bluuebunny/crossref_metadata_2025 huggingface dataset:
Mid-wavelength Infrared Avalanche Photodetector with AlAsSb/GaSb Superlattice
Authors: Li Jiakai , Dehzangi Arash , Brown Gail , Razeghi Manijeh
Published: January 2021

This work demonstrates a mid-wavelength infrared separate absorption and multiplication avalanche photodiode (SAM-APD) with AlGaAsSb/GaSb multi-quantum well as the multiplication layer and InAsSb bulk material as the absorption layer. The InAsSb-based SAM-APD structure was grown by molecular beam epitaxy. The device exhibits a 100 % cut-off wavelength of ~5.3 µm at 150 K and ~5.6 µm at 200 K. At 150 K and 200 K, the responsivity of the SAM-APD reaches a peak value of 2.26 A/W and 3.84 A/W at 4.0 µm under -1.0 V applied bias, respectively. The SAM-APD device was designed to have electron dominated avalanching mechanism via the multi-quantum well structure as the avalanche architecture. A multiplication gain value of 29 at 200 K was achieved under −14.7 V bias voltage. The electron and hole impact ionization coefficients were calculated and compared. A carrier ionization ratio of ~0.097 was achieved at 200 K.
Solid-pseudopapillary Neoplasm of the Pancreas: A 63-Case Analysis of Clinicopathologic and Immunohistochemical Features and Risk Factors of Malignancy
Authors: Chen Hongchun , Huang Yuchen , Yang Ningning , Yang Ruxue , Yan Wentian , Zhang Shan , Yang Panpan , Li Nan , Feng Zhenzhong
Published: January 2021

Background:Asolid-pseudopapillary neoplasm (SPN) of the pancreas, a rare tumor, has low malignant potential. However, some patients develop metastasis and recurrence after resection, with aggressive biological behaviors of SPNs. This study aimedtoexplorethefeatures andriskfactors associated withtheaggressivebiological behaviorsofSPNs.Materials and Methods: We retrospectively analyzed the clinicopathological and long-term follow-up data of 63 patients with SPN diagnosed at the First Affiliated Hospital of Bengbu Medical College between January 2007 and February 2019.Results: The 63 patients presented with atypical clinical symptoms. The mean tumor size was 7.2 cm (range, 2.4–17 cm), and imaging features were solid and cystic or solid tumors with uneven density. Frequent and diffuse nuclear LEF1 expression (94.2%) was observed with LEF1 having a higher sensitivity and specificity. Overall survival significantly correlated with tumor size, Ki-67 index, and lymph node metastasis(P<0.05).Conclusions: SPN is a rare low-grade malignancy with a specific pseudopapillary structure. LEF1 is an effective biomarker of SPNs. Although SPNs generally display indolent biological behavior, a large tumor size, high proliferation index and lymph node metastasis may be risk factors for the aggressive behavior and poor prognosis of anSPN.
Incidence and Clinical Characteristics of Oral Mucositis in Allogeneic Hematopoietic Stem Cell Transplantation with Post-transplant Cyclophosphamide Treatment
Authors: Gong Susu , Xiao Hong , Ding Xiaofang , Yang Kaitai , Hu Jian , Xu Yajing , Fu Bin
Published: January 2021

Post-transplant cyclophosphamide (PTCy) treatment has been increasingly used in allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, its effects on the burden and severity of oral mucositis (OM) remain unclear. A total of 177 patients received allo-HSCT with PTCy treatment at Xiangya Hospital between 2015 and 2020. Among them, 140 patients whose OM was prospectively graded using the World Health Organization (WHO) oral toxicity scale were included in this retrospective study. The grafts were peripheral stem cells from matched (28/140, 20.0%) and mismatched (112/140, 80.0%) donors. Conditioning intensity was categorized as myeloablative conditioning (MAC; 82/140, 58.6%) or reduced intensity conditioning (RIC; 58/140, 41.4%). The overall incidence of any OM was high (116/140, 82.9%) but the incidence of severe OM was relatively low (40/140, 28.6%). The median duration of OM was 10 days (2–22 days post-transplantation) from day –2 to day +15 (median day +8). Earlier onset of OM was correlated with greater severity. Multivariate analysis showed that conditioning intensity (MAC vs RIC, odds ratio [OR] 6.128, 95% confidence interval [CI] 2.319–16.198) and donor type (mismatched vs matched, OR 3.252, 95% CI 1.089–9.717) were associated with increased risk of severe OM. No significant implications of severe OM were observed on acute or chronic GVHD. Patients with severe OM had slightly worse overall survival, but the difference was not statistically significant (p = 0.078). Therefore, severe OM does not appear to lead to a worse transplant outcome if an intensified oral care protocol is adopted.
Do Root Modules Still Exist after they Die?
Authors: Li Jihong , You Chengming , Zhang Li , Li Han , Tan Bo , Liu Yang , Wang Lixia , Liu Sining , Xu Zhenfeng
Published: January 2021

Background: The terminal branch orders of plant root systems are increasingly known as an ephemeral module. This concept is very crucial to recognize belowground processes. However, it is unknown if root modules still exist after they die? Methods: The decomposition patterns of the first five root orders were observed for 3 years using a branch-order classification, a litter-bag method and sequential sampling in a common subalpine tree species (Picea asperata) of southwestern China. Results: Two root modules were observed during the 3-year incubation. Among the first five branch orders, the first three order roots exhibited temporal patterns of mass loss, nutrients and stoichiometry distinct from their woody mother roots throughout the experimental period. This study, for the first time, reported the decomposition pattern of each individual root order and found a similar decomposition dynamic among ephemeral root branches in a forest tree species. Conclusions: Results from this study clearly suggest that root modules may also exist after death, while more data are needed for confirmation. The findings may further advance our understanding of architecture-associated functional heterogeneity in fine-root system and also improve our ability to predict belowground processes.
Potential Role of a Three-Gene Signature for Predicting Diagnosis in Patients With Myocardial Infarction
Authors: Yao Yinhui , Zhao Jingyi , Zhou Xiaohui , Wang Ying
Published: January 2021

