bluuebunny/crossref_metadata_2025 huggingface dataset:
Chloride Ion Transport Blockade Enhances Cytocidal Effects of Sterile Water on Bladder Cancer Cells
Authors: Matsuoka Yuki , Taoka Rikiya , Tohi Yoichiro , Xia Zhang , Sugimoto Mikio
Published: January 2021

Background:Bladder cancer is a major health concern worldwide. The conventional intravesical Bacillus Calmette–Guérin therapy has certain shortcomings; thereby, demanding novel alternatives. Although sterile water is a probable agent for such novel intravesical therapies, bladder cancer cell lines differ in their sensitivity to hypotonic shock due to sterile water. Therefore, we aimed to investigate whether Cl- channel blockers enhance the cytocidal effect of hypotonic shock on bladder cancer cells resistant to sterile water.Methods:Bladder cancer cell lines of varying grades (RT112, T24, and J82) were exposed to sterile water, and morphological changes were closely observed using microscopy. Sterile water-induced changes in cell membrane integrity and cell viability were analyzed to determine the effects of hypotonic shock. These effects were further analyzed using a Cl- channel blocker.Results:T24 and J82 cells started swelling immediately upon exposure to sterile water and ruptured within 10 min. RT112 cells demonstrated limited hypotonic swelling with few cell ruptures. After treatment with the Cl- channel blocker, RT112 cells ruptured faster as compared to that in cells treated with sterile water. The percentages of viable dimethylsulfoxide and 5-nitro-2-(3-phenylpropylamino) benzoic acid -treated (50, 100, 200, and 300 µM) RT112 cells after 10 min of exposure to sterile water were 13.6 % ± 3.4 %, 6.3 % ± 1.2 %, 2.0 % ± 1.1 %, 0.7 % ± 0.7 %, and 0 %, respectively.Conclusions:Taken together, the Cl- channel blockers enhanced the cytocidal effects of hypotonic shock in bladder cancer cells. Intravesical therapy with sterile water after treatment with a Cl- channel blocker represents a potential new adjuvant therapy after TURBT with high efficacy.
The Trend of Leading Causes of Death Among Young People in Iran Within the Last Three Decades: A Retrospective Cohort Study
Authors: Heydari Mahdiyeh , Yarifard Khadijeh , Tajvar Maryam
Published: January 2021

Background: Youth is undeniably the most important force and resource of any country, thus, identifying the leading causes of death among them to develop preventable interventions is essential. This study aimed to determine the trend of mortality rate and the leading cause of death, based on the ICD-10, among young people in Iran.Methods: The present study is a retrospective cohort and examines the trend of Iranian youth mortality, aged 15-24 years, between 1990 and 2017. The data source was the Global Burden of Disease (GBD) website. Linear Regression analysis was used to measure the slope of changes in mortality rates and causes of mortality during the period, where "time" was the independent variable and "mortality rate" and "causes of mortality" were dependent variables.Results: the death rate of young people declined by 54% during the period, equal to an average of 1.37 units per year. The most common cause of death has been injuries (70%), and then NCDs (25%) and finally communicable diseases (5%). However, death due to injuries (except SUD) and communicable diseases (except HIV) declined significantly by 0.94 and 0.09 units per year, respectively (P<0.001), while, death due to the NCDs had an increasing trend by 0.12 units per year over 28 years (P=0.006).Conclusion: Examining past trends in death rates and causes strengthens insights into the state and future trends in health and death-related indicators, which are crucial for policy-making, especially in developing countries with limited resources.
An Unsupervised Big Data Visualization-Based Scheme for Anomalous Sound Detection of Facilities
Authors: Talmoudi Sana , Kanada Tetsuya , Hirata Yasuhisa
Published: January 2021

This paper is dedicated to validating the scalability and generalization of our previously proposed "machinery failure predictive scheme". Our aim is to have a generic core technology to provide a solution applicable in industry that is low-cost and low-intrusive. Background: In our previous works, we proposed an unsupervised predictive scheme combining the use of full spectrum of vibration / audio data and data visualization techniques. We then proposed a real time data tracker (RTDT) and we applied our proposal on vibration data of bearings. In this paper, we are applying our predictive scheme on a facility (composite system) rather than a specific mechanical component (singular system). We chose to apply our proposal on the MIMII dataset as it was used in task 2 of the DCASE 2020 challenge for the detection of anomalous sounds given normal data only. Methodology: We adopted two approaches: (1) the same scheme used in our application on bearing vibration data and (2) with a slightly modified approach where we apply a high pass filter (HPF) on the audio data to reduce the effect of the background noise. To effectively evaluate the accuracy of our scheme in detecting and recognizing anomalous sounds, we are comparing our results to the performance of the baseline system proposed by the organizers of the challenge as well as the results from the 40 participating teams. For the evaluation, we used the same metrics used in the challenge: the area under the receiver operation characteristic (ROC) curve (AUC) and the partial AUC (pAUC). Results: We obtained satisfactory values of AUC and pAUC compared to the related works. We also outperformed the baseline system in 13 out of 16 machines in terms of AUC and 15 out of 16 machines in terms of pAUC. Merits: Compared to the current related works, our "machinery failure predictive scheme" is featured by 0-training, and no complex preprocessing or de-noising techniques. Furthermore, our solution based on our scheme is provided as a white box, users will have the following merits: (1) our solution can be in operation right after a normal data set is obtained usually in a few days and (2) our solution can be built into conventional operation and maintenance systems without advanced background in artificial intelligence or data science.
The MMX Rover: Performing in-situ Surface Investigations on Phobos
Authors: Michel Patrick , Ulamec Stephan , Boettger Ute , Grott Matthias , Murdoch Naomi , Vernazza Pierre , Sunday Cecily , Zhang Yun , Valette Rudy , Castellani Romain , Biele Jens , Tardivel Simon , Groussin Olivier , Jorda Laurent , Knollenberg Joerg , Grundmann Jan Thimo , Arrat Denis , Pont Gabriel , Mary Stéphane , Grebenstein Markus , Miyamoto Hirdy , Nakamura Tomoki , Wada Koji , Yoshikawa Kent , Kuramoto Kiyoshi
Published: January 2021

