bluuebunny/crossref_metadata_2025 huggingface dataset:
Prediction of Distant Metastatic Recurrence by Tumor-Infiltrating Lymphocytes in Hormone Receptor-Positive Breast Cancer
Authors: Takada Koji , Kashiwagi Shinichiro , Asano Yuka , Goto Wataru , Morisaki Tamami , Fujita Hisakazu , Shibutani Masatsune , Takashima Tsutomu , Hirakawa Kosei , Ohira Masaichi
Published: August 2020

Background: Breast cancer subtypes are known to have different sites of metastatic recurrence. Distant metastases are often seen during the post-operative course in patients with human epidermal growth factor receptor 2 (HER2)-enriched breast cancer (HER2BC) and triple-negative breast cancer (TNBC) while being relatively rare in those with hormone receptor-positive and HER2-negative breast cancer (HR+HER2-BC). Tumor-infiltrating lymphocytes (TILs) can serve as an index to monitor tumor immune microenvironment and possibly predict the prognosis and therapeutic effect in breast cancer. This study aimed to investigate the correlation between TIL density and recurrence site in HR+HER2-BC.Methods: Four-hundred and seventy-one patients with HR+HER2-BC underwent surgery as the first treatment and received adjuvant endocrine therapy except adjuvant chemotherapy at the Osaka City University Hospital from April 2007 to October 2015. To evaluate tumor morphology and examine TILs, needle biopsy specimens were used. Morphological assessment was conducted using conventional hematoxylin and eosin staining.Results: Forty-two patients had a recurrence of breast cancer. In patients with no TIL density, local recurrence was significantly less (p = 0.022), while distant metastases were significantly more (p = 0.015) compared to those in patients with TIL density. Therefore, for the prediction of distant metastases in HR+HER2-BC without chemotherapy, TILs could be used as predictors in univariate analysis (p = 0.015, odds ratio [OR] = 0.127), although not as independent factors (p = 0.285, OR = 0.144).Conclusions: We concluded that TILs may be able to predict distant metastatic recurrence in stages I–II of HR+HER2-BC.
Amylin-mediated regulation of LRP1 by miR-103/107 induces cerebral microvascular dysfunction and impairs β-amyloid efflux
Authors: Velmurugan Gopal , Ly Han , Sharma Savita , Verma Nirmal , Despa Sanda , Nelson Peter T , Goldstein Larry B , Despa Florin
Published: August 2020

Background: The cerebral small blood vessels of individuals with Alzheimer’s Disease (AD) often have deposits of amylin, an amyloid-forming protein secreted in the blood by pancreatic β-cells. To determine whether systemic pancreatic amylin dyshomeostasis impairs amyloid β (Aβ) efflux across the blood-brain barrier (BBB), we studied cerebral microvessels in humans and rats with pancreatic expression of amyloidogenic human amylin, and evaluated the effect of human amylin in an in vitro BBB model. Methods: Brain sections from AD and cognitively unimpaired individuals were co-stained with anti-Aβ and anti-amylin antibodies. In vivo analyses of Aβ efflux across the BBB were carried out in aged rats that express amyloid-forming human amylin in pancreatic β-cells and littermates expressing non-amyloidogenic rat amylin. We also used an in vitro BBB model of Aβ transcytosis in which the endothelial cell monolayer was exposed to amylin-mediated stress to determine whether amylin stress downregulates LRP1, the Aβ efflux transporter. This allowed us to use pharmacology to rescue the endothelial LRP1. Results: In human AD brains, Aβ accumulation within the perivascular space frequently co-localized with deposits of amylin in the vessel wall. In rats with pancreatic expression of amyloid-forming human amylin, the high blood levels of human amylin promoted amylin deposition in brain capillaries, increased brain Aβ level, lowered plasma-to-brain Aβ ratio and suppressed expression of LRP1 protein. In vitro BBB model experiment revealed that amylin-induced stress downregulates LRP1 in endothelial cells through a miRNA-based translational repression mechanism. Conclusions: High blood human amylin levels cause cerebral microvascular dysfunction and interfere with Aβ efflux across the BBB through miRNA-mediated LRP1 downregulation. Lowering the blood amylin level in early AD could improve Aβ clearance from the brain.
Primary Aortic Aneurysm Characterized by Herald Gastrointestinal Bleeding
Authors: wang yadan , wu jing , wang canghai , wang jing , ding pengpeng , wang yun , liu hong , guo chunmei
Published: August 2020

