bluuebunny/crossref_metadata_2025 huggingface dataset:
Willingness and Cognition Toward Reporting Travel History to High-Risk Coronavirus Disease 2019 Epidemic Regions Among The Chinese Public: A Cross-Sectional Study
Authors: Wei Lifeng , Sha Zhuowa , Wang Ying , Zhang Gangyu , Jia Haonan , Zhou Shuang , Li Yuanheng , Liu Chao , Jiao Mingli , Sun Shufan , Wu Qunhong
Published: April 2020

Background
The coronavirus disease 2019 (COVID-19) that originated in Wuhan, China, is currently spreading throughout China. The majority of infected patients either traveled to Wuhan or came into contact with an infected person from Wuhan. Investigating members of the public with a travel history to Wuhan became the primary focus of the Chinese government’s epidemic prevention and control measures, but several instances of withheld histories were uncovered as localized clusters of infections broke out. This study investigated the public’s willingness and cognition toward reporting travel history to high-risk epidemic regions, to provide effective suggestions and measures for encouraging travel reporting.
Methods
A cross-sectional study was conducted online between February 12 and 19, 2020. Descriptive analysis, chi-squared test, and Fisher’s exact test were used to identify socio-demographic factors and cognition toward reporting, as well as their impact on the willingness to report on travel history to high-risk epidemic regions.
Results
Of the 1,344 respondents, 91 (6.77%) expressed an inclination to deliberately withhold travel history. Those who understood the benefits of reporting and the legal consequences for deliberately withholding information, showed greater willingness to report their history (P < 0.05); conversely, those who believed reporting would stigmatize them and feared being quarantined after reporting showed less willingness to report (P < 0.05).
Conclusions
As any incident of withheld history can have unpredictable outcomes, the proportion of people who deliberately withhold information deserves attention. Appropriate public risk communication and public advocacy strategies should be implemented to strengthen the understanding that reporting on travel history facilitates infection screening and prompt treatment, and to decrease the fear of potentially becoming quarantined after reporting. Additionally, social support and policies should be established, and measures should be taken to alleviate stigmatization and discrimination against potential patients and reporters of travel history. Reinforcing the legal accountability of withholding travel history and strengthening systematic community monitoring are the measures that China is currently taking to encourage reporting on travel history to high-risk epidemic regions. These non-pharmaceutical interventions are relevant for countries that are currently facing the spread of the epidemic and those at risk of its potential spread.
Changes in bowel sounds of inpatients undergoing general anesthesia
Authors: Wang Guojing , Wang Mingjun , Liu Hongyun , Zhao Suping , Liu Lu , Wang Weidong
Published: April 2020

Background: General anesthesia can affect intestinal function, but there is no objective, practical and effective indicator to evaluate the inhibition and recovery of intestinal function. The main objectives of this study were to assess whether bowel sounds (BSs) changed before, immediately after and 3 hours after general anesthesia, and whether these changes in BSs are an effective indicator of intestinal function and an accurate guide for post-operative feeding. Methods: We randomly selected 26 inpatients and collected three sets of 5-minute continuous BS data before the operation (Pre-op), immediately after the operation (Pro-op) and three hours after the operation (3h-Pro-op) for each patient. Then the linear and nonlinear characteristic values (CVs) of each EBS were extracted and paired t -tests and rank-sum tests were used to evaluate the changes in the BSs. Results: The differences in CVs, between Pre-op and Pro-op, as well as between Pro-op and 3h-Pro-op, were statistically significant ( p <0.05). However, there is no statistically significant differences between all the CVs between Pre-op and 3h-Pro-op ( p >0.05). Conclusion: BSs changes before and after general anesthesia. Furthermore, the BSs are weakened due to general anesthesia and recover to the pre-op state three hours later. Therefore, the BSs can be an indicator of intestinal function under general anesthesia, so as to provide guidance for postoperative feeding , which is of considerable clinical significance.
Comparison of volume and hemodynamic effects of crystalloid, hydroxyethyl starch, and albumin in patients undergoing major abdominal surgery: a prospective observational study
Authors: Toyoda Daisuke , Maki Yuichi , Sakamoto Yasumasa , Kinoshita Junki , Abe Risa , Kotake Yoshifumi
Published: April 2020