The Japanese MMX sample return mission to Phobos by JAXA will carry a Rover developed by CNES and DLR that will be deployed on Phobos to perform in-situ analysis of the Martian moon's surface properties. Past images of the surface of Phobos show that it is covered by a layer of regolith. However, the mechanical and compositional properties of this regolith are poorly constrained. In particular nothing is known regarding the particle sizes, their chemical composition, the packing density of the regolith as well as other frictional parameters and surface dynamics from current remote images. Understanding the properties and dynamics of the regolith in the low-gravity environment of Phobos is important to trace back its history and surface evolution. Moreover, this information is also important to support the interpretation of data obtained by instruments onboard the main spacecraft and to minimize the risks involved in the sampling by the spacecraft. The instruments onboard the Rover are an infrared radiometer (miniRad), a Raman spectrometer (RAX), two cameras looking forwards for navigation and science purposes (NavCams), and two cameras observing the flow of regolith around the rover wheels (WheelCams). The Rover will be deployed before the sampling of Phobos' surface by MMX spacecraft and will be the first rover driving on a Martian moon and in a low-gravity environment.
The Predictive Power of Serum Vitamin D for Poor Outcomes in COVID-19 Patients
Authors: Derakhshanian Hoda , Rastad Hadith , Ghosh Sanjoy , Zeinali Marjan , Khoeini Tara , Farrokhpour Mohsen , Qorbani Mostafa , Ghamsari Mona Ramezani , Hasani Hossein , Mirzaasgari Zahra
Published: January 2021

Background: Considering the high prevalence of vitamin D deficiency worldwide and its relationship with immune response to viral infections, this study attempted to identify the predictive power of serum vitamin D for poor outcomes among the COVID-19 patients.Methods: This retrospective cohort study included all patients with confirmed COVID-19 hospitalized between 20 February 2020 and 20 April 2020 at a designated COVID-19 hospital, located in Tehran province, Iran. General characteristics, medical history, and clinical symptoms were recorded by trained physicians. Blood parameters including complete blood count, creatinine, lactate dehydrogenase, creatine phosphokinase, erythrocyte sedimentation rate, C-reactive protein, and vitamin D were tested. Results: This study included 290 hospitalized patients with COVID-19 (the mean age (SD): 61.6 (16.9), 56.6% males), of whom 142 had vitamin D concentrations less than 20 ng/ml, defined as vitamin D deficiency. COVID-19 patients with vitamin D deficiency were more likely to die (Crude OR (95% CI): 2.30 (1.25-4.26)), require ICU care (2.06 (1.22-3.46)) and invasive mechanical ventilation (2.03 (1.04-3.93)) based on univariate logistic regression results. However, after adjusting for potentials confounders such as gender and age, the association between vitamin D and need to invasive mechanical ventilation lost its significance.Conclusion: Vitamin D deficiency can be considered as a predictor of poor outcomes and mortality in COVID-19 patients. Therefore, checking serum 25 (OH) D on admission and taking vitamin D supplements according to the prophylactic or treatment protocols is recommended for all COVID-19 patients.
A Solid-State NMR Study of the Antibacterial Drug Cefpodoxime Proxetil
Authors: Dey Krishna , Ghosh Manasi
Published: January 2021

The structure-activity relationship of various molecular moieties of cefpodoxime proxetil is described by measuring Chemical shift anisotropy (CSA) tensor, spin-lattice relaxation time and molecular correlation time at twenty one crystallographically different carbon nuclei sites. Cefpodoxime proxetil molecule is associated with three rings, the aminothiazole ring, β-lactam ring, and the dihydrothiazine ring, which provide stability to the drug molecule towards β-lactamases and increase the affinity of the drug to PBPs receptors. A large variation of CSA parameters and motional degrees of freedom are observed among carbon nuclei reside on these three rings, which implies that the electronic environment, molecular conformation, and molecular dynamics are altered substantially within the ring. The substitution at the C7 position of the β-lactam ring (like acyl side chain, oxime group, and aminothiazole ring) is responsible for semi-synthetic incorporation. It also influences the antibacterial activity and the binding affinity of the drug with β-lactamase. A huge variation of the spin-lattice relaxation time and molecular correlation time is observed in this region. These types of description of the structure-activity relationship of the antibacterial drug cefpodoxime proxetil will be beneficial for developing the advanced antibacterial drugs, and it will also be useful in NMR crystallography.
Incidence of Home Delivery Among Women Living With HIV in Lira, Northern Uganda: A Prospective Cohort Study
Authors: Napyo Agnes , Tylleskär Thorkild , Mukunya David , Tumuhamye Josephine , Ndeezi Grace , Arach Anna Ojok , Waako Paul , Tumwine James
Published: January 2021

