bluuebunny/crossref_metadata_2025 huggingface dataset:
“Standing on Common Ground” - A Qualitative Study of Self-management Support for Patients With Multimorbidity in Primary Health Care
Authors: Freilich Joel , Nilsson Gunnar , Ekstedt Mirjam , Flink Maria
Published: July 2020

Background: Multimorbidity, the co-existence of two or more chronic conditions in an individual, is present in most patients over 65 years. Primary health care (PHC) is uniquely positioned to provide the holistic and continual care recommended for this group of patients, including support for self-management. The aim of this study was to explore professionals’, patients’, and family caregivers’ perspectives on how PHC professionals should support self-management in patients with multimorbidity. This study also includes experiences of using telemedicine to support self-management. Methods: A mixed qualitative method was used to explore regular self-management support and telemedicine as a tool to support self-management. A total of 42 participants (20 physicians, 3 registered nurses, 12 patients, and 7 family caregivers) were interviewed using focus group interviews (PHC professionals), pair interviews (patients and family caregivers), and individual interviews (registered nurses, patients, and family caregivers). The study was performed in urban areas in central Sweden and rural areas in southern Sweden between April 2018 and October 2019. Data were analyzed using content analysis. Results: The main theme that emerged was “Standing on common ground enables individualized support.” To achieve such support, professionals needed to understand their own views on who bears the primary responsibility for patients’ self-management, as well as patients’ self-management abilities, needs, and perspectives. Personal continuity and trustful relationships facilitated this understanding. The findings also indicated that professionals should be accessible for patients with multimorbidity, function as knowledge translators (help patients understand their symptoms and how the symptoms correlated with diseases), and coordinate between levels of care. Telemedicine supported continual monitoring and facilitated patient access to PHC professionals.Conclusion: Through personal continuity and patient-centered consultations, professionals could collaborate with patients to individualize self-management support. For some patients, this means that PHC professionals are in control and monitor symptoms. For others, PHC professionals play a less controlling role, empowering patients’ self-management. Development and improvement of eHealth tools for patients with multimorbidity should focus on improving the ability to set mutual goals, strengthening patients’ inner motivation, and including multiple caregivers to enhance information-sharing and care coordination.
Smartphone and Medical Application use Among Dentists in China
Authors: Zhang Chao , Fan Lin , Chai Zhaowu , Yu Cong , Song Jinlin
Published: July 2020

Background
With the development of information technology, more and more healthcare professionals are using smartphones and mobile medical applications (apps) in their clinical practice. The objective of this study was to survey the use of smartphone based medical apps among dentists in China and their perceptions on such apps.
Methods
All data were collected using anonymous questionnaires. The questionnaires for this cross-sectional study were randomly sent to dentists by email, and 379 dentists completed the questionnaires. Dentists’ demographics and their perceptions on Wechat, QQ (the most popular social media apps in China) and other medical apps were assessed, including questions on the purpose, frequency, daily use, and opinion of these apps they used. Questions were answered using a Likert scale (1 = strongly agree, 2 = agree, 3 = not sure, 4 = disagree, and 5 = strongly disagree).
Results
A total of 379 valid responses were received with a median age of 33.6 years old (63.3% female). All subjects (100%) owned a smartphone, and all of them installed and used WeChat or QQ in their clinical practice. Only 76% subjects installed medical apps (except Wechat and QQ) on their smartphones. Male dentists would like to install medical apps than female dentists (p < 0.05). With the increasing of age, the percentage of dentists to install medical apps was decreasing ( p < 0.001). The frequency and daily use of WeChat or QQ were more often than medical apps. Medical apps were positively perceived, with dentists reporting to recommend these medical apps to other peers (Likert score: 1.67 ± 0.68).
Conclusion
Medical apps were perceived to provide positive impact on clinical practice, education and patient care in dentistry by providing relevant medical information. But there will be still much room for improvement in the future.
Joint trajectories of lifestyle pattern and subsequent psychopathological outcomes in adolescence
Authors: Zhang Anhui , Zhang Dan-dan , Wan Yuhui , Su Puyu , Tao Fangbiao , Sun Ying
Published: July 2020

Background: Rapid socio-economic development makes China a unique laboratory for examining how lifestyle changes affect adolescent mental health. This study aims to identify joint trajectories of modifiable lifestyle indicators during pubertal transition and its associations with psychopathological outcomes. Methods: A cohort of 1974 children aged 7-9 years were recruited in Anhui Province, China during March 2013. The assessment of lifestyle behaviors (screen time, physical activity, sleep duration and beverage intake) and depressive symptoms were conducted from Wave 1 to Wave 4 (2018). Suicide ideation, non-suicidal self-harm (NSSI) and alcohol use were self-reported at Wave 4. Longitudinal trajectories of lifestyle patterns were defined using group-based multi-trajectory models in 2019. Results: Four lifestyle trajectories were identified: persistent healthy (39.9%), suboptimal healthy (25.3%), unhealthy mitigation (17.2%), and persistent unhealthy (17.7%). Compared with persistent healthy group, the risk of subsequent suicide ideation [odds ratio (OR): 2.86, 95%CI: 2.15-3.81], depressive symptoms (OR: 2.16, 95%CI: 1.39-3.35), alcohol use (OR: 2.53, 95%CI: 1.78-3.61) and non-suicidal self-harm (OR: 1.35, 95%CI: 1.09-1.67) was significantly higher in persistent unhealthy group.Conclusions: This study provided convincing evidence that unhealthy lifestyle trajectory during adolescence would substantially confer more than two-fold elevated risk for multiple domains of psychopathological outcomes over 5 years.
Serum Platelet-derived Growth Factor-BB Levels as a Potential Biomarker in Assessing the Metabolic Activity of Lesions in Alveolar Echinococcosis Patients
Authors: Ke Ying , Bi Xiaojuan , Yang Ning , Li Xiaohong , Ma Wenmei , Liu Hui , Wang Hui , Li Liang , Li Cheng , Qin Yongde , Aji Tuerganaili , Shao Yingmei , Lü Guodong , Lin Renyong
Published: July 2020