Background
The volume effect of iso-oncotic colloid is supposedly larger than crystalloid, but such differences are dependent on clinical context. The purpose of this study was to compare the volume and hemodynamic effects of crystalloid and colloid during surgical manipulation in patients undergoing major abdominal surgery.
Methods
Subjects undergoing intraabdominal surgery for malignancies with intraoperative goal-directed fluid management enrolled in this observational study. Fluid challenges consisted with 250 ml of either bicarbonate Ringer solution, 6% hydroxyethyl starch or 5% albumin were provided to maintain optimal stroke volume index. Hematocrit derived-plasma volume and colloid osmotic pressure was determined immediately before and 30 min after the fluid challenge. Data were expressed as median (IQR) and statistically compared with Kruskal-Wallis test.
Results
One hundred thirty-nine fluid challenges in 65 patients were analyzed. bicarbonate Ringer solution, 6% hydroxyethyl starch and 5% albumin were administered in 42, 49 and 48 instances, respectively. Plasma volume increased 7.3 (3.6–10.0) % and 6.3 (1.4–8.8) % 30 min after the fluid challenge with 6% hydroxyethyl starch and 5% albumin and these values are significantly larger than the value with bicarbonate Ringer solution (1.0 (-2.7-2.3) %) Colloid osmotic pressure increased 0.6 (0.2–1.2) mmHg after the fluid challenge with 6% hydroxyethyl starch and 0.7(0.2–1.3) mmHg with 5% albumin but decreased 0.6 (0.2–1.2) mmHg after the fluid challenge with bicarbonate Ringer solution. The area under the curve of stroke volume index after fluid challenge was significantly larger after 6% hydroxyethyl starch or 5% albumin compared to bicarbonate Ringer solution.
Conclusions
Fluid challenge with 6% hydroxyethyl starch and 5% albumin showed significantly larger volume and hemodynamic effects compared to bicarbonate Ringer solution during gastrointestinal surgery.
Trial registration:
UMIN Clinical Trial Registry UMIN000017964. Registered July 01, 2015
Association between self-reported walking speed and calcaneal stiffness index in postmenopausal Japanese women
Authors: Tomita Yoshihito , Arima Kazuhiko , Mizukami Satoshi , Tsujimoto Ritsu , Kawashiri Shin-ya , Nishimura Takayuki , Okabe Takuhiro , Tanaka Natsumi , Honda Yuzo , Nakahara Kazumi , Yamamoto Naoko , Ohmachi Izumi , Goto Hisashi , Hasegawa Maiko , Sou Youko , Horiguchi Itsuko , Kanagae Mitsuo , Abe Yasuyo , Nonaka Fumiaki , Tamai Mami , Yamanashi Hirotomo , Nagata Yasuhiro , Kawakami Atsushi , Maeda Takahiro , Aoyagi Kiyoshi
Published: April 2020

Background
Osteoporosis and related fractures, a worldwide public health issue of growing concern, is characterized by compromised bone strength and an increased risk of fracture. Here we show an association between self-reported walking speed and bone mass among community-dwelling postmenopausal Japanese women aged 50 years and older.
Methods
A cross-sectional study was conducted among 1,008 postmenopausal women who underwent a general medical check-up in 2014 and 2016 as recommended by the Japanese government. Self-reported walking speed was ascertained by asking the participants: “Is your walking speed faster than others of the same age and sex?” to which participants responded “yes (faster)” or “no (moderate/slower).” Calcaneal stiffness index was measured.
Results
Women with a faster self-reported walking speed were younger and had a lower BMI, higher stiffness index, and higher grip strength than women with a slower walking speed. Multiple linear regression analysis adjusted for age, body mass index, grip strength, comorbidity, current smoking, and alcohol drinking status showed a significant association between faster self-reported walking speed and higher calcaneal stiffness index (p < 0.001).
Conclusions
Our findings suggest that questionnaires of walking speed may be useful for predicting bone mass and that a fast self-reported walking may benefit bone health in postmenopausal women.
STochastic Optical Reconstruction Microscopy (STORM) reveals the nanoscale organization of pathological aggregates in human brain
Authors: Codron Philippe , Letournel Franck , Marty Serge , Bodin Alexia , Renaud Laurence , Duchesne Mathilde , Verny Christophe , Lenaers Guy , Duyckaerts Charles , Julien Jean-Pierre , Cassereau Julien , Chevrollier Arnaud
Published: April 2020

Background
Histological analysis of brain tissue samples provide valuable information about the pathological processes leading to common neurodegenerative disorders such as Alzheimer’s or Parkinson’s diseases. In particular, high resolution and specific analysis of intra-neuronal lesions is crucial to understand the pathogenesis and progression of these diseases. In this context, the development of novel imaging approaches is a current challenge in neuroscience.
Methods
To this end, we used a recent super-resolutive imaging technique called STochastic Optical Reconstruction Microscopy (STORM) to analyze human brain sections. We combined STORM cell imaging protocols with neuropathological techniques and imaged cryopreserved brain samples from control subjects and patients with neurodegenerative diseases.
Results
This approach allowed us to perform 2D-, 3D- and two-color-STORM in central nervous system tissue sections, and to characterize with a nanometer-scale precision the architecture of physiological and pathological structures in neocortex, white matter and brainstem samples. STORM proved to be particularly effective to visualize the organization of dense protein inclusions, and allowed us to image with unprecedented details Aβ, Tau, α-synuclein and TDP-43 pathological aggregates within the central nervous system of patients with neurodegenerative disorders.
Conclusions
STORM imaging of human brain samples opens further gates to a more comprehensive understanding of the underlying mechanisms responsible for common neurological diseases. The convenience of this technique should open a straightforward extension of its application for super-resolution imaging of the human brain, with promising avenues to current challenges in neuroscience.
Can Cardiovascular Risk Management be improved by Shared Care with General Practice to Prevent Cognitive Decline Following Stroke/TIA? A feasibility randomised controlled Trial (SERVED Memory)
Authors: Davison William , Myint Phyo K , Loke Yoon K , Ravenhill Garth , Turner David A , Fox Chris , Shepstone Lee , Potter John F
Published: April 2020