IntroductionFacility delivery is one of the interventions recommended in the context of HIV to reduce on the risk of mother-to-child transmission of HIV. Home delivery has been associated with mother-to-child transmission of HIV and remains high among HIV-infected women. Predictors for home delivery in the context of HIV have not been fully studied and understood in Northern Uganda. We therefore aimed to find out the incidence and risk factors for home delivery among women living with HIV in Lira, Northern Uganda. Methods This prospective cohort study was conducted between August 2018 and January 2020 in Lira district, Northern Uganda. A total of 505 HIV infected women were enrolled and followed up at delivery. We used a structured questionnaire to obtain data on socio-demographic, reproductive-related and HIV-related characteristics. Data was analysed using Stata version 14.0 (StataCorp, College Station, Texas, U.S.A.). We estimated adjusted risk ratios using Poisson regression models to ascertain risk factors for home delivery.Results The incidence of home delivery among women living with HIV was 6.9% (95%CI: 4.9% - 9.5%). Women who were most likely to deliver at home were single mothers (adjusted risk ratio = 4.39, 95%CI: 1.68 – 11.42). Women who experienced night time onset of labour (adjusted risk ratio =0.4, 95%CI: 0.18 – 0.87) and women who were adherent to their ART were more likely to deliver in the hospital (adjusted risk ratio=0.33, 95%CI: 0.13 – 0.86). Conclusion HIV infected women most likely to deliver at home were single mothers. Women whose labour started at night and those who were adherent to their ART were more likely to deliver in the hospital. We recommend intensified counselling on birth planning and preparedness in the context of HIV and PMTCT especially for single women and those not adherent to their ART.
Intralesional injection of Rose Bengal augments the efficacy of gemcitabine chemotherapy against pancreatic tumors
Authors: Innamarato Patrick , Morse Jennifer , Mackay Amy , Asby Sarah , Beatty Matthew , Blauvelt Jamie , Kidd Scott , Mullinax John , Sarnaik Amod , Pilon-Thomas Shari
Published: January 2021

Background

Chemotherapy regimens that include the utilization of gemcitabine are the standard of care in pancreatic cancer patients. However, most patients with advanced pancreatic cancer die within the first 2 years after diagnosis, even if treated with standard of care chemotherapy. This study aims to explore combination therapies that boost the efficacy of standard of care regimens in pancreatic cancer patients.
Methods

In this study, we used PV-10, a 10% solution of rose bengal, to induce the death of human pancreatic tumor cells in vitro. Murine in vivo studies were carried out to examine the effectiveness of the direct injection of PV-10 into syngeneic pancreatic tumor cells in causing lesion-specific ablation. Intralesional PV-10 treatment was combined with systemic gemcitabine treatment in tumor-bearing mice to investigate the control of growth among treated tumors and distal untreated tumors. The involvement of the immune-mediated clearance of tumors was examined in immunogenic tumor models that express ovalbumin (OVA).
Results

In this study, we demonstrate that the injection of PV-10 into mouse pancreatic tumors caused lesion-specific ablation. We show that the combination of intralesional PV-10 with the systemic administration of gemcitabine caused lesion-specific ablation and delayed the growth of untreated distal tumors. We observed that this treatment strategy was markedly more successful in immunogenic tumors that express the neoantigen, OVA, suggesting that the combination therapy enhanced the immune clearance of tumors. Moreover, the regression of tumors in mice that received PV-10 in combination with gemcitabine was associated with the depletion of splenic CD11b+Gr-1+ cells and increases in damage associated molecular patterns HMGB1, S100A8, and IL-1α.
Conclusions

These results demonstrate that intralesional therapy with PV-10 can enhance the efficacy gemcitabine against pancreatic tumors.
Cortical Stroke Produces Secondary Injury and Long-lasting Gliosis in the Ipsilateral Thalamus
Authors: Kim Gab Seok , Stephenson Jessica , Mamun Abdullah Al , Wu Ting , Goss Monica , Min Jia-Wei , Li Jun , Liu Fudong , Marrelli Sean
Published: January 2021

Remote secondary injury in the thalamus has been observed following cortical infarct, however the mechanisms are not well understood. We used the distal MCAO stroke model (pdMCAO) to explore the cellular and temporal gliosis response in secondary thalamic injury in mice. At 3 days post-stroke (PSD3), primary infarct was limited to the cortex, with no infarct in the thalamus. However, at 2 weeks after stroke (PSD14), the ipsilateral thalamus demonstrated degenerating and severely damaged neurons. Staining for GFAP (astrogliosis) or IBA-1 (microgliosis) was first apparent in the ipsilateral thalamus by PSD3, and showed a progressive increase through PSD14. The number of activated microglia was increased within the thalamus at PSD14, reflecting proliferation of resident microglia as well as infiltration of peripheral monocytes. Interestingly, astrogliosis within the thalamus was enduring, as it was still evident at two years post-stroke. Furthermore, the astrogliosis at two years (but not at 6 weeks) demonstrated glial scar-like characteristics. Lastly, we demonstrated that post-stroke treatment with an NMDA receptor antagonist (memantine) reduces gliosis in the thalamus at PSD14. These findings highlight the development of lasting secondary injury in the thalamus following cortical stroke and support the value of memantine treatment in the mitigation of this injury.
A Crisis within a Crisis: An Assessment of COVID-19 Attitude and Practice among Syrians - A Cross-sectional Study
Authors: Bakkar Batoul , Mohsen Fatema , Armashi Humam , Marrawi Marah , Aldaher Nizar
Published: January 2021

