bluuebunny/crossref_metadata_2025 huggingface dataset:
Nrf2 protects against seawater drowning-induced acute lung injury via inhibiting ferroptosis
Authors: Qiu Yu-bao , Wan Bin-bin , Liu Gang , Wu Ya-xian , Chen Dan , Lu Mu-dan , Chen Jun-liang , Yu Ren-qiang , Chen Dao-zhen , Pang Qing-feng
Published: August 2020

Background: Ferroptosis is a new type of nonapoptotic cell death model that was closely related to ROS accumulation. Seawater drowning-induced acute lung injury (ALI) which is caused by severe oxidative stress injury, has been a major cause of accidental death worldwide. The latest evidences indicate nuclear factor (erythroid-derived 2)-like 2 (Nrf2) suppress ferroptosis and maintain cellular redox balance. Here, we test the hypothesis that activation of Nrf2 pathway attenuates seawater drowning-induced ALI via inhibiting ferroptosis.Methods: we performed studies using Nrf2-specific agonist (dimethyl fumarate), Nrf2 inhibitor (ML385), Nrf2-knockout mice and ferroptosis inhibitor (Ferrostatin-1) to investigate the potential roles of Nrf2 on seawater drowning-induced ALI and the underlying mechanisms. Results: Our data shows that Nrf2 activator dimethyl fumarate could increase cell viability, reduced the levels of intracellular ROS and lipid ROS, prevented glutathione depletion and lipid peroxide accumulation, increased FTH1 and GPX4 mRNA expression, and maintained mitochondrial membrane potential in MLE-12 cells. However, ML385 promoted cell death and lipid ROS production in MLE-12 cells. Furthermore, the lung injury became more aggravated in the Nrf2-knockout mice than that in WT mice after seawater drowning. These findings may guide the development of a new therapeutic approach for seawater drowning-induced ALI Conclusions: These results suggested that Nrf2 can inhibit ferroptosis and therefore alleviate ALI induced by seawater drowning. The effectiveness of ferroptosis inhibition by Nrf2 provides a novel therapeutic target for seawater drowning-induced ALI.
Timing for Closed Reduction of Developmental Dysplasia of the Hip and Failure Analysis
Authors: Zhang Zhiqiang , Li Hao , Li Hai , Zhang Ziming
Published: August 2020

Background It remains controversial whether the older age at closed reduction (CR) of developmental dysplasia of the hip (DDH), the higher incidence of complications. The aim of this study is to evaluate the Mid-term outcome of CR for DDH among difference age groups, and to analyze and identify risk factors for the failure of this procedure. Methods Clinical data of DDH patients, who received CR, were retrospectively reviewed. Hips were divided into three groups according to initial age (Group I: <12 months; Group II: 12 months to ≤18 months; Group III: >18 months). The presence of avascular necrosis (AVN), residual acetabular dysplasia (RAD), re-dislocation, further surgeries (FS) and failure of CR were observed. The risk factors were identified for those outcomes abovementioned. Receiver operating characteristics (ROC) curve analysis based on age, pre-op AI and post-op AI for failure was conducted.Results A total of 107 patients (156 hips) undergoing CR were evaluated with a median age at initial reduction of 13.0 months (range, 4 to 28 mo). Mean follow-up time in this study was 6.7 years (range, 3-8 years). The incidence of AVN, RAD and re-dislocation was 15.4% (24/156), 17.3% (27/156) and 14.7% (23/156). For AVN, RAD and re-dislocation, the risk factors were pre-op IHDI IV (p=0.033), age≥18 months (p=0.012), and pre-op IHDI IV and walking (p=0.004 and p=0.011), respectively. The areas under the ROC curve of failure were 0.841 (post-op AI), 0.688 (pre-op AI) and 0.650 (age).Conclusions RAD is a complication that must be carefully considered for severe patients older than 18 months before CR. Re-dislocation is associated with pre-op IHDI IV and walking. Patients, who are older than 12.5 months or have a pre-op AI of 38.7° or a post-op AI of 26.4°, are more likely fail of CR.
A Heat-Health Watch and Warning System with Extended Season and Evolving Thresholds.
Authors: Issa Mahamat Abdelkerim , Chebana Fateh , Masselot Pierre , Campagna Celine , Lavigne Éric , Gosselin Pierre , Ouarda Taha B.M.J.
Published: August 2020

BackgroundMany countries have developed heat-health watch and warning systems (HHWWS) or early-warning systems in an attempt to mitigate the health consequences of extreme heat events. HHWWS usually focus on the four hottest months of the year and impose the same threshold over these months. However, according to climate projections, hot season is expected to extend and/or shift. Some studies demonstrated that health impacts of heat waves are more severe when the human body is not acclimatized to heat. In order to adapt those systems to potential heat waves occurring outside the hottest months of the season, this study proposes specific health-based monthly heat indicators and thresholds over an extended season from April to October in the northern hemisphere. MethodsThe proposed approach, an extension of the HHWWS methodology currently adopted in the province of Quebec, Canada, was developed in the Greater Montreal area (current population 4.3 million) based on historical health and meteorological data over the years. This approach consists of determining excess mortality episodes and then choosing indicators and thresholds that may involve excess mortality.ResultsWe obtain thresholds for the maximum and minimum temperature couple (in °C) that range from (23 and 12, respectively) in April, to (32 and 21) in July and back to (25 and 13) in October. The resulting HHWWS is flexible, with health-related thresholds taking into account the seasonality as well as the monthly variability of temperatures in the threshold definition process for an extended summer season. ConclusionsThis adaptive system has the potential to prevent, by data-driven health alerts, heat-related mortality outside the typical July-August months of heat waves. The proposed methodology is general and can be applied or adapted to other regions and situations.
Spatial and transcriptional heterogeneity of β-cell neogenesis revealed by a time-resolved reporter system
Authors: Sasaki Shugo , Lee Michelle , Wakabayashi Yuka , Suzuki Luka , Winata Helena , Himuro Miwa , Matsuoka Takaaki , Shimomura Iichiro , Watada Hirotaka , Lynn Francis , Miyatsuka Takeshi
Published: August 2020

