bluuebunny/crossref_metadata_2025 huggingface dataset:
Isolation of axenic cyanobacterium and the promoting effect of associated bacterium on axenic cyanobacterium
Authors: Gao Suqin , Kong Yun , Yu Jing , Miao Lihong , Ji Lipeng , Song Lirong , Zeng Chi
Published: November 2020

Background: Harmful cyanobacterial blooms have attracted wide attention all over the world as they cause water quality deterioration and ecosystem health issues. Microcystis aeruginosa associated with a large number of bacteria is one of the most common and widespread bloom-forming cyanobacteria that secret toxins. These associated bacteria are considered to benefit from organic substrates released by the cyanobacterium. In order to avoid the influence of associated heterotrophic bacteria on the target cyanobacteria for physiological and molecular studies, it is urgent to obtain an axenic M. aeruginosa culture and further investigate the speciﬁc interaction between the heterotroph and the cyanobacterium. Results: A traditional and reliable method based on solid-liquid alternate cultivation is carried out to purify the xenic cyanobacterium M. aeruginosa FACHB-905. On the basis of 16S rDNA gene sequences, two associated bacteria named strain B905-1 and strain B905-2, are identified as Pannonibacter sp. and Chryseobacterium sp. with a 99% and 97% similarity value, respectively. The axenic M. aeruginosa FACHB-905A (Microcystis 905A) is not able to form colonies on BG11 agar medium without the addition of strain B905-1, while it grows well in BG11 liquid medium. Although the presence of B905-1 is not indispensable for the growth of Microcystis 905A, B905-1 has a positive effect on promoting the growth of Microcystis 905A. Conclusions: The associated bacteria are eliminated by solid-liquid alternate cultivation method and the axenic Microcystis 905A is successfully purified. The associated bacterium B905-1 has the potential to promote the growth of Microcystis 905A. Moreover, the purification technique for cyanobacteria described in this study is potentially applicable to a wider range of unicellular cyanobacteria.
The invasion depth measurement of bladder cancer using T2-weighted magnetic resonance imaging
Authors: Liu Yang , Zheng Haojie , Xu Xiaopan , Zhang Xi , Du Peng , Liang Jimin , Lu Hongbing
Published: November 2020

Background: Invasion depth is an important index for staging and clinical treatment strategy of bladder cancer (BCa). The aim of this study was to investigate the feasibility of segmenting the BCa region from bladder wall region on MRI, and quantitatively measuring the invasion depth of the tumor mass in bladder lumen for further clinical decision-making. This retrospective study involved 20 eligible patients with postoperatively pathologically-confirmed BCa. It was conducted in the following steps: (1) a total of 1159 features were extracted from each voxel of both the certain cancerous and wall tissues with the T2-weighted (T2W) MRI data; (2) the support vector machine (SVM)-based recursive feature elimination (RFE) method was implemented to first select an optimal feature subset, and then develop the classification model for the precise separation of the cancerous regions; (3) after excluding the cancerous region from the bladder wall, the three-dimensional bladder wall thickness (BWT) was calculated using Laplacian method, and the invasion depth of BCa was eventually defined by the subtraction of the mean BWT excluding the cancerous region and the minimum BWT of the cancerous region.Results: The segmented results showed a promising accuracy, with the mean Dice similarity coefficient of 0.921. The “soft boundary” defined by the voxels with the probabilities between 0.1 and 0.9 could demonstrate the overlapped region of cancerous and wall tissues. The invasion depth calculated from proposed segmentation method was compared with that from manual segmentation, with a mean difference of 0.277 mm.Conclusion: The proposed strategy could accurately segment the BCa region, and, as the first attempt, realize the quantitative measurement of BCa invasion depth.
Delayed COVID-19 sequel - A challenging case of recurrent spontaneous pneumothorax
Authors: Kasturi Srikanth , Muthirevula Arvind , Chinthareddy Rohan R , Lingaraju Vijay C
Published: November 2020

Pneumothorax, as a consequence of COVID-19 infection, has become an established entity but the delayed occurrence of pneumothorax after recovery from the illness is less commonly reported. We present a case of delayed recurrent spontaneous pneumothorax, presenting four weeks after recovery from COVID-19 in a previously healthy middle-aged gentleman, for which uniportal-VATS pleurectomy was performed but the cause of pneumothorax could not be ascertained. This report brings to light, the importance of continued surveillance of COVID-19 survivors, the unpredictability of the disease process, and the challenges of thoracic surgery in this unique subset of patients.
Endoscopic Retrieval of Ingested Dental Bur in a geriatric patient: A Case Report
Authors: K Keerthana , Shetty Karthik , Jathanna Vinod , Nath Kartik , M Roma
Published: November 2020

Background: Accidental ingestion of a dental bur during the dental procedure is not a routine incident, but can result in serious complication and consequences. Case scenario: In this case report, a 76 - year old male patient, accidentally ingested a dental bur during the procedure. The presence and location of the dental bur was confirmed using chest and abdominal x-rays and it was subsequently retrieved by endoscopy procedure under general anaesthesia. The analysis of this case reaffirms the importance of the use of physical barriers such as rubber dams and gauze screens as precautionary measures to prevent such incidents from occurring.Conclusion: Taking the patient into confidence and informing him regarding the possible complications of the accident and keeping him/her under observation until the object has been removed, would fulfil the professional responsibilities of a dentist, and will result in avoiding possible legal and ethical issues. Presented case represented the usage of physical barriers in dentistry and their usefulness in the treatment protocol.
Spatio-temporal Dynamics, Drivers, Effects and Environmental Implications of Land use/land Cover Changes in Ambo Town and Its Watershed, West Shoa Zone, Oromia Regional State, Ethiopia
Authors: Ogato Gemechu Shale , Bantider Amare , Geneletti Davide
Published: November 2020