Introduction: COVID-19 has overwhelmed public healthcare systems worldwide, exacted substantial economic burden, and forced governments to impose partial or complete lockdowns of entire countries with stringent infection control measures to curb the spread of the virus. This study aimed to reflect the Syrian public’s adherence to infection control measures by assessing their attitude and practice during this outbreak embedded within the war in Syria.Methods: This web-based cross-sectional study was distributed randomly in March 2020, nearly 11 years into the Syrian war crisis. The survey consists of 3 sections: socio-demographic characteristics, attitude, and practice. Multivariable logistic regression analysis was performed to identify factors associated with good practice, and negative attitude. Data were analyzed using the Statistical Package for Social Sciences version 25.0.Results: Of the 3586 participants, 68.2% were females, 50.8% were unemployed, and 79.2% were college-educated. Only 1402(39.1%) participants were wearing face masks when leaving their homes. Multiple logistic regression analysis revealed that female gender, age, and residence were factors associated with good practice towards avoiding mass gatherings, wearing face masks, and maintaining a 1-meter interpersonal distance; however, age and occupation were factors associated with a negative attitude towards the closure of universities and schools, travel ban, and quarantine for travelers.Conclusion: This survey sheds light on the need for multiple measures to address targeted populations; there must be a specialized method of prevention for each occupation, age group, and place of residence to prevent the outbreak of COVID-19.
Association Between Osteoarthritis and Urinary Tract Infection in Older Adults: A Nationwide Population-Based Cohort Study
Authors: Wang Wei-Hung , Tan Tian-Hoe , Ho Chung-Han , Chen Yi-Chen , Hsu Chien-Chin , Lin Hung-Jung , Wang Jhi-Joung , Huang Chien-Cheng , Chiu Yen-wei
Published: January 2021

Background: Osteoarthritis (OA) may increase urinary tract infection (UTI) in older adults. However, this issue remains unclear.Methods: We identified 8599 older patients (≥65 years) with OA, and an equal number of older patients without OA, matched by age, sex, and index date from the Taiwan National Health Insurance Research Database between 2001 and 2005. Past histories, including UTI and underlying comorbidities, were included in the analyses. Comparisons for any UTI, ≥1 hospitalization for UTI, and ≥3 hospitalizations for UTI between the two cohorts by following up until 2015 were performed.Results: In both cohorts, the percentages of age subgroups were 65–74 years (65.7%), 75–84 years (30.1%), and ≥85 years (4.2%). The male sex was 42.4%. Patients with OA had an increased risk of any UTI compared with those without OA after adjusting for all past histories (adjusted hazard ratio [AHR]: 1.72; 95% confidence interval [CI]: 1.64–1.80). The Kaplan–Meier curve and log-rank test showed that OA increased any UTI (p <.001). Compared with patients without OA, patients with OA also had an increased risk of ≥1 hospitalization for UTI and ≥3 hospitalizations for UTI (AHR: 1.13; 95% CI: 1.06–1.19 and AHR: 1.25; 95% CI: 1.13−1.38, respectively). In addition to OA, older age, female sex, history of UTI, benign prostatic hyperplasia, indwelling urinary catheter, cerebrovascular disease, diabetes, dementia, and urolithiasis were independent predictors for any UTI.Conclusions: OA increased UTI in older adults. We suggest appropriately managing OA and controlling underlying comorbidities to prevent subsequent UTI.
Galectin-3 in the Gut-liver axis Regulates Autistic-like Behaviors by Mechanism Associated with Cerebral Shank-3+ cell Niches in BALB/c Mice
Authors: Lemos Felipe , Prins Caio , Carpi-Santos Raul , Waclawiak Ingrid , Santos Sofia , Bernardes Emerson , Peça João , Martinez Ana , Benjamim Cláudia , Luisetto Roberto , Mello-Coelho Valéria , Chammas Roger , Oliveira Felipe
Published: January 2021

Galectin-3 stabilizes cell-cell junctions and regulates inflammatory pathways in the gut-liver axis. Galectin-3 knockout (Lgals3−/−) mice have atypical behaviors by obscure mechanisms. Given that BALB/c mice naturally develop low-sociability, stereotypies and restrict interest, they have been included as autism experimental model. Our major aims were to investigate whether galectin-3 in the gut-liver axis interferes with autistic-like behaviors analyzing BALB/c Lgals3−/− mice or under partial inhibition of galectin-3 oral intake of cow’s milk for 7 days. Behavioral patterns were assessed using a three-chambers test, open field, and self-grooming. Histological analysis and immunohistochemistry (Galectin-3, NOS-2, Iba-1, Ki-67, Dll-4, Shank-3, Synaptophysin and Drebrin) were performed in gut, liver, and/or brain. Lgals3−/− mice amplified stereotypies, social retraction and restrict interest associated with reduction of cerebral Shank-3+ cells. In Lgals3+/+ mice, cow’s milk intake also amplified atypical behaviors, reduced galectin-3 in enterocytes and Kupffer cells, and disturbed niches of intestinal KI67+ and Dll-4+ cells and hepatic NOS2+ cells. In the brain of milk-treated mice, Iba-1+ microglial cells and NOS2+ Purkinje cells were increased whereas Shank-3+ and Drebrin+Synaptophysin+ cells were reduced suggesting, for the first time, that galectin-3 interferes with autistic behavior. Perhaps, a perspective to new therapies in genetically predisposed individuals to atypical behaviors.
Assessing the Stress of Surgeons and Surgical Residents Using a Wearable Smart Device
Authors: Kim Jin Joo , Lee Chul Seung , Koh Wooree , Bae Jung Hoon , Han Seung rim , Lee In kyu , Lee Do sang , Lee Yoon Suk
Published: January 2021