While pancreatic β cells have been shown to originate from endocrine progenitors in ductal regions, it remains unclear precisely where β cells emerge and which transcripts define newborn β cells. Here, we used a mouse model “Ins1-GFP;Timer” that provides spatial information during β-cell neogenesis with high temporal resolution. Fluorescent imaging demonstrated that, as expected, some newborn β cells arise close to the ducts; unexpectedly, all the others arise away from the ducts and adjacent to blood vessels. Single-cell RNA-sequencing (scRNA-seq) demonstrated five distinct populations of newborn β cells, confirming the spatial heterogeneity of β-cell neogenesis, and integration analysis with scRNA-seq of hESC-derived β-like cells uncovered transcriptional similarity with the data in mouse β cells. Thus, the combination of time-resolved histological imaging with single-cell transcriptional mapping demonstrated novel features of spatial and transcriptional heterogeneity in β-cell neogenesis, which will lead to a better understanding of β-cell differentiation for future cell therapy.
Possible Association of Polymorphisms in Ubiquitin Specific Peptidase 46 Gene with Post-Traumatic Stress Disorder
Authors: Seo Jun-ho , Kim Tae-yong , Kim Se-joo , Choi Jin-hee , So Hyung-seok , Kang Jee In
Published: August 2020

Background: Dynamic proteolysis, through the ubiquitin-proteasome system, has an important role in DNA transcription and cell cycle, and is considered to modulate cell stress response and synaptic plasticity. We investigated whether genetic variants in the ubiquitin carboxyl-terminal hydrolase 46 (USP46) would be associated with posttraumatic stress disorder (PTSD) in people with exposure to combat trauma using a case-control candidate gene association design. Methods: Korean male veterans exposed to the Vietnam War were grouped into those with (n = 128) and without (n = 128) PTSD. Seven tagging SNPs of USP46 were selected, and single-marker and haplotype-based association analyses were performed. All analyses were adjusted for sociodemographic factors and levels of combat exposure severity and alcohol problem. Results: One single-marker (rs2244291) showed nominal evidence of association with PTSD status and with the ‘re-experiencing’ cluster, although the association was not significant after Bonferroni correction. No significant association with the other SNPs or the haplotypes was detected. Conclusion: The present finding suggests preliminarily that genetic vulnerability regarding the ubiquitin-proteasome system may be related to fear memory processes and the development of PTSD symptoms after trauma exposure. Further studies with a larger sample size will be needed to examine the role of the ubiquitin-proteasome system including USP46 in PTSD.
Regional Height Growth Models for Scots Pine in Poland
Authors: Socha Jarosław , Tymińska-Czabańska Luiza , Zięba Stanisław , Cywicka Dominika , Hawryło Paweł
Published: August 2020

Background: Site productivity remains a fundamental concern in forestry as a significant driver of resource availability. The site index (SI) reflects the overall impact of all environmental parameters that determine tree height growth and is the most commonly used indirect proxy for forest site productivity estimated using stand age and height. One of the most critical challenges in the site index (SI) concept are local variations in climate, soil, and genotype-environmental interactions that lead to variable height growth patterns among ecoregions and cause inappropriate estimation of site productivity. Developing regional models can solve this problem and allow us to determine forest growth and SI appropriately.Results: Therefore, the purpose of this study was to develop regional height growth models (RMs) for the Scots pine in Poland. For height growth modelling, we used the growth trajectory data of 855 sample trees, representing the entire range of geographic locations and site conditions of the Scots pine in Poland. Collected growth trajectories were used for the development of the global height growth model (GM) for Poland and RMs for six natural forest regions, which were adopted as the spatial unit for the model regionalisation. Height prediction errors by the global model were found to be significantly larger than those obtained with regional models in all regions. The results showed significant differences between growth trajectories in natural forest regions I, II, and III located in northern Poland compared to stands in natural forest regions IV, V, and VI in southern Poland.Conclusions: The presented study showed differences in height growth patterns of Scots pines in Poland and revealed that the use of local models could improve the growth prediction and quality of the SI estimation. Developed RMs show better fit statistics and predictive validity than the GM developed for the countrywide scale. Differences in climate and soil conditions which distinguish natural forest regions affect height growth patterns of Scots pine. Therefore, extending this research to models which directly describe the interactions of height growth with site variables, such as climate, soil properties, and topography, can provide additional valuable forest management information.
Determinants of Willingness to Accept Kidney Transplantation Among Chronic Kidney Disease Patients in Ghana
Authors: Boima Vincent , Amissah-Arthur Maame-Boatemaa , Yorke Ernest , Dey Dzifa , Fiagbe Delali , Yawson Alfred Edwin , Nonvignon Justice , Mate-Kole Charles Christopher
Published: August 2020

