bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk factors for recurrent wheezing after bronchiolitis in infants: 2-year follow up in China
Authors: Chen Sainan , Gu Wenjing , Wu Min , Hao Chuangli , Zhu Canhong , Shao Xuejun , Wang Yuqing
Published: November 2020

Background: Infants with bronchiolitis have an increased risk of developing recurrent wheezing and asthma. However, the association between bronchiolitis and recurrent wheezing remains controversial.Objective: To investigate the incidence of post-bronchiolitis recurrent wheezing and associated risk factors.Methods: Infants with bronchiolitis were enrolled from November 2016 through March 2017. We also enrolled 24 healthy children with no history of wheezing from the department of children's health prevention as a control group. Nasopharyngeal aspirates were obtained for detection of respiratory viruses which were analyzed by reverse transcriptase polymerase chain reaction (RT-PCR) and direct immunofluorescent assay. Serum cytokines including TSLP, IL2, IL13, TIMP-1, MMP-9, IL33, IL5, IL4, IL25, TNF- α and MIP-1α were measured by flow cytometry. Patients were followed every 3 months for a duration of 2 years by telephone or at outpatient appointments.Results: We enrolled 89 infants, of which 81 patients were successfully followed up. In total, 22.2% of patients experienced recurrent wheezing episodes. The proportion of patients with eczema, systemic glucocorticoid use and patients with moderate-to-severe disease were significantly higher in the recurrent wheezing group than the non-recurrent wheezing group (83.3% vs 52.4%; 66.7% vs 36.5%; 61.1% vs 33.3%, respectively, all P<0.05); The serum level of TNF‑ α was lower in the recurrent wheezing group (P<0.05), and the serum levels of IL-4, IL-5, IL-25, IL-33 were significantly higher among patients without recurrent wheezing (P<0.05). Logistic regression analysis showed that eczema was an independent risk factor for post-bronchiolitis recurrent wheezing (odds ratio [OR]=7.488; 95% confidence interval [CI], 1.447–38.759; P=0.016). Conclusion: The incidence of recurrent wheezing among infants after contracting bronchiolitis was 22.2% during a 2-year follow-up. Eczema was the only independent risk factor identified and no correlation was found between the specific virus and disease severity in children with post-bronchiolitis recurrent wheezing.
Influence of vitamin D binding protein polymorphism, demographics and lifestyle factors on vitamin D status of healthy Malaysian pregnant women
Authors: Lee Siew-Siew , Ling King-Hwa , Tusimin Maiza , Subramaniam Raman , Rahim Kartini Farah , Loh Su-Peng
Published: November 2020

Background: Vitamin D deficiency (VDD) has been related to vitamin D binding protein (GC) gene polymorphism, demographics and lifestyle factors in different populations. However, previous studies only focused on demographic and lifestyle factors or genetic factors alone. Therefore, this cross-sectional study aimed to assess the association between GC gene polymorphism, demographics and lifestyle factors with VDD among Malaysian pregnant women. ﻿Method: Information on demographic characteristics, dietary vitamin D intake from supplement and food, time spent outdoors, skin type and clothing were collected using questionnaire. Plasma total 25-hydroxyvitamin D (25OHD) levels were measured using a Ultra-High-Performance Chromatography (UHPLC). Maternal GC single nucleotide polymorphisms (SNPs) (rs4588 and rs7041) were determined using restriction fragment length polymorphism (RFLP) technique. Results: Results showed that 50.2% of pregnant women were vitamin D deficient (25OHD <30 nmol/L). VDD (25OHD <30 nmol/L) was significantly associated with age, veiled clothing, maternal vitamin D intakes, from both food and supplements, and GC rs7041(and GC diplotypes). In contrast to previous studies that reported for non-pregnant population, significant positive association was found between CC genotype for SNP GC rs7041, GC 1s-1s and GC If-2 with risk of VDD (25OHD <30 nmol/L). Conclusions: The high prevalence of maternal VDD found in this study suggests the need for urgent development and implementation of vitamin D supplementation or fortification strategies to reduce VDD among pregnant women. The discrepancy in the association between GC rs7041 gene polymorphism and VDD reflects the variation in the factors associated with VDD in pregnancy compared to non-pregnant state
The “Healthy Akame!” community – government – university collaboration for health: a community-based participatory mixed-method approach to address health issue in rural Japan 
Authors: Haya Marinda Asiah Nuril , Ichikawa Shuhei , Shibagaki Yukino , Board Akame Machijuu Genki Project Community Advisory , Wakabayashi Hideki , Takemura Yousuke
Published: November 2020