Although surgeon is one of the most stressful professions, only few studies have attempted to evaluate surgeons’ stress using impractical methods. Meanwhile, many wearable devices have been introduced in the health-care market. This study aimed to assess surgeons’ stress using a wearable device. Data were collected from 13 participants from June to September 2019. We checked level of stress, heart rate (HR) using Vivosmart4 (Garmin, Schaffhausenm, Switzerland) at rest and perioperatively, and also checked their perioperative self-perceived stress using the short-form State-Trait Anxiety Inventory (STAI). The perioperative stress level and HR significantly increased compared with resting state (stress level: 28.6 ± 18.2 at rest vs. 49.6 ± 25.5 before surgery vs. 55.1 ± 25.5 after surgery, p < 0.001; HR: 81.1 ± 6.2 at rest vs. 85.0 ± 11.5 before surgery vs. 85.0 ± 12.2 after surgery, p = 0.001). Scores on the short-form STAI significantly decreased after surgery (12.6 ± 4.9 before surgery vs. 11.7 ± 3.6 after surgery, p = 0.001). Stress level at rest was significantly higher among fellows and residents compared with professors (fellows: 40.7 ± 15.3 vs. residents: 29.9 ± 12.0 vs. professors: 13.2 ± 7.3, p < 0.001). We assessed surgeons’ stress using a smart device and demonstrated that surgery significantly increased stress. The level of stress was higher among fellows and residents compared with professors.
Same-Day Versus Next-Day Dexamethasone Intracanalicular Insert Administration for Inflammation and Pain Control Following Cataract Surgery: A Retrospective Analysis
Authors: Foster Brian
Published: January 2021

Background: The dexamethasone 0.4mg intracanalicular insert (Dextenza, Ocular Therapeutix, Bedford, MA) is approved for control of postoperative pain and inflammation following ocular surgery. This study compared pain and inflammation resolution following phacoemulsification in eyes that received the insert immediately postoperatively versus the next day.Methods: This was a retrospective analysis of existing electronic health records. Consecutive qualifying eyes were included for analysis. All patients received perioperative antibiotics and nonsteroidal anti-inflammatory drugs. Pain and inflammation were assessed at baseline and on postoperative days 1, 7, and 30. Pain was assessed by dichotomous patient report (present/absent). Anterior chamber cell (0, 0.5+, 1-4+) and flare (0-4+) were graded using the Standardization of Uveitis Nomenclature rubric. Results: Data from 17 eyes of 17 subjects were analyzed; 8 received the insert immediately postoperative and 9 in the office the next day. In both groups, trace cell was present in all eyes at day 1 and had resolved in all but 1 eye in each group at days 7 and 30. Flare was absent in all eyes at every time point, and transient pain was reported in a single same-day eye on day 7. No insert-related adverse events were observed, and no eyes required rescue corticosteroid therapy or insert removal.Conclusion: Similar rates of inflammation and pain resolution after phacoemulsification were achieved with the dexamethasone intracanalicular insert placed either immediately postoperatively or the next day. These findings expand options for insert use to offer surgeons and patients greater flexibility in developing perioperative pain and inflammation control strategies.
Radical Hysterectomy Versus Simple Hysterectomy and Brachytherapy for Patients with Stage II Endometrial Cancer
Authors: Wang Ming , Ran Ran , Wu Yu-Mei
Published: January 2021

Purpose To compare the survival outcome between radical hysterectomy and total hysterectomy with radiation therapy in patients with stage II endometrial cancer.Methods This is a retrospective cohort study. We identified 1349 patients diagnosed with stage II endometrial cancer from Jan 1, 1988 to Dec 31 2015 in the Surveillance, Epidemiology, and End Results. Patients were divided into two groups based on the primary treatment (total hysterectomy combined with brachytherapy or radical hysterectomy). All patients received external beam radiation therapy after the surgery. The primary outcome was the rate of 5-year-cause-specific survival and 5-year-overall survival.Results A total of 1349 patients were enrolled in the study, 117(7.35%) patients received radical hysterectomy and 460 patients who received total hysterectomy combined with vaginal brachytherapy were selected as control. All patients received external beam radiation therapy after the surgery. Overall, the median follow-up duration was 82.77±1.44months (95%CI: 79.94-85.61months). There was no difference in the baseline information between two groups, including ages, ethnicity, and rates of histologic subtypes. The 5-year overall survival was 62.31% among women who underwent radical hysterectomy which was lower than 78.48% among those who underwent total hysterectomy combined with vaginal brachytherapy (HR, 2.22; 95% CI, 1.52 to 3.24; P <0.001 by the log-rank test). Women who underwent radical hysterectomy also had shorter 5-year cause-specific survival (74.60 vs.85.38%; HR, 1.91; 95% CI, 1.13 to 3.23; P =0.01 by the log-rank test) than those who underwent total hysterectomy combined with vaginal brachytherapy. However, the negative outcomes were further validated in patients with high-risk endometrial cancer, not in patients with grade 1-2 low-risk endometrial cancer both on cause-specific survival and overall survival. In patients with grade 3 low-risk endometrial cancer, the tendency was only found with lower overall survival not cause-specific survival.Conclusions This study revealed that in patients’ stage II endometrial cancer, radical hysterectomy was associated with shorter overall survival and cause-specific survival than total hysterectomy combined with vaginal brachytherapy. The choice of different treatment modalities should base on the histology subtype of patients and further study based on molecular classification is needed.
Healing the Healers: A Phenomenological Exploration of a Brief Online Mindfulness Course on Stress, Burnout and Coping Strategies of Health Care Professionals During the COVID-19 Crisis
Authors: Osman Iram , Singaram Veena , Hamid Shaista
Published: January 2021