Background
The burden of chronic kidney disease in Africa is three to four times higher than high-income countries and the cost of treatment is beyond the reach of most affected persons. The ultimate treatment for end stage renal disease is kidney transplantation which is not available in most African countries. As kidney transplantation is a budding treatment in Ghana, this study assessed factors which could influence Chronic kidney disease patients’ willingness to accept it as a treatment option.
Aim
The aim of this study was to assess the determinants of willingness to accept kidney transplantation as a treatment option for end stage renal disease among chronic kidney disease patients in Ghana.
Methods
This cross-sectional survey was carried out among chronic kidney disease patients in Korle-Bu Teaching Hospital. Consecutive sampling method was used to recruit consenting patients. Structured questionnaire and standardized research instruments were used to obtain information on demographic, socio-economic characteristics, knowledge about transplant, perception of transplantation, religiosity and spirituality. Logistic regression model was used to assess the determinants of willingness to accept kidney transplantation.
Results
342 CKD patients participated in the study of which 56.7% (n = 194) were males. The mean age of the participants was 50.24 ± 17.08 years. The proportion of participants willing to accept kidney transplantation was 67.3% (95%CI: 62.0–72.2%). The factors which influenced participants’ willingness to accept this treatment include; willingness to attend a class on kidney transplantation (p < 0.016), willingness to donate a kidney if they had the chance (p < 0.005), perception that living person could donate a kidney (p < 0.001) and perception of improved quality of life after transplant (p < 0.005). The barriers for accepting kidney transplantation were anticipated complications of transplant surgery and financial constraints.
Conclusion
More than two-thirds of CKD patients were willing to accept kidney transplantation and this is influenced by multiple factors. Government health agencies must consider full or partial coverage of kidney transplantation through the existing national health insurance scheme. Further, efficient educational programmes are required to improve patients and physician’s knowledge on the importance of kidney transplantation.
Micropercutaneous Versus Minipercutaneous for the Management of Moderately Sized Kidney Stones: A Systematic Review and Meta-Analysis
Authors: Gao Xiaoshuai , Zhou Liang , Wang Wei , Di Xingpeng , Xiao Kaiwen , Jin Xi , Li Hong , Wang Kunjie
Published: August 2020

Background: To assess the efficacy and safety of mini-percutaneous nephrolithotomy (Miniperc) and micropercutaneous nephrolithotomy (Microperc) for moderately sized renal stones. Methods: Literature search of PubMed, Web of Science, and Embase was performed before January 2020. We used odds ratios (OR) and weighted mean difference (WMD) for dichotomous variables and continuous variables, respectively. Results were pooled by Review Manager version 5.3 software. Results: A total of 4 studies involving 172 Microperc and 162 Miniperc cases were included. The overall SFR of Microperc was 86.05% (148/172), while the SFR of the Miniperc was 87.65% (142/162). Microperc was associated with lower hemoglobin drop (WMD: -0.98; P = 0.03), higher renal colic requiring D-J stent insertion (OR: 3.49; P=0.01). No significant differences exist between Microperc and Miniperc with respect to stone-free rate (SFR) (OR: 0.90; P=0.75), urinary tract infection (OR: 0.38; P=0.18), operative time (WMD: 14.73; P = 0.54) and hospital stay time (WMD: -1.04; P=0.07). Conclusions: Our meta-analysis demonstrated that Microperc could obtain comparable SFR with Miniperc. Microperc was associated with lower hemoglobin drop, but Miniperc was associated with lower renal colic rates. In addition, the operation time and hospital stay time for these two procedures were similar.
O 6-Methylguanine DNA Methyltransferase and Glucose Transporter 2 in Foregut and Hindgut Gastrointestinal Neuroendocrine Neoplasms
Authors: Watanabe Hirofumi , Yamazaki Yuto , Fujishima Fumiyoshi , Izumi Komoto , Imamura Masayuki , Hijioka Susumu , Toriyama Kazuhiro , Yatabe Yasushi , Kudo Atsushi , Motoi Fuyuhiko , Unno Michiaki , Sasano Hironobu
Published: August 2020

Background: Streptozocin (STZ) is used for treating both pancreatic (PanNET) and gastrointestinal (GI-NET) neuroendocrine tumors but its therapeutic efficacy is relatively low in GI-NETs. Therefore, it has become pivotal to select GI-NET patients who could benefit from STZ treatment. STZ is transported via the glucose transporter 2 (GLUT2) into the cells and the loss of O6-methylguanine DNA methyltransferase (MGMT) also increases its therapeutic efficacy. Therefore, GLUT2 high and MGMT low status could be the surrogate markers of STZ. Methods: In this study, we examined the MGMT and GLUT2 status in gastrointestinal neuroendocrine neoplasm (NEN). We studied 84 NEN cases: 33 foregut and 37 hindgut GI-NETs and 14 gastrointestinal neuroendocrine carcinomas (GI-NECs). Results: In GI-NETs, MGMT scores of ≥2 and ≥3 were 77% (54/70) and 56% (39/70), respectively, and GLUT2 scores of ≥4 and ≥6 were 30% (21/70) and 4.3% (3/70), respectively. Methylation-specific polymerase chain reaction revealed that MGMT promoter methylation was detected only in 2/14 GI-NECs but in none of GI-NETs. GLUT2 (GLUT2 score) and MGMT immunoreactivity (MGMT and H-scores) were both significantly correlated with Ki-67 labeling index (GLUT2 score: P = 0.0045, ρ = -0.4570; MGMT score: P = 0.0064, ρ = -0.4399; H-score: P = 0.0110, ρ = -0.4135) and MGMT immunoreactivity were both significantly correlated with GLUT2 immunoreactivity (MGMT score: P = 0.0198; H-score, P = 0.0004, ρ = 0.5483) in hindgut NETs, but not in foregut NETs. However, discrepancies from the above correlation between GLUT2 and MGMT immunoreactivity were detected in several GI-NET cases which could be potential candidates for STZ therapy. Conclusion: The evaluation of MGMT and GLUT2 status could provide an important information in planning STZ therapy in GI-NET patients.
Safety and Efficacy of the Non-Cessation Method of Antithrombotic Agents After Emergency Endoscopic Hemostasis in Patients with Non-Variceal Upper Gastrointestinal Bleeding: A Multicenter Pilot Study
Authors: Yamaguchi Daisuke , Tominaga Naoyuki , Miyahara Koichi , Tsuruoka Nanae , Sakata Yasuhisa , Takeuchi Yuki , Matsunaga Takuya , Hidaka Hidenori , Akutagawa Takashi , Noda Takahiro , Ogata Shinichi , Tsunada Seiji , Esaki Motohiro
Published: August 2020