BackgroundCognitive impairment and dementia following cerebrovascular disease are increasingly common in the UK. One potential strategy to prevent post-stroke cognitive decline is multimodal vascular risk factor management. However, its efficacy remains uncertain and its application in vulnerable patients with incident cerebrovascular disease and early cognitive impairment has not been assessed.The primary aim of this study was to assess the feasibility of recruitment and retention of patients with early cognitive impairment post-stroke or transient ischaemic attack (TIA) to a trial of enhanced vascular risk factor management combining primary and secondary care.MethodsIn this single centre, open label trial adults with a recent stroke or TIA and mild cognitive impairment (MCI) were randomised 1:1 to a three-monthly multimodal vascular risk factor intervention jointly delivered by the trial team and General Practitioner (GP), or control (defined as usual care from the GP). Chosen risk factors were blood pressure (BP), total cholesterol, blood glucose (HbA1C) in those with diabetes, and heart rate and adequacy of anticoagulation in those with atrial fibrillation (AF). Similar patients with normal cognition were enrolled in an embedded observational cohort and also received usual care from the GP. Repeat cognitive screening was undertaken in all participants after 12 months.ResultsSeventy three participants were recruited to the randomised trial and 94 to the observational cohort (21.8% of those screened). From the randomised trial 35/73 (47.9%) dropped out before final follow-up. In all groups guideline based rates of risk factor control were mostly poor at baseline and did not significantly improve during follow-up. The observational cohort demonstrated greater decline in cognitive test scores at 12 months, with no difference between the randomised groups.ConclusionsRecruitment to such a study was feasible, but retention of participants was difficult and generally poor rates of risk factor control suggested insufficient application of the intervention. Consequently, successful scaling up of the trial would require protocol changes with less reliance on primary care services. Any future trial should include participants with normal cognition post-stroke as they may be at greatest risk of cognitive decline.Trial RegistrationISRCTN, ISRCTN42688361. Registered 16 April 2015, https://www.isrctn.com/ISRCTN42688361
Does diabetes mellitus increase the occurrence of early thrombosis in deep vein following unicompartmental arthroplasty of the knee: a retrospective cohort study
Authors: Jiao Xu-Feng , Li Zheng , An Shuai , Huang Jiang , Feng Ming-Li , Zheng Jia-Xing , Cao Guanglei
Published: April 2020

IntroductionMany patients with knee osteoarthritis also suffer from diabetes mellitus and the possibility of deep venous thrombosis (DVT) is increased following unicompartmental knee arthroplasty (UKA). Therefore, we evaluated whether DVT occurrence increased 3 days following operation in diabetic patients undergoing UKA.Materials and methodsThe incidence of deep venous thrombosis between non-diabetic and diabetic patients who underwent UKA in our hospital from August 2018 to January 2020 was compared, and the effect of glycosylated hemoglobin levels on DVT was evaluated.ResultsOf the 84 patients, 25 (29.8%) had diabetes and 59 (70.2%) did not. Within 3 days after operation, DVT occurred in 12 cases (48.0%) in the diabetic group and 8 cases (13.6%) (p < 0.001) in the control group. In logistic regression analysis, the results demonstrated that the risk of deep venous thrombosis in diabetic group was 5.53 times higher compared with non-diabetic group. For every 1 unit increase of glycosylated hemoglobin, the incidence of DVT increased 2.88 times (95% CI: 1.097–7.559, p = 0.032). There was no significant difference in age, sex, body mass index, hypertension, mode of anesthesia, operation time, intraoperative blood loss, tourniquet pressure and time between the two groups.ConclusionThe incidence of DVT in diabetic patients within 3 days after UKA is significantly higher than that in non-diabetic patients. The higher the concentration of glycosylated hemoglobin, the greater the risk of DVT.
Efficacy and safety of thrombolysis for acute ischemic stroke with atrial fibrillation: a meta-analysis
Authors: Hu Yunzhen , Ji Chunmei
Published: April 2020

Background
The efficacy and safety of intravenous thrombolysis (IVT) in acute ischemic stroke with atrial fibrillation (AF) were controversial.
Methods
We performed a meta-analysis of all relevant studies retrieved by systematic searches of the, Embase, and Cochrane databases up to December 31, 2019. Modified Rankin Scale (mRS) scores 0–1 at 90 days, mRS 0–2 at 90 days, overall mortality, and symptomatic intracranial hemorrhage (sICH) incidence were collected as outcome measures. Fixed effects meta-analytical models were used, and between-study heterogeneity was assessed.
Results
A total of 8,509 patients were enrolled in eighteen studies. In AF IVT versus non-AF IVT studies, AF was associated with a significant decrease in the proportion of patients with mRS of 0–1 (24.1% vs. 34.5%; OR 0.57; 95% CI 0.50–0.65; P = 0.000), mRS of 0–2 (33.6% vs. 47.8%; OR 0.50; 95% CI 0.44–0.57; P = 0.000) and significant higher in mortality (19.4% vs. 11.5%; OR 2.05; 95% CI 1.79–2.36; P = 0.000) and sICH incidence (6.4% vs. 4.1%; OR 1.60; 95% CI 1.27–2.01; P = 0.000). In AF IVT versus AF non-IVT studies, thrombolysis carried a higher risk of sICH (5.7% vs. 1.6%; OR 3.44; 95% CI 2.04–5.82; P = 0.000) instead of a better prognosis. Subgroup analysis in prospective studies also suggested a poorer functional prognosis and higher mortality in AF patients treated IVT compared with non-IVT.
Conclusion
Patients with AF had worse outcomes than those without AF after thrombolytic therapy. Patients with AF had a higher incidence of sICH after thrombolysis than those without thrombolysis.
Hospital transfer of people with dementia: results of the European RightTimePlaceCare project on their frequency, factors associated and costs
Authors: Argilés F. Javier Afonso , Meyer Gabriele , Stephan Astrid , Comas Mercè , Wübker Ansgar , Leino-Kilpi Helena , Lethin Connie , Saks Kai , Soto-Martin Maria , Sutcliffe Caroline , Verbeek Hilde , Zabalegui Adelaida , Renom-Guiteras Anna
Published: April 2020