Background: Land use/land cover change in urban watersheds of developing countries like Ethiopia is claimed to be a consequence of complex interaction of different actors, driving forces, and land itself. It is asserted to result in the degradation of natural vegetation and significant increases in impervious surfaces. The purpose of the study was to analyze spatio-teporal changes in land use/ land cover in Huluka watershed where Ambo town is situated and examine their drivers and effects with environmental implications.Results: The overall increase of urban built-up area, cultivated land, and bare land use/land cover type with 351%, 105%, and 41.9% respectively between the year 1979 and 2017 implies the increase in flooding disaster risk in the watershed as such land use/land cover types exacerbate the run-off conditions in the watershed. Infrastructural expansion, agricultural expansion, increased demand for fuel wood and wood for construction, local environmental factors, local biophysical drivers, and local Social events were identified as proximate drivers of land use/land cover changes in the study area. Demographic factors, economic factors, technological factors, policy and institutional factors and cultural factors were confirmed as the underlying drivers of land use/land cover change in the watershed. Increased flooding risk, increased soil erosion; increased sedimentation into the lake (Dendi lake) and rivers (Huluka, Awaro, Debis, Boji, Bolo, Aleltu, Karkaro, and Korke), decrease in soil fertility resulting from flooding risk, and change in climatic parameters (decrease in annual rainfall and increase in heat during dry season) were claimed as the negative effects of land use/land cover change in the study area.Conclusions: Practice of appropriate land use planning and management in the watershed, appropriate environmental impact assessment (EIA), and proper planning and management of socio-cultural, economic, and environmental development are of paramount importance to promote sustainable development in the watershed.
A Biomechanical Study of Double-row Suture-bridge and Double-screw Fixation Strength in Split-type Greater Tuberosity Fractures of the Humerus
Authors: Ma Man , Zhang Xiaomeng , Wang Yanhua , Zhang Dianying
Published: November 2020

Background: This study aimed to compare the fixation strength of double-row suture-bridge (DR) and double-screw (DS) fixation methods in treating split-type greater tuberosity fracture of the humerus.Methods: We established 24 fracture models of frozen pig shoulders with reserved supraspinatus, infraspinatus, and teres minor muscles. The specimens were randomly divided into two groups according to the fixation methods of double-row suture-bridge (group A) and double screws (group B). The loads of 3-mm displacement, 5-mm displacement, and fixation failure of each group were measured using a biomechanical device in both traction directions of the supraspinatus muscle (horizontal direction) and infraspinatus-teres minor muscles (vertical backward direction). Results: In the direction of supraspinatus traction, there was no statistical difference in the mean load values of 3-mm displacement, 5-mm displacement, and fixation failure in both groups (p > 0.05). In the direction of infraspinatus-teres minor traction, the mean load values of 3-mm displacement, 5-mm displacement, and fixation failure of double-screw fixation were greater than those of double-row suture-bridge fixation (p = 0.000). Conclusion: The fixation strength of double-screw suture-bridge and double screws were equivalent in the direction of the supraspinatus. However, the fixation strength of double-screw suture-bridge was less than that of double screws, indicating poor anti-rotation property. Double-screw suture-bridge fixation alone is not recommended to treat split-type greater tuberosity fracture with a large fragment.
Quercetin Prevents Primordial Follicle Loss via Suppression of PI3K/Akt/Foxo3a Pathway Activation in Cyclophosphamide - Treated Mouse
Authors: Yu Sha , Li Jianghui , Long Hui , Cong Yanyan , Gao Hongyuan , Lyu Qifeng , Kuang Yanping
Published: November 2020

Background: Chemotherapy improves survival rates but often causes some adverse effects associated with ovarian damage, characterized by a decreased of primordial follicle stockpiles. Recent studies reveal that chemotherapy may stimulate the PI3K signaling pathway, who has roles in manipulating the dormancy and activation of mammalian primordial follicles, resulting in accelerated primordial follicles activation followed by the loss of ovarian reserve. As an inhibitor of PI3K pathway, whether quercetin has protective properties against chemotherapy - induced follicle loss in mice is worth to be explored.Methods：The effects of quercetin on the mouse model of cyclophosphamide-induced ovarian dysfunction were investigated. Paraffin sections of mouse ovary were stained with hematoxylin and eosin for differential follicles count and TUNEL assay for apoptosis detection. Immunohistochemistry stain with ki67 and Foxo3a were used to evaluate the activation of primordial follicles. The function of PI3K signaling pathway were assessed via the western blot of ovary.Results: Quercetin cotreatment rescued the reduction number of dormant primordial follicles induced by cyclophosphamide. Moreover, analysis of the PI3K/Akt/Foxo3a pathway demonstrated that quercetin co - administration decreased phosphorylation of proteins that stimulate follicle activation in ovary induced by cyclophosphamide. Meanwhile, Quercetin prevents cyclophosphamide - induced apoptosis in early growing follicles and early antral follicles, maintaining AMH level secreted by these follicles, preserving the quiescence of the primordial follicle pool, characterized by the intranuclear staining of Foxo3a in primordial follicle. Conclusions: Quercetin attenuates cyclophosphamide - induced follicle loss by preventing the phosphorylation of PI3K/Akt/Foxo3a pathway members and maintaining AMH level secreted by growing follicles.
Visuo-postural Dependency Index (VPDI) in Human Postural Control.
Authors: Danna-dos-Santos Alessander , Santos Maria M Ribeiro dos , Magalhaes Alessandra T , Cardoso Vinicius S , Driusso Patricia , Mochizuki Luis , Degani Adriana M
Published: November 2020