Background and Aims The present study aimed to clarify the safety and efficacy of the non-cessation method of antithrombotic agents after emergency endoscopic hemostasis in Japanese patients with non-variceal upper gastrointestinal bleeding (UGIB). Methods In this multicenter, prospective, pilot study, we performed emergency endoscopic hemostasis for non-variceal UGIB in patients taking antithrombotic agents and resumed the medications without a cessation period (group A). The clinical characteristics, types of antithrombotic agents, UGIB etiology, treatment outcome, and adverse events were evaluated. We used propensity score matching to compare treatment outcome and adverse events with our previous cohort (group B) in whom antithrombotic agents were transiently discontinued after emergency endoscopic hemostasis. Results Forty-three consecutive patients were prospectively enrolled. The main antithrombotic agents were low-dose aspirin and direct oral anticoagulants; 11 patients (25.6%) were taking multiple antithrombotics. Peptic ulcers were the main cause of bleeding (95.4%). Endoscopic hemostasis was successful in all patients and the incidence of rebleeding within a month was 7.0%. Propensity score matching created 40 matched pairs. Endoscopic hemostasis was performed by soft coagulation significantly more frequently in group A than group B (97.5% vs. 60.0%, P < 0.001). Neither the rebleeding rate within a month nor thromboembolic event rate was different between the two groups. However, the mean duration of hospitalization was significantly shorter in group A than group B (8.6 ± 5.2 d vs. 14.4 ± 7.1 d, P < 0.001). Conclusions Antithrombotic agents possibly can be continued after successful emergency endoscopic hemostasis for non-variceal UGIB.
Evaluation of mechanical properties of coronal flaring nickel-titanium instruments
Authors: Weissheimer Theodoro , Só Marcus Vinícius Reis , Alcalde Murilo Priori , Cortez Julia Barrionuevo , Rosa Ricardo Abreu da , Vivan Rodrigo Ricci , Calefi Pedro Henrique Souza , Duarte Marco Antonio Hungaro
Published: August 2020

Background: The aim of this study was to evaluate the bending and torsional resistance of the following instruments: Mtwo 25.07, Navigator W-XN, ProTaper SX, MK Orifice Shapper and MK Sequence 17.12. Methods: One hundred instruments were used (n=20). Resistance to bending (n=10), torque and angular deflection (n=10) at the failure of new instruments were measured according to ISO 3630-1. The fractured surface of each fragment was examined by scanning electron microscopy (SEM). Data were analyzed using 1-way analysis of variance and Tukey tests. Results: Torsional resistance values of MK Sequence were higher than the other groups (P<.05). No differences were observed among Mtwo 25.07, W-XN and MK Orifice Shapper (P>.05) and ProTaper SX, which presented the lowest values (P<.05). Mtwo 25.07 showed the highest angular deflection (P<.05). W-XN and ProTaper SX presented no significant difference (P>.05). ProTaper SX and MK Orifice Shapper also showed no significant differences (P>.05). MK Sequence 17.12 instruments had the lowest angular deflection values (P<0.5). There were significant differences among all the groups in bending stiffness test (P<.05), but ProTaper SX had the lowest torque to bend (P<.05). MK Sequence 17.12 presented the larger cross-sectional area at 3mm from the tip. SEM analysis showed similar and typical features of torsional failure for all instruments tested.Conclusions: In conclusion MK Sequence 17.12 had the highest torsional fracture resistance. Mtwo 25.07 showed higher angular deflection capacity, and ProTaper SX the lower bending stiffness.
Biochemical Markers, Body Composition and Risk of Cardiovascular Disease Amongst Geriatric Population in Al Madinah Al Munawarah: A Risk Assessment Study
Authors: Mohammedsaeed Wala M , SHIKIERI AHLAM Badreldin EL
Published: August 2020

Objective: to assess selected biochemical markers and body composition and their association with CVD risk amongst older adults in Al Madinah Al Munawarah, Saudi Arabia.Results: Older adults had high glycated hemoglobin percent (women 7∙90±2∙95; men 8∙4±1∙64, P <0∙001), C-reactive protein (women 17∙1±5∙92; men 36∙1±7∙8, P <0∙003) and Atherogenic Index of Plasma (AIP; women 0∙21±0∙18; men 0∙22±0∙21, P <0∙04) with higher values amongst men compared to their counterparts. In addition, they suffered from hypoalbuminemia and low hemoglobin levels. Older adults were malnourished, either underweight (16%) or overweight and obese (35%). Based on their AIP, most of the participants had intermediate to high CVD risk. Multiple Linear Regression model with age as the dependent variable showed that the risk of CVD increased with higher BMI (women only: Odd ratio 6.99, 95% CI: 0.96-5.03, P <0.001), elevated triglycerides (women: Odd ratio 7.47, 95% CI: 0.16-3.17; men: Odd ratio: 6.55, 95% CI: 0.23-3.26, P <0.001), high C-reactive protein (Odd ratio 8.99, 95% CI: 0.99-6.00, P = 0.003; men: Odd ratio 4.00, 95% CI: 0.99-3.01, P < 0.002) and high AIP (women: Odd ratio 14.6, 95% CI: 0.0.56-16.18, P = 0.002; men: Odd ratio 7.35, 95% CI: 0.35-20.29, P < 0.001).
Oxandrolone Use Causes Dyslipidemia in Resistance-Training Practitioners
Authors: Greboggy Dênis de Lima , Pereira Ericson , Oliveira Tiago Franco de , Batista Thiago Beltrami Dias , Oliveira Sarah Eller Franco de , Birk Letícia , Barros Leonardo Cesar Santos de , Jesus Julia Souto de , Martins Pamela , Auler Flavia , Chaves Maria Heloisa Madruga , Werneck Renata Iani , Tiboni Fernanda , Barros Marlene Maria Tourais de , Rosa Edvaldo Antonio Ribeiro , Santos Milena Fernandes dos , Parolin Salma Ali El Chab , Carneiro Everdan , Gama Yesudian Yamada da , Ignácio Sérgio Aparecido , Brancher João Armando , Johann Aline Cristina Batista Rodrigues
Published: August 2020