Background
Hospitalisation is a critical moment for people with dementia and a major challenge for health care systems. The aims of this study were 1) to describe the frequency of hospital transfer among people with dementia from eight European countries, 2) to examine the factors associated with hospital transfer and 3) to evaluate the costs related with it.
Methods
The present study is a secondary data analysis of the RightTimePlaceCare European project. A cross-sectional survey was carried out with data collected from people with dementia who lived either at home or had been admitted to a nursing home in the last three months, as well as from their caregivers. Data on hospital transfers at three months were gathered with the "The Resource Utilization in Dementia" instrument. Demographic data, functional, cognitive and neuropsychiatric symptoms, comorbidity, polypharmacy, caregiver burden, nutritional status and falls were evaluated with validated tools. Multivariate regression models were used to investigate the factors associated with hospital transfers. Costs were estimated by multiplying quantities of resources used with the unit cost of each resource and inflated to the year 2018.
Results
The study sample comprised 1,700 people with dementia and their informal caregivers. Within three months, 16.7% experienced ≥ 1 hospital transfers. Multivariate logistic regression model showed a higher probability of hospital transfers among people with dementia with unintentional weight loss, polypharmacy, falls and those living in the community. The estimated costs per person with dementia/year among the participants living in a nursing home were 980.56 euros and 2,535.39 euros among those receiving home care.
Conclusion
Transfer to hospital is frequent among people with dementia, especially among those living in the community. These events are associated with the onset of geriatric syndromes such as involuntary weight loss, accidental falls and polypharmacy, and impose a remarkable economic burden. These results suggest that there is a need to develop and implement cost-effective supportive interventions that focus on the identification of people with dementia at risk of hospital transfer, the assessment and management of these geriatric syndromes and the promotion of individualised care planning for them, in order to prevent unnecessary hospital transfers.
Comorbidities associated with nontuberculous mycobacterial disease in Japanese adults: A claims-data analysis
Authors: Uno Shunsuke , Aasakura Takanori , Morimoto Kozo , Yoshimura Kimio , Uwamino Yoshifumi , Nishimura Tomoyasu , Hoshino Yoshihiko , Hasegawa Naoki
Published: April 2020

Background
Nontuberculous mycobacterial (NTM) lung disease is one of a growing number of chronic health problems that is difficult to cure in aging societies. While it is important to be vigilant about associated comorbidities in order to provide better patient care, data on the prevalence of comorbidities stratified by country or region are scarce. We aimed to elucidate the comorbidities associated with NTM disease based on Japanese health insurance claims data.
Methods
Cross-sectional analyses were performed using the claims data for 2014 provided by the Japan Medical Data Center Co., Ltd. Patients aged 20–75 years with ≥ 3 claims associated with NTM disease were identified and matched to 10 sex-and-age-matched controls that had never made a claim for NTM disease. Thirty-one comorbidities previously suspected to be associated with NTM disease were selected, and the prevalence of these comorbidities compared between cases and controls.
Result
Overall, 419 NTM patients (134 males and 285 females) and 4190 non-NTM controls were selected from the JMDC database. Aspergillosis, asthma, bronchiectasis, chronic heart failure, diffuse panbronchiolitis, gastroesophageal reflux, interstitial pneumonia, lung cancer, cancer other than breast, lung, ovary, or prostate cancer, and rheumatic arthritis were associated with NTM disease in both males and females. Chronic obstructive pulmonary disease was associated with NTM in males while chronic kidney disease, osteoporosis, and Sjögren syndrome were associated with NTM in females.
Conclusion
NTM disease was associated with multiple comorbidities that should be considered when providing medical care to individuals with NTM disease.
What we know and don’t know about the Immunization Program of Ethiopia: A Scoping Review of the Literature
Authors: Tilahun Binyam , Mekonnen Zeleke , Sharkey Alyssa , Shahabuddin Asm , Feletto Marta , Zelalem Meseret , Shiekh Kabir
Published: April 2020