ObjectiveIncreasing evidence underscored that the expression of genes was associated with the development and progression of myocardial infarction (MI). In this study, We evaluated the diagnostic value of the feature genes in MI based on data from the Gene Expression Omnibus (GEO) database.MethodsWe used the data from the GEO database (GSE66360) to identify a set of significant differentially expressed genes (DEGs) between MI and healthy control. Univariable logistic regression, the least absolute shrinkage and selection operator (LASSO), SignalP 3.0 server and multivariable logistic regression were used to find the potential role of genes for predicting diagnosis in patients with MI. Receiver operating characteristic (ROC) curve analyses, area under the curve (AUC) and C-index were used to estimate the diagnostic value of genes in patients with MI. The validation for the association was conduct in another six independent data sets (GSE141512, GSE24519, GSE34198, GSE48060, GSE60993, and GSE109048). Then, a meta-analysis was performed to evaluate the diagnostic value of genes in MI.ResultsA total of 44 DEGs were selected from GSE66360. Functional enrichment and KEGG analysis were performed to reveal the DEGs in some inflammation-related biological processes and pathways. A three-gene signature consisted of CCL20, IL1R2 and ITLN1, which could effectively distinguish patients in MI (AUC and C-index were the same value of 0.975). The three-gene signature was effectively validated in 7 independent cohorts, and diagnostic meta-analysis results of the three-gene signature showed that the pooled sensitivity, specificity and ROC curve AUC for MI were0.82 (95% CI: 0.68-0.90), 0.91 (95% CI: 0.81-0.96) and 0.94(95%CI, 0.91-0.96), respectively. ConclusionIt was magnificently suggest that the three-gene signature might potentially serve as novel candidate biomarkers for distinguishing MI from healthy control. Besides, more well-designed cohort studies need to be implemented to warrant the diagnostic value of three-gene signature in clinical purpose.
Validity of Using Mobile Phone Surveys to Evaluate Community Health Worker Program in Mali
Authors: Chen Xiaomeng , Mohan Diwakar , Maïga Abdoulaye , Frost Emily , Coulibaly Djeneba , Basil Luay , Gueye Birahim Yaguemar , Guindo Mariam Traore , Keita Assa Sidibé , Keita Haoua Dembelé , Marx Melissa A
Published: January 2021

BackgroundAssessing implementation strength through face-to-face interviews in hard-to-reach and unstable regions presents many challenges. Mobile phone-based interviews have become an alternative, but the validity of these data from this approach for Implementation Strength Assessment evaluation has not been sufficiently studied yet. The objective of this study was to assess the validity of mobile phone-based health provider interviews to measure the implementation strength of an integrated community case management (iCCM) and family planning program in Mali.MethodsFrom July to August 2018, interviewers administered a structured questionnaire to community health workers (ASCs) implementing the iCCM and family planning program in six districts in Mali. Interviews were conducted, first by phone, then verified through in-person visits. Survey questions addressed background information, training, supervision, demand generation activities and supplies of essential drugs and contraceptive methods. Sensitivity and specificity of the phone responses were calculated using the in-person response as the gold standard. A threshold of 80% for sensitivity and specificity respectively was considered acceptable.ResultsOf 157 ASCs interviewed by phone, 115 (73.2%) were reached in-person. Most indicators (9/10 iCCM indicators, 6/6 family planning indicators) for training, supervision, and availability of supplies on the day of interview, and those related to patient utilization reached the 80% threshold for sensitivity, but few (2/10 iCCM indicators, 1/6 family planning indicators) reached 80% for specificity. In contrast, most indicators of supply stock-outs in the last 3 months reached the threshold for specificity (5/6 iCCM indicators, 3/3 family planning indicators) but few reached the threshold for sensitivity (1/6 iCCM indicators, 1/3 family planning indicators).ConclusionsThe validity of data collected by phone were adequate for indicators of training, supervision, and day-of-interview commodity availability. Phone-based surveys are useful as a low-cost option for data collection in the assessment of implementation strength on general activities in inaccessible and resource-limited regions with mobile network connectivity.
Prevalence and Incidence of Postpartum Depression among Chinese Women: A Longitudinal Study
Authors: Qi Ling , Xiao Ao-Shuang , Wang Xin , Liu Yuan-Xia , Zhang Meng-Tian , Zhang Hong-Ling
Published: January 2021