Background: Several of young people and adults make use of anabolic-androgenic steroid (ASS), during resistance training. The purposes of this study were to compare blood and salivary parameters in male resistance training practitioners using oxandrolone with reference values, compare these with a control group in triplicate, and correlate salivary and blood parameters. Methods: In this prospective analytical observational study, blood, saliva, and urine were collected from 22 individuals (oxandrolone group, OG, n = 11 and control group, CG, n = 11), and these samples were analyzed at three time points: before oxandrolone consumption, at cessation of oxandrolone use, and three months after cessation of oxandrolone use. Complete blood count, lipid profile, metabolites, and enzymes were analyzed from blood samples. Salivary flow, pH, triglycerides, urea, aspartate transaminase, alanine aminotransferase, phosphorus, and calcium were analyzed from saliva. Urinalysis was used for toxicological screening. Mann-Whitney U tests, chi-square analysis, Friedman's ANOVA, and Spearman’s correlation tests were performed, with significance p<0.05. Results: We found a lower blood HDL level for the oxandrolone group (24 mg/dL) compared with the reference value ​​(>40 mg/dL), as soon as its use ceased, and a return to normal HDL levels three months later (49 mg/dL, >40 mg/dL). We also found higher triglyceride level (177 mg/dL) in this group compared with the reference value (<175 mg/dL), three months after use. Conclusions: Although there were distinct differences between the groups and timepoints, these did not show clinical relevance, as they were within typical values. There was no correlation between blood and salivary parameters, but it is clear that oxandrolone causes changes in the lipid profile of users.
The Preoperative and the Postoperative Neutrophil-to-Lymphocyte Ratio Both Predict Prognosis in Gastric Cancer Patients
Authors: Kim Eun Young , Song Kyo Young
Published: August 2020

Background: Both the preoperative and postoperative neutrophil-to-lymphocyte ratio (NLR) have been proposed to predict the long-term prognosis in some cancers, including gastric cancer. The present study investigated the prognostic impact of postoperative NLR, and its preoperative to postoperative changes, in patients with gastric cancer. Methods: From 2009 to 2012, 1,612 consecutive patients who underwent curative surgery for gastric cancer were enrolled in this study. The optimal cut-off value for the postoperative 6-month NLR was 1.7, as determined by receiver operating characteristic curve analysis. Patients were categorized into low- and high-NLR groups based on their postoperative NLR. Four additional groups (low to low, low to high, high to low, and high to high groups) were defined based on the preoperative to postoperative change in the NLR.Results: The 5-year overall survival (OS) rates of the low- and high-NLR group were 90.7% and 83.0%, respectively (P < 0.001). The differences in OS were significant in stage I and stage III gastric cancer patients. (P = 0.000 and 0.012, respectively). Postoperative NLR was an independent prognostic factor for OS (hazard ratio [HR] = 1.611; P = 0.005). The high to high NLR change was a significant predictor of OS (HR = 1.914; P = 0.001). Conclusions: High preoperative and postoperative NLRs, and especially the persistent elevation of preoperative to postoperative NLR, were significant prognostic factors for OS in patients with gastric cancer.
Bulk-up Synchronisation of Successive Larval Cohorts of Anopheles Gambiae Sensu Stricto and Anopheles Coluzzii Through Temperature Reduction at Early Larval Stages: Effect on Emergence Rates, Body Size and Mating Success
Authors: Zubair Qaswa , Matthews Holly , Sougoufara Seynabou , Mujeeb Fatima , Ashall Simon , Aboagye-Antwi Fred , Tripet Frédéric
Published: August 2020

Background: Malaria persists as a huge medical and economic burden. Although the number of cases and death rates have reduced in recent years, novel interventions are a necessity if such gains are to be maintained. Alternative methods to target mosquito vector populations that involve the release of large numbers genetically modified mosquitoes are in development. However, their successful introduction will require innovative strategies to bulk-up mosquito numbers and improve mass rearing protocols for Anopheles mosquitoes.Methods: Here we aimed to exploit the relationship between mosquito aquatic stage development and temperature so that multiple cohorts of mosquitoes, from separate egg batches, could be synchronised for a ‘bulk-up’ of the number of mosquitoes released. First instar larvae were separated into two cohorts: the first, maintained under standard insectary conditions at 27oC, the second subjected to an initial 5-day cooling period at 19oC. Results: Cooling of 1st instars slowed the mean emergence times of An. coluzzii and An. gambiae by 2.4 and 3.5 days, respectively, compared to their 27oC counterparts. Pupation and emergence rates were good (> 85%) in all conditions. Temperature adjustment had no effect on mosquito sex ratio and adult fitness parameters such as body size and mating success were also comparable with the control cohort. Conclusions: Bulk-up larval synchronization is a simple method allowing more operational flexibility in mosquito production towards mark-release-recapture studies and mass release interventions.
Bionomics of Anopheles Arabiensis from Mamfene in KwaZulu-Natal (South Africa): An Area of High Malaria Transmission in the Province
Authors: Maharaj Rajendra , Lakan Vishan , Maharaj Kiash
Published: August 2020