ObjectiveAlveolar echinococcosis (AE) is a chronic disease caused by the larval stage of Echinococcus multilocularis. Assessing the metabolic activity of AE lesions is critical to evaluate disease progression and survey treatment options. There is an urgent need to identify more rapid, convenient, and non-invasive clinical detection methods to substitute the current techniques. Herein, we evaluated the viability of platelet-derived growth factor-B B (PDGF-BB) as a biomarker for detecting the metabolic activity of AE patients. Concentration of serum PDGF-BB homodimers (sPDGF-BB) was assessed via ELISA. Correlations of PDGF-BB expression levels with clinicopathological features of AE patients were analyzed using SPSS. ResultsThe concentrations of sPDGF-BB were significantly lower in AE patients (p<0.0001), particularly in HMAE patients (p<0.05). The expression levels of PDGF-BB were significantly higher in CLT in AE patients (p<0.0001). We found that metabolically active AE and sPDGF-BB are significantly negatively correlated (r=-0.624, p=0.0004). Besides, the local expression levels of PGFD-BB was positively correlated with metabolic activity, the PNM stage, and lesion size. Notably, the sPDGF-BB levels were proposed as a potential biomarker for assessing metabolic activity of AE, with 85.7% sensitivity and 81% specificity (95% confidence interval, P = 0.003).
Lactate Albumin Ratio is Associated with Mortality in Patients with Moderate to Severe Traumatic Brain Injury
Authors: Wang Ruoran , He Min , Ou Xiaofeng , Xie Xiaoqi , Kang Yan
Published: July 2020

Background: Traumatic brain injury (TBI) is a serious public health issue all over the world. This study was designed to evaluate the prognostic value of lactate to albumin ratio (LAR) on moderate to severe traumatic brain injury.Methods: Clinical data of 273 moderate to severe TBI patients hospitalized in West China Hospital between May 2015 and January 2018 were collected. Multivariate logistic regression analyses were used to explore risk factors and construct prognostic model of in-hospital mortality in this cohort. Nomogram was drawn to visualize the prognostic model. Receiver operating characteristic (ROC) curve and calibration curve were respectively drawn to evaluate discriminative ability and stability of this model.Results: Non-survivors had higher LAR than survivors (1.0870 vs 0.5286, p<0.001). Results of multivariate logistic regression analysis showed that GCS (OR=0.818, p=0.008), blood glucose (OR=1.232, p<0.001), LAR (OR=1.883, p=0.012), and red blood cell distribution (RDW)-SD (OR=1.179, p=0.004) were independent risk factors of in-hospital mortality in included patients. These four factors were utilized to construct prognostic model. The area under the ROC curve (AUC) value of single lactate and LAR were 0.733 (95%Cl; 0.673-0.794) and 0.780 (95%Cl; 0.725-0.835), respectively. The AUC value of the prognostic model was 0.868 (95%Cl; 0.826-0.909), which was higher than that of LAR (Z=2.5143, p<0.05).Conclusions: LAR is a readily available prognostic marker of moderate to severe TBI patients. Prognostic model incorporating LAR is beneficial for clinicians to evaluate possible progression and make treatment decisions in these patients.
Everolimus-Eluting Bioresorbable Scaffolds and Metallic Stents in Diabetic Patients: a Patient-level Pooled Analysis of the Prospective ABSORB DM Benelux Study, TWENTE and DUTCH PEERS
Authors: Hommels T. M. , Hermanides R. S. , Berta B. , Fabris E. , De Luca G. , Ploumen E. H. , von Birgelen C. , Kedhi E.
Published: July 2020

Background: Several studies compared everolimus-eluting bioresorbable scaffolds (EE-BRS) with everolimus-eluting stents (EES), but only few assessed these devices in patients with diabetes mellitus.Aim: To evaluate the safety and efficacy outcomes of all-comer patients with diabetes up to 2 years after treatment with EE-BRS or EES.Methods: We performed a post-hoc pooled analysis of patient-level data in diabetic patients who were treated with EE-BRS or EES in 3 prospective clinical trials: The ABSORB DM Benelux Study (NTR5447), TWENTE (NTR1256/NCT01066650) and DUTCH PEERS (NTR2413/NCT01331707). Primary endpoint of the analysis was target lesion failure (TLF): a composite of cardiac death, target vessel myocardial infarction or clinically driven target lesion revascularization. Secondary endpoints included major adverse cardiac events (MACE): a composite of all-cause death, any myocardial infarction or clinically driven target vessel revascularization, as well as definite or probable device thrombosis (ST).Results: A total of 499 diabetic patients were assessed, of whom 150 received EE-BRS and 249 received EES. Total available follow-up was 222.6 patient years (PY) in EE-BRS and 464.9 PY in EES. The adverse events rates were similar in both treatment groups for TLF (7.2 vs. 5.2 events per 100 PY, p=0.39; adjusted hazard ratio (HR)=1.48 (95% confidence interval (CI): 0.77-2.87), p=0.24), MACE (9.1 vs. 8.3 per 100 PY, p=0.83; adjusted HR=1.23 (95% CI: 0.70-2.17), p=0.47), and ST (0.9 vs. 0.6 per 100 PY, p>0.99).Conclusion: In this patient-level pooled analysis of patients with diabetes mellitus from 3 clinical trials, EE-BRS showed clinical outcomes that were quite similar to EES.
Identification of differentially expressed genes and signaling pathways in rheumatoid arthritis by integrated bioinformatics analysis
Authors: Ge Yanzhi , Zhou Li , Chen Zuxiang , Mao Yingying , Li Ting , Tong Peijian , Shan Letian
Published: July 2020