PurposePostpartum Depression (PPD) is significant public health and clinical concern regarding to women of reproductive age. This study aims to examine the prevalence, incidence and persistence of at 1 and 6 months after delivery among Chinese women.MethodThis is a prospective cohort study in Wuhan, China. Participants were mothers recruited Wuhan Women and Children Medical Care Center, who gave singleton and live birth from January 2016 to September 2018. Edinburgh Postnatal Depression Scale (EPDS) was used to assess possible (scores of EPDS >9) and high-level (scores of EPDS >12) of depression at 1 and 6 months after delivery. Prevalence and incidence with 95% confidence intervals were calculated. ResultsWe included 1884 mothers. The prevalence of possible and high-level depression at 1 month were 37.7% and 15.2%, respectively; at 6 months were 32.6% and 13.1%, respectively. Both prevalence rates of possible and high depression were higher at 1 month than that at 6 month after delivery. The incidence rates of possible and high-level depression at 6 months were 11.8% and 7.2%, respectively. Of those with possible symptoms at 1month, 20.8% continued to have symptoms at 6 months. Higher EPDS scores at 1 month, employment during pregnancy and multiparas were risk factors for elevated EPDS scores at 6 months(P<0.05)..ConclusionData of incidences suggests that later-onset PPD after delivery. These results suggest that continuous postpartum monitoring maternal depression is helpful to identify high-risk groups as early as possible and reduce the incidence of PPD.
Longitudinal Study Based on a Safety Registry for Malaria Patients Treated With Artenimol-Piperaquine in Six European Countries
Authors: Vignier Nicolas , Bouchaud Olivier , Angheben Andrea , Bottieau Emmanuel , Calleri Guido , Salas-Coronas Joaquín , Martin Charlotte , Ramos José Manuel , Mechain Matthieu , Rapp Christophe , Nothdurft Hans-Dieter , Velasco Maria , Bardajì Azucena , Rojo-Marcos Gerardo , Visser Leo , Hatz Christophe , Bisoffi Zeno , Jelinek Tomas , Duparc Stephan , Bourhis Yann , Tommasini Silva , Iannucelli Maurizio , Bacchieri Antonella , Mattera Giovan Giuseppe , Pich Emilio Merlo , Behrens Ronald H.
Published: January 2021

BackgroundEuropean travelers are exposed to imported malaria and may be affected by co-existing morbidities. In this context, the safety profile, especially cardiac issues, of artenimol (previously dihydroartemisinin)-piperaquine (APQ) Eurartesim® during treatment of uncomplicated falciparum malaria is not adequately described due to the lack of longitudinal studies in this population. The present study was conducted to partially fill this gap.MethodsParticipants were recruited through Health Care Provider’s Safety Registry in 15 centers across 6 European countries in the period 2013-2016. Adverse Events (AE) were collected, with a special focus on cardiovascular safety by including electrocardiogram QT intervals evaluated after correction with either Bazett’s (QTcB) or Fridericia’s (QTcF) methods, at baseline and after treatment. QTcB and/or QTcF prolongation were defined by a value > 450 ms for males and children and > 470 ms for females.ResultsAmong 294 participants, 30.3% were women, 13.7% of Caucasian origin, 13.5% were current smoker, 13.6% current alcohol consumer and 42.2% declared at least one illness history. The mean (SD) age and body mass index were 39.8 years old (13.2) and 25.9 kg/m² (4.7).Among them, 75 reported a total of 129 AE (27 serious), 46 being suspected to be related to APQ (11 serious) and mostly labelled as due to haematological, gastrointestinal, or infection.. Women and Non-African participants had significantly (p<0.05) more AEs.Among AEs, 21 were due to cardiotoxicity (7.1%), mostly QT prolongation, while 6 were due to neurotoxicity (2.0%), mostly dizziness. Using QTcF correction, QT prolongation was observed in 17/143 participants (11.9%), only 2 of them reporting QTcF>500 ms but no clinical symptoms. Using QTcB correction increases of > 60 ms were present in 9 participants (6.3%). A trend towards increased prolongation was observed in those over 65 years of age but only a few subjects were in this group. No new safety signal was reported.The overall efficacy rate was 255/257 (99.2%).ConclusionsAPQ appears as an effective and well tolerated drug for treatment of malaria in patients recruited in European countries. AEs and QT prolongation were in the range of those obtained in larger cohorts from endemic countries.(This study has been registered in EU Post-Authorization Studies Register as EUPAS6942)
Nutritional Quality Improvement Of Soybean Meal By Bacillus Velezensis And Lactobacillus Plantarum During Two-Stage Solid- State Fermentation
Authors: Chen Long , Zhao Zijian , Yu Wei , Zheng Lin , Li Lijia , Gu Wei , Xu Haiyan , Wei Bingdong , Yan Xiaogang
Published: January 2021

Bacillus velezensis is widely used for agricultural biocontrol, due to its ability to enhance plant growth while suppressing the growth of microbial pathogens. However, there are few reports on its application in fermented feed. Here, a two-stage solid-state fermentation process using Bacillus velezensis followed by Lactobacillus plantarum was developed to degrade antinutritional factors (ANFs) and improve soybean meal (SBM) nutrition for animal feed. The process was evaluated for performance in degrading SBM antinutritional factors, dynamic changes in physicochemical characteristics, microorganisms and metabolites. After two-stage fermentation, degradation rates of glycinin and β-conglycinin contents reached 78.60% and 72.89%, respectively. The pH of fermented SBM (FSBM) decreased to 4.78±0.04 and lactic acid content reached 183.38±4.86 mmol/kg. NSP-degrading enzymes (Non-starch polysaccharide, NSPases) and protease were detected from the fermented product, which caused the changed microstructure of SBM. Compared to uninoculated SBM, FSBM exhibited increased proportions of crude protein (51.97±0.44% vs. 47.28±0.34%), Ca, total phosphorus (P), and trichloroacetic acid-soluble protein (11.79±0.13% vs. 5.07±0.06%). Additionally, cellulose and hemicellulose proportions declined by 22.10% and 39.15%, respectively. Total amino acid content increased by 5.05%，while the difference of AA content between the 24h, 48 h and 72 h of fermentation was not significant (P＞0.05). Furthermore, FSBM also showed antibacterial activity against Staphylococcus aureus and Escherichia coli. These results demonstrated that two-stage SBM fermentation process based on Bacillus velezensis 157 and Lactobacillus plantarum BLCC2-0015 is an effective approach to reduce ANFs content and improve the quality of SBM feed.
Biocompatible Nanoparticles as a Platform for Enhancing Antitumor Efficacy of Cisplatin-Tetradrine Combination
Authors: Liu Fangcen , Wang Xinyue , Liu Qin , Zhang Huan , Xie Li , Wang Qin , Li Lin , Li Rutian
Published: January 2021