Objective: We describe a case series of patients diagnosed with Primary aortic aneurysm characterized by herald gastrointestinal bleeding, reviewed the literature, aimed to identify and treat such patients without delay, reduce fatality rate.Materials and methods: We reviewed a case series of Primary aortic aneurysm in the Department of Gastroenterology, Beijing Shijitan Hospital Affliated to the Capital Medical University. Each patient was admitted to hospital with gastrointestinal bleeding as main complaint, and was diagnosed by CT or endoscopy. Then characteristics of endoscopy and CT were analyzed. Results: 3 patients were enrolled. In case 1, hematoma was formed after a ruptured abdominal aortic aneurysm, and compression of the hematoma led to ischemic colitis, abdominal pain and hematochezia were the main symptoms. In case 2 and case 3, aortic gastrointestinal fistula were found in the duodenum and esophagus, respectively, abdominal pain, melena and hematochezia were the main symptoms. Conclusion: A timely and accurate diagnosis of Primary aortic aneurysm may be challenging due to insidious episodes of GI bleeding, which are frequently under-diagnosed until the occurrence of massive hemorrhage. Clinical physicians should keep a high index of awareness for Primary aortic aneurysm.
Load Balancing in Software-Defined Networking using Controller Placement
Authors: Nejadnik Hamid , Sadeghi Rasool , Imani Sayed Mahdi Faghih
Published: August 2020

Software Defined Networking (SDN) is a novel architecture that separates the data plane from the control plane using an external controller. Similar to traditional networks, load balancing has a great impact on the performance and availability of SDN. Therefore, the Controller Placement Problem (CPP) in SDN influences on the load balancing solutions. In this paper, various topologies of CPP including different load balancer controllers are simulated and evaluated in the SDN using the OFSwitch13 module of ns-3 network simulator. The results provide a solid comparison of the proposed topologies in different network situations.
Should We Care About Plasmodium Vivax and HIV Coinfection? A Systematic Review and a Cases Series From the Brazilian Amazon
Authors: Del-Tejo Paola López , Cubas-Vega Nadia , Caraballo-Guerra Cecilia , Silva Bernardo Maia da , Valente Jefferson da Silva , Sampaio Vanderson Souza , Baia Djane Clarys , Castro Daniel Barros , Martinez-Espinosa Flor Ernestina , Siqueira André Machado , Lacerda Marcus Vinícius Guimarães , Monteiro Wuelton Marcelo , Val Fernando
Published: August 2020

Background. Malaria and HIV are two important public health issues. However, data on HIV-Plasmodium vivax co-infection (HIV/PvCo) is scarce, with most of the available data related to P. falciparum in the African region. It is unclear whether HIV can change the clinical course of Plasmodium vivax (Pv) malaria, and thereby increase the risk of complications. In this study, a systematic review of the HIV/PvCo is presented, including new cases from the Brazilian Amazon. Methods. Medical records from a tertiary care center in the Western Brazilian Amazon (2009 to 2018) were reviewed to identify HIV/PvCo hospitalized patients. Demographic, clinical and laboratory characteristics, and outcomes are reported. We also performed a systematic review of published studies on HIV/PvCo. Metadata, number of HIV/PvCo cases, demographic, clinical, and outcome data were extracted if available. Results. A total of 1048 vivax malaria patients were hospitalized in the 10-year period; 21 (2.0%) were HIV/PvCo cases, of which nine (42.9%) had AIDS-defining illnesses. For eleven (52.4%) patients, this was their first malaria infection. Seven (33.3%) patients were unaware of their HIV status and were diagnosed at hospitalization. Severe malaria criteria were found in 5 (23.8%) patients. One patient died. The systematic review provided 17 articles (12 cross-sectional or longitudinal studies and 5 case report studies). A higher prevalence of studies involved cases in African and Asian countries (35.3% and 29.4%, respectively), and the prevalence of reported co-infections ranged from 0.1 to 60%. Cases of severe malaria-HIV coinfection were not reported. Conclusion. Reports of HIV/PvCo are scarce in the literature, with only a few studies describing clinical and laboratory outcomes. Systematic screening for both co-infections are not performed, and therefore, a realistic prevalence of HIV/PvCo is absent. This study showed a low prevalence of HIV/PvCo, despite local malaria and HIV high prevalence. Even though relatively small, this is the largest case series to describe HIV/PvCo.
Inhibition of Mitochondrial Carrier Homolog 2 (MTCH2) Suppresses Tumor Invasion and Enhances Sensitivity to Temozolomide in Malignant Glioma
Authors: Yuan Qiuyun , Yang Wanchun , Zhang Shunxin , Li Tengfei , Zuo Mingrong , Zhou Xingwang , Li Junhong , Li Mao , Xia Xiaoqiang , Chen Mina , Liu Yanhui
Published: August 2020