Background
The disability rate associated with rheumatoid arthritis (RA) ranks high among inflammatory joint diseases. However, the cause and potential molecular events are as yet not clear. Here, we aimed to identify key genes and pathways involved in RA utilizing integrated bioinformatics analysis and uncover underlying molecular mechanisms.
Materials and methods
The expression profiles of GSE55235, GSE55457, GSE55584 and GSE77298 were downloaded from the Gene Expression Omnibus database, which contained 76 synovial membrane samples, including 49 RA samples and 27 controls. The microarray datasets were consolidated and differentially expressed genes (DEGs) were acquired and further analyzed by bioinformatics techniques. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses of DEGs were performed using R (version 3.6.1), respectively. The protein-protein interaction (PPI) networks of DEGs were developed utilizing the STRING database.
Results
A total of 828 DEGs were recognized, with 758 up-regulated and 70 down-regulated. GO and KEGG pathway analyses demonstrated that these DEGs focused primarily on multifactorial binding, transcription activity, cytokin-cytokin receptor interaction and relevant signaling pathways. The 30 most firmly related genes among DEGs were identified from the PPI network.
Conclusion
This study shows that screening for DEGs and pathways utilizing integrated bioinformatics analyses could aid in the comprehension of the molecular mechanisms involved in RA development. In addition, our study provides valuable data for the effective prevention, diagnosis, treatment and rehabilitation of RA patients as well as providing potential targets for the treatment of RA.
Accuracy of Implant Surgical Guides Fabricated Using Computer Numerical Control Milling for Edentulous Jaws: A Pilot Clinical Trial
Authors: Chai Jinyou , Liu Xiaoqian , Schweyen Ramona , Setz Jürgen , Pan Shaoxia , Liu Jianzhang , Zhou Yongsheng
Published: July 2020

Background
To evaluate the accuracy of a computer-aided design and computer-aided manufacturing (CAD-CAM) surgical guide for implant placement in edentulous jaws.
Methods
Nine patients with twelve edentulous jaws seeking implants were recruited. Radiographic guides with diagnostic templates were fabricated from try-in waxup dentures. Planning software (Organical® Dental Implant, Berlin, Germany) was used to virtually design the implant positions, and the radiographic templates were converted into surgical guides using computer numerical control (CNC) milling. Following the guided implant surgery protocol, forty-four implants were placed into twelve edentulous jaws. Cone-beam computed tomography (CBCT) scans were performed post-operatively for each jaw, and the deviations between the planned and actual implant positions were measured.
Results
All 44 implants survived, and no severe haematomas, nerve injuries or unexpected sinus perforations occurred. The mean three dimensional linear deviation of implant position between virtual planning and actual placement was 1.53 ± 0.48 mm at the implant neck and 1.58 ± 0.4 mm at the apex. The angular deviation was 3.96 ± 3.05 degrees. The mean deviation between virtual and actual implant position was significantly smaller in the maxilla than in the mandible. No significant differences were found in the deviation of implant position between cases with and without anchor pins.
Conclusions
The guides fabricated using the CAD-CAM CNC milling technique provided comparable accuracy as those fabricated by Stereolithography. The displacement of the guides on edentulous arch might be the main contributing factor of deviation.
Trial registration:
Chinese Clinical Trial Registry, ChiCTR-ONC-17014159
Does Tooth Extraction and Perioperative Medication Affect PT-INR of Patients Taking Warfarin?
Authors: Iwata Eiji , Tachibana Akira , Kusumoto Junya , Takata Naoki , Hasegawa Takumi , Akashi Masaya
Published: July 2020

Background: Various antibiotics and analgesics have been reported to interact with　warfarin. Reports that investigate the effects of medication taken for just a few days during tooth extraction on the prothrombin time-international normalized ratio (PT-INR) are rare. Methods: A total of 110 patients receiving long-term stable warfarin therapy underwent tooth extraction without interruption of warfarin treatment. INR values were measured one month before the tooth extraction, the day of the extraction, and one week after the extraction. We investigated the changes of INR values between the day of extraction and one week after the extraction, as well as the various risk factors for increases in INR values.Results: Before and after tooth extraction, the number of patients taking cefcapene pivoxil, amoxicillin, and azithromycin was 57, 36, and 8, respectively. Nine patients were administered ampicillin before tooth extraction and received amoxicillin after their tooth extraction. One week after tooth extraction, the INR values increased beyond the therapeutic range in 3 out of 110 patients (2.7%). The INR values before tooth extraction in these three patients were close to 3.0. The INR value increased by more than twice as much in 1 of 110 patients (0.9%).Conclusion: When a tooth extraction is performed in patients taking warfarin, certain factors could increase the INR, such as interaction between warfarin and antibiotics or analgesics, post-extraction inflammation or infection, and eating disorders due to post-extraction pain. However, our results suggest that it has little effect on the INR values one week after extraction.
EMS utilization predictors in a Mobile Integrated Health (MIH) program: A retrospective analysis
Authors: Peralta Luis Mauricio Pinet , Sanna Evan , Frankel Brian , Lindqvist Ernest , Glos Lukas
Published: July 2020