Background: There has been significant recent prioritization and investment in the immunization program in Ethiopia. However, coverage rates have stagnated and remained low for many years, suggesting the presence of systemic barriers to implementation. Hence, there is a need to consolidate the existing knowledge, in order to address them and consequently improve program effectiveness. Methods: A thorough literature review and Delphi method were used. In the literature review, we searched Pubmed/Medline, WHO library, Science direct, Cochrane library, Google scholar and Google using different combinations of search strategies. Studies that applied any study design, data collection and analysis methods related to immunization program were included. In the Delphi method, a panel of 28 national and international experts were participated to identify current evidence gaps and set research priorities under the immunization program. Results: In this review, a total of 55 studies and national documents were included. The review showed that the vaccination coverage ranged from 20.6% in Afar to 91.7% in Amhara region with large inequities related to socio-economic, health service access and knowledge about vaccination across different settings. Only one study reported evidence on timeliness of immunization as 60%. The review revealed that 80% of health facilities provide immunization service nationally while service availability was only 2% in private health facilities. This review indicated that poor vaccine storage, vaccine shortage, service interruptions, poor defaulter tracing, low community engagement and poor documentation were the main barriers for the EPI program with variations across different regions. Through expert panel of discussion using Delphi method, 10 priority research areas were identified across different domains of the immunization program at national level.Conclusion: We found out that there is substantial knowledge on vaccination coverage, however, there is little evidence on timeliness of vaccination. The existing barriers that affect full immunization coverage also varied from context to context which indicates there is a need to design and implement evidence based locally tailored interventions. This review also indicated evidence gaps with more focus on health system related implementation barriers at lower level and identified further research priorities in the immunization program of Ethiopia.
Remote ischaemic preconditioning influences the levels of acylcarnitines in vascular surgery: a randomised clinical trial
Authors: Kasepalu Teele , Kuusik Karl , Lepner Urmas , Starkopf Joel , Zilmer Mihkel , Eha Jaan , Vähi Mare , Kals Jaak
Published: April 2020

Background Vascular surgery affects tissues` blood supply and microcirculation and might lead to mitochondrial dysfunction, which may result in the accumulation of acylcarnitines (ACs). It has been suggested that remote ischaemic preconditioning (RIPC) has its organ protective effect via promoting mitochondrial function. The aim of this study was to evaluate the effect of RIPC on the profile of ACs in the vascular surgery patients.Methods. This is a randomised, sham-controlled, double-blinded, single-centre study. Patients undergoing open abdominal aortic aneurysm repair, surgical lower limb revascularisation surgery or carotid endarterectomy were recruited non-consecutively. The RIPC protocol consisting of 4 cycles of 5 minutes of ischaemia, followed by 5 minutes of reperfusion, was applied. A blood pressure cuff was used for RIPC or a sham procedure. Blood was collected preoperatively and approximately 24 hours postoperatively. The profile of ACs was analysed using the AbsoluteIDQp180 kit (Biocrates Life Sciences AG, Innsbruck, Austria).Results Ninety-eight patients were recruited and randomised into the study groups and 45 patients from the RIPC group and 47 patients from the sham group were included in final analysis. There was a statistically significant difference between the groups regarding the changes in C3-OH (p=0.023) - there was a significant decrease (-0.007 µmol/L, ± 0.020 µmol/L, p=0.0233) in the RIPC group and insignificant increase (0.002 µmol/L, ±0.015 µmol/L, p=0.481) in the sham group. Additionally, a statistically significant decrease (p<0.05) was detected both in the sham and the RIPC group in the levels of following ACs: C2, C8, C10, C10:1, C12, C12:1, C14:1, C14:2, C16, C16:1, C18, C18:1, C18:2. In the sham group, there was a statistically significant increase (p<0.05) in the levels of C0 (carnitine) and a statistically significant decrease in the level of C18:1-OH. In the RIPC group, a statistically significant decrease (p<0.05) was noted in the levels of C3-OH, C3-DC (C4-OH), C6:1, C9, C10:2.Conclusions It can be concluded that RIPC has an effect on the levels of ACs and can therefore have protective effects on mitochondria in the vascular surgery patients. Further studies conducted on metabolically more homogenous populations are needed to make more definite conclusions about the effect of RIPC on the levels of ACs.Trial registration: ClinicalTrials.gov database, NCT02689414. Registered 24 February 2016 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02689414.
Effects Which M6A RNA Methylation Regulation Exerts on the Prognosis of Hepatocellular Carcinoma
Authors: Jia Baoxue , Pei Xiaojian , Sun Yue , Xing Yaming , Hu Jinna , Wang Qiong , Wang Yukun
Published: April 2020

Background: Hepatocellular carcinoma (HCC) ,which has been known as the most common subtype in the range of primary liver cancer . Besides, it hails as one of China ’s common cancers , giving rise to the major cancer death cause in men. N6 methyladenosine (m6A) RNA methylation is under the regulation of m6A RNA methylation regulators in dynamic way (the proteins of "writer" "eraser"; "reader"). More and more evidences show that the m6A modification level is connected with self-renewal of tumor stem cells, the growth, proliferation, anti chemotherapy and radiosensitivity of tumor cells. The relationship between m6A RNA and human cancer types has been confirmed in a variety of cancers. This research aims to investigate the relationship betwixt m6A RNA methylation regulators and liver cancer. Methods: firstly, the comparison of the expression levels harbored by 13 major m6A RNA methylation regulators in liver cancer with normal tissues was conducted by means of the data of TCGA database. Secondly, we cluster the presentation data of m6A RNA methylated regulator uniformly and dissect HCC tissue into two subgroups (group 1 and 2) by comparing these subgroups according to the overall survival rate (OS), WHO phase and pathological level . Thirdly, based on the combination of least absolute contraction with selection operator (lasso) regression, the risk characteristics of m6A RNA methylation regulators was constructed , which affected OS in TCGA analysis. Results: there were significant differences in the presentation degrades held by 12 major m6A RNA methylation regulators in liver cancers and normal tissues. The primary liver cancer was divided into 1 and 2 groups. It was found that the OS of 1 subgroup was poor, the WHO stage was high and the pathological grade was high. In TCGA analysis, five m6A methylation regulators (YTHDF1, ZC3H13, YTHDF2, METTL3 and KIAA1429) were selected to affect OS, and a risk marker significantly related to who staging was constructed, which was also an independent prognostic marker of OS. Conclusion: m6A RNA methylation regulator is a key player in the progression of HCC and has potential value in the prediction and treatment of HCC.
Identification of risk factors for involuntary psychiatric hospitalization: Using environmental socioeconomic data and methods of machine learning to improve prediction
Authors: Karasch Olaf , Schmitz-Buhl Mario , Mennicken R Roman , Zielasek Jürgen , Gouzoulis-Mayfrank Euphrosyne
Published: April 2020