Combination therapy has been a standard strategy in the clinical tumor treatment. We have demonstrated that combination of Tetradrine (Tet) and Cisplatin (CDDP) presented a marked synergistic anticancer activity, but inevitable side effects limit their therapeutic concentration. Considering the different physicochemical and pharmacokinetic properties of the two drugs, we loaded them into a nanovehicle together by the improved double emulsion method. The nanoparticles (NPs) were prepared from the mixture of poly(ethyleneglycol)-polycaprolactone (PEG-PCL) and polycarprolactone (HO-PCL), so CDDP and Tet can be located into the NPs simultaneously, resulting in low interfering effect and high stability. Images from fluorescence microscope revealed the cellular uptake of both hydrophilic and hydrophobic agents delivered by the NPs. In vitro studies on different tumor cell lines and tumor tissue revealed increased tumor inhibition and apoptosis rates. As to the in vivo studies, superior antitumor efficacy and reduced side effects were observed in the NPs group. Furthermore, 18 FDG-PET/CT imaging demonstrated that NPs reduced metabolic activities of tumors more prominently. Our results suggest that PEG-PCL block copolymeric NPs could be a promising carrier for combined chemotherapy with solid efficacy and minor side effects.
Influence of Ultrasonic Surface Rolling Process and Shot Peening on Fretting Fatigue Performance of Ti-6Al-4V
Authors: Wang Ning , Zhu Jin long , Liu Bai , Zhang Xiancheng , Zhang Jiamin , Tu Shantung
Published: January 2021

The shot-peening (SP) and ultrasonic surface rolling process (USRP) were performed on Ti–6Al-4V plate specimens. The surface hardness and residual stresses of the material were tested by vickers indenter and X-ray diffraction residual stress analyzer. The effects of different surface strengthening on its fretting fatigue properties were verified by fretting fatigue experiments. It is shown (i) that the fretting fatigue life of Ti–6Al-4V effectively improved after USRP and SP and（ii）that the surface integrity of specimens after USRP is the best, which has deeper residual compressive stress layer and more refined grain. The fretting fatigue fracture surface and wear morphology of the samples were studied and analyzed by means of microscopic observation, and the mechanism of improving fretting fatigue life by surface strengthening process was further explained
Performance of Liver Stiffness Measurement from FibroScan was Affected by Glucose Metabolism in Patients with Nonalcoholic Fatty Liver Disease
Authors: Yang Xinyu , Chang Xinxia , Wu Shengdi , Sun Xiaoyang , Zhu Xiaopeng , Wang Liu , Xu Yushan , Yao Xiuzhong , Rao Shengxiang , Hu Xiqi , Xia Mingfeng , Bian Hua , Yan Hong-Mei , Gao Xin
Published: January 2021

Background: The performance of liver stiffness measurement (LSM) obtained using FibroScan can be affected by several factors and cut-off values were different for fibrosis caused by various etiologies. The aim of this study was to evaluate the diagnostic performance of LSM in nonalcoholic fatty liver disease (NAFLD) patients with abnormal glucose metabolism and investigate whether LSM value would be affected by metabolic indicators. Methods: The study involved 91 NAFLD patients with abnormal glucose metabolism who underwent liver biopsy. The receiver operator characteristic (ROC) curves were used to evaluate the diagnostic accuracy, with the biopsy results taken as the gold standard. Multivariate linear regression and subgroup analysis were used to determine the correlated indicators.Results: The areas under ROC curves (AUROCs) of LSM values in diagnosing fibrosis stage≥1, 2, 3 and 4 were 0.793 (95% confidence interval [CI]: 0.695-0.871), 0.764 (95% CI: 0.663-0.846), 0.837 (95% CI: 0.744-0.906) and 0.902 (95% CI: 0.822-0.955), with cut-off values of 6.3, 7.6, 8.3 and 13.8 kPa, respectively. Multivariate linear regression demonstrated that HbA1c (β=0.200, p=0.038) and AST (β=0.200, p=0.044) were independently associated with LSM value after adjustment for fibrosis stage from liver biopsy. Subgroup analysis revealed that LSM values were slightly higher in patients with HbA1c ≥7% than those HbA1c <7%, and in patients with BMI ≥30kg/m2 than those BMI <30kg/m2.Conclusions: FibroScan was valuable for the evaluation of liver fibrosis in NAFLD patients with abnormal glucose metabolism. It was recommended for evaluating severe fibrosis, especially for excluding advanced fibrosis. Glucose metabolism state may affect LSM value.
Effect of HSP90AB1 and CC Domain Interaction on Bcr-Abl Protein Cytoplasm Localization and Function in Chronic Myeloid Leukemia Cells
Authors: Peng Yuhang , Huang Zhenglan , Zhou Fangzhu , Wang Teng , Mou Ke , feng wenli
Published: January 2021