Background. The provision of unnecessary Emergency Medical Services (EMS) care remains a challenge throughout the US and contributes to ER overcrowding, delayed services and lower quality of care. New EMS models of care have shown promise in improving access to health services for patients who do not need urgent care. The goals of this study were 1) to identify factors associated with EMS utilization (911) and 2) their effects on total EMS calls and transports in an MIH program. Methods. The study sample included 110 MIH patients referred to the program or considered high-users of EMS services between November 2016-September 2018. The study employed descriptive statistics and Poisson regression to estimate the effects of covariates on total EMS calls and transports. Results. The typical enrollee is a 60-year old single African-American male living with two other individuals. He has a PCP, takes 12 medications and is compliant with his treatment. The likelihood of calling and/or being transported by EMS was higher for males, patients at high risk for falls, patients with asthma/COPD, psychiatric or behavioral illnesses, and longer travel times to a PCP. Each prescribed medication increased the risk for EMS calls or transports by 4%. Conclusions. This study shows that age, marital status, high fall risk scores, the number of medications, psychiatric/behavioral illness, asthma/COPD, CHF, CVA/stroke and medication compliance may be good predictors of EMS use in an MIH setting. MIH programs can help control utilization of EMS care and reduce both EMS calls and transports.
Size measurements of hepatocellular carcinoma: comparisons between contrast and two-dimensional ultrasound
Authors: Chen Fei , Wang Fei , Zhu Mei , Sun Si , Liu Zheng
Published: July 2020

Background
Ultrasound (US) imaging is known to underestimate tumor size in clinical. This study is aimed to compare the size measurements of hepatocellular carcinoma (HCC) in three US imaging modalities, i.e. two-dimensional (2D) imaging, the arterial phase (AP) and the late phase (LP) imaging of contrast-enhanced US (CEUS).
Methods
Fifty-eight clinically proved HCC patients were included. The 2D and CEUS imaging were performed with Siemens S2000, Philips iu22 and BioSound Twice. 2.5 mL of SonoVue® was injected for every CEUS performance. Two physicians measured the maximal longitudinal and the transverse diameters of the tumors in 2D, the AP and the LP of CEUS from one image section. The three measurements were compared by paired t test.
Results
The mean longitudinal diameter of HCC appeared to be maximal in the AP (4.73 ± 2.04 cm) of CEUS and minimal in the LP (3.98 ± 1.99 cm) of CEUS. The 2D diameter (4.26 ± 2.07 cm) was in the middle between two CEUS measurements. There were significant differences between any two measurements.
Conclusion
There is size difference between the three kinds of HCC measurement. It appeared to be maximal in the AP of CEUS and minimal in the LP. The 2D diameter was in the middle.
Short- and long-term outcomes after colonic self-expandable metal stent placement for malignant large-bowel obstruction as a bridge to surgery
Authors: Tajima Jesse Yu , Matsuhashi Nobuhisa , Takahashi Takao , Mizutani Chika , Iwata Yoshinori , Kiyama Shigeru , Kubota Masaya , Ibuka Takashi , Araki Hiroshi , Shimizu Masahito , Doi Kiyoshi , Yoshida Kazuhiro
Published: July 2020

Purpose Malignant large-bowel obstruction (MLBO) is a highly urgent condition in colorectal cancer with high complication rates. Self-expandable metal stent (SEMS) placement in MLBO is a new decompression treatment in Japan. Preoperative stent placement (bridge to surgery: BTS) avoids emergency surgery, but oncological influences of stent placement and post-BTS surgical approach remain unclear. We examined short- and long-term results of surgery for MLBO after SEMS placement in our hospital.Methods We retrospectively reviewed 75 patients with MLBO who underwent resection after SEMS placement at our hospital from June 2013 to December 2018. Postoperative morbidity and mortality were evaluated by comparison with the surgical approach.Results Tumor location was significantly higher in the left-side colon and rectum (n=59, 78.7%) than right-side colon (n=16, 21.3%). Technical and clinical success rates for SEMS placement were 97.3% and 96.0%, respectively. Laparoscopic surgery was performed in 54 patients (69.0%), and one-stage anastomosis was performed in 73 (97.3%). Postoperative complications were similar in the open surgery (Open) group (n=5, 23.8%) and laparoscopic surgery (Lap) group (n=7, 13.0%), with no severe complications requiring reoperation. Three-year overall survival (OS) and relapse-free survival (RFS) rates were not significantly different in the Lap vs Open group (67.5% vs 66.4%; 82.2% vs 62.5%).Conclusion Preoperative stent treatment avoids stoma construction but allows anastomosis. One-time surgery was performed safely contributing to minimally invasive treatment and acceptable short- and long-term results.
Impaired Fasting Plasma Glucose is a Risk indicator of Interventricular Septum Thickening among Non-Diabetic Subjects with Obesity
Authors: Zupo Roberta , Castellana Fabio , Sardone Rodolfo , Scicchitano Pietro , Lampignano Luisa , Ciccone Marco Matteo , Triggiani Vincenzo , Giannelli Gianluigi , De Pergola Giovanni
Published: July 2020