Background: The purpose of this study was to identify factors associated with a high risk of involuntary psychiatric in-patient hospitalization both on the individual level and on the level of mental health services and the socioeconomic environment that patients live in. Methods: The present study expands on a previous analysis of the health records of 5764 cases admitted as in-patients in the four psy­chiat­ric hospitals of the Metropolitan City of Cologne, Germany, in the year 2011 (1773 cases treated under the Mental Health Act and 3991 cases trea­ted voluntarily). Our previous analysis had included medical, socio­demographic and socioeconomic data of every case and used a machine learning-based prediction model employing chi-squared automatic interaction detection (CHAID). Our current analysis attempts to improve the previous one through (1) optimizing the machine learning procedures (use of a different type of decision-tree prediction model (CART) and application of hyperparameter tuning), and (2) the addition of socioeconomic data on the patients’ environment to the data set. Results: Compared to our previous analysis, model fit was improved. Main diagnoses of an organic mental or a psychotic disorder (ICD-10 groups F0 and F2), suicidal behavior upon admission, admission outside of regular service hours and absence of outpatient treatment prior to admission were confirmed as powerful predictors of detention. Particularly high risks were shown for (1) patients with an organic mental disorder, specifically if they were retired, admitted outside of regular service hours and lived in assisted housing, (2) patients with suicidal tendencies upon admission who did not suffer from an affective disorder, specifically if it was unclear whether there had been previous suicide attempts, or if the affected person lived in areas with high unemployment rates, and (3) patients with psychosis, specifically those who lived in densely built areas with a large proportion of small or one-person households. Conclusions: Certain psychiatric diagnoses and suicidal tendencies are major risk factors for involuntary psychiatric hospitalization. In addition, service-related and environmental socioeconomic factors contribute to the risk for detention. Identifying modifiable risk factors and particularly vulnerable risk groups should help to develop suitable preventive measures.
TMIGD1 is Expressed at Low Levels in Abdominal Adhesion Tissue and Reduces Oxidative Stress in Peritoneal Mesothelial Cells
Authors: Wu Yunhua , Li Xuqi , Shen Cong , Wang Zijun , Liu Dong , Gao Qiuying , Wei Guangbing
Published: April 2020

BackgroundPostoperative abdominal adhesion is one of the most commonly observed complications after abdominal surgery. However, there is no effective treatment for adhesion other than enterolysis. Mesothelial cell repair plays an extremely important role in the process of adhesion formation. Here, we hypothesize that transmembrane and immunoglobulin domain-containing 1 (TMIGD1) is expressed at low levels in abdominal adhesion tissue and can reduce oxidative stress and promote cell adhesion in peritoneal mesothelial cells.Materials and MethodsFirst, we performed gene microarray analysis and used qPCR, western blotting, immunohistochemistry and immunofluorescence to detect the expression of TMIGD1 in rat adhesion tissue and normal peritoneal tissue. Then, we established a TMIGD1-overexpressing HMrSV5 cell line and detected ROS, apoptosis, and the mitochondrial membrane potential by the MTT assay, western blotting, flow cytometry with 2’,7’-dichlorofluorescein diacetate (DCFH-DA) as a probe. Furthermore, we examined p38 phosphorylation in different TMIGD1-expressing cell lines and used a p38 inhibitor to determine whether the antioxidant effect of TMIGD1 is dependent on p38. Finally, we evaluated the adhesion ability of different TMIGD1 cell lines using scratch wound and adhesion assays.ResultsTMIGD1 was expressed at low levels in adhesion tissue and at lower levels in mesothelial cells. TMIGD1 overexpression alleviated H2O2-induced oxidative stress injury in human HMrSV5 cell lines. The phosphorylation level of p38 was higher in the TMIGD1-overexpressing cell line, and we found that the effect of TMIGD1 was inhibited by a p38 inhibitor. In addition, TMIGD1 overexpression inhibited mesothelial cell migration and promoted mesothelial cell adhesion.ConclusionTMIGD1 is expressed at low levels in abdominal adhesion tissue and can reduce H2O2-induced oxidative stress by promoting p38 phosphorylation. In addition, TMIGD1 can promote cell adhesion.# These authors contributed equally to this work.
Minimum 3.5-year outcomes of operative treatment for Achilles tendon partial tears in the midportion and retrocalcaneal area
Authors: Lohrer Heinz
Published: April 2020

