803) and 0.493 (0.306-0.793), respectively. C2C6AR exhibited the largest area under the curve (0.714; 95% CI 0.633–0.794).Conclusions: C2C6AR based on preoperative X-ray images may be the most accurate predictor of cervical mobility indicators for difficult laryngoscopy in patients with cervical spondylosis.Trial registration: The study was registered at the Chinese Clinical Trial Registry (http://www.chictr.org.cn; identifier: ChiCTR-ROC-16008598) on June 6, 2016.
Establishment of a prognostic model based on immune infiltration-related genes and clinical information in ovarian cancer
Authors: Kong Weikaixin , Zhang Xi , Gao Miaomiao , Jin Yuchen , Huang Zhuo , Guo Hongyan , Xie Zhengwei
Published: August 2020

Background Ovarian cancer is one of the most lethal gynecological cancers,and is in the top five cancer types associated with death in women. Immune infiltration of ovarian cancer is a critical factor in determining patient's prognosis. In addition to immune infiltration, key mutations also have a greater impact on the development and prognosis of OV.Methods Using data from TCGA and GTEx database combined with WGCNA and ESTIMATE methods, genes related to OV occurrence and immune infiltration were identified. Lasso and multivariate Cox regression were applied to define a prognostic score (IGCI score) based on immune genes and clinical information. The IGCI score has been verified by K-M curves, ROC curves, C-index on test set. Based on mutation data from TCGA, we identified key mutations related to immune infiltration by Chi-squared tests and we also did survival analysis of these mutations.Results In this section, we found 46 genes related to disease occurrence and immune infiltration, IGCI score was established based on six factors: Age, White, Pharmaceutical, FGF7, CCR1 and CD14. In test set, IGCI score (C-index = 0.630) is significantly better than AJCC stage (C-index = 0.541, P < 0.05) and CIN25 (C-index = 0.571, P < 0.05). Chi-squared tests revealed that 6 mutations are significantly (P < 0.05) related to immune infiltration : BRCA1, ZNF462, VWF, RBAK, RB1, and ADGRV1. According to mutation survival analysis, we found another 5 key mutations significantly related to patient prognosis (P < 0.05): CSMD3, FLG2, HMCN1, TOP2A, TRRAP. RB1 and CSMD3 mutations had small p-value (P < 0.1) in both Chi-squared tests and survival analysis. Then we conducted a drug sensitivity analysis of key mutation and found when RB1 mutation occurs, the efficacy of six anti-tumor drugs has changed significantly (P < 0.05).Conclusion Based on immune-related genes and clinical information, we have established an ovarian cancer prognosis score that is superior to other methods. At the same time, RB1 and CSMD3 gene mutations are considered to be closely related to ovarian cancer immunity and prognosis.
Large air pressure changes triggered by P-SV ground motion in a cave in northern Taiwan
Authors: Chen Chieh-Hung , Sun Yang-Yi , Lin Li-Ching , Han Peng , Yu Huai-Zhong , Zhang XueMin , Tang Chi-Chia , Chen Chun-Rong , Yen Horng-Yuan , Lin Cheng-Horng , Liu Jann-Yenq , Lin Ching-Ren
Published: August 2020

Barometers in the cave of the SBCB station observe a novel phenomenon of larger pressure changes inside than that at the Xinwu station (outside). Accordingly, the comparison between the observation data inside and outside the cave can drive investigations of potential sources of the novel phenomenon. Analysis of phase angle differences reveal that the air pressure outside the cave often lead air pressure changes inside. However, the larger pressure changes at frequencies > 2 × 10− 4 Hz inside the cave lead smaller changes outside. To expose causal mechanism of the novel phenomenon, continuous seismic waveforms recorded inside the cave are further conducted for examination. When the horizontal and vertical ground velocities of ground motion yield difference in the phase angle close to 90°, air pressure inside the cave increases accordingly. This suggests that the pressure-shear vertical ground motion can drive air pressure changes. Meanwhile, the results shed light on investigating the existence of acoustic waves near the Earth’s surface using a partially confined space underground due to that the assumptions of the waves can propagate upward in the atmosphere driving changes in the ionosphere.
Nutritional Predictors of Mortality after Discharge in Older Patients with type 2 Diabetes
Authors: Beretta Mileni Vanti , Silva Camila Nery da , Feldman Juliane Viero , Rodrigues Ticiana da Costa
Published: August 2020