Background
Alterations of glucose metabolism have a detrimental effect on cardiovascular risk parameters, even before overt diabetes, especially in obesity contexts. We aimed to evaluate whether progressively higher fasting plasma glucose (FPG) is associated to thickening of the interventricular septum (IVS) among non-diabetic subjects with obesity.
Methods
We studied 227 consecutive non diabetic patients (155 women and 72 men, age range 18–72 years) with overweight or obesity (BMI ≥ 25 Kg/m2), taking no medication or supplement. Hormonal, metabolic and routine laboratory parameters were collected. Echocardiography and ultrasonography echo-color Doppler of intima-media thickness of the common carotid artery (IMT-CCA) were performed to evaluate intima-media thickness of the common carotid artery (IVST) and early signs of atherosclerosis, respectively, in all enrolled subjects.
Results
Of the 227 subjects, 48.9% had higher IVST values. Age (p 0.04), waist circumference (p 0.01), systolic (p < 0.01) and diastolic blood pressure (p < 0.01), FPG (p < 0.01), insulin (p 0.04), HOMA IR (p = 0.01), uric acid (p < 0.01) serum levels, IMT-CCA (p < 0.01), and left atrial diameter (LAD) (p < 0.01) were significantly higher in subjects with pathological IVST. Logistic regression models demonstrated an independent relation of FPG to IVST, both in semi and fully adjusted models (ORs 1.045 and 1.039, respectively). Moreover, graph presentation of the ORs and 95% CIs by FPG quintiles showed a positive risk trend for pathological IVST.
Conclusions
Higher FPG levels represent an independent sensitive predictor of IVS thickening in subjects with obesity, even before overt diabetes. These results emphasize the importance of preventive management of the diabetes risk in obesity.
Effect of intestinal flora on the formation of endometritis of sow
Authors: Zhang Ling , Wang Linkang , Dai Yimin , Tao Tianyu , Wang Jingqi , Wu Yunzheng , Zeng Xiu , Zhang Jinhua
Published: July 2020

Background

Aberration of birth canal microbiota is one of the most important factors in the etiology of sow endomentritis. Nevertheless, reports about the structure and composition of birth canal microbiota in endomentritis sow and their relationship with intestinal microbes is limited. Therefore, understanding the relationship between birth canal microbiota and intestinal microbiota of the host has become exceedingly crucial.
Results

In this study, 4 healthy and 4 endomentritis sows were selected basing on whether the sow had endometritis or not in a farm of China. The microflora of their birth canal secretions and fresh feces were analyzed via sequencing the V3 + V4 region of bacterial 16S rDNA gene. The results showed that the significant difference between endometritis and healthy sows birth canal flora in the composition and abundance. Sow endomentritis was associated with increasing in the relative abundance of Porphyromonas, Clostridium_sensu_stricto_1, Streptococcus, Ezakiella, Fusobacterium, Actinobacillus, Bacteroides, and Prevotella as well as Anaerococcus. On the contrary, the majority of beneficial bacteria that belonging to Firmicutes phylum (e.g., Lactobacillus and Enterococcus ) declined in endomentritis sow. The increased relative abundance of Porphyromonas in the vaginal secretions might correlate with the decrease of Lactobacillusin the feces of endometritis sows. Moreover, the experimental result also found that some intestinal bacteria (such as Escherichia-Shigella and Bacteroides) may be bound up with the onset of sow endometritis.
Conclusion

Sow endometritis is closely related to the microbiota of birth canal, and that some intestinal bacteria may promote the onset of endometritis. The above results can supply a theoretical basis to research the pathogenesis of endometritis and the microbiota of sow's birth canal and gut.
Consistent Independent Low-Rank Matrix Analysis for Determined Blind Source Separation
Authors: Kitamura Daichi , Yatabe Kohei
Published: July 2020

Independent low-rank matrix analysis (ILRMA) is the state-of-the-art algorithm for blind source separation (BSS) in the determined situation (the number of microphones is greater than or equal to that of source signals). ILRMA achieves a great separation performance by modeling the power spectrograms of the source signals via the nonnegative matrix factorization (NMF). Such highly developed source model can eﬀectively solve the permutation problem of the frequency-domain BSS, which should be the reason of the excellence of ILRMA. In this paper, we further improve the separation performance of ILRMA by additionally considering the general structure of spectrogram called consistency, and hence we call the proposed method Consistent ILRMA. Since a spectrogram is calculated by an overlapping window (and a window function induces spectral smearing called main- and side-lobes), the time-frequency bins depend on each other. In other words, the time-frequency components are related each other via the uncertainty principle. Such co-occurrence among the spectral components can be an assistant for solving the permutation problem, which has been demonstrated by a recent study. Based on these facts, we propose an algorithm for realizing Consistent ILRMA by slightly modifying the original algorithm. Its performance was extensively studied through the experiments performed with various window lengths and shift lengths. The results indicated several tendencies of the original and proposed ILRMA which include some topics have not discussed well in the literature. For example, the proposed Consistent ILRMA tends to outperform the original ILRMA when the window length is suﬃciently long compared to the reverberation time of the mixing system.
The Anti-Adhesive Effect of Granulocyte-Colony Stimulating Factor on an Abdominal Adhesion Model in Sprague-Dawley Rats
Authors: Park In-Hwa , Song Yi-Sun , Joo Hyun-Woo , Shen Guang-Yin , Seong Jin-Hee , Shin Na-Kyoung , Lee A-Hyeon , Kim Hyuck , Kim Kyung-Soo
Published: July 2020