Background: Although Japan has a decentralized public health system, local governments have considered expert opinions over those of the community in decisions about public health programs. Differences in communities’ interests may create gaps between health program objectives and implementation. We hypothesized that community-based participatory research (CBPR), which involves the community at every step, promotes effective program implementation and community empowerment. This study addressed the first step of CBPR, assessing community needs and developing a tailored health program for a rural community in Japan. Methods: In this sequential exploratory mixed-method study (qualitative followed by quantitative), we first formed a community advisory board (CAB) representing community organizations, city officials, and university researchers. The CAB conducted group discussions with community residents to identify the community’s health issues and strengths. These group discussions were analyzed using thematic analysis, and the results were used to develop a questionnaire, which was subsequently sent to all households in the community to obtain priority scores for health issues and proposed action and to assess willingness to participate in community health program. The CAB then designed a program using the overall study results. Results: Ten group discussions with 68 participants identified the following health issues: 1) diseases; 2) unhealthy behaviors; and 3) unsupportive environment. Nature, vacant lots, and local farms were considered local strengths. Of a total of 1470 households in the community, questionnaires were collected from 773 households. Cancer, lifestyle-related diseases, and cerebrovascular diseases were ranked as the most important health problems. Improving services and access to medical checkups, use of public space for exercise, local farming, and collaboration with the community health office were considered necessary to address these health problems. Considering feasibility and the availability of resources in the community, the CAB decided to focus on lifestyle-related diseases and designed activities centered on health awareness, nutrition, and exercise. These activities drew on community’s strengths and were adapted to Japanese culture.Conclusions: The community’s priority health problem was closely related to the epidemiology of diseases. The CBPR approach was useful for identifying community’s needs and for designing a unique community health program that made use of local strengths.
Prevalence and associated factors of undernutrition among pregnant women visiting ANC clinics in Silte zone, southern Ethiopia
Authors: Muze Mohammed , Yesse Mubarek , Kedir Shemsu , Mustefa Abdilmejid
Published: November 2020

Background: Maternal undernutrition is highly prevalent in underdeveloped countries. Hence, this study was intended to determine the prevalence and associated factors of undernutrition among pregnant women visiting ANC follow up clinics of health facilities.Method: Facility-based cross-sectional study was conducted from July to January 2019. Systematic random sampling technique was used to select 422 study participants from 11 randomly selected health facilities. Data was collected by using a structured-interviewer administered questionnaire. Mid upper arm circumference (MUAC) was measured by standard non stretchable MUAC tape. Data was entered into a computer using Epi data 3.1 and edited, cleaned, and analyzed using SPSS version 20. Both bivariate and multiple logistic regression analyses were employed to identify factors associated with maternal undernutrition.Result: In this study, the overall prevalence of undernutrition among study subjects was 21.8%. Age greater than 31 years of women (AOR=0.15; 95% CI: 0.03, 0.93), Birth intervals > 2 years (AOR= 0.18; 95% CI: 0.04, 0.76), good nutritional knowledge (AOR=0.34; 95% CI: 0.17, 0.67), and having no dietary change as a result of current pregnancy AOR=6.02; 95% CI: 2.99, 12.14) were significantly associated with undernutrition.Conclusion and recommendation: The prevalence of undernutrition among pregnant women was 21.8 %. Current estimate is lower than previously reported in the study area but higher than reported in developed country. Age of women, Birth intervals, and Dietary change as a result of current pregnancy and Nutrition knowledge were important risk factors/ predictors of undernutrition (MUAC < 23 cm). Interventions targeting maternal nutrition education and child spacing with giving special emphasis to adolescent pregnant women are recommended.
A modified technique for paravaginal repair for the treatment of anterior vaginal prolapse and cystocele：a retrospective study
Authors: Huang Shuai , Lv Qiubo , Li Ye , Li Min , Zhang Sichen
Published: November 2020

Background: We aimed to determine the efficacy and safety of a modified protocol for paravaginal repair for treating symptomatic paravaginal defects and cystocele. Methods: This study was an observational case series of 98 consecutive female patients, referred to our hospital between June 2014 and May 2018, with symptomatic grade II to IV paravaginal defects and cystocele. Our modified technique for paravaginal repair is based on the conventional protocol but incorporates reverse bridge repair and the cross-stitching of bilateral sutures. The curative effect of this new technique was evaluated subjectively and objectively during postoperative follow-up. Results: All operations were successful. Patients were followed up for 12 to 48 months, until June 2019; the mean follow-up period was 32.4 months. Three months after surgery (98 cases), the subjective cure rate was 100%; in each case, the top of the vagina lay above the level of the sciatic spine. The objective cure rate was 100%. The objective cure rate was 94.9% (93 cases) twelve months after surgery (98 cases), 91.0% (61 cases) twenty-four months after surgery (71 cases), and 76.2% (16 cases) forty-eight months after surgery (21 cases). Four cases required a second round of surgery; three of these cases were treated with sacrocolpopexy, and one case was treated with sacrospinous ligament fixation. Conclusion: Our modified technique for paravaginal repair was safe and effective for the treatment of anterior vaginal prolapse and cystocele, as confirmed by the results observed over a mean follow-up period of 32.4 months.
Associations of Oral Health-Related Quality of Life with Age, Oral Status, and Oral Function among Psychiatric Inpatients in Japan: a cross-sectional study
Authors: Haresaku Satoru , Nakashima Fuyuko , Hara Yayoi , Kuroki Madoka , Aoki Hisae , kubota Keiko , Naito Toru
Published: November 2020