Background: The fusion oncoprotein Bcr-Abl is mostly located in the cytoplasm, which causes chronic myeloid leukemia (CML). After moving into the nucleus, the fusion protein can induce apoptosis of CML cells. The coiled-coil domain (CC domain) of Bcr-Abl protein plays a central role in the subcellular localization. However, how CC domain affects subcellular localization of Bcr-Abl remains unclear. Methods: Herein, the key proteins interacting with the Bcr-Abl CC domain were screened by immunoprecipitation binding mass spectrometry. The specific site of Bcr-Abl CC domain binding to target protein was predicted by Deep Viewer. Immunoprecipitation assay was used to confirmed the specific sites of protein binding. IF and western blot were used to observe the subcellular localization of target protein. Western blot was used to examine the protein changes. CCK-8, clonal formation test and FCM cycle detection were used to observe the effect of inhibitor on the proliferation ability of CML cells. FCM apoptosis detection was used to observe the level of cells apoptosis.Results: HSP90AB1 interacts with Bcr-Abl CC domain via N-terminal domain (NTD), preventing the transport of Bcr-Abl protein to the nucleus and maintaining the activation of Bcr-Abl tyrosine kinase. The nucleus-entrapped Bcr-Abl markedly inhibits the proliferation and induces apoptosis of CML cells by activating p73 and repressing the expression of cytoplasmic oncogenic signaling pathways mediated by Bcr-Abl. Moreover, the combination of 17AAG (Tanespimycin) with Leptomycin B (LMB) considerably decreased the proliferation of CML cells.Conclusion: Our study provides evidence that it is feasible to transport Bcr-Abl into the nucleus as an alternative strategy for the treatment of CML, and targeting the NTD of HSP90AB1 to inhibit the interaction with Bcr-Abl is more accurate for the development and application of HSP90 inhibitor in the treatment of CML and other Bcr-Abl-addicted malignancies.
Delayed Embolization Associated With Increased Mortality in Patients With Hemodynamically Stable Pelvic Fracture
Authors: Aoki Makoto , Abe Toshikazu , Matsumoto Shokei , Hagiwara Shuichi , Saitoh Daizoh , Oshima Kiyohiro
Published: January 2021

Background: Embolization is widely used for controlling arterial hemorrhage associated with pelvic fracture. However, the effect of a delay in embolization among hemodynamically stable patients with pelvic fracture is unknown. Therefore, our aim was to investigate the association between the time to embolization and mortality in hemodynamically stable patients with a pelvic fracture.Methods: A multicenter, retrospective cohort study was undertaken using data from the Japan Trauma Data Bank from between 2004 and 2018. Hemodynamically stable patients with pelvic fracture who underwent an embolization within 3 h were divided into six groups of 30-min blocks of time until pelvic embolization (0–30, 30–60, 60–90, 90–120, 120–150, and 150–180 min). We compared the adjusted 30-day mortality rate according to time to embolization. Results: We studied 620 hemodynamically stable patients with a pelvic fracture who underwent pelvic embolization within 3 h of hemorrhage. The median age was 68 (48–79) years and 55% were male. The median injury severity score was 26 (18–38). Thirty-day mortality was 8.9% (55/620) and 24-hour mortality was 4.2% (26/619). A Cochran–Armitage test showed that a 30-min delay for embolization was associated with increased 30-day (p = 0.0186) and 24-hour (p = 0.033) mortality. Mortality within 0–30 min to embolization was 0%. The adjusted 30-day mortality rate increased with delayed embolization and was up to 17.0% (10.2–23.9) for the 150–180 min group. Conclusion: Delayed embolization was associated with increased mortality among hemodynamically stable patients with pelvic fracture. Early identification and embolization reduced mortality in such patients.
A Consensus Statement for Trauma Surgery Capacity Building in Latin America
Authors: Dasari Mohini , Johnson Erica D. , Montenegro Jorge H. , Griswold Dylan , Jiménez Maria Fernanda , Puyana Juan Carlos , Rubiano Andres M.
Published: January 2021

Background: Trauma is a significant public health problem in Latin America (L.A.), contributing to substantial death and disability in the region. Several LA countries have implemented trauma registries and injury surveillance systems. However, the region lacks an integrated trauma system. The consensus conference's goal was to integrate existing L.A. trauma data collection efforts into a regional trauma program and encourage the use of the data to inform health policy.Methods: We created a consensus group of 25 experts in trauma and emergency care with previous data collection and injury surveillance experience in the L.A. region. Experts participated in a consensus conference to discuss the state of trauma data collection in L.A. We utilized the Delphi method to build consensus around strategic steps for trauma data management in the region. Consensus was defined as the agreement of ≥ 70% among the expert panel. Results: The consensus conference determined that action was necessary from academic bodies, scientific societies, and ministries of health to encourage a culture of collection and use of health data in trauma. The panel developed a set of recommendations for these groups to encourage the development and use of robust trauma information systems in L.A. Consensus was achieved in one Delphi round.Conclusions: The expert group successfully reached a consensus on recommendations to key stakeholders in trauma information systems in L.A. These recommendations may be used to encourage capacity-building in trauma research and trauma health policy in the region.
Differences in Heart Rate Variability and Body Composition in Breast Cancer Survivors and Women Without Cancer
Authors: Escutia-Reyes Daniel , Garduño-García José , López-Chávez Gerardo , Gómez-Villanueva Ángel , Pliego-Carrillo Adriana , Soto-Piña Alexandra , Reyes-Lagos José Javier
Published: January 2021