Background: Intra-abdominal adhesions are among the most common complications following abdominal surgery. In this study, using an abdominal adhesion rat model, we investigated the anti-adhesive effect of granulocyte-colony stimulating factor (G-CSF) on intra-abdominal adhesions. Methods: All rats were laparotomized with 3 ischemic peritoneal buttons developed to cause adhesions. The experimental rats were divided randomly into 3 groups (n=8/group): control, pluronic gel, and G-CSF groups. Fourteen days after surgery, all rats were sacrificed, and intra-abdominal adhesions were assessed. The percentage of adhesions, adhesion severity scale and density of adhesion formation were evaluated. Real-time PCR was conducted to assess the cytokine mRNA levels of substance P (SP), neurokinin 1 receptor (NK-1R), transforming growth factor-β1 (TGF-β1), and intercellular adhesion molecule-1 (ICAM-1).Results: The severity scores of intra-abdominal adhesions of, and the degree of adhesion formation in, rats treated with G-CSF were significantly lower than those in case of rats from other groups. Additionally, in the G-CSF group, the number of ischemic buttons with developed adhesions was significantly lower than that in the other groups. In adhesion samples of the G-CSF group, the expression level of SP was significantly lower than that in the other groups.Conclusions: Our study demonstrated that G-CSF treatment decreases the formation of intra-abdominal adhesion after surgery by reducing inflammatory reactions in adhesion tissues.
Interferon-bèta Enhances Sensitivity to Gemcitabine in Pancreatic Cancer
Authors: Blaauboer Amber , Booy Stephanie , Koetsveld Peter M. van , Karels Bas , Dogan Fadime , Zwienen Suzanne van , Eijck Casper H.J. van , Hofland Leo J.
Published: July 2020

Background
Adjuvant gemcitabine for pancreatic cancer has limited efficacy. Impaired drug metabolism is associated with treatment resistance. We aimed to evaluate the chemosensitising effect of interferon-bèta (IFN-β).
Methods
BxPC-3, CFPAC-1, and Panc-1 cells were pre-treated with IFN-β followed by gemcitabine monotherapy. The effect on cell growth, colony formation, and cell cycle was determined. RT-qPCR was used to measure gene expression. BxPC-3 cells were used in a heterotopic subcutaneous mouse model.
Results
IFN-β increased sensitivity to gemcitabine (4-, 7.7-, and 1.7-fold EC50 decrease in BxPC-3, CFPAC-1, and Panc-1, respectively; all P < 0.001). Findings were confirmed when assessing colony formation. The percentage of cells in the S-phase was significantly increased after IFN-β treatment only in BxPC-3 and CFPAC-1 by 12% and 7%, respectively (p < 0.001 and p < 0.05, respectively). Thereby, IFN-β upregulated expression of the drug transporters SLC28A1 in BxPC-3 (252%) and SLC28A3 in BxPC-3 (127%) and CFPAC-1 (223%) (all p < 0.001). In vivo, combination therapy reduced tumor volume with 45% (P = 0.01). Both ex vivo and in vivo data demonstrate a significant reduction in the number of proliferating cells, whereas apoptosis was increased.
Conclusions
For the first time, we validated the chemosensitizing effects of IFN-β when combined with gemcitabine in vitro, ex vivo, and in vivo. Thereby, we show the interaction between IFN-β and genes involving intracellular uptake of gemcitabine. The use of IFN-β as adjuvant treatment seems promising and need to be further explored.
Association of Clinical and Para-clinical Factors With the Occurrence of Febrile Neutropenia Following Autologous Bone Marrow Transplantation in Patients With Lymphoma
Authors: Nejati Babak , Kourehpaz Zohreh , Dolatkhah Roya , Varshochi mojtaba , Farmani Maryam
Published: July 2020

Purpose: Promising results have been achieved by the administration of autologous bone marrow transplantation (BMT) in patients with lymphoma. However, infectious complications limit its positive outcomes. Therefore, better identification of related factors to the occurrence of febrile neutropenia may lead to improved management of these patients. This study aimed to evaluate the incidence and associated factors with the occurrence of febrile neutropenia in following BMT in patients with lymphoma Method: In this prospective study, 45 patients with a definite diagnosis of lymphoma who were candidates for BMT were consecutively included. Demographic characteristics, lymphoma type, and medical history, as well as the results of selected laboratory tests, were recorded. After BMT, neutrophil count and body temperature were evaluated. Results: Febrile neutropenia occurred in 28 patients (62.5 %). No statistically significant difference was seen between those with febrile neutropenia and those without, in terms of age, gender, BMI, type of lymphoma, blood group, and the number of radiotherapy or chemotherapy courses (p>0.05 for all). Multivariable logistic regression analysis demonstrated a significant positive relationship between the number of administered units of platelet and serum uric acid and development of febrile neutropenia. Conclusion: The results of our study showed that the incidence of febrile neutropenia is significantly high in lymphoma patients who receive BMT. Moreover, the number of administered units of platelet and uric acid before BMT are significantly associated with febrile neutropenia.
Standardized Post-Resuscitation Damage Assessment of Two Mechanical Chest Compression Devices: A Prospective Randomized Large Animal Trial
Authors: Ruemmler Robert , Stein Jakob , Duenges Bastian , Renz Miriam , Hartmann Erik Kristoffer
Published: July 2020

Background

Mechanical chest compression devices are accepted alternatives for cardiopulmonary resuscitation (CPR) under specific circumstances. Current devices lack prospective and comparative data on their specific cardiovascular effects and potential for severe thoracic injuries.
Objectives