Background: Older patient with type 2 diabetes (T2D) and malnutrition have a greater chance of negative events during hospitalization and a higher risk of mortality. The aim of this study was to investigate nutritional markers as mortality predictors following discharge hospitalized older patients with T2D. Methods: This is a prospective cohort study with follow-up of four years. All patients were subjected to Mini Assessment Nutrition, Subjective Global Assessment, calf circumference, arm circumference and adductor pollicis muscle thickness, obtained all within 48 h of admission. Mortality data were verified by medical registry and analyzed using Cox-proportional hazard models and survival curves. Results: 311 patients were included; the mean age was 71.35 years. There were 113 (36.3 %) deaths in the follow-up period. Nutritional status evaluated according to BMI identified 54.5% (n = 168) were overweight, for other hand the MAN identified 45.7% of patients were at risk of malnutrition and 37.7% malnutrition and the SGA identify 61.7% (n = 192) presented normal nutrition in admission. Malnutrition patients (OR=2.02), with low calf circumference (OR=1.43) or with APMT less than 5th percentile (2.33) were associated with post-discharge mortality. Conclusion: Malnutrition, reduced calf circumference and reduced APMT were nutritional predictors of mortality after hospital discharge in older patients with diabetes
Safety & Cost-Effectiveness of Primary Neonatal Posterior Sagittal Ano-recto Plasty (PNPSARP)
Authors: Raboe Enaam , Owiwi Yazeed , Ghallab Alaa , Alsaggaf Ameen , Zidan Mazen , Alawi Ahmed , Shalaby Hanin
Published: August 2020

Background: Early repair of Anorectal malformation (ARM) within 6 months may be one of the factors that improve fecal continence. Delayed and multiple-stage repairs require dilatation, strict bowel preparation, fasting and total parenteral nutrition (TPN). PNPSARP requires neither bowel preparation nor parenteral nutrition. We believe it can be achieved within 72 hours of life.Aim: To evaluate the safety, feasibility and cost effectiveness of PNPSARP within 72 hours of life versus delayed or multiple-stage repair of vestibular and perineal fistula. Material & Methods: A retrospective study was carried out of all newborns with ARM at our institute between August 2016 and August 2019. PNPSARP within 72 hours of life was compared with delayed or multiple-stage repair. Neither bowel preparation nor parenteral nutrition was required in the PNPSRP group. Perioperative complications and costs were evaluated. Results: Eight PNPSARP were compared with 7 delayed or multiple stage repair over the study period. Four babies (50%) were operated at day 1 post delivery in the PNPSARP group. Mean operative time (MOT) was 109 minutes (68-155). Mean follow up period was 22 months (12-36). One girl with a vestibular fistula had wound infection. This group had a good outcome with no morbidity, high satisfaction rate and low costs in comparison to delayed or multiple-stage repair.Conclusions: PNPSARP for perineal and vestibular fistula with supportive ancillary services in the first few days of life appears to be safe and cost effective with minimal morbidity. PNPSARP is now the standard technique in our unit.
Effect of improved cookstove intervention on childhood acute lower respiratory infection in Northwest Ethiopia: Cluster randomized controlled trial
Authors: Adane Mesafint Molla , Alene Getu Degu , Mereta Seid Tiku , Wanyonyi Kristina L
Published: August 2020

