bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness of Electroacupuncture for Thin Endometrium in Infertile Women: Study Protocol for A Single-Blind, Randomized Controlled Trial
Authors: Li Fangyuan , Lu Hua , Wang Xinxin , Zhang Qi , Liu Qianchen , Wang Tong
Published: October 2020

Background: Thin endometrium negatively impacts the reproductive function. Current treatments for thin endometrium do not always improve endometrial receptivity. Preliminary evidence suggests that electroacupuncture could have potential therapy for thin endometrium in infertile women. Thus, this randomized controlled trial was designed to test whether electroacupuncture can improve endometrial receptivity in infertile women with thin endometrium.Methods: This study is a randomized, single-blinded, controlled, clinical trial. A total of 142 eligible patients will be recruited and randomly assigned to the electroacupuncture (EA) group or the sham electroacupuncture (SEA) group in a 1:1 ratio. Participants will receive 36 sessions over three menstrual cycles (12 weeks in total), with the same acupoint prescription. The primary outcome of this trial is endometrial thickness in the midluteal phase. The secondary outcomes include endometrial pattern, resistance index (RI) and pulsatility index (PI) of bilateral uterine artery and endometrium blood flow, serum estradiol (E2) and progesterone (P), and pregnancy rate. The pregnancy rate will be evaluated during a six-month follow-up after completion of the trial. All other outcomes will be evaluated before treatment, during the treatment of 1st, 2nd, and 3rd menstrual cycle, and 6 months after treatment.Discussion: If the outcome confirms the effectiveness of electroacupuncture for thin endometrium in infertile women, this treatment will be proposed for application in clinical practice.Trial registration: Trial registration: Chinese Clinical Trials Registry, ChiCTR2000029983. Registered on 18 February 2020, http://www.chictr.org.cn
A novel approach for learning Ontology from Relational Database: From the construction to the evaluation
Authors: Mahria Bilal Ben , Chaker Ilham , Zahi Azeddine
Published: October 2020

The aim of converting relational database into Ontology is to provide applications that are based on the semantic representation of the data. Whereas, representing the data using ontologies has shown to be a useful mechanism for managing and exchanging data. This is the reason why bridging the gap between relational databases and ontologies has attracted the interest of the ontology community from early years, and it is commonly referred to as the database-to-ontology mapping problem. In this paper, we: (1) propose a new life cycle for ontology learning from RDBs based on the software engineering requirements; (2) describe a new process for building ontology from Relational database based on the predefined life cycle; (3) add three new semantics that can be extracted from RDB;(4) we suggest an evaluation process based on two categories of metrics: (i) Conceptual Ontology (TBox) Evaluation metrics; (ii) Factual ontology (ABox) evaluation metrics.
Detection of Human Papillomavirus Genotypes in Breast Cancer Patients
Authors: Mofrad Morvarid Golrokh , Sadigh Zohreh Azita , Ainechi Sanaz , Faghihloo Ebrahim
Published: October 2020

Background: The role of viruses as a cause of breast cancer (BC) have been significantly investigated in recent years. Human papillomavirus (HPV) has been detected in invasive breast carcinomas, while most studies have only focused on the detection of viral DNA, we aimed to determine genotypes of the culprit HPV's. Methods: We collected and analyzed 70 Formalin Fixed Paraffin Embedded (FFPE) blocks including 59 BC samples, and 11 benign breast lesions as control from Iranian patients using nested PCR. Real-time PCR utilized as a confirming test to nested PCR findings. Genotyping of HPV positive samples was performed, the samples were also subjected to a multiplex PCR to detect herpes simplex-1 (HSV-1), herpes simplex-2 (HSV-2), varicella zoster virus (VZV) and cytomegalovirus (CMV) in BC.Results: Papillomavirus DNA was present in 7 of 59 BC samples (11.8%); while none was detected in control samples. The most prevalent type was HPV18, followed by HPV 6. No HPV16 genotype was detected .All HPV positive patients had high tumor grades (II/ III) with histologic diagnosis of ductal carcinoma. The patient age range was 33 to 73 years with median of 51 years. Most of HPV positive patients had low levels of education. Also 5 of 59 BC specimens (8.47%), were positive for HSV-1.Conclusions: Our results suggest a carcinogenesis role for High risk HPVs in breast tumors. Our findings of HPV6 and HSV1 genotypes in BC samples, propose a cancer causing role for low risk HPVs and herpes viruses. Further large scale studies are warranted to assess the significance of our findings.
Utilizing ultrasound findings of a single indicator joint to assess non-systemic juvenile idiopathic arthritis
Authors: Huang Yung-Hsien , Hu Ya-Chiao , Liao Chun-Hua , Chiang Bor-Luen , Lu Cheng‐Hsun , Li Ko-Jen , Yang Yao-Hsu
Published: October 2020