【Background】As the general population of Japan ages, the population of hospitalized psychiatric patients is also ageing. The purpose of this study was to investigate the associations of oral health-related quality of life (OHRQoL) with age and oral health, including oral and swallowing function, among psychiatric inpatients.【Methods】The subjects included 165 psychiatric inpatients in psychiatric hospitals in Japan. The General Oral Health Assessment Index (GOHAI) and the Eating Assessment Tool (EAT-10) were included in the questionnaire survey for the measurement of OHRQoL and the screening of dysphagia. A score ≥3 on the EAT-10 was defined as suspected dysphagia. Oral examinations and oral diadochokinesis (ODK) measurements for the tongue-lip motor function evaluation were conducted. The inpatients with acute psychiatric symptoms, moderate and severe dementia, and cognitive impairment that affected their ability to communicate and relate their feelings were excluded. A chi-squared test, the Mann-Whitney U test, and linear regression analysis were used for the analysis. The data were analysed at the 5% significance level.【Results】A total of 100 (64.5%) psychiatric inpatients (mean age, 67.3 [SD, 14.5] years, 49% males, and 51% females) participated in this study. The means±SDs for the decayed missing filled teeth (DMFT) index and GOHAI score were 20.6±6 and 49.7±7.9, respectively. The GOHAI score in the older age group (≥65 years) was significantly lower than that in the younger age group (<65 years). The mean ODK scores were less than 3 times/sec for all syllables. The percentage of the participants with suspected dysphagia was 45.0%. Tooth loss and suspected dysphagia were significantly associated with low GOHAI scores. The EAT-10 score was significantly correlated with the GOHAI score only after adjusting for age and sex (β=-0.725, 95% CI:-0.97, -0.64).【Conclusions】In hospitalized psychiatric patients, impaired oral health in the older subjects was more pronounced compared with that among general adults. Tooth loss and swallowing function were associated with OHRQoL. Therefore, oral care for the recovery of occlusal and swallowing functions may be needed to improve OHRQoL among psychiatric patients.
A full-length transcriptome and gene expression analysis reveal genes and molecular elements expressed during seed development in Gnetum luofuense
Authors: deng Nan , Hou Chen , He Boxiang , Ma Fengfeng , Song Qingan , Shi Shengqing , Liu Caixia , Tian Yuxin
Published: November 2020

Background: Gnetum is an economically important tropical and subtropical gymnosperm genus with various dietary, industrial and medicinal uses. Many carbohydrates, proteins and fibers accumulate during the ripening of Gnetum seeds. However, the molecular mechanisms related to this process remain unknown.Results: We therefore assembled a full-length transcriptome from immature and mature G. luofuense seeds using PacBio sequencing reads. We identified a total of 5,726 novel genes, 9,061 alternative splicing events, 3,551 lncRNAs, 2,160 transcription factors, and we found that 8,512 genes possessed at least one poly(A) site. In addition, gene expression comparisons of six transcriptomes generated by Illumina sequencing showed that 14,323 genes were differentially expressed from an immature stage to a mature stage with 7,891 genes upregulated and 6,432 genes downregulated. The expression of 14 differentially expressed transcription factors from the MADS-box, Aux/IAA and bHLH families was validated by qRT-PCR, suggesting that they may have important roles in seed ripening of G. luofuense.Conclusions: These findings provide a valuable molecular resource for understanding seed development of gymnosperms.
Rosaceae, Brassicaceae and Pollen Beetles: exploring relationships and evolution in an anthophilous beetle lineage (Nitidulidae, Meligethes-complex of genera) using an integrative approach 
Authors: LIU MEIKE , HUANG MIN , CLINE ANDREW RICHARD , MANCINI EMILIANO , SCARAMUZZI ANDREA , PARADISI SIMONE , AUDISIO PAOLO , BADANO DAVIDE , Sabatelli Simone
Published: November 2020

Meligethes are pollen-beetles associated with flowers of Rosaceae as larvae. This genus, in its present-day concept, consists of 63 known species in two subgenera, Meligethes and Odonthogethes, predominantly occurring in the eastern Palaearctic. We analyzed 74 morphological and ecological characters (169 states) of all species, as well as of 11 outgroup species from 7 Meligethinae genera (including the believed sister-genus Brassicogethes), to investigate their phylogeny. A parallel molecular analysis was carried out on 9 Meligethes, 9 Odonthogethes, 3 Brassicogethes and 2 Meligethinus species, based on DNA sequence data from mitochondrial (COI, 16S) and nuclear (CAD) genes, to obtain additional phylogenetic information on the group. Results: Morphological phylogenetic reconstructions supported the monophyly of the genus, and clades corresponding to purported subgenera Meligethes s.str. and Odonthogethes. Main species-groups were mostly confirmed, however some unresolved polytomies remained. Molecular data placed members of Brassicogethes (including 42 mostly W Palearctic species associated with Brassicaceae) as sister to Odonthogethes, with this clade being sister to Meligethes s.str. This phylogenetic scenario suggests that monophyletic Meligethes s.str., Odonthogethes and Brassicogethes should be regarded alternatively as three subgenera of a monophyletic Meligethes, or three genera in a monophyletic genus-complex, with mutually monophyletic Brassicogethes and Odonthogethes. Molecular analyses estimated the origin of this lineage at ca. 14-15 Mya from a common stem including Meligethinus. Conclusions: We hypothesize that the ancestor of Meligethes specialized on Rosaceae in the Middle Miocene (likely in Langhian Age) and subsequently radiated during Late Miocene and Plio-Pleistocene maintaining a trophic niche on this plant family. This radiation was primarily due to geographic isolation in E Asiatic mountain systems. Combined evidence from morphology, ancestral state parsimony reconstruction of host-plant associations and molecular evidence suggested that Rosoideae (Rosa spp.) represented the ancestral hosts of Meligethes s.str., followed by an independent shift of ancestral Odonthogethes (ca. 9-15 Mya) on Rubus (Rosoideae) and members of Rosaceae Spiraeoideae. Other ancestral Odonthogethes probably shifted again on the unrelated plant family Brassicaceae (maybe 8-14 Mya in S China), allowing a rapid westward radiation of the Brassicogethes clade.
Comparison of the effectiveness and safety of intravenous and topical regimens of tranexamic acid in complex tibial plateau fracture: a retrospective study
Authors: Wang Zhimeng , Lu Yao , Wang Qian , Song Leilei , Ma Teng , Ren Cheng , Li Zhong , Yang Jiarui , Zhang Kun , Zhang Bing
Published: November 2020