To compare CPR effectiveness and thoracic injuries of two mechanical chest compression devices in pigs.
Study design:
Prospective randomised trial
Animals:
18 male German landrace pigs
Methods

Ventricular fibrillation was induced in anaesthetised and instrumented pigs and the animals were randomised into two intervention groups. Mechanical CPR was initiated by means of LUCAS™ 2 (mCCD1) or Corpuls™ cpr (mCCD2) device. Advanced life support was applied for a maximum of 10 cycles and animals achieving ROSC were monitored for 8 hours. Ventilation/perfusion measurements were performed and blood gas analyses were taken. Thoracic injuries were assessed via a standardised damage score.
Results

Five animals of the mCCD1 group and one animal of the mCCD2 group achieved ROSC (p = 0.048). Only the mCCD1 animals survived until the end of the monitoring period (p < 0.01). MCCD1 animals showed less pulmonary shunt (p = 0.025) and higher normal V/Q (p = 0.017) during CPR. MCCD2 animals showed significantly more severe thoracic injuries (p = 0.046).
Conclusion

The LUCAS 2 device shows superior resuscitation outcomes and less thoracic injuries compared to Corpuls cpr when used for experimental CPR in juvenile pigs. Researchers should be aware that different mCCDs for experimental studies may significantly influence the respective outcome of resuscitation studies and affect comparability of different trials. Controlled human and animal CPR studies and a standardised post-resuscitation injury evaluation could help to confirm potential hazards.
Do Population Density, Socio-Economic Ranking and Gini Index of Cities Influence Infection Rates from Coronavirus? Israel as a case Study
Authors: Arbel Yuval , Fialkoff Chaim , Kerner Amichai , Kerner Miryam
Published: July 2020

A prominent characteristic of the COVID-19 pandemic is the marked geographic variation in COVID-19 prevalence. The objective of the current study is assess the influence of population density and socio-economic measures (socio-economic ranking and the Gini index) across cities on coronavirus infection rates. Israel provides an interesting case study based on the highly non-uniform distribution of urban populations, the existence of one of the most densely populated cities in the world and diversified populations. The outcomes of our study show that ceteris paribus, projected probabilities to be infected from coronavirus rise with higher population density and Gini coefficients and drop with higher socio-economic ranking of the city. Moreover, when measured by identical units of standard deviations, the contribution of the socio-economic measure is the highest. Findings thus provide a tool to city and public health planners in an effort to address the spatial and socio-economic aspects of the pandemic. Compared with wealthier cities, poorer and denser cities should employ more pre-emptive measures to better enable the early identification of the incidence of COVID-19 in these cities. Finally, from a public health perspective, a densly populated city with a low socio-economic ranking and high income inequality requires immediate intervention in order to mitigate the dissemination of the virus.
Numerical and experimental study on air thrust foil bearing performance with improved structural model based on real-time taper inlet height
Authors: Xu Fangcheng , Hou Liukai , Wu Bin , Dong Zeda , Wang Yongliang
Published: July 2020

Air thrust foil bearings are key bearings of micro turbo-machinery (such as micro gas turbines, turbo blowers, and air compressors). The bearing load capacity is affected by many factors, and the taper inlet height of bearing structure is closely related to the load capacity. In many previous literature the taper inlet height, as a constant value, was used to calculate film thickness distribution. However, the reality is that the foil will be squeezed by the pressure generated between runner disk and top foil, which makes taper inlet height change during iteration. Therefore, the actual bearing taper inlet height should be chosen properly instead of the constant taper inlet height when iterating. In this paper, an improved computational model of film thickness for adjusting the taper inlet height in real-time is proposed. The relationship between the maximum bearing load capacity and taper inlet height at different rotor speeds of two models is obtained through numerical simulation. It is found that the optimal taper inlet height of the new model is larger than that of the old model. Three types of bearings with different taper inlet height (20μm, 70μm, 114μm) had been tested and the maximum load capacity at different rotor speeds had been obtained. Finally, test data and the simulation results of the two models are compared. It is found that the simulation results of the two models are quite different when the taper inlet height is near the optimal taper inlet height, and the new model is more agree well with the test data.
Critical care demand and intensive care supply for patients in Japan with COVID-19 at the time of the state of emergency declaration in April 2020: a descriptive analysis.
Authors: Fujii Yosuke , Hirota Kiichi
Published: July 2020

Background : The coronavirus disease 2019 (COVID-19) pandemic, due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), threatened to overwhelm Japan’s intensive care capacity due to the rising numbers of infected patients. This study aimed to determine the number of critically ill patients with COVID-19 who required intensive care, including mechanical ventilation and extracorporeal membrane oxygenation (ECMO), during the pandemic and to compare these patient numbers with Japan’s overall intensive care capacity. Results : Japanese Society of Intensive Care Medicine datasets were used to obtain the number of confirmed patients with COVID-19 who had undergone mechanical ventilation and ECMO between February 15 and June 4 2020, to determine and compare intensive care unit (ICU) and attending bed needs for patients with COVID-19, and to estimate peak ICU demands in Japan. In total, 17968 ICU days, 15171 mechanical ventilation days, and 2797 ECMO days were attributable to patients with COVID-19. There was a median (interquartile range) 143 (63-255) patients in ICU, 124 (51-225) patients on mechanical ventilation, and 18 (15-36) patients on ECMO machines. During the epidemic peak in late April, 11443 patients (1.03 per 10000 adults) had been infected, 373 patients (0.034 per 10000 adults) were in ICU, 312 patients (0.028 per 10000 adults) were receiving mechanical ventilation, and 62 patients (0.0056 per 10000 adults) were on ECMO machines per day. The number of infected patients at the peak of the epidemic was 651% of total designated beds and the number of patients requiring intensive care at the peak of the epidemic was 6.0% of total ICU beds in Japan, 19.1% of total board-certified intensivists in Japan and 106% of total designated medical institutions for Category II infectious diseases in Japan, respectively. Conclusions : Following the state of emergency declaration on April 7 2020, the number of patients with COVID-19 and the number of critically ill patients continued to rise, exceeding the number of designated beds but not exceeding ICU capacity. Urgent nationwide and regional planning is needed to prevent an overwhelming burden on ICUs in relation to critically ill patients with COVID-19 in Japan.
Development of prognosis model for colon cancer based on autophagy-related genes
Authors: Wang Xu , Xu Yuanmin , Li Ting , Chen Bo , Yang Wenqi
Published: July 2020