Background: Malignant glioma exerts a metabolic shift from oxidative phosphorylation (OXPHOs) to aerobic glycolysis, with suppressed mitochondrial functions. This phenomenon offers a proliferation advantage to tumor cells and decrease mitochondria-dependent cell death. However, the underlying mechanism for mitochondrial dysfunction in glioma is not well elucidated. MTCH2 is a mitochondrial outer membrane protein that regulates mitochondrial metabolism and related cell death. This study aims to clarify the role of MTCH2 in glioma. Methods: Bioinformatic analysis from TCGA and CGGA databases were used to investigate the association of MTCH2 with glioma malignancy and clinical significance. The expression of MTCH2 was verified from clinical specimens using real-time PCR and western blots in our cohorts. siRNA-mediated MTCH2 knockdown were used to assess the biological functions of MTCH2 in glioma progression, including cell invasion and temozolomide-induced cell death. Biochemical investigations of mitochondrial and cellular signaling alternations were performed to detect the mechanism by which MTCH2 regulates glioma malignancy. Results: Bioinformatic data from public database and our cohort showed that MTCH2 expression was closely associated with glioma malignancy and poor patient survival. Silencing of MTCH2 expression impaired cell migration and enhanced temozolomide sensitivity of human glioma cells. Mechanistically, MTCH2 knockdown increased mitochondrial oxidative damage and decreased pro-survival AKT signaling. Conclusion: Our work identifies the oncogenic role of MTCH2 in gliomas, and establishes the causal relationship between MTCH2 expression and glioma malignancy, which may provide a potential target for future interventions.
ECMO Therapy for Critically Ill Coronavirus Disease 2019 Patients in Wuhan, China: A Retrospective Multicenter Cohort Study
Authors: Fang Jing , Chen Yue , Hu Ming , Li Rui , Qin Juanjuan , Cheng Lin , He Yi , Li Yi , Zhou Qiang , Zhou Daixing , Chen Jun , Huang Fei , Lei Fang , Yang Bo , Deng Hongping , Yuan Yufeng , Xia Jiahong , Li Hongliang , Huang Chaolin , Wan Song , Wei Xiang
Published: August 2020

Background

The coronavirus disease 2019 (COVID-19) pandemic has led to surges in the demand for extracorporeal membrane oxygenation (ECMO) therapy. However, little in-depth evidence is known about the application of ECMO therapy in COVID-19 patients.
Methods

This retrospective multicenter cohort study included 88 patients who had been diagnosed with COVID-19 and received ECMO therapy at seven designated hospitals in Wuhan, China. The clinical characteristics, laboratory examinations, treatments, and outcomes were extracted from electronic medical records and compared between weaned and non-weaned ECMO patients. The patients were followed until June 30, 2020. Logistic regression analyses were performed to identify the risk factors associated with unsuccessful ECMO weaning. Propensity score matching was used to match patients who received veno-venous ECMO with those who received invasive mechanical ventilation (IMV)-only therapy. The primary endpoint, 120-day all-cause mortality after intensive care unit (ICU) admission during hospitalization, was compared using a mixed-effect Cox model.
Results

Of 88 patients who received ECMO therapy, 27 and 61 patients were and were not successfully weaned from ECMO, respectively. Additionally, 15, 15, and 65 patients were further weaned from IMV, discharged from hospital, or died during hospitalization, respectively. A lymphocyte count ≤ 0.5 × 109/L and D-dimer concentration > 4 × the upper limit of normal at ICU admission, a peak PaCO2 > 60 mmHg at 24 hours before ECMO initiation, and no tracheotomy performed during the ICU stay were independently associated with lower odds of ECMO weaning. In the propensity score-matched analysis, a mixed-effect Cox model detected a lower hazard ratio for 120-day all-cause mortality after ICU admission during hospitalization in the ECMO group, as compared with the IMV-only group.
Conclusion