Background: Although great strides have been made in controlling malaria, the disease is of significant public health importance. Historically, efforts to control the vector has concentrated on adult vector control targeting the female Anopheles mosquitoes. As there is now a focus on eliminating residual malaria from KwaZulu-Natal, new strategies are being investigated to increase the impact of malaria elimination strategies. Greater attention is now being given to larval control, as a complementary measure to indoor residual spraying. However, there is a large gap in knowledge of the bionomics of the larval stages of this mosquito vector of malaria in South Africa. In order to focus on both larval and adult mosquito control methods, larval development and the reproductive stages of the vector were investigated since these variables influences our ability to impact mosquito populations through larval control. This study was therefore conducted to determine the peak eruption times and the emergent sex ratios, as well as the peak egg oviposition time in order to attack the mosquito when it is at its most vulnerable and when control interventions will have the most impact.Results: Oviposition studies showed two peaks corresponding with late evening and again just before dawn. Most eggs were also laid in the first half of the night (18h00 – midnight). Most mosquitoes erupted just after sunset and the sex ratios showed that twice as many females as males emerged. Females readily took a bloodmeal after oviposition or just after erupting. Hatch rate to viable first instar larvae was 74.5%.Conclusions: The results of this study have provided information as to when interventions would be most effective in controlling mosquito populations and have provided information that highlights the value of larval control as a complementary measure to adult mosquito control. The most vulnerable stages of the female Anopheles arabiensis are when they have just emerged or when they have just oviposited. Vector control strategies should be designed to target these vulnerable stages at the breeding sites in order to have maximum impact.
Expanded Circulating Follicular Dendritic Cells Facilitate Immune Responses in Chronic HBV Infection
Authors: Li Xiaoyi , Zhang Qifan , Zhang Wanyue , Ye Guofu , Ma Yanchen , Wen Chunhua , Gu Shuqin , Tang Libo , Li Yongyin
Published: August 2020

Background: Restoration of host hepatitis B virus (HBV)-specific antiviral immunity is an effective strategy for hepatitis B recovery. Follicular dendritic cells (FDCs) play a crucial role in immune regulation. This study aims to investigate the characteristics and functions of FDCs in chronic HBV infection. Methods: The frequencies of FDCs in peripheral blood, liver, and spleen were measured in patients with chronic HBV infection. Isolated FDCs from splenic tissues of HBV-related liver cirrhosis-induced hypersplenism patients were cultured with autologous intrasplenic CD4+ T cells and CD19+ B cells. Results: We found that patients with chronic HBV infection had a significantly increased frequency of circulating FDCs compared with that of healthy controls. Additionally, the frequency of circulating FDCs was positively correlated with that of intrahepatic and intrasplenic counterparts. Moreover, a positive correlation between the frequency of circulating FDCs and plasmablast and memory B cells, as well as C-X-C motif chemokine receptor type 5 (CXCR5)+CD4+ T cells and CXCR5+CD8+ T cells was also observed. Notably, in vitro experiments demonstrated that FDCs derived from splenic tissues of chronic HBV patients facilitated interferon-γ and interleukin-21 production from autologous intrasplenic CD4+ T cells and promoted the proliferation of autologous intrasplenic CD19+ B cells.Conclusions: Expanded FDCs in patients with chronic HBV infection may favor the host immune responses against HBV. The identification of this unique population may contribute to a better understanding of the immune regulatory mechanisms and provide a potential immunotherapeutic target in chronic HBV infection.
Change in Age Distribution of the Injuries and Comparison of Different Scoring Tools in Predicting Mortality Among Geriatric Trauma Patients
Authors: Jiang Libing , Zheng Zhongjun , Zhang Mao
Published: August 2020

Purpose: The aim of this study was to describe the age trend of trauma patients and to compare different scoring tools to predict in-hospital mortality in elderly trauma patients.Methods: National Trauma Database (NTDB) in the United States from 2005 to 2015 and the Trauma Register DGU® in German from 1994 to 2012 was searched to describe age change of trauma patients. Then we secondly analyzed the data published in http://datadryad.org/. According to the in-hospital survival status, patients were divided into survival group and non-survival group. Receiver Operating Characteristic Curve (ROC) analysis was used to evaluated the value of ISS (injury severity score); NISS (new injury severity score), APACHE Ⅱ (Acute Physiology and Chronic Health Evaluation Ⅱ), SPAS Ⅱ (simplified acute physiology score Ⅱ) and TRISS (Trauma and Injury Severity Score) in predicting in-hospital mortality among geriatric trauma patients.Results:The analysis of NTDB showed the percentage of geriatric trauma has increased from 0.18 to 0.30, 2005-2015. The analysis of DGU showed the mean age rose from 39.11 in 1993 to 51.10 in 2013, and the percentage of patients aged ≥60 rose from 16.5% to 37.5%. A total of 311 patients aged more than 65 years were secondly analyzed. One hundred and sixty-four (52.73%) patients died in the hospital. ISS, NISS, APACHE, and SAPS in the death group were significantly higher than those in the survival group, but TRISS in the death group was significantly lower than those in the survival group. The AUC of APACHE Ⅱ was 0.715, ISS was 0.807, NISS was 0.850, SPAS Ⅱ was 0.725, and TRISS was 0.828.Conclusion:The increasing number of trauma in the elderly is a challenge for current and future trauma management. Compared with APACHE and SAPS, ISS, NISS and TRISS are more suitable for predicting in-hospital mortality in elderly trauma patients.
Service Quality, Brand Image, Perceived Value, Patient Satisfaction and Loyalty in China’s Private Dental Clinics
Authors: LIN Wenyi , Yin Wanxia
Published: August 2020