Purpose: To explore cardiac autonomic changes assessed by linear and nonlinear indexes of heart rate variability (HRV) and body composition modifications in breast cancer survivors and cancer-free control women. Methods: Women who were breast cancer survivors (BCS, n=27) and cancer-free control participants with similar characteristics (Control, n=31) were enrolled in the Regional General Hospital No. 251 of the Mexican Institute of Social Security (Metepec, Mexico). We processed five minutes of R-R interval time series, and we calculated relevant linear and nonlinear parameters of HRV such as mean RR interval (RRave), the Root Mean Square of the Successive Differences (RMSSD), the Poincaré plot measures SD1, SD2, SD1/SD2, and the sample entropy (SampEn). Additionally, we indirectly assessed body composition measures such as body weight, fat mass, visceral fat rating (VFR), normalized VRF (nVFR), muscle mass, metabolic age, and total body water.Results: We found that diverse HRV indexes and only one body composition measure showed statistical differences (p<0.05) between the BCS and Control groups: RRave: 729 (648–802) vs. 795 (713–852) ms; RMSSD: 16.5 (8.9–27.0) vs. 19.7 (14.2–28.5) ms; SD1: 11.6 (6.3–19.0) vs. 13.9 (10.0–20.1) ms; SD1/SD2: 2.5 (2.1–3.3) vs. 2.2 (1.9–2.7), SampEn: 1.5 (1.3–1.8) vs. 1.7 (1.5–1.8), and nVFR 0.12 (0.11–0.13) vs.0.10 (0.08–0.12) points/kg, respectively. The nVFR was significantly correlated to several indexes of HRV.Conclusions: BCS exhibit a lower parasympathetic cardiac activity and changes in HRV patterns than controls, likely because of the concomitant increase of visceral fat.
Involvement of TLR4 Signaling Regulated-COX2/PGE2 Axis in Liver Fibrosis Induced by Schistosoma japonicum Infection
Authors: Chen Lan , Ji Xiaofang , Wang Manni , Liao Xiaoyan , Liang Cuiying , Tang Juanjuan , Wen Zhencheng , Dominique Ferrandon , Li Zi
Published: January 2021

Background: The hepatic stellate cells (HSCs) activation plays pivotal role in hepatic inflammation and liver fibrosis.TLR4 pathway activation has been reported to be involved in mice liver fibrosis induced by hepatitis virus infection, alcohol abuse, biliary ligation, carbon tetrachloride 4 treatment and Schistosoma japonicum (Sj) infection. The effect and mechanisms of cyclooxygenase 2 (COX2)/prostanoid E2 (PGE2) axis on liver fibrosis induced by Sj are still unclear. Results: This study investigated the link between COX2/PGE2 axis and TLR4 signaling in the induction of liver fibrogenesis in mice during Sj infection and in vitro culturing hepatic stellate cells (HSCs) strain-LX-2. The COX2/PGE2 axis was positively related with Sj-induced liver fibrosis. TLR4 pathway activation stimulated the COX2/PGE2 axis, in Sj-infected mice andin lipopolysaccharide (LPS)-exposed cultured HSCs. Synthetic PGE2 activated culturing HSCs through up-regulating alpha smooth muscle actin (α-SMA) expression. In LPS-triggered HSCs, NS398, a COX2 inhibitor led to suppression of PGE2 synthesis and reduced expression of α-SMA and type I collagen (COL I). Conclusions: These results indicated firstly the positive association of COX2/PGE2 axis with liver fibrosis induced by Sj infection. TLR4 signaling may control COX2/PGE2 axis in Sj-infected mice liver and in vitro culturing HSCs at least partially. COX2/PGE2-EP2/EP4 axis might be good drug targets against liver fibrosis induced by Sj infection.
Identification of Hub Genes Associated With Progression and Prognosis of Bladder Cancer by Integrated Bioinformatics Analysis.
Authors: Liu Daoquan , Ma Jianhong , Wei Sheng , Liu Jianmin , Li Mingzhou , He Weixiang , Qian Qiaofeng , Zhou Yongying , Li Yan , Fu Xun , Liu Huan , Wang Qian , Chen Ping , Xu Deqiang , Wang Xinhuan , DiSanto Michael E , Zhang Xinhua
Published: January 2021

Background: Bladder cancer (BLCA) is the most popular malignant carcinomas in genitourinary system which has a high incidence and is prone to relapse. However, the molecular mechanism of BLCA remains to be unclear. Moreover, there is still a shortage of effective biomarkers that can predict progression and prognosis of BLCA. The objective of current study is to screen significant genes as biomarkers to forecast the progression and prognosis of BLCA patients.Methods: Gene expression profile downloaded from TCGA database and GEO database was used. Differential gene expression analysis and WGCNA were conducted to identify differential co-expression genes. In addition, GO enrichment analysis and KEGG pathway analysis were used to explore the functions of these genes. Moreover, PPI network, OS and DFS were used to identify survival-related hub genes. Finally, the expression levels of these genes were validated by qRT-PCR and HPA database.Results: About 124 differential co-expression genes were identified. And these genes were mainly enriched in muscle system process and muscle contraction (BP), contractile fiber, myofibril, sarcomere, focal adhesion and cell-substrate junction (CC) and actin binding (MF) in GO enrichment analysis, while enriched in vascular smooth muscle contraction, focal adhesion, cardiac muscle contraction, hypertrophic cardiomyopathy, dilated cardiomyopathy and regulation of actin cytoskeleton in KEGG analysis. Furthermore, five survival-related hub genes (MYH11, ACTA2, CALD1, TPM1, MYLK) were identified via overall OS and DFS. In addition, the expression levels of the five survival-related genes were upregulated with the procession of BLCA, such as grade, stage and TNM stage. Finally, all survival-related hub genes were found to be down-regulated in BLCA via qRT-PCR and HPA database.Conclusions: Our current study verified five new key genes in BLCA, which could help us better understand the pathogenesis of BLCA. And these five hub genes may be involved in the development and progression of BLCA and served as potential biomarkers.
Image-Guided Microwave Ablation of Hepatocellular Carcinoma (≤5.0 cm): Is MR Guidance More Effective Than CT Guidance?
Authors: Li Zhaonan , Wang Chaoyan , Si Guangyan , Zhou Xueliang , Li Yahua , Li Jin , Jiao Dechao , Han Xinwei
Published: January 2021