BackgroundAchilles tendon partial tears are not easy to diagnose and to manage. Most frequently, they are located in the midportion and insertional area. These entities result from different pathologic pathways and different treatment strategies are applied. The outcome is rarely investigated.MethodsThis study includes patients who underwent surgery for partial tears in the midportion or retrocalcaneal Achilles tendon area between the years 2009 and 2015 by a single surgeon. Patients were prospectively assessed preoperatively and 3, 6, and 12 months postoperatively, using the VISA-A-G questionnaire. The final retrospective follow-up was performed after a minimum of 3.5 years postoperatively. Forty-eight Achilles tendon partial tears at the level of the retrocalcaneal bursa (impingement lesions) and 27 midportion Achilles tendon partial tears were identified. After applying rigorous exclusion criteria, 21 and 16 cases, respectively, remained for the final follow-up. Results were analysed by descriptive statistics.ResultsThe VISA-A-G outcome scores improved significantly from preoperative to six months, 12 months, and final postoperative assessment. Preoperatively, the average VISA-A-G score was 42.1 (range, 18–73) for patients operated for Achilles tendon partial tears at the level of the retrocalcaneal bursa and 44.6 (range, 10–73) for the midportion Achilles tendon partial tear group, respectively (p = 0.690). At final follow-up 88.8 (range, 15 to 100) and 96.9 (range, 71 to 100) were scored in the respective treatment groups (p = 0.002).ConclusionsIn Achilles tendon partial tears recalcitrant to conservative treatment, operative intervention is highly successful in most cases, irrespective of the level of the injury. Twelve months postoperatively and at final follow-up, however, results were significantly better in the midportion Achilles tendon partial tear group.Trial registrationDRKS, DRKS00014266. Registered 06 April 2018. 'Retrospectively registered', https://www.drks.de/drks_web/navigate.do?navigationId=results .
Non-specific diagnoses are frequent in patients hospitalized after calling 112 and their mortality is high – a register-based Danish cohort study
Authors: Nielsen Frederikke Vestergaard , Nielsen Mette Rønn , Lorenzen Ida Lund , Amstrup Jesper , Kløjgaard Torben Anders , Færk Emil , Bøggild Henrik , Christensen Erika Frischknecht
Published: April 2020

Background The number of patients calling for an ambulance increases. A considerable number of patients receive a non-specific diagnosis at discharge from the hospital, and this could imply less serious acute conditions, but the mortality has only scarcely been studied. The aim of this study was to examine the most frequent sub-diagnoses among patients with hospital non-specific diagnoses after calling 112 and their subsequent mortality. Methods A historical cohort study of patients brought to the hospital by ambulance after calling 112 in 2007-2014 and diagnosed with a non-specific diagnosis, chapter R or Z, in the International Classification of Diseases, 10 th edition (ICD-10). 1-day and 30-day mortality was analyzed by survival analyses and compared by the log-rank test. Results We included 74,847 ambulance runs in 53,937 unique individuals. The most frequent diagnoses were ‘unspecified disease’ (Z039), constituting 47.0 % (n 35,279). In children 0-9 years old, ‘febrile convulsions’ was the most frequent non-specific diagnosis used in 54.3 % (n 1,602). Overall, 1- and 30-day mortality was 2.2 % (n 1,205) and 6.0 % (n 3,258). The highest mortality was in the diagnostic group ‘suspected cardiovascular disease’ (Z035) and ‘unspecified disease’ (Z039) with 1-day mortality 2.6 % (n 43) and 2.4 % (n 589), and 30 day mortality of 6.32 % (n 104) and 8.1 % (n 1,975). Conclusion Among patients calling an ambulance and discharged with non-specific diagnoses the 1- and 30-day mortality, despite modest mortality percentages lead to a high number of deaths.
Determinants of Uptake of Malaria Preventive Interventions among Pregnant Women in Eastern Uganda
Authors: Wafula Solomon Tsebeni , Mendoza Hilbert , Nalugya Aisha , Musoke David , Waiswa Peter
Published: April 2020

Background Consistent use of insecticide-treated nets (ITNs) and intermittent preventive treatment in pregnancy (IPTp) have been recommended as cost-effective interventions for malaria prevention during pregnancy in endemic areas. However, the coverage of these interventions during pregnancy in sub-Saharan Africa is still suboptimal. In this study, we investigated the uptake of IPTp and ITNs, and associated factors among women during their recent pregnancy in Eastern Uganda. Methods This was a cross-sectional study conducted among 2,062 women who had delivered within the last 12 months in three districts in Eastern Uganda. The primary outcomes were consistent ITN use and optimal uptake (at least 3 doses) of IPTp. A modified Poisson regression was used to examine the association between consistent ITN use and the uptake of optimal doses of IPTp with independent variables. Data were analyzed using Stata 14 software. Results The level of uptake of IPTp3 (at least three doses) was 14.7 %, while IPTp2 (at least two doses) was 60.0%. The majority (86.4%) of mothers reported regularly sleeping under mosquito nets for the full duration of pregnancy. Uptake of IPTp3 was associated with engaging in farming (adjusted PR = 1.71, 95% CI [1.28 – 2.28]) or business (adjusted PR = 1.60, 95% CI [1.05 – 2.44]), and attending at least 4 antenatal care (ANC) visits (adjusted PR = 1.72, 95%CI [1.34 – 2.22]). On the other hand, consistent ITN use was associated with belonging to the fourth wealth quintile (adjusted PR = 1.08, 95% CI [1.02 – 1.14]) or fifth wealth quintile (adjusted PR = 1.08, 95% CI [1.02- 1.15]), and attending at least 4 ANC visits (adjusted PR = 1.07, 95% CI [1.03- 1.11]). Conclusion Uptake of IPTp3 and consistent ITN use during pregnancy were lower than recommended guidelines, thus threatening the progress so far made towards malaria elimination. Our findings highlight the need for more efforts to enhance utilisation of ANC services, which is likely to increase the uptake of these two key malaria preventive measures during pregnancy.
Automated synthesis of 18F radiolabelled indole containing Oncrasin-like molecules; a comparison of iodonium salts and boronic ester chemistry.
Authors: McDonald Alexander Franklin , Goh Yit Woo , White Jonathan M , Scott Andrew M , Ackermann Uwe
Published: April 2020