Background Previous studies have demonstrated the effectiveness and safety of tranexamic acid (TXA) in orthopedic surgery. However, no study has investigated TXA in complex tibial plateau fracture surgery. Therefore, the purpose of this study was to confirm the safety and effectiveness of i.v. (intravenous) TXA and topical TXA.Material and methods This was a retrospective analysis of prospectively collected data. The control group received an equal amount of placebo (physiological saline solution); the i.v. group received 1.0 g TXA by intravenous injection before the tourniquet was inflated and before the surgical incision was closed, and the topical group received 3.0 g TXA in 75 mL of physiological saline solution 5 minutes prior to the final tourniquet release. Perioperative blood loss, vascular events, wound complications, and adverse reactions were compared among the three groups. The pain, knee function, and quality of life (QoL) assessments were based on their corresponding scoring systems.Results Baseline data were comparable for all groups. The i.v. group showed the best results for total blood loss (TBL) and hidden blood loss (HBL) (424.5 ± 49.4 mL and 219.3 ± 33.4 mL, respectively, all P values < 0.001). Patients in the i.v. group had lesser real Hb decrease than those in the control group (0.9 vs 1.5, P＜0.001) and topical group (0.9 vs 1.2, P = 0.026). The blood coagulation level as measured using fibrinolysis (D-dimer) was lower in the i.v. group than in the control and topical groups on POD1 and POD3; however, this difference was not significant; the fibrin-degradation products also showed a similar trend. Patients in the topical group experienced less pain than those in the control group on POD2, POD4, and PO6W. The VAS pain score was 3.6 vs. 4.4 (POD2, P＜0.05), 2.8 vs 3.3 (POD4, P＜0.05), and 2.1 vs. 2.6 (PO6W, P＜0.001) in the topical group vs control group, respectively. No significant differences were identified in vascular events, wound complications, adverse reactions, knee function, and QoL among the three groups.Conclusion To our knowledge, this is the first study that showed both i.v. TXA and topical TXA are safe and effective for complex tibial plateau fractures. The i.v. regimen effectively reduced blood loss during the perioperative period, whereas patients under the topical regimen had less vascular events, wound complications, and a lower incidence of adverse reactions compared to those in the i.v. group.
Assessment of sodium thiosulfate neutralizing effect on micro-hardness of dentin treated with sodium hypochlorite
Authors: Sahebi Safoora , Sobhnamayan Fereshteh , Moazami Fariborz , Naseri Mohammadhasan
Published: November 2020

Background: This study aims to evaluate the ability of sodium thiosulfate (STS) to neutralize the adverse effect of sodium hypochlorite (NaOCl) on dentin micro-hardness.Methods: Fifty single-rooted teeth were longitudinally sectioned. The samples divided into a control and four sample groups (n = 20). All the samples were immersed in different solutions as follows, Control: Normal saline for 15 min, G1and G2: 2.5% NaOCl for 15 min, G3: 2.5% NaOCl for 15 min, followed by 5% STS for 10 min, G4: Normal saline for 15 min followed by 5% STS for 10 min. All groups except G1 incubated for one week before the test. The micro-hardness of samples was measured. Data were analyzed using the Kruskal-Wallis test for pairwise comparisons. A p-value < 0.05 was considered significant.Results: All groups showed a significant decrease in the micro-hardness value compared with the control group. NaOCl for one week (G2) reduced the micro-hardness of dentine compared with samples, tested immediately after immersion in NaOCl (G1) (p < 0.05). NaOCl alone (G2) or treated with STS (G3) resulted in a significant decrease in micro-hardness compared with the STS group (G4) (p < 0.05). Conclusions: STS as a neutralizing agent could not prevent the dentin micro-hardness downturn caused by NaOCl.
Impact of nonsteroidal anti-inflammatory drug administration for 12 months on renal function
Authors: Hayashi Kazuhiro , Miki Kenji , Kajiyama Hiroshi , Ikemoto Tatsunori , Yukioka Masao
Published: November 2020

Background: The use of nonsteroidal anti-inflammatory drugs (NSAIDs) is associated with an increased risk of renal complications. Resolution of renal side effects following NSAID administration has been observed following short-term use. Thus, the aim of the present study was to investigate a series of patients with chronic musculoskeletal pain who underwent long-term NSAIDs administration followed by switching to TA combination tablets to study the impact of NSAID-induced renal side effects.Methods: This was a longitudinal retrospective study of 99 patients with chronic musculoskeletal pain. The patients were administrated NSAIDs daily during the first 12 months followed by daily TA combination tablets for 12 months. Estimated glomerular filtration rate (eGFR) and serum levels of aspartate aminotransferase and alanine transaminase were measured at baseline, after NSAIDs administration, and after TA administration.Results: eGFR was significantly reduced following 12-month NSAIDs administration (median, from 84.0 mL/min/1.73 m2 to 72.8 mL/min/1.73 m2), and the reduction was not shown following the subsequent 12-month TA administration (median, 71.5 mL/min/1.73 m2). Reduction in eGFR was less in patients who received celecoxib (median, -1.8 mL/min/1.73 m2) during the first 12 months. There was no significant difference in aspartate aminotransferase and alanine transaminase in each period.Conclusions: Thus, patients receiving NSAIDs for 12 months displayed both reversible and irreversible reduction of eGFR upon cessation of NSAIDs and switching to TA. Our data highlights the potential safety benefit of utilizing multimodal analgesic therapies to minimize the chronic administration of NSAIDs.
Impact of corticosteroids and immunosuppressive therapies on symptomatic SARS-CoV-2 infection in a large cohort of patients with chronic inflammatory arthritis
Authors: Favalli Ennio Giulio , Bugatti Serena , Klersy Catherine , Biggioggero Martina , Rossi Silvia , De Lucia Orazio , Bobbio-Pallavicini Francesca , Murgo Antonella , Balduzzi Silvia , Caporali Roberto , Montecucco Carlomaurizio
Published: November 2020