Background: During the COVID-19 pandemic, health professionals were pushed to the front line of a global health crisis unprepared, resource constrained, and with heightened uncertainty and distress levels. The impact of an online mindfulness-based intervention (MBI) for health care professionals amid a pandemic has not been previously documented. This study aimed to investigate the feasibility and effectiveness of a brief online MBI on stress, burnout and mindful awareness for health professionals training and working during the COVID-19 crisis.Methods: A mixed methods, phenomenological, participatory evaluation framework was adopted for this study. A four-week online training programme was adapted and delivered to health professionals via the Zoom platform. Non-probability snowball sampling was used to recruit participants. The quantitative data was analysed using descriptive analysis via Stata 15.1 statistical software, and the participants’ qualitative experiences were interpreted using interpretative phenomenological analysis (IPA).Results: Forty-seven participants took part in this study. The study found a statistically significant (p < 0.05) reduction in stress levels and emotional exhaustion as well as an increase in mindful awareness and feelings of personal accomplishment between the pre-and post-intervention assessments of the MBI. The participants’ shared experiences were analysed in two parts. The pre-intervention analysis presented with central themes of loss of control and a sense of powerlessness due to COVID-19. The post-intervention analysis comprised themes of a sense of acquired control and empowerment through increased mindfulness.Conclusions: The study found that a brief online MBI can be associated with increased awareness and present-moment focus as well as reduced levels of stress and burnout. The MBI had a positive impact on the health care professionals’ sense of control and empowerment, and increased their perceived sense of competence and accomplishment, both personally and professionally, during the global crisis.
Self-Reported Weather Sensitivity is Associated with Clinical Symptoms and Structural Abnormalities in Patients with Knee Osteoarthritis: A Cross-Sectional Study
Authors: Xue Yan , Chen Yan , Jiang Ding , Wang Lin , Wang Xuezong , Li Ming , Wu Yuyun , Zhang Min , Pang Jian , Zhan Hongsheng , Zheng Yuxin , Ding Daofang , Cao Yuelong
Published: January 2021

Background Patients with knee osteoarthritis (KOA) often complain about clinical symptoms affected by weather-related factors. The purpose of the present study was to use cross-sectional analysis to determine whether weather sensitivity was associated with clinical symptoms, as well as structure abnormalities, in KOA patients.Methods Data from 80 participants were obtained from the Feng Hans Shi Effects on OA (FHS) study, an OA cohort study initiated in China in 2015. The weather sensitivity of each participant was determined by a self-reported questionnaire. The following measurements were used to assess clinical and biological outcomes: a visual analog scale (VAS) for pain; Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC); and blood levels of tumor necrosis factor α (TNF-α), interleukin 6 (IL-6), and interleukin 1(IL-1). Structural changes identified via magnetic resonance imaging (MRI) were also evaluated. Independent sample t-tests, chi-square tests, Fisher’s exact tests, Cochran-Armitage tests for linear trends, and binary linear regression were used to evaluate the clinical characteristics, biomarkers, WOMAC, and Whole-Organ Magnetic Resonance Imaging Score (WORMS) of weather-sensitive KOA patients and non-weather-sensitive KOA patients.Results Most of the KOA participants (57.5%) perceived the weather as affecting their knee-joint clinical symptoms. Through logistic regression analysis, the presence of weather sensitivity was found to increase the risk of KOA participants reporting higher levels of WOMAC pain scores [OR = 3.3 (95% CI: 1.1, 9.9), P > 0.032], functional scores [OR = 5.5 (95% CI: 1.8,16.8), P > 0.003], total scores [OR = 3.3 (95% CI: 1.1, 10.2), P = 0.034], WORMS cartilage scores [OR = 3.1 (95% CI: 1.1, 8.5), P < 0.027], and marrow abnormality scores [OR = 3.0 (95% CI: 1.1, 8.1), P > 0.029].Conclusions Weather-sensitive KOA patients were prone to show more serious clinical symptoms and structural abnormalities in their knee joints. Therefore, the existence of weather sensitivity may accelerate the progress of KOA.
Does Aid Matter for Foreign Direct Investment in ECOWAS: Investigating The Infrastructure Channel?
Authors: ONYE KENNETH , BASSEY GODWIN , IRIABIJE ALEX , EFFIOM LIONEL
Published: January 2021

We ask the data whether and how aid targeted at specific sub-categories of economic infrastructure could assist ECOWAS economies to attract higher Foreign Direct Investment (FDI) inflow via improvement in infrastructure in Water Supply and Sanitation (WSS), energy, transport, and ICT. By relying on the 3SLS estimation technique that is able to explicitly account for dependencies between 3 structural equations on the allocation of targeted aid, the determinants of infrastructure, and the determinants of FDI – we found quite interesting results. First, aid targeted at infrastructure indicates strong positive effect on the countries’ infrastructure endowment, as expected. Second, there is robust evidence that aid promotes FDI but, surprisingly, not necessarily through the infrastructure channel. Targeted aid appears to exert a positive and direct knock-on effect on FDI - apparently, because investors anticipate the positive effect that targeted aid is almost always inclined to produce on host countries’ infrastructure endowment. Finally, aid allocation by Development Assistance Committee donors seems to have primarily been merit-based, followed by weaker evidence for ‘need’. Therefore, we recommend more need-based aid allocation particularly in economies where initial infrastructure endowment is minimal. There is also need for extended effort at index construction (e.g., index of infrastructure need) and data collection to drive country-case studies. This should identify the transmission channel from aid to FDI and how the associated binding constraints could be overcome.
Risk Stratification for Organ/Space Surgical Site Infection in Digestive System Cancer: A Prospective Cohort Study
Authors: Sun Chen , Gao Hui , Zhang Yuelun , Pei Lijian , Huang Yuguang
Published: January 2021