Background: Autophagy is an orderly catabolic process for degrading and removing unnecessary or dysfunctional cellular components such as proteins and organelles. Although autophagy is known to play an important role in various types of cancer, the effects of autophagy-related genes (ARGs) on colon cancer have not been well studied.Methods: Expression profiles from ARGs in 457 colon cancer patients were retrieved from the TCGA database (https://portal.gdc.cancer.gov). Differentially expressed ARGs and AGRs related to overall patient survival were identified. Cox proportional-hazards models were used to investigate the association between ARG expression profiles and patient prognosis.Results: 20 ARGs were significantly associated with overall survival of colon cancer patients. Five of these ARGs had a mutation rate ≥3%. Patients were divided into high-risk and low-risk groups based on Cox regression analysis of 8 ARGs. Low-risk patients had a significantly longer survival time than high-risk patients (p<0.001). Univariate and multivariate Cox regression analysis showed that the resulting risk score, which was associated with infiltration depth and metastasis, could be an independent predictor of patient survival. A nomogram was established to predict 3- and 5-year survival of colon cancer patients based on 5 independent prognosis factors, including the risk score. The prognostic nomogram with online webserver was more effective and convenient to provide information for researchers and clinicians.Conclusion: The 8 ARGs can be used to predict the prognosis of patients and provide information for their individualized treatment.
Nutritional assessment and surgical outcomes in very elderly patients undergoing pancreaticoduodenectomy: a retrospective study
Authors: Utsumi Masashi , Aoki Hideki , Nagahisa Seichi , Une Yuta , Kimura Yuji , Watanabe Megumi , Taniguchi Fumitaka , Arata Takashi , Katsuda Koh , Tanakaya Kohji
Published: July 2020

Background Conflicting data on the safety of pancreaticoduodenectomy (PD) for elderly patients exist. Therefore, this study aimed to evaluate and compare the nutritional factors and clinical outcomes of PD between elderly and non-elderly patients.Methods A retrospective study of 122 consecutive patients who underwent PD from April 2008 to April 2020 was conducted. Preoperative and postoperative nutritional factors (prognostic nutritional index [PNI]), complication rates, and survival rates were compared between the elderly (age ≥80 years) and non-elderly (age <80 years) patient groups. Furthermore, changes in nutrition markers were evaluated before surgery to 1 year after surgery. Data were analyzed using unpaired Student’s t-test, chi-squared test with Fisher’s exact test, and log-rank test.Results A total of 20 elderly patients (16.4%) and 102 non-elderly patients (83.6%) underwent PD. With respect to preoperative factors, elderly patients had a significantly lower PNI than non-elderly patients. The duration of operation, amount of blood loss, postoperative complication rate, and incidence rate of pancreatic fistula were similar between the two groups. At 3 months postoperatively, elderly patients had a lower albumin level and PNI than non-elderly patients. The median length of hospital stay was significantly longer in the elderly group than in the non-elderly group (39.9 vs. 27 days, P=0.004). The rate of death due to other diseases was relatively higher in the elderly group than in the non-elderly group. Elderly patients had a significantly lower overall survival rate than non-elderly patients (1-/3-/5-year overall survival rates: 78.1%/26.7%/13.3% vs. 87.1%/54.4%/46.7%; log-rank test, P=0.008).Conclusions Elderly patients had a lower nutritional status and lower survival rate than non-elderly patients. Careful patient selection and optimal perioperative care are necessary to determine whether PD is indicated for elderly patients.
The motor and leisure time conditioning of young table tennis players' physical fitness
Authors: Pluta Beata , Galas Szymon , Krzykała Magdalena , Andrzejewski Marcin
Published: July 2020

Background: This study aimed to determine what factors influence the level of physical fitness of young athletes. Its purpose was therefore to assess the association between physical fitness and objectively measure the lifestyle determinants of elite junior table tennis players. Methods: The basic anthropometric characteristics (body height and body weight) were collected of 87 Polish table tennis players (girls and boys, at different stages of sport training) aged 9–12 years. The level of special fitness tests from the Table Tennis Specific Battery Test were used, assessing reaction speed and displacement speed. All eight International Physical Fitness Test trials were also used to determine the level of general fitness of the participants. Selected questions from the Health Behaviour in School-Aged Children questionnaire were asked to measure factors associated with leisure time. Results: The findings confirm a relationship between sedentary forms of leisure time activity and the training of young players being at the targeted stage. Moreover, competitors with longer training experience more often chose active forms of spending free time. Conclusion: Knowledge of the global physical activity undertaken by young athletes during their leisure time provides a better understanding of their individual needs, and may help young table tennis players to succeed at a world-class level in the future.