BackgroundPercutaneous tumor ablation is usually performed using computed tomography (CT) or ultrasound (US) guidance, although reliable visualization of the target tumor may be challenging. MRI guidance can provide more reliable visualization of the target tumor and allow for multiplanar capabilities, making it the modality of choice. Due to the lack of comparative studies of microwave ablation(MWA) guided by different images. This study retrospectively compared the effectiveness of computed tomography (CT)-guided versus magnetic resonance (MR)-guided MWA for hepatocellular carcinoma (HCC≤5.0 cm). MethodsIn this retrospective study, 47 patients and 54 patients received MWA under the guidance of CT and MR, respectively. The inclusion criteria were a single HCC≤5.0 cm or a maximum of three. The local tumor progression (LTP), overall survival (OS), prognostic factors for local progression, and safety of this technique were assessed.ResultsAll procedures were technically successful. The complication rates of the two groups were significantly different with respect to liver abscess and pleural effusion (P<0.05). The mean LTP was 44.264 months in the CT-guided group versus 47.745 months in the MR-guided group of HCC (P = 0.629, log-rank test). The mean OS was 56.772 months in the patients who underwent the CBCT-guided procedure versus 58.123 months in those who underwent the MR-guided procedure (P = 0.630, log-rank test). Multivariate Cox regression analysis further illustrated that tumor diameter (<3 cm) and the number of lesions (single) were important factors affecting LTP and OS.ConclusionsCT-guided and MR-guided MWA are safe and effective in the treatment of HCC with a diameter of less than 5 cm. Furthermore, MR-guided MWA could reduce the incidence of complications.
Phosphorylation of an Arabidopsis villin activates host actin remodeling to restrict microbial invasion
Authors: Zou Minxia , Guo Mengmeng , Zhou Zhaoyang , Xiao Bingxiao , Pan Qing , Li Jiajing , Zhou Jian-Min , Li Jiejie
Published: January 2021

Actin cytoskeleton is a dynamic framework of cytoplasmic filaments that rearranges as the needs of the cell change during growth and development. Incessant turnover mechanisms allow these networks to be rapidly redeployed in defense of host cytoplasm against microbial invaders. However, the precise functions of host actin and the molecular mechanisms underlying actin rearrangements in host defense remain largely unknown. Here, we uncover the mechanism by which host actin controls innate immunity gates on plant surface to actively prevent microbial entry into internal tissue. VLN3, a villin protein from Arabidopsis is a key regulator of this process. Our in vitro and in vivo phosphorylation assays show that VLN3 is a physiological substrate of two pathogen-responsive mitogen-activated protein kinases (MAPKs). Quantitative analyses of actin dynamics and genetic studies reveal that phosphorylation of VLN3 by MAPKs govern actin remodeling to activate innate immunity gating on host surface.
Magnaporthe oryzae Systemic Defense Trigger 1 (MoSDT1)-Mediated Metabolites Regulate Defense Response in Rice
Authors: Duan Guihua , Li Chunqin , Liu Yanfang , Ma Xiaoqing , Luo Qiong , Yang Jing
Published: January 2021

Background: Some of the pathogenic effector proteins play an active role in stimulating the plant defense system to strengthen plant resistance. Results: In this study, ultra-high performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UHPLC/Q-TOF-MS) was implemented to identify altered metabolites in transgenic rice containing over-expressed M. oryzae Systemic Defense Trigger 1 (MoSDT1) that was infected at three-time points. The characterized dominating metabolites were organic acids and their derivatives, organic oxygen compounds, lipids, and lipid-like molecules. Among the identified metabolites, shikimate, galactinol, trehalose, D-mannose, linolenic acid, dopamine, tyramine, and L-glutamine are precursors for the synthesis of many secondary defense metabolites Carbohydrate, as well as amino acid metabolic, pathways were revealed to be involved in plant defense responses and resistance strengthening. Conclusion: The increasing salicylic acid (SA) and jasmonic acid (JA) content enhanced interactions between JA synthesis/signaling gene, SA synthesis/receptor gene, raffinose/fructose/sucrose synthase gene, and cell wall-related genes all contribute to defense response in rice. The symptoms of rice after M. oryzae infection were significantly alleviated when treated with six identified metabolites, i.e., galactol, tyramine, L-glutamine, L-tryptophan, α-terpinene, and dopamine for 72 h exogenously. Therefore, these metabolites could be utilized as an optimal metabolic marker for M. oryzae defense.
Participation in disease management programs and major adverse cardiac events in patients after acute myocardial infarction. A longitudinal study based on registry data
Authors: Fischer Christian , Höpner Jens , Hartwig Saskia , Noutsias Michel , Mikolajczyk Rafael
Published: January 2021