Background: Computerized stabilometry has been utilized to investigate the effect of vision on the neuromechanisms of human postural control. However, this approach lacks operational methods to quantify visual dependency during upright stance. Objectives: The study had three goals: (1) To introduce the concept of visuo-postural dependency indices (VPDI) representing balance sway characteristics in multiple analytical domains (spatial, temporal, frequency, and structural), (2) To investigate the age and gender effects on VPDIs, and (3) To investigate the degree of relationships between VPDI and both subjective visual vertical and horizontal perception (SVV and SVH, respectively). Methods: 102 participants (16 to 80 years old) performed bipedal stance on a force platform with eyes open and closed. Response variables included the VPDIs computed for each postural index. In addition, 29 participants also performed SVV and SVH assessments. Results: Fifteen VPDIs showed to be robust indicators of visual input modulation, and the variation across their magnitudes of modulation revealed a non-homogeneous response to changes in visual stimuli. Gender and age were not found to be a significant factor to VPDI modulation. Conclusions: VPDIs revealed to be potential measures capable to quantitatively assess visuo-postural dependency and aid the assessment of fall risks and balance impairments.
Combination of Lyophilized Adipose-Derived Stem Cells Concentrated Conditioned Medium and Polysaccharide Hydrogel in the Inhibition of Hypertrophic Scarring
Authors: Zhang Chaoyu , Wang Ting , Zhang Li , Chen Penghong , Tang Shijie , Chen Aizhen , Li Ming , Peng Guohao , Gao Hangqi , Weng Haiyan , Zhang Haoruo , Li Shirong , Chen Jinghua , Chen Liangwan , Chen Xiaosong
Published: November 2020

BackgroundMesenchymal stem cell-based acellular therapies have been widely exploited in managing hypertrophic scar. However, low maintenance dose and transitory therapeutic effects during topical medication remain a thorny issue. Herein, this study aimed to optimize the curative effect of adipose-derived stem cells conditioned medium (ADSC-CM) in the prevention of hypertrophic scarring. MethodsIn the present study, ADSC-CM was concentrated via the freeze-drying procedure. The efficacy of different dose groups (CM, CM5, CM10) was conducted on the proliferation, apoptosis, and α-smooth muscle actin (α-SMA) expression of human keloid fibroblasts (HKFs) in vitro. Incorporation of adipose-derived stem cells concentrated conditioned medium (ADSCC-CM) into polysaccharide hydrogel was investigated in rabbit ear, in vivo. Haematoxylin-eosin (H&E) and Masson's trichrome staining were performed for the evaluation of scar hyperplasia. ResultsWe noted that ADSCC-CM could downregulate the α-SMA expression of HKFs in a dose-dependent manner. In the rabbit ear model, the scar hyperplasia in the medium-dose group (CM5) and high-dose group (CM10) was inhibited with reduced scar elevation index (SEI) under 4 months of observation. It is noteworthy that the union of CM5 and polysaccharide hydrogel (CM5+H) yielded the best preventive effect on scar hyperplasia. Briefly, melanin, height, vascularity and pliability in the CM5+H group were better than those of the control group. Collagen was evenly distributed, and skin appendages could be regenerated.ConclusionsAltogether, ADSCC-CM can downregulate the expression of α-SMA due to its anti-fibrosis effect, and promote the rearrangement of collagen fibres, which is integral to scar precaution. The in situ cross bonding of ADSCC-CM and polysaccharide hydrogel could remarkably enhance the therapeutic outcomes in inhibiting scar proliferation. Hence, the alliance of ADSCC-CM and hydrogel may become a potential alternative in hypertrophic scar prophylaxis.
Natural Course of Metabolically Healthy Phenotype and Risk of Developing Cardiometabolic Diseases: a three years follow-up study
Authors: Elías-López Daniel , Vargas-Vázquez Arsenio , Mehta Roopa , Bautista Ivette Cruz , Olvera Fabiola Del Razo , Valdes Paloma Almeda , Aguilar-Salinas Carlos A. , Gómez-Velasco Donaji V.
Published: November 2020

Background:

Whether the metabolically healthy obese (MHO) phenotype is a single, stable or a transitional, fluctuating state is currently unknown. The Mexican-Mestizo population has a genetic predisposition for the development of type 2 diabetes and other cardiometabolic complications. Little is known about the natural history of metabolic health in this population. The aim of this study was to analyze the transitions over time among individuals with different degrees of metabolic health and body mass index, and evaluate the incidence of cardiometabolic outcomes according to phenotype.
Methods:

The study population consisted of a metabolic syndrome cohort with at least three years of follow up. Participants were apparently-healthy urban Mexican adults ≥ 20 years with a BMI ≥ 20 kg/m2. Metabolically healthy phenotype was defined using the criteria of the NECP ATP III metabolic syndrome criteria and the subjects were stratified into 4 groups according to their BMI and metabolic health. For cardiometabolic outcomes we estimated the incidence of cardiometabolic outcomes and standardized them per 1, 000 person-years of follow-up. Finally, to evaluate the risk for transition and development of cardiometabolic outcomes, we fitted Cox Proportional Hazard regression models.
Results:

Amongst the 5,541 subjects, 54.2% were classified as metabolically healthy and 45.8% as unhealthy. The MHO prevalence was 39.3%. Up to a third of the population changed from their initial category to another and the higher transition rate was observed in MHO (42.9%). We also found several novel factors associated to transition to metabolically unhealthy phenotype; socioeconomic status, number of pregnancies, a high carbohydrate intake, history of obesity and consumption of sweetened beverages. Similarly, visceral adipose tissue (VAT) was a main predictor of transition; loss of VAT ≥5% was associated with reversion from metabolically unhealthy to metabolically healthy phenotype (HR 1.545, 95%CI 1.266–1.886). Finally, we observed higher incidence rates and risk of incident T2D and hypertension in the MUHO and MUHL phenotypes compared to MHO.
Conclusions

Metabolic health is a dynamic and continuous process, at high risk of transition to metabolically unhealthy phenotypes over time. It is imperative to establish effective processes in primary care to prevent such transitions.
Pregnancy and Parenting Experiences of Women With Twin-to-twin Transfusion Syndrome: A Qualitative Study
Authors: Ren Lijie , Song Cancan , Xia Chunling , Wang Nan , Yang Yan , Yin Shaowei
Published: November 2020

BackgroundQualitative research can reflect the actual thoughts and experience of research subjects and can be used to explore the experiences of women presenting with twin-to-twin transfusion syndrome (TTTS) to facilitate the provision of targeted psychological support.MethodsA semi-structured interview method was used to assess the pregnancy and parenting experiences of women who presented with TTTS.ResultsWomen who presented with TTTS during pregnancy experienced persistent worry about their children’s health from the disease diagnosis to the subsequent parenting processes, when slight changes in their children’s health elicited concern. The lack of an efficient referral process and health information increased their uncertainty about their children’s health.ConclusionIn addition to the children’s health, other difficulties encountered during pregnancy and parenting may aggravate the pressure. Regardless of whether with successful delivery, women who experiencing TTTS may be more susceptible to psychological problems. Clinicians should improve the referral process and establish a follow-up system to provide women with health information and psychological support.
Value of Amniotic Fluid Homocysteine Assay in Prenatal Diagnosis of Combined Methylmalonic Acidemia and Homocystinuria, Cobalamin C Type
Authors: Chen Ting , Liang Lili , Zhang Huiwen , Ye Jun , Qiu Wenjuan , Xiao Bing , Zhu Hong , Wang Lei , Xu Feng , Gong Zhuwen , Gu Xuefan , Han Lianshu
Published: November 2020

Background: Combined methylmalonic acidemia and homocystinuria, cobalamin C type (cblC defect) is the most common inborn error of cobalamin metabolism. Even with rapid diagnosis and treatment, the long-term outcome remains poor. A reliable method for the prenatal diagnosis of cblC defect is needed for parental decisions regarding continuation of pregnancies of cblC defect fetuses.Results: The between-day and within-day imprecision of Hcy assay were 1.60%∼5.87% and 1.11%∼4.31%, respectively. For the 248 at-risk fetuses, there were 63 affected fetuses with cblC defect and 185 unaffected fetuses. The levels of Hcy in 63 affected fetuses were significantly higher than those in 185 unaffected fetuses, without overlap between the affected and unaffected groups. Sixteen fetuses displayed inconclusive genetic results of MMACHC variants, in which seven fetuses were determined to be affected with elevated amniotic fluid levels of Hcy, C3, C3/C2 and MMA. The remaining nine fetuses were considered unaffected based on a normal amniotic fluid metabolite profile. The diagnostic sensitivities of Hcy and other characteristic metabolites including propionylcarnitine (C3), ratio of C3 to acetylcarnitine (C2; C3/C2), methylmalonic acid (MMA), and methylcitrate acid (MCA) in amniotic fluid were 100%, 87.50%, 100%, 85.71%, and 28.57%, respectively. The respective specificities were 92.05%, 100%, 100%, 97.73%, and 99.43%. Conclusions: Hcy appears to be another sensitive characteristic metabolite biomarker for the prenatal diagnosis of cblC defect. The combination of Hcy assay with acylcarnitine and organic acid analysis is a fast, sensitive, and reliable prenatal diagnostic biochemical approach. This approach could overcome the challenge of the lack of genetic analysis for families with at-risk cblC defect fetuses.
Genes Induced by Fusarium Crown Rot in Wheat and Barley Significantly Overlap with those Induced by Drought Stress
Authors: Liu Chunji , Su Z.Y. , Powell Jonanthan , Gao Shawn , Zhou M.
Published: November 2020