Background: This study seeks to explore the relationship of service quality, brand image, perceived value, service satisfaction and loyalty in China’s private dental clinics. Methods: This is a cross-sectional survey study, being conducted in Dongguan City, Guangdong Province, China in January 2019. The participants were selected by convenience sampling method. A total of 230 residents were surveyed. Among them, 125 had received services in private dental clinics, being the valid sample of this study. A multiple regression model was run to explore factors influencing patient loyalty. Subsequently, the path analysis was used to understand the relationship of service quality, brand image, perceived value, patient satisfaction, and patient loyalty. Results: After controlling for the effect of demographic and socio-economic variables, perceived value and patient satisfaction have significant influences on patient loyalty. The path analysis indicates the perceived value, perceived quality, and expected quality have direct effects on patient satisfaction, and have indirect effects on patient loyalty, with patient satisfaction as a mediator. Additionally, perceived value has a direct and indirect effect on patient satisfaction. Conclusion: This study helps managers in private dental clinics to gain support from customers through building customer loyalty towards dental clinics.
Right Apical-Posterior Segmentectomy with Abnormal Anterior Segmental Bronchus and Artery: A Case Report
Authors: Zhang Xining , Lin Gang , Li Jian
Published: August 2020

Background: Displaced anterior segmental bronchus and pulmonary artery is extremely rare. A keen knowledge of such variations is required in the field of pulmonary segmentectomy, for unawareness of the structural variation could lead to intra- and postoperative complications. Case presentation: A 50-year-old female presented to our department with suspected lung adenocarcinoma. Preoperative 3-dimensional computed tomographic bronchography and angiography revealed anterior segmental bronchus and anterior segmental pulmonary artery variation: the anterior segmental bronchus derived from the middle lobe bronchus, accompanied by a distally distributed anterior segmental pulmonary artery branch. A right apical-posterior segmentectomy was performed successfully. Conclusions: The keen observation and proper application of modern imaging technology and operative technique could greatly aid segmentectomy, preventing intra- and postoperative complications from happening.
Novel and traditional anthropometric indices for identifying metabolic syndrome in non-overweight/obese adults
Authors: Wu Lihong , Zhu WenHua , Qiao Qiaohua , Huang Lijuan , Li Yiqi , Chen Liying
Published: August 2020

Background: Metabolic syndrome (MetS) in non-overweight/obese people is insidiously associated with cardiovascular disease (CVD). Novel anthropometric indices can reflect central obesity better than the traditional anthropometric indices. Therefore, we hypothesize that these newly developed anthropometric indices can better identify MetS in non-overweight/obese people than conventional indices.Methods: Cross-sectional data of sociodemographic, biochemical and anthropometric indices were collected from 2916 non-overweight/obese Chinese people. A body shape index (ABSI), body roundness index (BRI), waist-to-height ratio (WHtR), weight-adjusted-waist index (WWI) and abdominal volume index (AVI) were calculated. Partial correlation analysis was used to clarify the correlation between anthropometric indices and MetS variables. Binary logistic regression analysis was applied to assess the association between anthropometric indices and MetS and its components. Receiver-operating characteristic (ROC) curve was used to identify the diagnostic ability of anthropometric indices for MetS and its components. The area under curve (AUC) difference between WHtR and each new anthropometric index was compared in pairs.Results: After adjusting for covariates, AVI had the optimal ability of identifying MetS (AUC: 0.743 for male, 0.819 for female) and the strongest correlation with high-density lipoprotein cholesterol (HDL-C) (coe: -0.227 for male, -0.207 for female) and the highest odds rations (OR) with low HDL-C group (male: OR = 1.37, female: OR = 1.55). The WHtR was comparable to BRI in assessing MetS (AUC: 0.739 for male, 0.817 for female). WHtR or BRI could also well identify hypertension (AUC: 0.602 for male, 0.688 for female) and dysglycemia (AUC: 0.669 for male, 0.713 for female) and female's high triglyceride level (AUC 0.712). The recognition ability of the two was equivalent. The ability of ABSI and WWI to identify MetS was weak.Conclusions: AVI is the optimal anthropometric indices to identify MetS in non-overweight/obese Chinese adults. BRI and WHtR can also be considered as discriminators, while ABSI and WWI are weak discriminators. WHtR is easy to measure. So, it is recommended as an early preliminary screening method for the MetS in non-overweight/obese people.
Fluoroquinolone resistance of Staphylococcus epidermidis isolated from healthy conjunctiva and analysis of their mutations in quinolone-resistance determining region
Authors: Kang Jung Youb , Lee Woonhyung , Jeong Bo Hyeon , Park Indal , Lee Sang Joon
Published: August 2020