Background: Prevalence and outcomes of Coronavirus Disease (COVID)-19 in relation to immunomodulatory medications are still unknown. The aim of the study is to investigate the impact of glucocorticoids and immunosuppressive agents on COVID-19 in a large cohort of patients with chronic immune-mediated inflammatory arthritis.Methods: The study was conducted in the arthritis outpatient clinic at two large Academic Hospitals in the COVID-19 most endemic area of Northern Italy (Lombardy). We circulated a cross-sectional survey exploring the prevalence of Severe Acute Respiratory Syndrome-Coronavirus-2 nasopharyngeal swab positivity and the occurrence of acute respiratory illness (fever and/or cough and/or dyspnea), administered face-to-face or by phone to consecutive patients from 25th February to 20th April 2020. COVID-19 cases were defined as confirmed or highly suspicious according to the World Health Organization criteria. The impact of medications on COVID-19 development was evaluated. Results: The study population included 2050 adults with chronic inflammatory arthritis receiving glucocorticoids, conventional-synthetic (cs), or targeted-synthetic/biological (ts/b) disease-modifying drugs (DMARDs). Laboratory-confirmed COVID-19 and highly suspicious infection were recorded in 1.1% and 1.4% of the population, respectively. Treatment with glucocorticoids was independently associated with increased risk of COVID-19 (adjusted OR [95% CI] ranging from 1.23 [1.04-1.44] to 3.20 [1.97-5.18] depending on the definition used). Conversely, patients treated with ts/bDMARDs were at reduced risk (adjusted OR ranging from 0.46 [0.18-1.21] to 0.47 [0.46-0.48]). No independent effects of csDMARDs, age, sex, and comorbidities were observed.Conclusions: During the COVID-19 outbreak, treatment with immunomodulatory medications appears safe. Conversely, glucocorticoids, even at low-dose, may confer increased risk of infection.Trial registration: retrospectively registered
CDX2 and Reg IV expression and correlation in gastric cancer
Authors: Chai Dandan , Du Huifen , Li Kesheng , Zhang Xueliang , Li Xiaoqin , Zhao Xiaoning , Lian Xiaowen , Xu Yang
Published: November 2020

Background: Ectopic expression of CDX2 is associated with the development and progression of gastric cancer. Previous studies showed that CDX2 may be an upstream regulator of Reg IV expression in gastric cancer, and our previous report showed that Reg IV upregulated SOX9 expression and enhanced cell migration and invasion in gastric cancer cells. However, the regulatory roles of CDX2 have not been clarified in gastric cancer, and the correlation between CDX2 and Reg IV requires further study.Methods: CDX2 and Reg IV were examined in gastric cancer specimens and paired adjacent tissues via real-time PCR and immunohistochemistry (IHC). The association between CDX2 and Reg IV was assessed using the χ2-test and Spearman’s rank correlation. To verify their relationship, knockdown and exogenous expression of CDX2 or Reg IV were performed in AGS and MKN-45 gastric cancer cells, and their expression was subsequently analyzed via a real-time PCR and western blotting. Wound-healing and Transwell assays were used to examine migration and invasion in AGS and MKN-45 cells following CDX2 silencing or overexpression.Results: A positive correlation was observed between CDX2 and Reg IV expression at the mRNA and protein levels in gastric cancer tissues. CDX2 silencing significantly downregulated Reg IV expression, and CDX2 overexpression significantly upregulated Reg IV expression in AGS and MKN-45 cells. Neither Reg IV silencing nor overexpression had any effect on CDX2 protein expression in AGS or MKN-45 cells, even though both affected the expression of CDX2 mRNA. Functionally, CDX2 silencing significantly inhibited cell migration and invasion, and CDX2 overexpression significantly promoted cell migration and invasion in AGS and MKN-45 cells.Conclusions: Our findings demonstrate that CDX2 expression was positively correlated with that of Reg IV in gastric cancer, and CDX2 promoted cell migration and invasion through upregulation of Reg IV expression in AGS and MKN-45 cells.
Effectiveness of introducing a 20-gauge core biopsy needle with a core trap in EUS-FNA/B for diagnosing pancreatic cancer
Authors: Watanabe Shunsuke , Miyoshi Jun , Toki Masao , Kambayashi Komei , Kitada Shuichi , Nosaka Takeshi , Goto Tomoyuki , Ota Hirotaka , Ochiai Kazushige , Gondo Koichi , Ikeuchi Nobuhito , Tsuji Shujiro , Nakamura Kenji , Shibahara Junji , Hisamatsu Tadakazu
Published: November 2020