Background: Organ/space surgical site infection (organ/space SSI) is one of the serious postoperative complications, closely related to a poor prognosis. Few studies have attempted to design risk scoring systems for patients with digestive system cancer. This study aimed to develop a simple and practical risk stratification score for these patients to identify a priori risk of organ/space SSI.Methods: This prospective cohort study was based on two prospective studies (NCT02756910, ChiCTR-IPR-17011099), including patients undergoing elective radical resection of digestive system cancer. Logistic regression analysis was used to identify the determinant variables. The incidence of organ/space SSI stratified over perioperative factors was compared and compounded in a risk score.Results: Among the 839 patients, 51 developed organ/space SSI (6.1%) within 30 days after surgery. Patients undergoing gastrectomy (OR=8.466, 95% CI: 2.728-26.270, P<0.001), colorectal resection (OR=11.180, 95% CI: 3.921-31.881, P<0.001) and pancreatoduodenectomy (OR=9.054, 95% CI: 3.329-24.624, P<0.001) with an anaesthesia time > 4 h (OR=2.335, 95% CI: 1.035-5.271, P=0.041) and prolonged intensive care unit (ICU) stays > 24 h (OR=4.243, 95% CI: 1.715-10.498, P=0.002) had a significantly higher risk of organ/space SSI. These risk factors (procedure type, anaesthesia time, prolonged ICU stays) were also associated with an increase in organ/space SSI rates based on a compounded score (P<0.001). Comparisons with the overall population revealed that patients with 0 or 1 risk factor (n=602) had an organ/space SSI rate of 2.8% (RR=0.197, 95% CI: 0.112-0.345), those with 2 risk factors (n=223) had an organ/space SSI rate of 13.0% (RR=3.641; 95% CI: 2.138-6.202), and those with 3 risk factors (n=14) had an organ/space SSI rate of 35.7% (RR=6.405, 95% CI: 3.005-13.653).Conclusion: The risk stratification score in this study provides a simple and practical tool to stratify patients with digestive system cancer so that the relative risk of developing postoperative organ/space SSIs can be predicted.Trial Registration: This study was based on one randomized controlled trial (NCT02756910) registered at ClinicalTrials.gov on April 29, 2016 and one prospective cohort study (ChiCTR-IPR-17011099) registered at the Chinese Clinical Trial Registry on April 9, 2017.
Whole-exome Sequencing Identify Rare Variants in Novel Candidate Genes with Non-syndromic Patent Ductus Arteriosus
Authors: Gao Ying , Liu Ying , Li Jiaoyu , Chen Yinghui , Zhang Qi , Zhang Bingyao , Zhao Pengjun , Chen Bo
Published: January 2021

Background Patent Ductus Arteriosus (PDA) is one of the most common congenital heart defects that can cause pulmonary hypertension, heart failure, and even death. Prior studies have suggested a role for genetics in determining spontaneous ductal closure, however the clinical characteristics and genetic cause underlying PDA remain unclear. Results Therefore, to further explore genetic etiology of PDA, we applied Whole-exome Sequencing (WES) in 39unrelated isolated, non-syndromic PDApatientsand 100 healthy controls. Through a series of bio-information filtering strategies, the candidate genes are prioritized by comprehensively considering factors such as genefunctional enrichment, expression pattern and mutation burden during heart development. 18 rare damage variants of 6 total novel genes (SOX8, NES, CDH2, ANK3, EIF4G1, HIPK1)were identified for the first time and these pathogenic candidates are also highly expressed in the heart of human embryos. Conclusions WES is an efficient diagnostic tool for identifying PDA related genes. The finding of our study contributes new insights into the molecular basis of PDA and may inform further studies on genetic risk factors for this congenital birth defect.
Quantitative Evaluation of Upper Urinary Tract Pump Function in Pigs With Acute Unilateral Lower Ureteral Obstruction by 640-slice Dynamic Volume CT
Authors: Mao Chongwen , Peng Cong , Li Song , Chen Liling , You Mengjing , Fang Kewei , Xiang Shutian , Su Yunshan
Published: January 2021

Background: It is a challenging problem to differentiate obstructive hydronephrosis from non-invasive evaluation of renal pelvis and ureteral motility in patients. The purpose of this study was to explore the value of 640-slice dynamic volume CT (DVCT) in quantitative measurement of upper urinary tract (UUT) pump function after acute unilateral lower ureteral obstruction in pigs. Methods: In this study, perfusion pig model was made by constant pressure perfusion test of renal pelvis and left nephrostomy. The perfusion and pressure measuring devices were connected to create the state of no obstruction, acute obstruction of the lower part of the left ureter. After successful modeling, continuous dynamic volume scanning of bilateral renal excretion phase was performed with 640-slice DVCT, and pump functions of the renal pelvis and part of the upper ureter were calculated and analyzed. No obstruction, acute obstruction of the lower part of the left ureter. Pump functions of the renal pelvis and part of the upper ureter. Results: Results showed after LUUT fistulostomy, the time difference between the average UUTs volume and positive volume value increased gradually, and the calculated flow velocity decreased, which was significantly different from that of the RUUT. The volume difference of the LUUT increased significantly in mild obstruction. In the bilateral control, the volume change rate of the LUUT increased in mild obstruction and decreased in severe obstruction, and there was significant difference between the left and the right side. Conclusion: The continuous dynamic volume scan and measurement of 640-slice DVCT can obtain five pump function data of UUT in pigs with acute lower ureteral obstruction.
COVID-19 – Protocol for Observational Studies Utilising Near Real-Time Electronic Australian General Practice Data to Promote Effective Care and Best-Practice Policy – A Design Thinking Approach
Authors: Georgiou Andrew , Li Julie , Pearce Christopher , McLeod Adam , Wabe Nasir , Hardie Rae-Anne , Franco Guilherme Saffi , Imai Chisato , Sezgin Gorkem , Thomas Judith , Dai Zhaoli , Sheikh Muhammad Kashif , Proposch Amanda , Weeding Stephen , Wickham Brendon , Badrick Tony , Murgatroyd Darnel
Published: January 2021