Background: Musculoskeletal ultrasound (MSUS) has been used worldwide in adult patients with rheumatoid arthritis (RA) but is beginning to play an increasing role in patients with juvenile idiopathic arthritis (JIA). The aim of this study was to investigate the application of MSUS findings of a single indicator joint in JIA to assess the disease activity and classify disease subtype.Methods: Thirty-five non-systemic JIA patients with a total of 62 visits were retrospectively recruited in this study. Among the involved joints, the joint with highest value of grey-scale (GS) plus power Doppler (PD) (=GSPD) was selected as the indicator joint at each visit. The correlations between each MSUS parameter (GS, PD, GSPD) of indicator joints and the Physician Global Assessment (PGA) score, the Childhood Health Assessment Questionnaire‐disability index (CHAQ-DI), and laboratory data were analyzed. The ultrasound features in different subtypes of JIA were also compared.Results: PD was weakly correlated with the PGA score (rho=0.323, p=0.010), while both GS and GSPD were moderately correlated with the PGA score (rho=0.405, p=0.001; rho=0.434, p=0.000). On the other hand, GS, PD, and GSPD were weakly correlated with CHAQ-DI. Although erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) had a weak correlation with PGA, they were not statistically correlated with GS, PD, or GSPD. The proportions of effusion, synovial hypertrophy, and enthesopathy in three different subtypes, showed significant differences (Fisher’s exact test, p=0.037; p=0.004; p=0.019). Enthesopathy was only seen in joints of enthesitis-related arthritis (ERA), but not in joints of polyarthritis and oligoarthritis.Conclusions: MSUS is an acceptable non-invasive tool for the patients with JIA, particularly for those with non-systemic JIA, that might assist disease classification, and whose parameters of the indicator joints may potentially contribute to the evaluation of disease activity.
Ensemble Flash Flood Predictions Using a High-Resolution Nationwide Distributed Rainfall-Runoff Model: Case Study of the Heavy Rain Event of July 2018 and Typhoon Hagibis in 2019
Authors: Sayama Takahiro , Yamada Masafumi , Sugawara Yoshito , Yamazaki Dai
Published: October 2020

The heavy rain event of July 2018 and Typhoon Hagibis in October 2019 caused severe flash flood disasters in numerous parts of western and eastern Japan. Flash floods need to be predicted over a wide range with long forecasting lead time for effective evacuation. The predictability of flash floods caused by the two extreme events are investigated by using a high-resolution (~150 m) nationwide distributed rainfall-runoff model forced by ensemble precipitation forecasts with 39-h lead time. Results of the deterministic simulation at nowcasting mode with radar and gauge composite rainfall could reasonably simulate the storm runoff hydrographs at many dam reservoirs over western Japan for the case of heavy rainfall in 2018 (F18) with the default parameter setting. For the case of Typhoon Hagibis in 2019 (T19), a similar performance was obtained by incorporating unsaturated flow effect in the model applied to Kanto region. The performance of the ensemble forecast was evaluated based on the bias ratios and the relative operating characteristic curves, which suggested the higher predictability in peak runoff for T19. For the F18, the uncertainty arises due to the difficulty in accurately forecasting the storm positions by the frontal zone; as a result, the actual distribution of the peak runoff could not be well forecasted. Overall, this study showed that the predictability of flash floods was different between the two extreme events. The ensemble spreads contain quantitative information of predictive uncertainty, which can be utilized for the decision making of emergency responses against flash floods.
Cooperative Coverage Based Lifetime Prolongation for Microgrid Monitoring WSN in Smart Grid
Authors: Shao Sujie , Wu Lei , Zhang Qinghang , Zhang Neng , Wang Kaixuan
Published: October 2020

To take full advantage of the flexibility of access and disconnection from smart grid, organizing distributed renewable energy resources in form of microgrid becomes one solution of energy replenishment in smart grid. A large amount of accurate and comprehensive information data are needed to be monitored by a variety of different types of sensors to guarantee the effective operation of this kind of microgrid. Energy consumption of microgrid monitoring WSN consequently becomes an issue. This paper presents a novel lifetime prolongation algorithm based on cooperative coverage of different types of sensors. Firstly, according to the requirements of monitoring business, the construction of cooperative coverage sets and connected monitoring WSN are discussed. Secondly, energy consumption is analyzed based on cooperative coverage. Finally, the cooperative coverage based lifetime prolongation algorithm (CC-LP) is proposed. Both the energy consumption balancing inside the cooperative coverage set and the switching scheduling between cooperative coverage sets are discussed. Then we draw into an improved ant colony optimization algorithm to calculate the switching scheduling. Simulation results show that this novel algorithm can effectively prolong the lifetime of monitoring WSN, especially in the monitoring area with a large deployed density of different types of sensors.
Knowledge of Dental Academics about the COVID-19 Pandemic: A Multi-Country Online Survey
Authors: Ammar Nour , Aly Nourhan M. , Folayan Morenike O. , Mohebbi Simin Z. , Attia Sameh , Howaldt Hans-Peter , Boettger Sebastian , Khader Yousef , Maharani Diah A. , Rahardjo Anton , Khan Imran , Madi Marwa , Shamala Anas , Al-Batayneh Ola B. , Rashwan Maher , Pavlic Verica , Cicmil Smiljka , Galluccio Gabriella , Polimeni Antonella , Mancino Davide , Arheiam Arheiam , Dama Mai A. , Nyan Myat , Phantumvanit Prathip , Kim Jin-Bom , Choi Youn-Hee , Castillo Jorge L. , Joury Easter , Abdelsalam Maha M. , Alkeshan Mohammad M. , Hussein Iyad , Vukovic Ana P. , Iandolo Alfredo , Kemoli Arthur M. , Tantawi Maha El
Published: October 2020