Background: Cardiovascular diseases are still the main cause of death in the western world. However, diminishing mortality rates of acute myocardial infarction (AMI) are motivating the need to investigate the process of secondary prevention after AMI. Besides cardiac rehabilitation, disease management programs (DMPs) are an important component of outpatient care after AMI in Germany. This study aims to analyze outcomes after AMI among those who participated in DMPs and cardiac rehabilitation (CR) in a region with overall increased cardiovascular morbidity and mortality. Methods: Based on data from a regional myocardial infarction registry and a 2-year follow-up period, we assessed the occurrence of major adverse cardiac events (MACE) in relation to participation in CR and DMP, risk factors for complications and individual healthas well as lifestyle characteristics. Multivariable Cox regression was performed to compare survival time between participants and non-participants until an adverse event occurred. Results: Of 1,094 observed patients post-AMI, 272 were enrolled in a DMP. An association between DMP participation and lower hazard rates for MACE compared to non-enrollees could not be proven in the crude model (hazard ratio = 0.93; 95% confidence interval = 0.65-1.33). When adjusted for possible confounding variables, these results remained virtually unchanged (1.03; 0.72-1.48). Furthermore, smokers and obese patients showed a distinctly lower chance of DMP enrollment. In contrast, those who participated in CR showed a lower risk for MACE in crude (0.52; 0.41-0.65) and adjusted analysis (0.56; 0.44-0.71). Conclusions: Participation in DMP was not associated with a lower risk of MACE, but participation in CR showed beneficial effects. Adjustment only slightly changed effect estimates in both cases, but it is still important to consider potential effects of confounding variables.
Effects of pre-emptive pregabalin and multimodal anesthesia on postoperative opioid requirements in patients undergoing robot-assisted laparoscopic prostatectomy
Authors: Sisa Katrin , Huoponen Saara , Ettala Otto , Antila Heikki , Saari Teijo I. , Uusalo Panu
Published: January 2021

Background: Previous findings indicate that pre-emptive pregabalin as part of multimodal anesthesia reduces opioid requirements compared to conventional anesthesia in patients undergoing robot-assisted laparoscopic prostatectomy (RALP). However, recent studies show contradictory evidence suggesting that pregabalin does not reduce postoperative pain or opioid consumption after surgeries. We conducted a register-based analysis on RALP patients treated over a five-year period to evaluate postoperative opioid consumption between two multimodal anesthesia protocols.Methods: We retrospectively evaluated patients undergoing RALP between years 2015 and 2019. Patients with American Society of Anesthesiologists status 1-3, age between 30 and 80 years and treated with standard multimodal anesthesia were included in the study. Pregabalin (PG) group received 150 mg of oral pregabalin as premedication before anesthesia induction, while the control (CTRL) group was treated conventionally. Postoperative opioid requirements were calculated as intravenous morphine equivalent doses for both groups. The impact of pregabalin on postoperative nausea and vomiting (PONV), and length of stay (LOS) was evaluated.Results: We included 245 patients in the PG group and 103 in the CTRL group. Median (IQR) opioid consumption over 24 postoperative hours was 15 (8-24) and 17 (8-25) mg in PG and CTRL groups (p = 0.44). We found no difference in postoperative opioid requirement between the two groups in post anesthesia care unit, or within 12 hours postoperatively (p=0.16; p = 0.09). The length of post anesthesia care unit stay was same in each group and there was no difference in PONV Similarly, median postoperative LOS was 31 hours in both groups.Conclusion: Patients undergoing RALP and receiving multimodal analgesia do not need significant amount of opioids postoperatively and can be discharged soon after the procedure. Pre-emptive administration of oral pregabalin does not reduce postoperative opioid consumption, PONV or LOS in these patients.
Modeling Familial Predictors of Proband Outcomes in Neurogenetic Disorders: Initial Application in XYY Syndrome
Authors: Wilson Kathleen E. , Fish Ari M. , Mankiw Catherine , Xenophontos Anastasia , Warling Allysa , Whitman Ethan , Clasen Liv , Torres Erin , Blumenthal Jonathan , Raznahan Armin
Published: January 2021

Background: Disorders of gene dosage can significantly increase risk for psychopathology, but outcomes vary greatly amongst carriers of any given chromosomal aneuploidy or sub-chromosomal copy number variation (CNV). One potential path to advance precision medicine for neurogenetic disorders is modeling penetrance in probands relative to observed phenotypes in their non-carrier relatives. Here, we seek to advance this general analytic framework by developing new methods in application to XYY syndrome – a sex chromosome aneuploidy that is known to increase risk for psychopathology.Methods: We analyzed a range of cognitive and behavioral domains in XYY probands and their non-carrier family members (n = 58 families), including general cognitive ability (FSIQ), as well as continuous measures of traits related to autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). Proband and relative scores were compared using covariance, regression and cluster analysis. Comparisons were made both within and across traits.Results: Proband scores were shifted away from family scores with effect sizes varying between 0.9 and 2.4 across traits. Only FSIQ and vocabulary scores showed a significant positive correlation between probands and their non-carrier relatives across families (R2 ~ 0.4). Variability in family FSIQ also cross-predicted variability in proband ASD trait severity. Cluster analysis across all trait-relative pairings revealed that variability in parental psychopathology was more weakly coupled to their XYY versus their euploid offspring.Conclusions: We present a suite of generalizable methods for modeling variable penetrance in aneuploidy and CNV carriers using family data. These methods update estimates of phenotypic penetrance for XYY and suggests that the predictive utility of family data is likely to vary for different traits and different gene dosage disorders. Trial registrations: ClinicalTrials.gov NCT00001246, “89-M-0006: Brain Imaging of Childhood Onset Psychiatric Disorders, Endocrine Disorders and Healthy Controls.” Date of registry: 01/10/1989.