Patients in Wuhan who received ECMO therapy had a relatively high mortality rate. This outcome may be largely attributable to resource-limited situations during the COVID-19 outbreak. In future, the presence of lymphocytopenia and higher D-dimer concentrations at ICU admission and hypercapnia at 24 hours before ECMO initiation could help to identify patients with a poor prognosis. Moreover, tracheotomy could facilitate weaning from ECMO. Despite the high mortality, ECMO was associated with improved outcomes relative to IMV-only therapy in critically ill COVID-19 patients.
The Prevalence of Behavioral Risk Factors in People with HIV/AIDS and Its Effect on Adherence to Treatment
Authors: Soofi Moslem , moradi atefeh , Shakiba Ebrahim , Moradinazar Mehdi
Published: August 2020

Background: Behavioral risk factors, in addition to increasing the risk of HIV/AIDS transmission, can affect the antiretroviral therapy (ART) pattern of people with the condition. The aim of this study was to determine the prevalence of behavioral risk factors and its effect on adherence to antiretroviral drugs (ARV) treatment in patients with HIV/AIDS in western Iran.Methods: This study was performed on all patients who were diagnosed with HIV/AIDS in Kermanshah province during the years 1995-2019 (25 years). Adherence to treatment in these patients was divided into three categories according to the WHO definition: Non-adherence, cessation and adherence to treatment. Using single-variable and multi-variable logistic regression, the effect of important variables in four models was modified and the effect of each of the behavioral risk factors was studied in patients who had non-adherence or experienced cessation compared to those who adhered to ARV.Results: Of the 2,867 patients with HIV/AIDS, 2,449 (85.42%) were men. The mean age of HIV infection was 33.36 ± 11.8 years. In 1995, less than 10 percent of people received treatment, which is 2019 it reached to more than 67 percent. All behavioral risk factors increased the non-adherence to medication and cessation of ARV. In general, after controlling confounding variables except needle sharing, all behavioral variables affected ARV treatment; The greatest impact on non-adherence to medication was History of drug abuse, History of the prison, History of injection drug use and Sex with non-spouse with a chance of 10.87 (7.21-16.39), 3.94 (2.84-5.46), 3.86 (2.47-6.03) and 3.38(2.19-5.23) times more than patients without these risk factors, respectively.Conclusion: Although the process of receiving treatment has been increasing since 2005, the non-adherence to medication is still high in high-risk groups, so it is important to focus more on reducing non-adherence and eventually cessation of treatment. In particular, more focus is necessary for health education and raising the level of awareness of these groups.
Evaluation of Avian Malaria in An Inter-Andean Dry Forest of Imbabura Province in Ecuador
Authors: Spencer Lilian Maritza , Tellkamp Markus P , Vispo Nelson F Santiago , Amaro Isidro R , Cevallos-Chavez Jordy J , Anchalí Sophía N , Cabada Dalia N , Arcos Mariana M , Aldaz María J
Published: August 2020

Background: Hematozoa of the genus Plasmodium cause malaria in birds, and are frequently found in passerines. They are characterized by particularly small meronts and elongated gametocytes in peripheral blood. Although the disease is not fatal, it affects reproductive success and, therefore, the biodiversity of the birds, so it is a necessity to know the species of birds that are infected. Methods: The presence of Plasmodium in passerine birds were investigated in three locations in the inter-Andean dry forest of the province of Imbabura in Ecuador. Prevalence and parasitaema were determined by light microscopy of blood smears and was confirmed by the indirect immunofluorescence assay (IFA) with a monoclonal antibody that recognizes protein 1 of merozoite surface (MSP-1). Results: The percentage of prevalence and parasitaemia in the bird species captured in the three locations was determined and was related to the elevation and presence of bodies of water in the studied areas. A 100% prevalence was found at the lowest site but decreased with elevation and the absence of nearby water bodies. The IFA test supported the identity of the Plasmodium parasite. Discussion: This study shows that bird species are highly parasitized in the dry forest of Imbabura and underscores the influence elevation and the presence of water as a possible source proliferation of the vector insects. As elevation increases, prevalence and parasitaemia decrease. Besides, we present a useful new diagnostic tool, a monoclonal antibody that recognizes Plasmodium protein MSP-1, which is highly conserved among the species of this parasite.
Topographic control of forest species distributions in the Interior West USA
Authors: Bekker Matt , DeRose R Justin
Published: August 2020