Background: Household air pollution exposure is linked with over 3.5 million premature deaths every year, ranking highest among environmental risk factors globally. Children are uniquely vulnerable and sensitive to the damaging health effects of household air pollution which includes childhood acute lower respiratory infection (ALRI). The use of improved cookstoves has been widely encouraged to reduce these health burdens. It is, however, unclear as to whether it is possible to prevent household air pollution-related disease burdens with biomass-fuelled improved cookstove intervention and the evidence regarding its child health effect still attracts wide debate. Therefore, we investigated the child health effect of improved baking stove intervention compared with the continuation of the open burning traditional baking stove.Methods: A cluster randomized controlled trial was conducted to assess the health effect of improved baking stove intervention. A total of 100 clusters were randomly allocated to both arms at a 1:1 ratio, and a total of four follow-up visits were carried out within one year immediately after the delivery of the intervention to all households allocated into the intervention arm. Data were analyzed in SPSS-22, and the intervention effect was estimated using a Generalized Estimating Equations modeling approach among the intention-to-treat population.Results: A total of 5508 children were enrolled in the study across 100 randomly selected clusters in both arms, among which data were obtained from a total of 5333 participants for at least one follow-up visit which establishes the intention-to-treat population dataset. The intervention was not found to have a statistically significant effect on the longitudinal childhood ALRI with an estimated odds ratio of 0.95 (95% CI: 0.89-1.02). Nevertheless, the longitudinal change in childhood ALRI was significantly associated with age, baseline childhood ALRI, location of cooking quarter, secondary stove type and frequency of baking event measured at baseline.Conclusions: We found no evidence that an intervention comprising biomass-fuelled improved baking stove reduced the risk of childhood ALRI compared with the continuation of an open burning traditional baking stove. Therefore, effective cooking solutions are needed to avert the adverse health effect of household air pollution, particularly, childhood ALRI. Trial registration: The trial was registered on August 2, 2018 at clinical trials.gov registry database (registration identifier number: NCT03612362).
Early Enteral Permissive Underfeeding in Critically Ill Young Adults with Traumatic Brain Injury: A Single-Blind Randomized Controlled Pilot Trial
Authors: Kazemi Maryam , Nematy Mohsen , Malekahmadi Mahsa , Pahlavani Naseh , Samini Fariborz , Assadzadeh Hamid , Ehsaei Mohammad Reza , Barkhidarian Bahareh , Norouzy Abdolreza
Published: August 2020

Background and Objectives: There is no consensus on optimal initial energy requirements for critically ill patients. The present study aimed to compare the clinical outcomes of early enteral permissive underfeeding (EEPU) with those of early enteral standard feeding (EESF) in critically ill patients with traumatic brain injury (TBI). Materials and Methods: In this single-blind, randomized, controlled pilot trial, 60 young adults with TBI were randomly assigned to either EESF or EEPU groups (initiation energy goal: 100% vs. 30% of estimated energy requirements, respectively). Enteral feeding was administered during 24-48 hours of intensive care unit admission. Patients receiving EEPU were prescribed to achieve full energy requirements by day seven of the intervention. Results: The EEPU group demonstrated improved glycemic control (205.6±68 vs. 137.4±59 mg/dL, P=0.02), reduced duration of hospital stay (57.5±29 vs. 70.9±24 days, P=0.08) and shorter duration of mechanical ventilation (20.2±11 vs. 26.4±9 days, P=0.04). Gastrointestinal complications were more frequent in the EESF group (3.5±2 vs. 1.4±3 days, P=0.001). There were no differences between the EESF and EEPU groups in terms of 28-day mortality rate (3.8% vs. 10.7%, RR: 0.33; 95% CI: 0.03, 3.42; P=0.61).Conclusion: EEPU may be associated with beneficial effects on gastrointestinal toleration and glycemic control in young TBI patients, which might contribute to improved clinical outcomes in this population; however, further investigations are required on this issue. Trial registration: This trial was registered at Iranian Registry of Clinical Trials (www.irct.ir) as IRCT201201128709N1.
Arresting doubly excited electronic state mediating lightning speed ring-opening reaction of 1,3-cyclohexadiene
Authors: Karashima Shutaro , Uenishi Ryuta , Horio Takuya , Kanno Manabu , Humeniuk Alexander , Mitric Roland , Ohta Tetsuro , Nishitani Junichi , Suzuki Toshinori
Published: August 2020