Background: Endoscopic ultrasound-guided fine-needle aspiration/biopsy (EUS-FNA/B) is a standard method for pathological diagnosis of pancreatic solid lesions. The EchoTip ProCore 20G® (PC20), a 20-gauge biopsy needle with a forward-bevel core trap, has been available in Japan since 2015.Methods: We compared the efficacy of the PC20 with that of the EchoTip ProCore 22G® (PC22) and Acquire 22G® (AC22) in EUS-FNA/B for diagnosing pancreatic cancer. This retrospective study included 191 patients with pancreatic cancer who underwent EUS-FNA/B using the PC20, PC22, or AC22 at our facility from April 2013 to October 2019. We investigated the patients’ clinical characteristics and the diagnostic accuracy and safety of each needle.Results: A sufficient stroke length of puncture was secured in all patients. The maximum length under EUS was shorter with the AC22 (22.1±2.2 mm) than PC20 (30.6±0.7 mm, p<0.01) and PC22 (30.3±0.8 mm, p<0.01). The histological accuracy was 96.4% with the PC20 but only 58.8% with the PC22 (adjusted p (p-adj)<0.0001) and 75.0% with the AC22 (p-adj=0.06). The diagnostic accuracy of the combination of histology and cytology was 96.4% with the PC20, while it was 72.1% with the PC22 (p-adj<0.0001) and 91.7% with the AC22 (p-adj>0.99). One patient (0.9%) in the PC20 group developed mild pancreatitis, but no adverse events occurred with the other needles. Conclusions: The PC20 showed better diagnostic capability than the PC22. The diagnostic efficacy was similar between the PC20 and AC22. The high histological accuracy of the PC20 could be advantageous for lesions in which histological assessment is critical.
Unplanned hospitalizations in patients with locoregionally advanced head and neck cancer treated with (chemo)radiotherapy with and without prophylactic percutaneous endoscopic gastrostomy
Authors: Bojaxhiu Beat , Shrestha Binaya K. , Luterbacher Pascal , Elicin Olgun , Shelan Mohamed , Macpherson Andrew J. S. , Heimgartner Benjamin , Giger Roland , Aebersold Daniel M. , Zaugg Kathrin
Published: November 2020

Background: Current studies about percutaneous endoscopic gastrostomy (PEG) tube placement report equivalent patient outcomes with prophylactic PEG tubes (pPEGs) versus common nutritional support. Unreported was if omitting a pPEG is associated with an increased risk of complications leading to a treatment-related unplanned hospitalization (TRUH). Methods: TRUHs were retrospectively analyzed in patients with advanced head and neck squamous cell carcinoma (n=310) undergoing (chemo)radiotherapy with (pPEG) or without PEG (nPEG). Results: In 88 patients (28%), TRUH was reported. One of the leading causes of TRUH in nPEG patients was inadequate oral intake (n = 16, 13%), and in pPEG patients, complications after PEG tube insertion (n=12, 10%). Risk factors for TRUH were poor performance status, tobacco use, and surgical procedures. Conclusions: Omitting pPEG tube placement without increasing the risk of an unplanned hospitalization (UH) due to dysphagia, dehydration or malnutrition, is an option in patients being carefully monitored . Patients aged >60 years with hypopharyngeal carcinoma, tobacco consumption, and poor performance status appear at risk of PEG tube-related complications leading to an unplanned hospitalization.
Radiographic and Clinical Evidence: Osteoarthritic Knee Can Change Surgical Result for Lumbar Degenerative Disease Patient Undergone Surgery for 3-year Follow-up: A Retrospective Comparative Clinical Study
Authors: Kim Yong-Chan , Kim Ki-Tack , Ha Kee-Yong , Ahn Joonghyun , Ko Seungnam , Luo Qiang , Kim Sung-Min , Kim Mingyu , Yoo Sunin
Published: November 2020

AbstractBackground: There is a paucity of reports clarifying the implication of knee osteoarthritis (OA) on spinal sagittal alignment of patients undergone surgery for lumbar spine. This study aimed to analyze how osteoarthritic knee affects radiographic and clinical results of degenerative lumbar disease patients undergone lumbar fusion.Methods: We retrospectively reviewed the medical records and radiographs of 74 consecutive degenerative lumbar disease patients who underwent posterior instrumentation and fusion surgery between May 2016 and June 2017 and were followed up for minimum 3 years postoperatively. The patients were divided into 2 groups according to the severity of knee OA by Kellgren-Lawrence grading (KLG) scale (group I, KLG 1 or 2 [n=39]; group II, KLG 3 or 4 [n=35]). Patient demographic data, comorbidities, spinal sagittal parameters and clinical scores were extracted and compared at preoperative, postoperative 1 month and the ultimate follow-up between the groups. In radiographic assessment, sagittal alignment parameters and sagittal balance were used. In clinical assessment, the scores of Oswestry disability index (ODI) and Scoliosis Research Society questionnaire (SRS-22) were used. For the frequency analysis of categorical variables across the groups, chi-square test was used and student t tests was used to compare the differences of continuous variables.Results: In radiographic assessment, TLK (thoracolumbar kyphosis), LL (lumbar lordosis), PT (pelvic tilt), C7 SVA (sagittal vertical axis) in both groups improved significantly after surgery (p<0.05). However, LL, PT, C7SVA improved at postoperative 1 month in the group II were not maintained at the ultimate postoperative follow-up. In clinical assessment, preoperative Oswestry disability index (ODI, %) and all SRS-22 subscores of the group I and II were not different (p>0.05). There were significant differences between the groups at the ultimate follow-up in ODI (-25.6 vs -12.1, p<0.001), SRS total score (%) (28 vs 20, p=0.037), function subscore (1.4 vs 0.7, p=0.016), and satisfaction subscore (1.6 vs 0.6, p<0.001).Conclusion: Osteoarthritic knee with KLG 3 or 4 have a negative influence on maintaining postoperative spinal sagittal alignment, balance, and the clinical outcomes achieved immediately by posterior instrumentation and fusion for lumbar degenerative disease.Trial registration: This study was retrospectively registered with approval by the institutional review board(IRB) of our institution(approval number: 2018-11-007).
Multidimensional item response theory to assess psychometric properties of GHQ-12 in parents of school children
Authors: Haem Elham , Doostfatemeh Marziyeh
Published: November 2020