Background: Health systems around the world have been forced to make choices about how to prioritise care, manage infection control and maintain reserve capacity for future disease outbreaks. Primary health care has moved into the frontline as COVID-19 testing transitions from hospitals to multiple providers, where tracking testing behaviours can be fragmented and delayed. Pooled general practice data are a valuable resource which can be used to inform population and individual care decision-making. This project aims to utilise near real-time electronic general practice data to promote effective care and best-practice policy. Methods: The project will utilise a design thinking approach involving all collaborators (Primary Health Networks [PHNs], general practices, consumer groups, researchers, and digital health developers, pathology professionals) to enhance the development of meaningful and translational project outcomes. The project will be based on a series of observational studies utilising near real-time electronic general practice data from a secure and comprehensive digital health platform [POpulation Level Analysis and Reporting (POLAR) general practice data warehouse]. The study will be carried out over 1.5 years (July 2020 – December 2021) using data from over 350 general practices within three Victorian Primary Health Networks (PHNs) and Gippsland PHN, Eastern Melbourne PHN and South Eastern Melbourne PHN, supplemented by data from consenting general practices from two PHNs in New South Wales, Central and Eastern Sydney PHN and South Western Sydney PHN. Discussion: Developed using a design thinking approach, this project will deliver: 1) A near real-time geo-spatial reporting framework at community, state and nation-wide levels to identify emerging trends and monitor the impact of interventions/policy decisions. 2) Timely evidence about the impact of the COVID-19 pandemic related to its diagnosis, treatment and medications prescribed and its impact on patients. 3) A predictive geo-spatial analytics dashboard for timely, evidence-based decision-making at community, state and nation-wide levels. 4) An evidence-based suite of general practice outcome measures to monitor incidence, prevalence, recovery and mortality in response to the COVID-19 pandemic.
The Case Selection for Vaginal Cuff Brachytherapy in Cervical Cancer Patients after Radical Hysterectomy and External Beam Radiation Therapy
Authors: LAI Ying-Lu , JIN Ye-Ning , WANG Xi , QI Wei-Xiang , CAI Rong , Xu Hao-Ping
Published: January 2021

ObjectiveTo Explore the suitable cases for vaginal cuff brachytherapy(VCB) combined with external beam radiation therapy(EBRT) in the postoperative treatment of cervical cancer. MethodsWe retrospectively analyzed the clinical data of 214 postoperative cervical cancer patients who received radiotherapy from January 2008 to December 2015. Among them, 146 patients received postoperative EBRT, 68 received EBRT plus VCB. There was no statistical difference in clinical and pathological characteristics between these two groups. Those who with negative vaginal cuff underwent supplemented 12-18Gy/2-3Fx VCB. Survival analyses were performed using Kaplan-Meier method, and Cox model was used to analyze prognostic factors. ResultsThe median follow-up was 52 months (9-136 months), and 4-year RFS (recurrence-free survival) was 77%. Among them, 58 patients had local or distant recurrences, 29 in pelvic, 8 with metastases to para-aortic or inguinal lymph nodes, 17 with distant metastases and 4 with both local and distant recurrences. The postoperative brachytherapy boost did not improve RFS or OS (overall survival) among the investigated subjects, P=0.77, P=0.99, respectively. Neither it decreased the local relapse in the pelvis or vaginal cuff, P=0.56, P=0.59. Subgroup analyses showed that brachytherapy boost improved RFS in patients who had bulky mass (>4cm) as well as 1) with deep stromal invasion (>50% stromal invasion), P=0.012 or 2) received low EBRT dose (≤ 45Gy), P=0.033, and in patients with deep stromal invasion as well as received low EBRT dose (P=0.018). ConclusionsWe first proposed the case selection model for postoperative EBRT plus VCB. Brachytherapy boost were considered in the setting of postoperative radiotherapy if the patients had at least 2 out of these following factors: bulky mass, deep stromal invasion and low EBRT dose.
Hippocampal CA3 Transcriptional Modules Associated with Granule Cell Alterations and Cognitive Impairment in Refractory Mesial Temporal Lobe Epilepsy Patients
Authors: Bando Silvia , Bertonha Fernanda , Pimentel-Silva Luciana , Oliveira João Mansano de , Carneiro Marco Duarte , Oku Mariana Manoel , Wen Hung-Tzu , Castro Luiz Martins , Moreira-Filho Carlos
Published: January 2021

In about a third of the patients with epilepsy the seizures are not drug-controlled. The current limitation of the antiepileptic drug therapy derives from an insufficient understanding of epilepsy pathophysiology. In order to overcome this situation, it is necessary to consider epilepsy as a disturbed network of interactions, instead of just looking for changes in single molecular components. Here, we studied CA3 transcriptional signatures and dentate gyrus histopathologic alterations in hippocampal explants surgically obtained from 57 RMTLE patients submitted to corticoamygdalohippocampectomy. By adopting a systems biology approach, integrating clinical, histopathological, and transcriptomic data (weighted gene co-expression network analysis), we were able to identify transcriptional modules highly correlated with age of disease onset, cognitive dysfunctions, and granule cell alterations. The enrichment analysis of transcriptional modules and the functional characterization of the highly connected genes in each trait-correlated module allowed us to unveil the modules’ main biological functions, paving the way for further investigations on their roles in RMTLE pathophysiology. Moreover, we found 15 genes with high gene significance values which have the potential to become novel biomarkers and/or therapeutic targets in RMTLE.