Background: COVID-19 is a global pandemic affecting all aspects of life in all countries. We assessed COVID-19 knowledge and associated factors among dental academics in 26 countries. Methods: We invited dental academics to participate in a cross-sectional, multi-country, online survey from March to April 2020. The survey collected data on knowledge of COVID-19 regarding the mode of transmission, symptoms, diagnosis, treatment, protection, and dental treatment precautions as well as participants’ background variables. Multilevel linear models were used to assess the association between dental academics’ knowledge of COVID-19 and individual level (personal and professional) and country-level (number of COVID-19 cases/ million population) factors accounting for random variation among countries. Results: Two thousand forty-five academics participated in the survey (response rate 14.3%, with 54.7% female and 67% younger than 46 years of age). The mean (SD) knowledge percent score was 73.2 (11.2) %, and the score of knowledge of symptoms was significantly lower than the score of knowledge of diagnostic methods (53.1% and 85.4%; P< 0.0001). Knowledge score was significantly higher among those living with a partner/spouse than among those living alone (regression coefficient (B)= 0.48); higher among those with PhD degrees than among those with Bachelor of Dental Science degrees (B= 0.48); higher among those seeing 21 to 30 patients daily than among those seeing no patients (B= 0.65); and higher among those from countries with a higher number of COVID-19 cases/million population (B= 0.0007). Conclusions: Dental academics had poorer knowledge of COVID-19 symptoms than of COVID-19 diagnostic methods. Living arrangements, academic degrees, patient load, and magnitude of the epidemic in the country were associated with COVD-19 knowledge among dental academics. Training of dental academics on COVID-19 can be designed using these findings to recruit those with the greatest need.
Putative positive role of inflammatory genes in fat deposition supported by altered gene expression in purified human adipocytes and preadipocytes from lean and obese adipose tissues
Authors: Lee Sang-Hyeop , Choi Nak-Hyeon , Koh In-Uk , Kim Bong-Jo , Lee Song , Kim Song-Cheol , Choi Sun Shim
Published: October 2020

Background Obesity is a chronic low-grade inflammatory disease that is generally characterized by enhanced inflammation in obese adipose tissue (AT). Here, we investigated alterations in gene expression between lean and obese conditions using mRNA-Seq data derived from human purified adipocytes (ACs) and preadipocytes (preACs).Results Total mRNA-seq data were generated with 27 AC and 21 preAC samples purified from human visceral AT collected during resection surgery in cancer patients, where the samples were classified into lean and obese categories by BMI > 25 kg/m2. We defined four classes of differentially expressed genes (DEGs) by comparing gene expression between 1) lean and obese ACs, 2) lean and obese preACs, 3) lean ACs and lean preACs, and 4) obese ACs and obese preACs. Based on an analysis of comparison 1, numerous canonical obesity-related genes, particularly inflammatory genes including IL-6, TNF-a and IL-1b, i.e., the genes that are expected to be upregulated in obesity conditions, were found to be expressed at significantly lower levels in obese ACs than in lean ACs. In contrast, some inflammatory genes were found to be expressed at higher levels in obese preACs than lean preACs in the analysis of comparison 2. The analysis of comparisons 3 and 4 showed that inflammatory gene classes were expressed at higher levels in differentiated ACs than undifferentiated preACs under both lean and obese conditions; however, the degree of upregulation was significantly greater for lean than for obese conditions. We validated our observations using previously published microarray transcriptome data deposited in the GEO database (GSE80654).Conclusions Taken together, our analyses suggest that inflammatory genes are expressed at lower levels in obese ACs than in lean ACs because lean adipogenesis involves even greater enhancement of inflammatory responses than does obese adipogenesis.
Quarantine At Home May Not Enough!-From the Epidemiological Data In Shaanxi Province of China
Authors: Shi Lei , Li Qian , Li Kang , Zheng Jie , He Yingli , Zhang Xi , Gong Xianfeng , Wang Wei , Zhang Qing , Dai Chao , Zhao Wenxuan , Meng Xuefei , Du Feng , Fan Pei , Li Chunyan , Gao Chunyan , Yang Yuan , Liu Xiaojing , Chen Yunru , Liu Jinfeng , Li Jianzhou , Yang Nan , Niu Yinghua , Chen Hongmei , Zhang Guoyu , Yan Taotao , Zhu Li , Han Qunying , Fan Wanhu , Ye Feng , Liu Zhengwen , Lin Shumei , Zhao Yingren , Chen Tianyan
Published: October 2020

Objectives : A pneumonia associated with 2019 novel coronavirus (2019-nCoV, subsequently named SARS-CoV2) emerged worldwide since December, 2019. We aimed to describe the epidemiological characteristics of 2019 coronavirus disease (COVID-19) in Shaanxi province of China. Results: 1. Among the 245 patients, 132 (53.9%) were males and 113 (46.1%) were females. The average age was 46.15±16.43 years, ranging from 3 to 89 years. 2. For the clinical type, 1.63% (4/245) patients were mild type , 84.90% (208/245) were moderate type, 7.76% (19/245) were severe type, 5.31% (13/245) were critical type and only 0.41% (1/245) was asymptomatic. 3. Of the 245 patients, 116 (47.35%) were input case, 114 (46.53%) were non-input case , and 15 (6.12%) were unknown exposure. 4. 48.57% (119/245) cases were family cluster , involving 42 families. The most common pattern of COVID-19 family cluster was between husband and wife or between parents and children.
Low bone mineral density is a potential risk factor for symptom onset and related with hypocitraturia in urolithiasis patients: A single-center retrospective cohort study
Authors: Taguchi Kazumi , Hamamoto Shuzo , Okada Atsushi , Tanaka Yutaro , Sugino Teruaki , Unno Rei , Kato Taiki , Ando Ryosuke , Tozawa Keiichi , Yasui Takahiro
Published: October 2020