Background: Fusarium crown rot is a chronic disease in cereal production worldwide. The impact of this disease is highly environmentally dependant and significant yield losses occur mainly in drought-affected crops. Results: In the study reported here, we evaluated possible relationships between genes conferring FCR resistance and drought tolerance using two approaches. The first approach studied FCR induced DEGs (differentially expressed genes) targeting two barley and one wheat loci against a panel of selected genes with known functions in drought tolerance. Of the 149 selected genes, 61% were responsive to FCR infection across the three loci. The second approach was an comparison of the global DEGs induced by FCR infection with the global transcriptomic responses under drought in wheat. This analysis found that approximately 48.0% percent of the DEGs detected one week following drought treatment and 74.4% of the DEGs detected three weeks following drought treatment were also differentially expressed between the susceptible and resistant isolines under FCR infection at one or more timepoints. As for the results from the first approach, the vast majority of common DEGs were downregulated under drought and expressed more highly in the resistant isoline than the sensitive isoline under FCR infection. Conclusions: Results from this study suggest that the resistant isoline in wheat was experiencing less drought stress, which could contribute to the stronger defence response than the sensitive isoline. However, most of the genes induced by drought stress in barley were more highly expressed in the susceptible isolines than the resistant isolines under infection, indicating that genes conferring drought tolerance and FCR resistance may interact differently between these two crop species. Nevertheless, the strong relationship between FCR resistance and drought responsiveness provide further evidence indicating the possibility to enhance FCR resistance by manipulating genes conferring drought tolerance.
Reliability and validity of the Patient Benefit Assessment Scale for Hospitalised Older Patients (P-BAS HOP)
Authors: Kluit Maria van der , Dijkstra Geke , de Rooij Sophia
Published: November 2020

Background: The Patient Benefit Assessment Scale for Hospitalised Older Patients (P-BAS HOP) is a tool which is capable of both identifying the priorities of the individual patient and measuring the outcomes relevant to him, resulting in a Patient Benefit Index (PBI) with range 0-3, indicating how much benefit the patient had experienced from the admission. The aim of this study was to evaluate the reliability, validity, responsiveness and interpretability of the P-BAS HOP.Methods: A longitudinal study among hospitalised older patients with a baseline interview during hospitalisation and a follow-up by telephone three months after discharge. Test-retest reliability of the baseline and follow-up questionnaire were tested. Percentage of agreement, Cohen’s kappa with quadratic weighting and maximum attainable kappa were calculated per item. The PBI was calculated for both test and retest of baseline and follow-up and compared with Intraclass Correlation Coefficient (ICC). Construct validity was tested by evaluating pre-defined hypotheses comparing the priority of goals with experienced symptoms or limitations at admission and the achievement of goals with progression or deterioration of other constructs. Responsiveness was evaluated by correlating the PBI with the anchor question ‘How much did you benefit from the admission?’. This question was also used to evaluate the interpretability of the PBI with the visual anchor-based minimal important change distribution method.Results: Reliability was tested with 53 participants at baseline and 72 at follow-up. Mean weighted kappa of the baseline items was 0.38. ICC between PBI of the test and retest was 0.77.Mean weighted kappa of the follow-up items was 0.51. ICC between PBI of the test and retest was 0.62.For the construct validity, tested in 451 participants, all baseline hypotheses were confirmed. From the follow-up hypotheses, tested in 344 participants, five of seven were confirmed. The Spearman’s correlation coefficient between the PBI and the anchor question was .51.The optimal cut-off point was 0.7 for ‘no important benefit’ and 1.4 points for ‘important benefit’ on the PBI. Conclusions: Although the concept seems promising, the reliability and validity of the P-BAS HOP appeared to be not yet satisfactory. We therefore recommend adapting the P-BAS HOP.
Assessment of embolization effect with temperature-sensitive p(N-isopropylacrylamide-co-butyl methylacrylate) nanogels in rabbit renal artery by CT perfusion and pathology
Authors: Zhang Zhen , Cen Chunyuan , Qian Kun , Li Han , Zhang Xin , Zhang Hongsen , Ma Guina , Chen Yan , Jiang Nanchuan , Zheng Chuansheng , Zhao Yanbing , Han Ping
Published: November 2020

The temperature-sensitive p(N-isopropylacrylamide-co-butyl methylacrylate) (PIB) nanogel is a novel embolic agent, but methods to assess its performance are limited. The study aimed to assess the effect of embolization with PIB nanogels in rabbit renal artery by non-invasive computed tomography (CT) perfusion and pathology to evaluate the feasibility of the nanogel as a blood vessel embolization agent. Ten healthy adult Japanese rabbits underwent right renal arterial embolization with PIB nanogels. CT perfusion scans were performed pre- and post-treatment at different time points (1, 4, 8, and 12 weeks). Two rabbits were euthanized and histologically examined each time, and the remaining rabbits were sacrificed at 12 weeks after the embolization. The efficacy of the nanogels was further confirmed by pathological examination. The renal volume and renal blood flow of the right kidney significantly decreased post-treatment during the 12-week CT re-examination (both P <��������������������������������������������������������������������������������������������������������������������������������
Radiologist’s Perspectives on the Use of Imaging for Diagnosis and Monitoring of Chronic Nonbacterial Osteomyelitis 
Authors: Nuruzzaman Farzana , Huang Mingqian , Hedrich Christian M. , Girschick Hermann J. , Cherian Julie , Sato T. Shawn , Ferguson Polly J. , Onel Karen B. , Wang Xing , Zhao Yongdong
Published: November 2020