The photoinduced ring-opening reaction of 1,3-cyclohexadiene to produce 1,3,5-hexatriene is a well-known example of the Woodward-Hoffmann rule for stereochemical reactions governed by molecular orbital symmetry, and it plays an essential role in photobiological synthesis of vitamin D3 in the skin. Since the photoexcited 11B state of 1,3-cyclohexadiene is not electronically correlated to the ground state of 1,3,5-hexatriene, the reaction is expected to proceed via non-adiabatic transitions through a doubly excited 21A electronic state. However, spectroscopic observation of this elusive state has been difficult. Here we present the results of a photoelectron spectroscopy study using table-top ultrafast deep and extreme UV lasers, based on filamentation four-wave mixing and high-harmonic generation, which enabled us to arrest the 21A state. It is shown that the ring-opening reaction takes only 60 fs to complete, which is a considerably shorter time than previous experimental and theoretical estimates. The ballistic reaction creates vibrational coherence in the reaction products.
Function-oriented Design of Robust Metal Cocatalyst for Photocatalytic Hydrogen Evolution on Metal/Titania Composites
Authors: Wang Dong , Gong Xue-Qing
Published: August 2020

To realize the rational design of improved catalysts is one of ultimate goals in catalysis, though practical strategies are generally in shortage, especially for the complicated photocatalytic processes. Here, we take the hydrogen evolution reaction (HER) as an example, and introduce a theoretical approach for designing robust metal cocatalysts supported on TiO2, using density functional theory calculations adopting on-site Coulomb correction and/or hybrid functionals. The approach starts with clarifying the individual function of each metal layer of metal/TiO2 composites in photocatalytic HER, covering both the electron transfer and surface catalysis aspects, followed by conducting a function-oriented optimization via exploring competent candidates. With this approach, we successfully determined and verified bimetallic Pt/Rh/TiO2 and Pt/Cu/TiO2 catalysts to be robust substitutes for conventional Pt/TiO2. The right metal type as well as the proper stacking sequence are demonstrated to be the key to boosting the performance. Moreover, we pioneeringly identified the tunneling barrier height as an effective electron transfer descriptor for photocatalytic reactions on metal/oxide catalysts. We believe that this study pushes forward the frontier of photocatalyst design towards higher water splitting efficiency.
Essential core competencies for health policy doctoral graduates
Authors: Doshmangir leila , Takian Amirhossein , Sakha Minoo Alipouri , Mostafavi Hakimeh
Published: August 2020

Background: In the health sector, competency-based education focuses on the desired performance characteristics of health professionals through designing and implementing the evidence-based standards, performance indicators and, quality outcomes. This paper aims to explore core competencies required for health policy graduates, aiming to prepare doctoral students for a spectrum of future roles, i.e. academic and non-academic.Methods: The databases including PubMed, Scopus, Google scholar, and SID were searched to identify the required competencies for health policy students worldwide. Students and well-known academics in the field of health policy (from Iran and other countries) were interviewed. This qualitative study was conducted in three phases: a critical review of literature; interviews; and validation of identified competencies through face to face consultations with experts complemented by a survey. We used three methods for data collection: 1) review of the literature; 2) 74 face to face and email-based semi-structured interviews and 3) validating the identified competencies through face to face consultations with qualified experts. Results: We identified five core competencies for health policy doctoral graduates without specific order including research, policy analysis, education, decision making, and communication.Conclusions: As countries are gearing up towards sustainable development goals (SDGs), the role of health policy graduates is crucial paving the pathway towards SDGs on health and well-being. Appropriate and contextually-tailored curriculum is pivotal, we envisage, to foster multi-dimensional competencies that are complementary to the specific disciplines of health policy scholars of future, those who can genuinely serve their health systems towards sustainable health development.