Oncrasin-1 is a small molecule which was identified from a screen of KRAS mutant cancer cells and has shown specificity for KRAS mutant cell killing. We aimed to develop a radiolabelled form of Oncrasin-1 to enable in-vivo imaging of mutant KRAS expression in malignant tumours. This work outlines the synthesis of 3 fluorinated derivatives and development of iodonium salt and boronic ester precursors for radiolabelling with the 18F isotope. Attempted synthesis of iodonium salts showed that the indole structure is incompatible with oxidizing conditions required for iodonium salt formation. Synthesis and radiolabelling of boronic acid pinacol ester precursors were successful and resulted in RCY of 10–25% across the 3 different substitution patterns. The successful synthesis of these tracers will allow for investigation of Oncrasin based molecules as potential diagnostics for cancers expressing mutant KRAS protein.
Conditional quantiles estimation of the incubation period of COVID-19
Authors: Liu Xiaohui , Wang Lei , Ma Xiansi , Wang Jiewen
Published: April 2020

Background : In December 2019, some cases of pneumonia with unknown etiology were identified in Wuhan, Hubei province in China. The World Health Organization (WHO) has named this disease as COVID-19, standing for ``2019 coronavirus disease", and announced the disease have become a public health incident on December 31, 2019. This study aimed to investigate the conditional distribution of the incubation period of COVID-19 on the age of infected cases, and estimate its corresponding conditional quantiles from information on 2172 confirmed cases from 29 provinces outside Hubei in China. Methods : We collected data including the infection dates, onset dates, and ages of the confirmed cases from the websites of the centres of disease control, or the daily public reports through February 16th, 2020. A new maximum likelihood method was developed to account for the biased sampling, or right truncation, issue of the data as the epidemic is still ongoing. The estimators can be shown to be consistent asymptotically under mild conditions. Results : Based on the collected data, we found that the conditional quantiles of the incubation period distribution of COVID-19 varies over ages. In detail, the high conditional quantiles of people in the middle age group are shorter than those of others. We estimated that the 0.95-th quantile related to people in the age group 23$\sim$55 is less than 15 days. Conclusions : Observing that the conditional quantiles vary over ages, we may take more precise measures for people of different ages. For example, we may consider carrying out an age-dependent quarantine duration, rather than a uniform 14-days quarantine, in practice. Remarkably, we may need to extend the current quarantine duration for people aged $0\sim22$ and over 55 because the related 0.95-th quantiles are much greater than 14 days.
Effects of brisk walking on blood pressure in the Chinese Han occupational population with a sedentary lifestyle: A baseline control trial
Authors: Yu Yingxiang , Chang Cuiqing , Wu Yifan , Xie Lan , Guo Chengcheng
Published: April 2020

Background: Physical activity has proven to be effective in improving blood pressure (BP), but research on the beneficial exercise volume for BP control is limited. We assessed the intervention effects of walking on BP in the Chinese Han occupational population with a sedentary lifestyle to explore the appropriate exercise volume needed for BP control.Methods: A total of 802 subjects were recruited from enterprises and institutions for our study. This study was designed as an intervention study for a baseline control trial. All participants received a 3-month open and prescription pedometer-assisted self-monitoring walking intervention. Multiple linear regression models were used to assess the association between physical activity and changes in systolic (SBP) and diastolic (DBP) BP. We divided the effective step counts into five levels: 4000-<6000 (level 1), 6000-<8000 (level 2), 8000-<10000 (level 3), 10000-12000 (level 4), and >12000 (level 5) steps/day for statistical analysis to evaluate the exercise intervention efficiency.Results: Data of 688 participants who completed the study were analyzed. After 3 months, SBP and DBP decreased by 1.9 and 2.0 mmHg, respectively (P < 0.05). Taking level 5 (>12000 steps/day) as reference, SBP can be better controlled at levels 1-4: level 1 had the best effect (-6.05 mmHg, P=0.007), followed by level 2 (-3.54 mmHg, P=0.006), showing a significant dose-effect relationship between exercise and SBP. Furthermore, the effective step count of 6000-<8000 steps/day was better in controlling SBP in males (-4.26 mmHg, P = 0.014), while 4000-<6000 steps/day had a better effect on females (-6.86 mmHg, P = 0.037). The significant dose-effect relationship was only observed in the 36-50 age group. However, no significant dose-effect relationship between exercise and DBP.Conclusions: Brisk walking can effectively control BP in the Chinese Han occupational population with a sedentary lifestyle. There was a significant dose-effect relationship between exercise and SBP with differences in sex and age. Trial registration: ChiCTR-OOh-16010229. Registered 5 January 2017 - Retrospectively registered, http://www.chictr.org.cn/showprojen.aspx?proj=17362.