Background. Radiological imaging is integral to the diagnosis of chronic nonbacterial osteomyelitis (CNO). Objectives of this study were: 1) to determine imaging modalities and features deemed important by radiologists in the diagnostic workup of suspected CNO cases; 2) to generate input from radiologists regarding monitoring of patients with CNO.Methods. The population targeted were actively practicing radiologist physician members of the Society of Skeletal Radiology. The survey was administered online through RedCap. Fisher's exact test was used to examine associations between any two categorical variables. FDR adjusted p-values were used for the pairwise comparisons of proportions for more than 2 groups. A mixed effects logistic regression model was used to assess the association between variables.Results. Half of the survey respondents were pediatric radiologists, subspecializing in musculoskeletal radiology and 54% had >10 years of experience. Radiologists considered CNO in the radiological imaging interpretation differential diagnosis an average of 10 cases per year. 79% and 45% of respondents reported high confidence in identifying imaging features of CNO on whole body MRI (WBMRI) and localized MRI, respectively. The level of confidence dropped to 25% and 19% when interpreting X-rays or bone scintigraphy. Among all imaging modalities interpreted “always” in the initial diagnostic workup of potential cases of CNO, X-rays (52%) were most commonly interpreted, followed by localized MRI (46%) and WBMRI (35%). In established cases of CNO, wherein WBMRI was the most frequently requested (48%), followed by localized MRI (26%) and X-rays (25%). Conclusions. By radiologists, WBMRI is currently considered the most useful imaging modality for initial diagnosis and monitoring of CNO by radiologists. Findings from this survey will promote discussion within a focused group to develop imaging recommendations for the diagnostic workup and disease monitoring in CNO.
An Immunohistochemical Panel of Three SUMO Genes Predicts Outcomes of Patients With Triple-negative Breast Cancer
Authors: Lin Yuxiang , Wang Qingshui , Xiao Han , Chen Zhiwei , Jiang Meichen , Zhang Jie , Guo Rongrong , Kang Shaohong , Lin Yao , Song Chuangui
Published: November 2020

Background: Triple negative breast cancer (TNBC) is a highly heterogeneous and aggressive disease. Developing new candidate biomarkers for chemotherapy response and possible therapeutic targets has become an urgent clinical need. Small ubiquitin-like modifier (SUMOs) mediate post-translational modifications (SUMOylation) that target multiple proteins was involved in many biological processes. The role of SUMOylation in TNBC remains to be elucidated.Method: The expression of SUMO1/2/3 were analyzed using TCGA and GEO databases (N=412). We also evaluated the SUMO1/2/3 protein expression in 212 local TNBC patients using immunohistochemical (IHC) staining. We then built a classifier with the LASSO Cox regression model based on associations between the expression of SUMO1/2/3 proteins and the disease-free survival (DFS) of TNBC patients. Results: Elevated SUMO1/2/3 levels were indicated to be associated with a poorer overall survival (OS) and DFS for TNBC patients. Using the LASSO model, we built a classifier based on the IHC scores of SUMO1/2/3 proteins and named it ‘SB classifier’. Patients with the SB classifier defined high score were found to have an unfavorable response to chemotherapy (HR 4.04, 2.14-7.63; p<0.0001). We then developed a nomogram to predict which patients might benefit from chemotherapy. Finally, our analysis provides insights on possible mechanisms that MYC activation causes the activation of SUMOylation. Conclusion: We constructed a reliable prognostic and predictive tool for TNBC patients treated with chemotherapy. It may facilitate patient counseling and individualize management of TNBC patients. Meanwhile, our results suggested that the activation of SUMOylation pathway in TNBC may be induced by MYC signaling.
Path Analysis of Hospitalization Expenses of 2,164 Appendicitis Patients at County-Level Public Hospitals in Anhui Province, China
Authors: Xue Junjun , Wang Heng , Li Niannian , Ling Yuhuan , Qian Chen , Shen Chunhan , Gu Xinlong , Zhang Xue , Jiang Ping
Published: November 2020

Background and objective Appendicitis resection is one of the most common surgical procedures. Hospitalization expenses are a major determinant of appendicitis treatment. This study explored the factors influencing hospitalization expenses of appendicitis patients in Anhui province and provided a scientific basis for reasonably controlling medical expenses. Methods A multi-stage random cluster sampling method was used to collect case information on 2,164 patients who underwent appendicitis surgery at 6 county-level public hospitals in Anhui province, China. Path analysis was used to study the factors influencing hospitalization expenses of appendicitis patients. Results The average length of stay was 5.62 ± 2.64 days, with a median of 5 days; the average hospitalization expenses were 6,109.60 ± 2,109.44 CNY, with a median of 5,511.93 CNY. The direct effect of length of stay was 0.535. Surgical grades, surgical methods, and chronic appendicitis directly affected hospitalization expenses, with direct effects of 0.149, 0.081, and -0.037; surgical costs, anesthesia costs, disease outcomes, age, acute simple appendicitis, and operative duration not only directly affected hospitalization expenses, but also indirectly affected hospitalization expenses, the total effects were 0.283, 0.045, 0.200, 0.202, -0.162, and 0.062, respectively. The total number of surgeons and assistants only indirectly affected hospitalization expenses, with indirect effect of 0.020. Conclusions The length of stay is the most important factor affecting hospitalization expenses. Based on controlling the average length of stay, combined with shortening operative duration, conducting health education, strengthening controllable factors, and other comprehensive measures can effectively reduce the economic burden of patients and hospitals.
Monitoring Positive Mental Health in Swedish Adolescents: Psychometric Evaluation of the Mental Health Continuum – Short Form
Authors: Söderqvist Fredrik , Larm Peter
Published: November 2020