Background: Patients with urolithiasis have a lower bone mineral density (BMD) than those without stones, suggesting a potential correlation between calcium stone formation and bone resorption disorders, including osteopenia and osteoporosis. Methods: To investigate the influence of BMD on clinical outcomes in urolithiasis, we performed a single-center retrospective cohort study to analyze patients with urolithiasis who underwent both BMD examination and 24-hour urine collection between 2006 and 2015. Data from the national cross-sectional surveillance of the Japanese Society on Urolithiasis Research in 2015 were utilized, and additional data related to urinary tract stones were obtained from medical records. The primary outcome was the development of stone-related symptoms and recurrences during follow-up. A total of 370 patients were included in this 10-year study period. Results: Half of the patients had recurrent stones, and the two-thirds were symptomatic stone formers. While only 9% of patients had hypercalciuria, 27% and 55% had hyperoxaluria and hypocitraturia, respectively. There was a positive correlation between T-scores and urinary citrate excretion. Both univariate and multivariate analyses demonstrated that female sex was associated with recurrences (odds ratio=0.44, p=0.007), whereas a T-score <−2.5 and hyperoxaluria were associated with symptoms (odds ratio=2.59, p=0.037; odds ratio=0.45, p=0.01; respectively). Conclusion: These results revealed that low T-scores might cause symptoms in patients with urolithiasis, suggesting the importance of BMD examination for high-risk Japanese patients with urolithiasis having hypocitraturia.
Performance characteristics of a quantitative PCR assay on repository stool specimens and smeared filter-paper cards
Authors: Tisdale Michele , Mitra Indrani , McCoy Andrea J , Simons Mark P , Reynolds Nathanael D , Swierczewski Brett E , Liu Jie , Houpt Eric R , Fraser Jamie A , Riddle Mark S , Tribble David R , Lalani Tahaniyat
Published: October 2020

Objective Stool repositories are a valuable resource for retrospective analyses including quantitative PCR assays to distinguish between asymptomatic shedding and clinical disease. The suitability of archival specimens for this purpose is unclear and requires assessment. We conducted a pilot study to evaluate pathogen detection by TaqMan Array Card (TAC) in travelers’ diarrhea (TD) stool specimens stored for 1-13 years, as well as the impact of transporting specimens on Whatman FTA Elute cards (FTA Cards) on detection. Results The positive percent agreement (PPA) for TAC on stool vs. microbiologic testing was lower than our a priori PPA estimate of 80% for most pathogens: Shigella spp. (100% [95%CI: 69-100%]), enterotoxigenic E coli (ETEC) (63% [95%CI: 49-75%]), Campylobacter spp. (66% [95%CI: 43-85%]) and Norovirus (37% [95%CI: 16-61%]). Use of the FTA card resulted in a further reduction of PPA. Our findings suggest that archival specimens may lead to insensitive detection on quantitative PCR assays due to degradation of nucleic acid with prolonged storage, although our limited sample size precluded us from evaluating the impact of storage duration on nucleic acid yield. Additional studies are needed to understand the impact of storage duration on quantitative PCR data.
Optimization of orbital retraction during endoscopic transorbital approach via quantitative measurement of the intraocular pressure – SevEN 006
Authors: Kim Woo Hyun , Moon Ju Hyung , Kim Eui Hyun , Hong Chang Ki , Han Ji Sang , Hong Je Beom
Published: October 2020

Background: Increased use of the transorbital approach (TOA) warrants greater understanding of the risk of increased intraocular pressure (IOP) and intraorbital pressure (IORP) due to orbital compression. We aimed to investigate the changes in IOP and IORP in response to orbital retraction in TOA and establish a method for the continuous measurement of intraoperative IORP.Methods: We assessed nine patients who underwent TOA surgery from January 2017 to December 2019, in addition to five cadavers. IORP and IOP were measured using a cannula needle monitor, tonometer, cuff manometer, and micro strain gauge monitor.Results: In all nine clinical cases and five cadavers, increased physical compression of the orbit increased the IOP and IORP in a curvilinear pattern. In clinical cases, when the orbit was compressed 1.5 cm from the lateral margin in the sagittal plane, the mean IOP and IORP were 25.4±5.2 mmHg and 14±9.2 mmH2O, respectively. The IORP satisfactorily reflected the IOP (Pearson correlation coefficient=0.824, p<0.001).Conclusion: We measured IOP and IORP simultaneously during orbital compression to gain basic information on pressure changes. In clinical cases, the change in the IOP could be conveniently and noninvasively monitored using continuous IORP measurements.
Engaging Patients and Family Members to Design and Implement Patient-Centered Kidney Disease Research
Authors: Browne Teri , Swoboda Amy , Ephraim Patti L. , Lang-Lindsey Katina , Green Jamie A. , Hill-Briggs Felicia , Jackson George L. , Ruff Suzanne , Schmidt Lana , Woods Peter , Danielson Patty , Bolden Shakur , Bankes Brian , Hauer Chelsie , Strigo Tara , Boulware L. Ebony
Published: October 2020

Background: This article describes a method for successful engagement of patients and family members in all stages of a 5-year comparative effectiveness research trial to improve transitions of care for patients from chronic kidney disease to end-stage kidney disease.Methods: This project utilized the Patient-Centered Outcomes Research Institute's conceptual model for engagement with patients and family members. We conducted a qualitative analysis of grant planning meetings to determine patient and family member Co-Investigators' priorities for research and to include these engagement efforts in the research design. Patient and family member Co-Investigators partnered in writing this paper.Results: Patients and family members were successfully engaged in remote and in-person meetings to contribute actively to research planning and implementation stages. Three patient-centered themes emerged from our data related to engagement that informed our research plan: kidney disease treatment decision-making, care transitions from chronic to end-stage kidney disease, and patient-centered outcomes. Conclusions: The model we have employed represents a new paradigm for kidney disease research in the United States, with patients and family members engaged as full research partners. As a result, the study tests an intervention that directly responds to their needs, and it prioritizes the collection of outcomes data most relevant to patient and family member Co-Investigators.Trial registration: NCT02722382
Morphological study of the vastus medialis oblique in recurrent patellar dislocation based on magnetic resonance images
Authors: Shu Lei , Yang Xu , He Hangyuan , Chen Biao , Chen Liaobin , Ni Qubo
Published: October 2020