Background: S. epidermidis is the most common pathogen in postoperative endophthalmitis and causes various infectious eye diseases. However, there is very little information on fluoroquinolone antibiotic resistance to S. epidermidis identified in conjunctival microbe and analysis of related genes. Here, the authors investigated the rate of resistance to fluoroquinolones of Staphylococcus epidermidis isolated from normal conjunctival microbes and mutations in the quinolone-resistance determining region (QRDR).Methods: 377 eye samples from 187 patients who underwent intravitreal injection and cataract surgery were included. Before the procedure, specimens were taken from the bilateral lower conjunctival sacs using a cotton swab and cultured. The cultures were identified and gyrA, gyrB, parC, and parE gene mutations of QRDR were confirmed by DNA extraction from resistant strains of S. epidermidis with a micro-dilution method using ciprofloxacin, levofloxacin, and moxifloxacin.Results: The culture positive rate was 61.8% (231) for 374 eye samples. Of the 303 total strains cultured, S. epidermidis was the most common with 33.7% (102). Ten types of gene mutations were observed in the resistant S. epidermidis of 21 strains. One-point mutation was observed mainly in gyrA and parC, and a small number of mutations were observed in parE in the form of a double point mutations. When there were multiple point mutations in both gyrA and parC, the highest minimum inhibitory concentration (MIC) was observed.Conclusions: The quinolone resistance rate of S. epidermidis increased in comparison with previous studies, and resistant S. epidermidis showed mostly QRDR mutations, which were mainly found in gyrA and parC, and showed strong resistance when mutated in both genes.
Variations in BCO2 Coding Sequence Causing a Difference in Carotenoid Concentration in the Skin of Chickens
Authors: Wang Yan , Gan Shiyi , Luo Chenglong , Liu Tianfei , Zhao Xiaoling , Ma Jie , Lin Chuxiao , Shu Dingming , Qu Hao
Published: August 2020

Background: Carotenoid consumption decreases the risk of cancer, osteoporosis, or neurodegenerative diseases through interrupting the formation of free radicals. Carotenoid-pigmented egg yolk, skin, legs, beak, comb, and feathers in broilers give consumers the impression that they are healthier than none-pigmented ones. Deposition of carotenoids in chicken skin makes the skin color turn from white into yellow. The enzyme β-carotene oxygenase 2 (BCO2) plays a key role during the degradation process of carotenoids in skin. How does the BCO2 affects the skin color of chicken, and whether it is the key factor resulted in the phenotypic difference between yellow- and white- skin chickens are still unclear. Three female chickens of the Guangxi Huang and Qingjiao Ma breed were slaughtered and used for carotenoid concentration and BCO2 expression level analysis. The carotenoid concentration in chicken skin was determined by HPLC. A total of 1054 DNA samples from seven different chicken breeds were genotyped and allele frequencies analysis.Results: In the present study, we measured the concentration of carotenoids in chicken skin showed that the carotenoid concentration in chicken with a yellow skin was significantly higher than that with white skin chicken. Then we analyzed the expression profile of BCO2 in different tissues and observed significant differences in gene expression in the back skin between yellow- and white- skin chicken. Scanning the SNPs in BCO2 gene, it revealed a G/A mutation in exon 6, which was confirmed by PCR-RFLP. Copy number variation (CNV) was also detected; the copy number in white yellow skin chicken was almost 2-fold of that than in yellow skin chicken. These results implied that the G/A mutation and CNV in chicken skin may play a key role in regulating the carotenoids degradation. Conclusions: Generally, reduced expression of the BCO2 gene due to lower CVNs may be responsible for the deposition of carotenoids and as a consequence a yellow skin color in yellow skin chicken. One SNP c.890A>G was found to be associated with the chicken skin color and may be used as a genetic marker in breeding for yellow skin in chicken in the future.
Modelling Cost-Effectiveness of Syphilis Detection Strategies In Prisoners: Exploratory Exercise In A Chilean Male Prison
Authors: Castillo-Laborde Carla , Gajardo Pedro , Ferrari Manuel Nájera-De , Matute Isabel , Hirmas-Adauy Macarena , Aguirre Pablo , Ramírez Héctor , Rámirez Daniel , Aguilera Ximena
Published: August 2020

BACKGROUND: Syphilis, together with other sexually transmitted infections, remains a global public health problem that is far from being controlled. People deprived of liberty are one of the vulnerable population. Control activities in prisons rely mostly on passive case detection, despite the existence of affordable alternatives that would allow switching to active case-finding strategies. Our objective was to develop a mathematical modelling framework for cost-effectiveness evaluation, from a health system perspective, of different approaches using rapid tests for the detection of syphilis in inmates' populations and to explore the results based on a Chilean male prison population. Methods: A compartmental model was developed to characterize the transmission dynamics of syphilis inside a prison with the ongoing strategy (passive case detection, with VRDL + FTA-ABS), considering the entrance and exit of inmates over a 40 year period. The model allows to simulate the implementation of a reverse algorithm for the current situation (rapid test + VDRL), different screening strategies (entry point, massive periodically; both with rapid test + VDRL) and treatment of detected cases. The parameters for the exploratory exercise were obtained from systematic searches of indexed and grey literature and field work (EQ-5D questionnaire application and key actors interviews). Probabilistic sensitivity analysis was conducted to account for uncertainty in relevant parameters. RESULTS: The proposed framework allows the evaluation of different detection strategies. In this study, all the strategies were cost-effective in the baseline scenario when considering an ICER threshold of 1 Chilean GDP per capita (US$15,000). The strategies most likely to be cost-effective (over 80% probability) were: current situation with reverse algorithm, entry point screening and mass screening every two years; the latter was the most effective, achieving the lowest prevalence (0.7% and 1.7% over the period versus the 3% prevalence in the current situation).CONCLUSIONS: Mathematical modelling that considers the performance of different test and detection strategies might be a powerful tool for decision making. The exploratory results show the efficiency of adopting both the use of the rapid tests and to perform active case detection to significantly reduce the burden of syphilis in Chilean prisons in the near future.