BackgroundThe Mental Health Continuum – Short form (MHC-SF) is a self-report measure that has been increasingly used to monitor mental well-being at the population level. The aim of this study was to evaluate, for the first time, the psychometric properties of the MHC-SF in a Swedish population, more specifically adolescents. MethodsFirst, the evaluation was performed by examining face validity and test–retest reliability obtained in a pre-study (n = 93). Then using data from the Survey of Adolescent Life in Vestmanland 2020 (n = 3880; participation rate = 71%; females = 51%; mean age = 16.23 years), we performed confirmatory factor analysis on different factor structures based on theory and previous research. Model-based estimates were calculated for assessing the internal reliability of the factor structure with the best fit. Convergent validity was assessed by bivariate as well as model-based correlations, and test–retest reliability was evaluated by intra-class correlation coefficients. ResultsThis study on Swedish adolescents found that the MHC-SF is essentially unidimensional and best described with a bifactor model consisting of a dominant general well-being factor and three specific group factors of emotional, social and psychological well-being. Its overall reliability and the reliability of the general well-being factor were good to excellent, while the reliability of its subscales (specific group factor) was poor, and thus should not be used alone. Test–retest reliability of the total scale was good, and convergent validity was supported by strong to very strong correlations with the Short Warwick–Edinburg Mental Well-being Scale. ConclusionsIn conclusion, we consider the Swedish MHC-SF to be a psychometrically sound instrument for monitoring overall mental well-being in Swedish adolescents.
Health-related Quality of Life Among Cervical Cancer Survivors at a Tertiary Hospital in Kumasi, Ghana
Authors: Antwi Kwabena Amo , Agambire Ramatu , Konney Thomas Opkoti , Nartey Yvonne , Kubi Adu-Appiah , Nguah Samuel Blay , Dassah Edward T. , Akakpo Patrick K. , Opoku Baafour K. , Ankobea Frank , Tawia Augustine , Nti Maxwell K. , Djokoto Rex Mawuli , Peprah Amponsah , Ansah Mavis Bobie , Johnston Carolyn
Published: November 2020

BackgroundCervical cancer survivors often experience significant diminution in health-related quality of life (HRQoL). We aimed to investigate the overall HRQoL, determine the role of the stage of disease and type of treatment received on HRQoL, and evaluate predictors of HROoL among cervical cancer survivors in Ghana.MethodsA hospital-based cross-sectional study was conducted in 153 cervical cancer patients who completed curative treatment between January 2004 and December 2018 at Komfo Anokye Teaching Hospital. The European Organization for Research and Treatment of Cancer core questionnaire (EORTC QLQ C-30) supplemented with the cervical cancer-specific (EORTC QLQ-CX24) module was used. The Kruskal-Wallis test was used to determine the effect of the stage of cervical cancer and the type of treatment received on mean scores of the different domains of HRQoL. Multivariate logistic regression was performed to identify predictors of HRQoL.ResultsThe mean global health status (GHS) was 79.7 (+/-16.2), and it differed significantly with FIGO stage, with 84.1 76.2, and 79.9, for stages I, II and III respectively (p=0.012). Financial burden was higher in participants with FIGO stage II compared to stage I disease (45.4 vs 20.8, p=0.012.). The mean GHS scores for surgery, chemoradiation and radiation only were 85.2, 75.9, and 82.1 respectively (p=0.027). Compared to participants who were treated with Chemoradiation, those treated with surgery had lower financial difficulties (12.1 vs 41.6 , p=0.019), better body image (95.7vs 79.5, p =0.039) and better symptom experience (5.9 vs 12.0, p =0.043).The likelihood that survivors’ HQROL is affected is decreased with illiteracy (AOR = 0.30, 95% CI=0.09–1.00), and increased with complaints of pain (AOR=5.50, 95%CI=1.68-18.29), loss of appetite (AOR=13.24, 95% CI=2.71– 64.67) and diminution in body image perception (AOR = 6.04, 95% CI=1.67–21.83). Conclusion﻿Cervical cancer survivors in Ghana have overall satisfactory HRQoL. Surgical treatment is associated with improved HRQoL and less financial burden. Efforts to enhance HRQoL should also be focused on maximizing survivors’ body image and managing pain and loss of appetite. Educating women about expected impacts on their quality of life, and strategies to manage and mitigate these impacts, is essential.
Optimized application of 68Ga-prostate-specific membrane antigen-617 whole-body PET/CT and pelvic PET/MR in prostate cancer initial diagnosis and staging
Authors: Qin Chunxia , Gai Yongkang , Liu Qingyao , Ruan Weiwei , Liu Fang , Hu Fan , Zhang Xiaoping , Lan Xiaoli
Published: November 2020