Background: To investigate the morphological parameters of the vastus medialis obliquus (VMO) muscle and delineate its importance in the maintenance of patellofemoral joint stability. Methods: The magnetic resonance imaging (MRI) data of 75 knees (54 patients) with recurrent lateral patella dislocation (LPD) and 75 knees (70 patients) without recurrent LPD were retrospectively analysed. Five morphological parameters related to the VMO (elevation in the sagittal plane and coronal plane, craniocaudal extent, muscle-fibre angulation, cross-sectional area ratio) and two patella tilt parameters (patella tilt angle, bisect offset ratio) were measured in MRI images. The independent-samples t test or chi-square test was used for statistical comparisons. Results: The mean ages of the patients in the recurrent LPD group and control group were 22.1 ± 9.9 years and 24.0 ± 6.5 years, respectively. MRI demonstrated that 24% (18 of 75) VMO injuries were found in recurrent LPD patients. Compared with the control group, the patients with recurrent LPD showed significantly higher sagittal VMO elevation (10.4 ± 2.3 mm vs 4.1 ± 1.9 mm), coronal VMO elevation (15.9 ± 5.7 mm vs 3.9 ± 3.7 mm), muscle-fibre angulation (35.4 ± 8.0° vs 27.9 ± 6.3°), patella tilt angle (25.9 ± 10.7° vs 9.1 ± 5.2°), and bisect offset ratio values (0.9 ± 0.3 vs 0.5 ± 0.1) and significantly lower craniocaudal extent (13.7 ± 5.3 mm vs 16.7 ± 5.1 mm) and cross-sectional area ratio values (0.05 ± 0.02 vs 0.07 ± 0.02). Conclusions: The results showed that abnormalities in the VMO and patella tilt were clearly present in recurrent LPD patients compared with normal people.
Results of repeat manipulation under ultrasound-guided cervical nerve root block (MUC) with corticosteroid and local anesthetic injection for recurrence of frozen shoulder. 
Authors: Oshiro Tatsuki , Yagi Masayoshi , Harada Kazuki , Park Kieun
Published: October 2020

BackgroundThis study aimed to evaluate the clinical results of a repeat manipulation under ultrasound-guided cervical nerve root block (MUC) with corticosteroid and local anesthetic injection for recurrence of idiopathic frozen shoulder after MUC.MethodsA consecutive series of 42 shoulders in 39 patients with idiopathic frozen shoulder underwent MUC. All patients were assessed according to the American Shoulder Elbow Surgeon (ASES) score and shoulder range of motion (ROM) both before MUC and at one-year thereafter. If patients continued to have pain and limited ROM at 3 months after the procedure, they were offered a repeat MUC. Such patients were also assessed before the procedure and at 3 months and one-year thereafter.Results The initial MUC was successful in 31 shoulders (single group). Repeat MUC was required in 11 shoulders (repeat group). Patients in the single group showed significant improvement in ROM and ASES score at one-year after the procedure (p<0.001); similarly, patients in the repeat group had significant improvement in ROM and ASES score at 3 months and one-year after the procedure (p<0.001). Patients in the repeat group had had significantly more severely limited ROM (p<0.01) and decreased ASES score (p<0.001) before the procedure compared with those in the single group.ConclusionsA repeat MUC with corticosteroid and local anesthetic injection is a valuable option before proceeding to surgery for recurrence of idiopathic frozen shoulder. When there is severely limited ROM and decreased ASES score before the MUC, a repeat MUC may be　necessary, which would require the patient’s informed consent.Trial registration Retrospectively registered.
Investigating effects of preoperative inflammatory biomarkers on predicting survival outcomes of intrahepatic cholangiocarcinoma after curative resection.
Authors: Zhang Zeyu , Zhou Yufan , Hu Kuan , Huang Yun
Published: October 2020

Introduction: Intrahepatic cholangiocarcinoma (ICC) stands as the second most common malignant tumor in liver with poor patient prognosis. Increasing evidences have shown that inflammation plays a significant role in tumor progression, angiogenesis and metastasis. However, the prognosis significance of inflammatory biomarkers on recurrence-free survival (RFS) and overall survival (OS) in ICC patients is poorly recognized.Methods: ICC patients who underwent curative hepatectomy and diagnosed pathologically were retrospectively analyzed. Inflammatory biomarkers, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), systemic immune-inflammation index (SII), were investigated.Results: Receiver operating characteristic (ROC) curves showed no significance in NLR, PLR and LMR in RFS and OS, while significant results were shown on SII in both RFS (P=0.035) and OS (P=0.034) with areas under ROC curve as 0.63 (95%CI: 0.52-0.74) and 0.62 (95%CI: 0.51-0.72), respectively. Kaplan-Meier curves revealed statistically significant better survival data in SII-low groups on both RFS (P＜0.001) and OS (P＜0.001). The univariate and multivariate analyses revealed that higher level of SII was independently associated with both poorer RFS time and OS time. However, no significant result was shown on NLR, PLR or LMR.Conclusion: SII is an effective prognostic factor for predicting the prognosis of ICC patient undergone curative hepatectomy, while NLR, PLR and LMR are not associated with clinical outcomes of these patients.
Liver Resection for Colorectal Liver-limited Metastases in Elderly Patients: A Propensity Score Matching Analysis
Authors: Jin Ke-Min , Wang Kun , Bao Quan , Wang Hong-Wei , Xing Bao-Cai
Published: October 2020