Background: Multidimensional item response theory (MIRT) model provides an ideal foundation to assess psychological properties of a questionnaire designed with multidimensional structure. This study aimed to present the first use of MIRT models to investigate psychometric properties of general health questionnaire (GHQ-12) in parents of school children. Methods: A total of 1104 parents of school children completed the Persian version of GHQ-12 questionnaire. Unidimensional IRT model and MIRT models with two and three factors were applied to model the observed scores for each GHQ-12 item as a function of the subject’s latent traits while taking the correlation between dimensions of the questionnaire into account. The goodness of fit indices were reported for the three models, and items fit were assessed for the best model. Individual items were described in detail through item characteristic curves, and the amount of information carried by different items was presented using information curves. Results: The MIRT analysis with two factors corresponding to psychological distress and social dysfunction provided the best account of the GHQ-12 data. The model showed that all items were fitted adequately. Items varied in their discrimination ranged from 0.86 to 2.35 and 1.18 to 2.41 for psychological distress and social dysfunction, respectively. Moreover, items 8 and 2 provided the least information in psychological distress and social dysfunction dimensions, respectively. Conclusions: The developed framework to evaluate psychometric properties of GHQ-12 can be a suitable alternative to traditional approaches and also unidimensional IRT models, the use of which has been restricted due to multidimensional structure of the questionnaire.
Magnetotelluric study in the Los Lagos Region (Chile) to investigate volcano-tectonic processes in the Southern Andes
Authors: Segovia Maria Jose , Diaz Daniel , Slezak Katarzyna , Zuñiga Felipe
Published: November 2020

In order to analyze the process of subduction of the Nazca and South American plates in the area of the Southern Andes, and its relationship with the tectonic and volcanic regime of the place, magnetotelluric measurements were made through a transversal profile of the Chilean continental margin. The data processing stage included the analysis of dimensional parameters, which as first results showed a three-dimensional environment for periods less than 1s and two-dimensional for periods greater than 10s. In addition, through the geomagnetic transfer function (tipper), the presence of structural electrical anisotropy was identified in the data. After the dimensional analysis, a deep electrical resistivity image was obtained by inverting a 2D and a 3D model. Surface conductive anomalies were obtained beneath the central depression related to the early dehydration of the slab and the serpentinization process of the mantle that coincides in location with a discontinuity in the electrical resistivity of a regional body that we identified as the Nazca plate. A shallow conductive body was located around the Calbuco volcano and was correlated with a magmatic chamber or reservoir which in turn appears to be connected to the Liquiñe Ofqui fault system and the Andean Transverse Fault system. In addition to the serpentinization process, when the oceanic crust reaches a depth of 80 - 100 km, the ascending fluids produced by the dehydration and phase changes of the minerals present in the oceanic plate produce basaltic melts in the wedge of the subcontinental mantle that give rise to an eclogitization process and this explains a large conductivity anomaly present beneath the main mountain range.
Predictive value of HMGB1 for atrial fibrillation recurrence after catheter ablation in paroxysmal atrial fibrillation patients
Authors: Li Xin-xin , Zhao Cui-ting , Li Meng , Yu Hong-xiao , Liu Xi-ping , Zhu Qing , Song Xiao-kun , Wang Yong-huai , Yu Bo , Ma Chun-yan
Published: November 2020

Background: To evaluate the clinical efficacy of serum high-mobility group box-1 (HMGB1) released from the left atrium to predict atrial fibrillation (AF) recurrence in paroxysmal AF (pAF) patients after catheter ablation (CA) at 1-year follow-up.Methods: We included 72 pAF patients who underwent CA. To determine the expression levels of HMGB1, left atrial blood samples were collected from the patients prior to CA and after the procedure through the transseptal sheath placed into the left atrium. Patients were followed-up for AF recurrence after 1 year of CA.Results: A total of 19 (26%) patients of the 72 experienced AF recurrence. No significant differences were noted in the clinical baseline data between the AF recurrence and AF nonrecurrence groups. The level of postoperative HMGB1 (HMGB1post) was higher in the AF recurrence group than in the AF nonrecurrence group (298.51µg/L vs. 278.17 µg/L; P = 0.03). However, no differences were noted in the levels of other biomarkers such as preoperative high-sensitivity C-reactive protein (hs-CRPpre), postoperative hs-CRP (hs-CRPpost), and preoperative HMGB1 (HMGB1pre) between the two groups. Multiple logistic regression analysis revealed that a higher level of serum HMGB1post from the left atrium (HMGB1post: ≥279.35 µg/L) was an independent predictor of AF recurrence (odds ratio [OR]: 5.29 [1.17–23.92], P = 0.04). Receiver operating characteristic (ROC) analysis revealed that HMGB1post had a moderate predictive power for AF recurrence (area under the curve [AUC]: 0.68; sensitivity: 72%; specificity: 68%). The 1-year AF-free survival was significantly lower in patients with a high serum HMGB1post level than in those with a low HMGB1post level (hazard ratio [HR]: 3.81 [1.49–9.75], P = 0.005). Conclusion: In pAF patients who underwent CA, the level of HMGB1 from the left atrium immediately after CA was associated with AF recurrence and demonstrated a moderate predictive power. Thus, we offer a potential predictor to identify pAF patients at high risk of AF recurrence.
Prediction of COVID-19 Possibilities using KNN Classification Algorithm
Authors: Theerthagiri Prasannavenkatesan , Jacob I.Jeena , Ruby A.Usha , Y.Vamsidhar
Published: November 2020