Background The geographic distribution of forest and woodland ecosystems in the Interior West United States is strongly influenced by topographic gradients that, in part, control moisture availability through their effect on insolation, and precipitation capture and retention. Through an empirical approach, we use unique, plot-level data from the Forest Inventory and Analysis Program ( n = 13,437) over eight ecoregions within eight Interior West states to characterize the distribution of the 12 most abundant tree species with respect to the effects of elevation, slope aspect, and slope steepness. Results Across species, elevation, and aspect, most plots occurred on gentle slopes and the number decreased with increasing slope. Species-specific differences to microenvironmental conditions were evident in the variation between observed (plots containing a subject tree) and expected (all forest plots from the systematic sample) numbers of plots across the gradient combinations. Species groups, broadly defined as woodland, montane, and subalpine, generally exhibited similar responses and revealed more generality than hypothesized. Only Douglas-fir, white fir, subalpine fir, and Engelmann spruce exhibited significant patterns of affinity for particular aspects—most often on north and least often on south—with the relative importance of south aspects decreasing with increasing elevation. Limber pine showed unique, unimodal patterns of affinity for moderately steep slopes, with no consistent patterns by aspect or elevation. Although not significant, at high elevations woodland species exhibited a tendency to occur more often on south aspects on gentle to intermediate slopes, and less often on north aspects. Conclusions Unique microenvironments created by interactions between aspect, slope, and elevation create some predictability in patterns of geographic distribution. However, the general lack of species-specific response suggests that patterns of occurrence in relation to physiographic gradients is much broader than in common generalizations.
Prevalence of Malnutrition and Associated Risk Factors Among Children Under Five Years of age in Amhara Region, Ethiopia: Evidence from 2016 Ethiopian Demographic and Health Survey
Authors: Mengesha Damitie Kebede , Merkeb Yidnekachew
Published: August 2020

Background: Under-nutrition is the outcome of insufficient food intake and recurrent infectious diseases. Childhood malnutrition is most widely prevalent among children under the age of five in Amhara Region, Ethiopia. This study explored the major determinants of malnutrition and its association with anemia among children under five years of age in Amhara Region, Ethiopia.Methods: Data from the 2016 Ethiopian Demographic and Health Survey (EDHS) was used. A total of 974 children under five years of age were used. A multivariable binary logistic regression analysis was used at a 5% level of significance to determine the individual- and community-level factors associated with childhood malnutrition.Results: The prevalence of stunting, wasting, and underweight were 46.3%, 9.8%, and 28.4%, respectively. About 23.1% of children were both stunting and underweight, 7.3% were both underweight and wasting, and 4.5% of children had all the three conditions. Among the factors considered in this study, Age of child in months, birth weight of the child at birth, mother’s highest education level, sex of household head, sources of drinking water, and type of toilet facility were significantly associated with malnutrition in Amhara Region.Conclusion: Malnutrition among under-five children was one of the public health problems in the Amhara Region. The influence of these factors should be considered to develop strategies for reducing malnutrition in Amhara Region. Finally improving the living standards of the children is important to get better health care, to enhance the child’s nutritional status, and reduce child mortality.
Application of Acidophilic Microorganism in the Metal Enrichment of Electroplating Sludge Use the Membrane Bioreactor
Authors: Yang Yiran , Chu Huichao , Qian Can , Jia Chunyou , Qi Shiyue , Xin Baoping
Published: August 2020

Background: Bioleaching is an important technology for treating electroplating sludge. Previous researches have focus on improving the leaching rate of metals in electroplating sludge by bioleaching. However, the concentration of heavy metals in the leachate after single leaching was lower, which is quite unfavorable for subsequent metal recovery. Additionally, membrane bioreactors (MBRs) have been widely used in the field of sewage treatment. Research on the application of bioleaching technology combined with MBRs to enrich metals in electroplating sludge has not been reported. Therefore, in this study, we first combined bioleaching technology and MBRs for metal enrichment in electroplating sludge to obtain the key technology of "acid production - electroplating sludge leaching - leachate regeneration -repeated electroplating sludge leaching - achievement of valuable metal enrichment".Results: In this research, through scaling up from the laboratory scale (shake flasks) to a factory-scale application (10 m³ membrane bioreactors), we mastered the key technology of acid production by acidophilic microorganism, and the acid solution can be repeatedly used for metal leaching. The results showed that the MBR maintained high-density cell growth (≈2.1×109/mL) and a stable sulfuric acid production rate (850 L/h) throughout the entire operational period. Under the above conditions, the maximum cycle number (10 times) for enrichment of the target metals in the electroplating sludge was obtained. Additionally, after the end of the cycle enrichment process, the concentrations of the target metals Ni+, Cu2+, and Zn2+ were 13.867 g/L, 18.118 g/L and 21.075 g/L, respectively, which were highly enriched.Conclusions: This study first solved the difficulties in the industrialization of bioleaching electroplating sludge through combining bioleaching technology and MBRs. Furthermore, this research can provide a demonstration project for the industrial application of MBR-bioleaching technology in electroplating sludge, with a view to applying this technology to the disposal of more types of hazardous waste.
The expression of HOXA9 and its prognostic value in cervical cancer
Authors: Zhang Keqian , Mao Tianqi , He Zhicheng , Wu Xiaojiao , Peng Yu , Chen Yanrong , Dong Yan , Ruan Zhihua , Wang Zhe
Published: August 2020