Background: Few studies have focused on the role of hepatectomy for colorectal liver-limited metastases in elderly patients compared to matched younger patients.Methods: From January 2000 to December 2018, 724 patients underwent hepatectomy for colorectal liver-limited metastases. Based on a 1:2 propensity score matching (PSM) model, 64 elderly patients (≥70 years of age) were matched to 128 younger patients (＜70 years of age) to obtain two balanced groups with regards to demographic, therapeutic and prognostic factors.Results: There were 73 elderly and 651 younger patients in the unmatched cohort. Compared with the younger group (YG), the elderly group (EG) had significantly higher proportion of American Society of Anesthesiologists score Ⅲ and comorbidities, and lower proportion of more than 3 liver metastases and postoperative chemotherapy (p<0.05). After PSM for these factors, rat sarcoma virus proto-oncogene/B-Raf proto-oncogene (RAS/BRAF) mutation status and primary tumor sidedness, the EG had significantly less median intraoperative blood loss than the YG (175ml vs. 200ml, p=0.046), a shorter median postoperative hospital stay (8 days vs. 11 days, p=0.020) and a higher readmission rate (4.7% vs.0%, p=0.036). The EG also had longer disease-free survival (DFS), overall survival (OS) and cancer-specific survival (CSS) compared to the YG, but these findings were not statistically significant (p>0.05). Old age was not an independent factor for DFS, OS and CSS by Cox multivariate regression analysis (p>0.05).Conclusions: Hepatectomy is safe for colorectal liver-limited metastases in elderly patients, and these patients may subsequently benefit from prolonged DFS, OS and CSS.
Age Distribution and Associated Factors of Cornea Biomechanical Parameter Stress-Strain Index in Chinese Healthy Population
Authors: Liu Guihua , Rong Hua , Pei Ruxia , Du Bei , Jin Nan , Wang Di , Jin Chengcheng , Wei Ruihua
Published: October 2020

Background: To investigate the new cornea biomechanical parameter stress-strain index (SSI) in Chinese healthy people and the factors associated with SSI.Methods: A total of 175 eyes from 175 participants were included in this study. Axial length was measured with the Lenstar LS-900. Pentacam measured curvature of the cornea and anterior chamber volume (ACV). Cornea biomechanical properties assessments were performed by corneal visualization Scheimpflug technology (Corvis ST). Student’s t-test, one-way ANOVA, partial least square linear regression (PLSLR) and linear mixed effects (LME) model were used in the statistical analysis.Results: The mean (±SD) SSI was 1.14 ± 0.22 (range, 0.66–1.78) in all subjects and affected by age significantly after age of 35 (P < 0.05). In LME models, SSI was significantly associated with age (β=0.526, P<0.001), axial length (AL) (β=-0.541, P<0.001), intraocular pressure (IOP) (β=0.326, P<0.001) and steepest radius of anterior corneal curvature (RsF) (β=0.229, P<0.001) but not with ACV, biomechanical corrected intraocular pressure (bIOP), flattest radius of anterior corneal curvature (RfF) or central corneal thickness (CCT) (P>0.05 for each).Conclusions: SSI increased with age after the age of 35. In addition to age, SSI was positively correlated with RsF and IOP, while negatively correlated with AL.
Electrochemical detection of white spot syndrome virus with a silicone rubber disposable electrode composed of graphene quantum dots and gold nanoparticle-embedded polyaniline nanowires
Authors: Takemura Kenshin , Satoh Jun , Boonyakida Jirayu , Park Sungjo , Chowdhury Ankan Dutta , Park Enoch Y.
Published: October 2020

Background: With the enormous increment of globalization and global warming, it is expected that the number of newly evolved infectious diseases will continue to increase. To prevent damage due to these infections, the development of a diagnostic method for detecting a virus with high sensitivity in a short time is highly desired. In this study, we have developed a high-sensitivity and high-accuracy disposable electrode and evaluated it for several target viruses. Results: Conductive silicon rubber (CSR) was used to fabricate a disposable sensing matrix composed of nitrogen and sulfur-codoped graphene quantum dots (N,S-GQDs) and a gold-polyaniline nanocomposite (AuNP-PAni). A specific anti-white spot syndrome virus (WSSV) antibody was conjugated to the surface of this nanocomposite, which wassuccessfully applied for the detection of WSSV over a wide linear range of 1.45 × 10 2 to 1.45 × 10⁵ DNA copies/ml, with a detection limit as low as 48.4 DNA copies/ml. Conclusion: The engineered sensor electrode can retain the detection activity for up to 5 weeks, a vital long-term stability requirement for disposable sensing applications. This is the first demonstration of the detection of WSSV by ananofabricated sensing electrode with high sensitivity, selectivity, and stability, providing a potential diagnostic tool to monitor WSSV in the aquaculture industry.
Repeat pulmonary resection for lung malignancies does not affect the postoperative complications: a retrospective study
Authors: Motono Nozomu , Iwai Shun , Iijima Yoshihito , Usuda Katsuo , Uramoto Hidetaka
Published: October 2020