Purpose To analyze 68Ga-PSMA-617 PET/CT or PET/MR and delayed PET/MR images in patients diagnosed with or suspected of prostate cancer, and to explore the optimal use of PET/CT and PET/MR for initial diagnosis and staging in prostate diseases.Methods Images from conventional scan by 68Ga-PSMA whole-body PET/CT or PET/MR followed by delayed pelvic PET/MR were retrospectively analyzed. Prostatic 68Ga-PSMA uptake was measured as SUVmax1 (conventional scan 1 h post injection) and SUVmax2 (delayed scan 3 h post injection). Age, PSA levels, and SUVmax were compared between benign and malignant cases. The correlation of SUVmax1 and SUVmax 2 was analyzed. Diagnostic performance was evaluated by ROC analysis.Results We enrolled 56 patients with 41 malignant and 15 benign prostate lesions. Fifty-three patients had paired conventional and delayed scans. Age, PSA levels, and SUVmax were significantly different between benign and malignant cases. A good correlation was found between SUVmax1 and SUVmax2. There was significant difference between SUVmax1 and SUVmax2 in the malignant group (p = 0.001). SUVmax1 had superior diagnostic performance than SUVmax2, SUVmax difference and PSA levels, with a sensitivity of 85.4%, a specificity of 100% and an AUC of 0.956. A combination of SUVmax1 with nodal and/or distant metastases and MR PIRADS V2 score had a sensitivity and specificity of 100%. Delayed pelvic PET/MR imaging in 33 patients were found to be redundant because these patients had nodal and/or distant metastases which can be easily detected by PET/CT.Conclusion Combined 68Ga-PSMA whole-body PET/CT and pelvic PET/MR can accurately differentiate benign prostate diseases from prostate cancer and accurately stage prostate cancer. Whole-body PET/CT is sufficient for advanced prostate cancer, and more economic and time-saving than PET/MR. Pelvic PET/MR contributes to diagnosis and accurate staging in early prostate cancer. Imaging at about 1 hour after injection is sufficient in most patients.Trial registration: NCT03756077. Registered 27 November 2018 - Retrospectively registered, https://clinicaltrials.gov/show/NCT03756077
Knowledge, attitudes and practices (KAP) to assess the impact of school children's awareness of malaria using the MOSKI KIT® tool: study case of some Dakar schools in Senegal
Authors: Manga Isaac Akhénaton , Gaye Aissatou , Kouevidjin Aliou Dia , Ekoue  , Reis Maria Rosa Dos , Niang Aboubakry Sadikh , Fall Amy Ndao , Anquetil Christelle Maitre , Ndiaye Jean Louis Abdourahim
Published: November 2020

Background MOSKI KIT® is a fun tool designed to interest children for prevention and management of malaria. This study was carried out with the objective to assess the short- and long-term impacts of this tool on the knowledge, attitudes and practices of school children, and on the transmission of the knowledge received at the household level as well. Method The study took place in elementary schools in the city center (with relatively low endemicity) and in the Niayes area (at high risk of anopheline and malaria) in the Dakar region of Senegal. The various schools chosen for our study were divided into an intervention group and a control group. The intervention schools were also divided into two subgroups, a full package subgroup and another partial package. We conducted three surveys there, a first before exposure to the MOSKI KIT®, a second a week later and a third a year later. In the control schools, we only carried out one at the same time as the last in the intervention schools. We carried out two household surveys (a week and a year after exposure) for the intervention schools, against one for the control schools.Results Before sensitization, the proportion of school children with a grade above or equal to the average was 50% for the complete package subgroup (CPS) and 53% for the partial package subgroup (PPS). A week later, these proportions were 69% and 71% respectively for the complete and PPSs. A year later, they were 99.4% for the CPS, 98.1% for the PPS and 99.5% for the control group; The number of children who spoke to their parents about malaria was greater in intervention schools than that of control schools. They were 46.63% and 32.58% respectively in intervention and control schools.Conclusion The MOSKI KIT, has enabled an increase of the knowledge of school children about malaria in the short term and favored its retention in the long term. However, its impact was not felt on their attitudes and practices.
Asymptomatic malaria and anemia among pregnant women during high and low malaria transmission seasons in Burkina Faso: household-based cross-sectional surveys in Burkina Faso, 2013–2017
Authors: Rouamba Toussaint , Samadoulougou Sékou , Ouédraogo Mady , Hien Hervé , Tinto Halidou , Kirakoya-Samadoulougou Fati
Published: November 2020

Background: Malaria in endemic countries is often asymptomatic during pregnancy, but it has substantial consequences for both the mother and her unborn baby. In Burkina Faso, the prevalence and risk factors of asymptomatic malaria in pregnancy and its main consequence, anemia, during high and low malaria transmission seasons is underexplored at the household level.Methods: Data of 1751 pregnant women from October 2013 to March 2014 and 1931 pregnant women from April 2017 to June 2017 were drawn from two cross-sectional household surveys conducted in 24 health districts of Burkina Faso. Pregnant women were tested for malaria in their household after consenting. Asymptomatic carriage was defined as a positive result from malaria rapid diagnostic tests in the absence of malaria symptoms. Anemia was defined as hemoglobin level less than 11 g/dL.Results: Prevalence of asymptomatic malaria in pregnancy was estimated at 23.9% (95%CI: 20.2–28.0) during the high transmission season (October–November) in 2013. During the low transmission season, it was 12.7% (95%CI: 10.9–14.7) between December and March in 2013–2014 and halved (6.4%; 95%CI: 5.3–7.6) between April and June 2017. Anemia prevalence was estimated at 43.7% (95%CI: 39.3–48.3) during the high transmission season in 2013. During the low transmission season, it was 32.7% (95%CI: 30.1–35.5) between December and March 2013–2014 and 46.6% (95%CI: 44.3–48.9) between April and June, 2017.Conclusion: Prevalence of asymptomatic malaria in pregnancy was significantly higher during the high malaria transmission season while anemia prevalence was lower. Our study provides an opportunity to assess the prevalence of asymptomatic carriage and one of its main consequences, anemia, among pregnant women at the community level throughout the year. In order to mitigate the harmful effects of asymptomatic carriage for both the mother and fetus, health programs aimed at increasing the number of women coming into contact with health workers are necessary.