This paper studies the different machine learning classification algorithms to predict the COVID-19 recovered and deceased cases. The k-fold cross-validation resampling technique is used to validate the prediction model. The prediction scores of each algorithm are evaluated with performance metrics such as prediction accuracy, precision, recall, mean square error, confusion matrix, and kappa score. For the given dataset, the k-nearest neighbour (KNN) classification algorithm produces 80.4 % of predication accuracy and 1.5 to 3.3 % of improved accuracy over other algorithms. The KNN algorithm predicts 92 % (true positive rate) of the deceased cases correctly with 0.077 % of misclassification. Further, the KNN algorithm produces the lowest error rate as 0.19 on the prediction of accurate COVID-19 cases than the other algorithm. Also, it produces the receiver operator characteristic curve with the output value of 82 %.
Fully printed, all-carbon, recyclable electronics
Authors: Williams Nicholas , Bullard George , Brooke Nathaniel , Therien Michael , Franklin Aaron
Published: November 2020

The rapid growth of electronic waste must be curtailed to prevent accumulation of environmentally and biologically toxic materials, which are essential to traditional electronics1. The recent proliferation of transient electronics has focused predominantly on biocompatibility(2,3), and studies reporting material recapture have only demonstrated reuse of conducting materials(4–6). Meanwhile, the ideal solution to the electronic waste epidemic — recapture and reuse of all materials — has been largely neglected. Here we show complete recyclability of all materials in printed, all-carbon electronics using paper substrates, semiconducting carbon nanotubes, conducting graphene, and insulating crystalline nanocellulose. The addition of mobile ions to the dielectric produced significant improvements in switching speed, subthreshold swing, and among the highest on-current for printed transistors. These devices evinced superlative stability over 6 months, after which they are shown to be controllably decomposed for complete recycling of materials and re-printing of devices with similar performance to baseline devices. The printing of all-carbon, recyclable electronics presents a new path toward green electronics with potential to mitigate the environmental impact of electronic waste. We anticipate all-carbon, recyclable electronics to be a watershed, facilitating internet-of-everything applications, such as ubiquitous sensors for continuous monitoring of diseases or environmental conditions, while preserving carbon neutrality in the device lifecycle.
The technique for less infectious and earlier healing of stoma closure wound: Negative Pressure Wound Therapy with instillation and dwelling followed by primary closure
Authors: yane Yoshinori , Hida Jin-ichi , Makutani Yusuke , Ushijima Hokuto , Yoshioka Yasumasa , Iwamoto Masayoshi , Wada Toshiaki , Daito Koji , Tokoro Tadao , Ueda Kazuki , Kawamura Junichiro
Published: November 2020

Background:Temporary stomas have been widely used to avoid the risk of complications such as anastomotic leakage after colorectal resection. Stoma closure is relatively easy; however, postoperative surgical site infection (SSI) may be a problem. Various methods have been used to reduce the incidence of SSI. We aimed to evaluate a new technique for stoma wound closure.Methods:We enrolled patients who underwent stoma closure at our hospital between September 2019 and May 2020. We selected patients who lived far from our hospital and had difficulty visiting the hospital regularly and who agreed to undergo this surgical technique. We used negative pressure wound therapy with instillation and dwelling (NPWTi-d) and delayed primary closure for these patients.Results:Four patients underwent NPWTi-d and delayed primary closure without the occurrence of SSI. The median postoperative hospital stay was 9 days (range: 7-14 days), and the median number of days to confirmation of epithelialization was 11.5 days (range: 10-16 days).Conclusion:The combined use of NPWTi-d and delayed primary closure for the stoma wound was very effective. This method may be a valuable new technique for wound management after stoma closure.
Design of Intelligent Diagnosis System for Teaching Quality Based on Wireless Sensor Network and Data Mining
Authors: Zhang Yanping , Huang Wanwei
Published: November 2020

With the popularization of computers and various mobile intelligent terminals, intelligent teaching systems based on learners are becoming more and more popular among learners. The above phenomenon has greatly affected and changed the current teaching quality diagnosis methods and models. However, the author found through investigation that the current intelligent teaching quality diagnosis still has different degrees of deficiencies in the design and implementation. In response to the above problems, this paper proposes a teaching quality intelligent diagnosis model based on the combination of wireless sensor networks and fuzzy comprehensive evaluation algorithms. First of all, this article is based on the wireless sensor network to link various levels of intelligent teaching systems, and constructs the information transmission structure of the teaching intelligent diagnosis system. Secondly, this article uses fuzzy comprehensive evaluation and convolutional neural network algorithms to evaluate and excavate intelligent teaching information. Finally, the model successfully passed the simulation test and simulation application, which can provide intelligent diagnosis of teaching quality for modern intelligent teaching system.