Background: Although repeat pulmonary resection (RPR) for multiple lung cancer (MLC) has been performed for non-small cell lung cancer (NSCLC) and metastatic lung tumor, with the prognostic benefit detailed in several reports, the risk of RPR has not been well analyzed.Methods: Patients with lung malignancies who underwent complete resection at Kanazawa Medical University between January 2010 and October 2019 were analyzed. The relationship between postoperative complications and preoperative and perioperative factors was analyzed. Postoperative complications were categorized into five grades according to the Clavien–Dindo classification system.Results: A total of 41 patients who were received RPR were enrolled in this study. Primary lung tumor was found in 31 patients, and metastatic lung tumor was found in 10 patients. The postoperative complication rate of the first operation was 29%, and that of the second operation was 29%. While there were no significant factors for an increased incidence of postoperative complication in a multivariate analysis, an operation time over 2 h at the second operation tended to affect the incidence of postoperative complication (p=0.06). Furthermore, the operation time was significantly longer (p=0.02) and wound length tended to be longer (p=0.07) in the ipsilateral group than in the contralateral group. The rate of postoperative complications and the length of the postoperative hospital stay were not significantly different between the two groups.Conclusion: RPR is safely feasible and is not associated with an increased rate of postoperative complications, even on the ipsilateral side.
Development and Validation of the Peptic Ulcer Scale under the System of Quality of Life Instruments for Chronic Diseases based on Classical Test Theory and Generalizability Theory
Authors: Wan Chonghua , Chen Ying , Gao Li , Zhang Qingqing , Quan Peng , Sun Xiaoyuan
Published: October 2020

Background: Quality of life (QOL) for patients with Peptic ulcer disease (PUD) is of interest worldwide and disease-specific instruments are needed for clinical research and practice. This paper focus on the development and validation of the PUD scale under the system of Quality of Life Instruments for Chronic Diseases (QLICD-PU) by the modular approach and both classical test theory and Generalizability Theory.Methods: The QLICD-PU is developed based on programmatic decision-making procedures, including multiple nominal and focus group discussions, in-depth interviews, and quantitative statistical procedures. Based on the data of 153 PUD inpatients, correlation analysis, factor analysis, t-test, and Generalizability Theory analysis (including generalizability study and decision study, ie. G-study and D-study) were used to assess the validity, reliability, and responsiveness of the scale.Results: When the popular scale health survey short form (SF-36) was used as the standard, correlation and factor analysis confirmed good construct validity and criterion-related validity of QLICD-PU. Except for the social domain (0.62), the internal consistency α of all domains is higher than 0.70. The overall score and the test-retest reliability coefficients (Pearson r and intra-class correlation ICC) in all domains are higher than 0.80 (0.77 in the social domain). After treatments, the overall score and scores of all domains have statistically significant changes (P <0.01), except for social impact and sexual function scores. The SRM of domain-level scores ranges from 0.34 to 1.03. The G coefficient and reliability index (Ф coefficient) further confirm the reliability of the scale through more accurate variance components and decision-making information about changes in the number of items.Conclusions: The QLICD-PU can be used as a useful measurement to assess the quality of life of PUD patients with good psychometric characteristics and multiple advantages.
Advanced care planning during the COVID-19 pandemic: ceiling of care decisions and their implications for observational data
Authors: Straw Sam , McGinlay Melanie , Drozd Michael , Slater Thomas A , Cowley Alice , Kamalathasan Stephe , Maxwell Nicholas , Bird Rory , Koshy Aaron O , Prica Milos , Patel Peysh A , Relton Samuel D , Gierula John , Cubbon Richard M , Kearney Mark T , Witte Klaus K
Published: October 2020

Background Observational studies investigating risk factors in coronavirus disease 2019 (COVID-19) have not considered the confounding effects of advanced care planning, such that a valid picture of risk for elderly, frail and multi-morbid patients is unknown. We aimed to report ceiling of care and cardiopulmonary resuscitation (CPR) decisions and their association with demographic and clinical characteristics as well as outcomes during the COVID-19 pandemic. Methods Retrospective, observational study conducted between 5th March and 7th May 2020 of all hospitalised patients with COVID-19. Ceiling of care and CPR decisions were documented using the Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) process. Unadjusted and multivariable regression analyses were used to determine factors associated with ceiling of care decisions and death during hospitalisation.Results A total of 485 patients were included, of whom 409 (84·3%) had a documented ceiling of care; level one for 208 (50·9%), level two for 75 (18·3%) and level three for 126 (30·8%). CPR decisions were documented for 451 (93·0%) of whom 336 (74·5%) were ‘not for resuscitation’. Advanced age, frailty, White-European ethnicity, a diagnosis of any co-morbidity and receipt of cardiovascular medications were associated with ceiling of care decisions. In a multivariable model only advanced age (odds 0·89, 0·86-0·93 p<0·001), frailty (odds 0·48, 0·38-0·60, p<0·001) and the cumulative number of co-morbidities (odds 0·72, 0·52-1·0, p=0·048) were independently associated. Death during hospitalisation was independently associated with age, frailty and requirement for level two or three care.Conclusion Ceiling of care decisions were made for the majority of patients during the COVID-19 pandemic, broadly in line with known predictors of poor outcomes in COVID-19, but with a focus on co-morbidities suggesting ICU admission might not be a reliable end-point for observational studies where advanced care planning is routine.
A Large Database Study of Hospitalization Charges and Follow-up Re-admissions in US Lumbar Fusion Surgeries Using a Cellular Bone Allograft (CBA) versus Recombinant Human Bone Morphogenetic Protein-2 (rhBMP-2)
Authors: Wetzell Bradley , McLean Julie B , Moore Mark A , Kondragunta Venkateswarlu , Dorsch Kimberly
Published: October 2020

BackgroundThe objective of this study was to retrospectively compare initial procedure and 12-month follow-up hospitalization charges and resource utilization (lengths of stay; LOS) for lumbar fusion surgeries using either recombinant human bone morphogenetic protein-2 (rhBMP-2) or a cellular bone allograft comprised of viable lineage-committed bone cells (V-CBA) via a large US healthcare system database. Potentially-relevant re-admissions during the follow-up period were also assessed.MethodsA total of 16,172 patients underwent lumbar fusion surgery using V-CBA or rhBMP-2, of whom 3,503 (21.66%) patients had follow-up re‑admission data. Initial patient, procedure, and hospital characteristics were assessed to determine confounding factors. Multivariate regression modeling compared differences in hospitalization charges (in 2018 US dollars) and LOS (in days) between the groups, as well as incidences of potentially-relevant readmissions during the 12‑month follow-up‑ period.ResultsThe adjusted mean initial procedure and 12-month follow-up‑ hospital charges were significantly lower in the V-CBA group versus the rhBMP-2 group ($109,061 and $108,315 versus $160,191 and $130,406, respectively; P<0.0001 for both comparisons). This disparity remained in an ad hoc comparison of charges for initial single-level treatments only (V-CBA = $103,064, rhBMP-2 = $149,620; P<0.0001).The adjusted mean initial LOS were significantly lower in the V-CBA group (3.77 days) versus the rhBMP-2 group (3.88 days; P<0.0001), but significantly higher for the cumulative follow-up hospitalizations in the 12‑month follow-up period (7.87 versus 7.46 days, respectively; P<0.0001). Differences in rates of follow-up re‑admissions aligned with comorbidities at the initial procedure. Subsequent lumbar fusion rates were comparable, but significantly lower for V-CBA patients who had undergone single-level treatments only, in spite of V-CBA‑ patients having significantly higher rates of initial comorbidities that could negatively impact clinical outcomes.ConclusionsThe results of this study indicate that use of V-CBA for lumbar fusion surgeries performed in the US may result in substantially lower overall hospitalization charges versus rhBMP-2, with both exhibiting similar rates of 12-month re-admissions and subsequent lumbar fusion procedures.
An Inverse Association of Weight and the Occurrence of Asymptomatic Gallbladder Stone Disease in Hypercholesterolemia Patients: A Case-control Study
Authors: Sheng Binwu , Zhao Qingbin , Ma Mao , Zhang Jianqin
Published: October 2020

Background: Despite the fact that the majority of gallstones formed in the gallbladder are mainly composed of cholesterol, as they are formed from cholesterol-supersaturated bile, and hypercholesterolemia is a common metabolic disorder, which is closely related to cardiac, hepatic, renal and other oxidative damage inflammation and necrosis, there is still no consensus regarding the contribution of blood serum lipids in the pathogenesis of gallbladder stone disease (GSD). This study aimed to investigate the relationship between hypercholesterolemia and the risk of new-onset asymptomatic GSD, and to determine the prevalence of factors associated with new-onset asymptomatic GSD in patients with hypercholesterolemia. Methods: In this study, 927 Chinese patients with new-onset asymptomatic gallstone disease and 845 healthy controls were enrolled starting from August 2012. Patients were matched for age, gender, race, occupation, systolic blood pressure, diastolic blood pressure, and fasting blood glucose levels (FBG). Body mass index (BMI), nonalcoholic fatty liver disease (NAFLD) and serum lipids indexes were compared and the relationships between BMI, blood lipid and gallbladder stone hazards were examined by logistic multivariate regression models. Results: The result showed a significantly higher morbidity with GSD in hypercholesterolemia than non-hypercholesterolemia patients (Χ2=17.211, P<0.001). Of hypercholesterolemia patients, low density lipoprotein (OR=1.493, P=0.029) and NAFLD (OR=2.723, P=0.022) were significant risk factors for GSD, while being male (OR=0.244, P=0.033), weight (OR=0.961, P=0.022), high density lipoprotein (OR=0.305, P<0.001), and FBG (OR=0.687, P=0.034) were significantly negatively correlated with GSD in univariate analysis. Multivariate logistic regression indicated weakly positive correlations with NAFLD (OR=3.284, P=0.054), and significant negative correlations with weight (OR=0.930, P=0.018), HDL-c (OR=0.144, P<0.001), and GSD. Conclusion: Hypercholesterolemia acts as an independent risk factor for new-onset asymptomatic GSD, while obesity and NAFLD are synergistic factors. Interestingly, it is first reported that elevated weight was inversely associated with GSD in patients with hypercholesterolemia. The results of this study suggest that effective control of hyperlipidemia is of greater significance than weight loss, which might make the situation worse, in the prevention of GSD in obese patients with hyperlipidemia.
A Seamlessly Integrated Device of Micro-supercapacitor and Wireless Charging with Ultrahigh Energy Density and Capacitance
Authors: Gao Chang , Huang Jiancheng , Xiao Yukun , Zhang Guoqiang , Dai Chunlong , Li Zengling , Zhao Yang , Jiang Lan , Qu Liangti
Published: October 2020

Microdevice integrating energy storage with wireless charging could provide new opportunities for electronics design, such as moveable charging. Herein, we report a seamlessly integrated wireless charging micro-supercapacitors (IWC-MSCs) by taking advantage of a designed highly consistent material system that both wireless coil and electrode are of the graphite paper. The transferring power efficiency of the wireless charging is 52.8%. Benefitting from unique circuit structure, the intact IWC-MSCs displays low resistance and excellent voltage tolerability with a capacitance of 454.1 mF cm− 2, superior to state-of-the-art conventional planar MSCs. Besides, a record high energy density of 567.6 µWh cm− 2 exceeds the existing metal ion hybrid MSCs and even commercial thin film batteries (350 µWh cm− 2). After charging for 6 minutes, the IWC-MSCs reaches up to a power output of 4.5 mW, which can drive an electrical toy car immediately. The specific electrode layout brings new insight for contactless micro-electronics and flexible micro-robotics.