Background

The HOXA9 gene, belonging to homeobox (HOX) gene family, has been recently reported dys-expressed in several kinds of human cancers. This study aimed to investigate the expression of HOXA9 and its prognostic value in cervical cancer.
Methods

The HOXA9 mRNA expression was detected with a quantitative real-time polymerase chain reaction (qRT-PCR) assay, and the association of HOXA9 expression with clinical characteristic was analyzed via chi-square test. Kaplan-Meier and cox regression analyses were conducted to estimate the prognostic value of HOXA9 in cervical cancer.
Results

HOXA9 expression was significantly down-expressed in cervical cancer tissues compared with that in adjacent normal tissues (P < 0.01). And the expression of HOXA9 was significantly associated with TNM stage, pathological grade, FIGO stage and differentiation (All P < 0.05). In addition, Kaplan–Meier analysis indicated that the overall survival of patients with low HOXA9 expression was shorter than those with high HOXA9 expression (log rank test, P = 0.000). Cox regression analysis revealed that HOXA9 had a high prognostic value in cervical cancer.
Conclusion

HOXA9 is down-regulated and involved in the development of cervical cancer. Moreover, it may be an useful independent prognostic bio-marker for patients with cervical cancer.
Application of Percutaneous Endoscopic Interlaminar Discectomy (PEID) with Modified Sensation-Motion Separation Anesthesia in the Treatment of L5-S1 Disc Herniation
Authors: Kong Meng , Gao Changtong , Wang Chao , Xu Derong , Han Shuo , Li Guanghui , Han Xing , Ma Xuexiao , Zhou Chuanli
Published: August 2020

Study Design: A retrospective cohort study.Purpose: To compare the clinical effects of local anesthesia (LA), general anesthesia (GA) and modified sensation-motion separation anesthesia (MA) in percutaneous endoscopic interlaminar discectomy (PEID) for treating L5/S1 lumbar disc herniation (LDH) and guide the junior surgeons.Patients and methods: Eighty-four patients with L5/S1 LDH underwent PEID using three anesthesia methods. Patients in groups LA (26), GA (29) and MA (29) were given a follow-up examination retrospectively. General parameters, preparation and anesthesia time, operation time, recovery time, incidence rate of complications, ambulation time, length of hospital stay, severe complications, and reoperation rate were compared, and clinical outcomes were analyzed using a visual analog scale (VAS), the Oswestry Disability Index (ODI), and the Short-Form Health Survey 36 (SF-36).Results: MA demonstrated obvious advantages over the other two methods in operation time and led a better intraoperative experience than LA. Group MA and LA required less time in bed postoperatively and shorter hospital stays than group GA. The mean postoperative VAS score, ODI score and SF-36 score were significantly better than the preoperative values in all groups (P<0.05), but no significant differences were found among the three groups (P>0.05). Three cases (3/29) of nervous disorder occurred in the GA group. Two cases in the GA (1/29) and LA (1/26) groups were revised among all three groups, with a total recurrence rate of 2.4% (2/84). Conclusions: Modified anesthesia with sensation-motion separation was a suitable method for spinal surgeons who were inexperienced with PEID in the treatment of L5/S1 disc herniation due to its high safety and good patient tolerance.
Differential Diagnostic Value of Parathyroid 99mTc-MIBI SPECT/CT in MIBI Uptake Lesion
Authors: Sa Ri , Liu Danyan , Hou Sen , Zhao Hongguang , Guan Feng
Published: August 2020

Background: To investigate the role of parathyroid technetium-99m-hexakis2-methoxy-2-methylpropylisonitrile (99mTc-MIBI) single photon emission computed tomography/ computed tomography (SPECT/CT) combined with the serum calcium (Ca) and serum parathyroid hormone (PTH) in the differential diagnosis of MIBI uptake lesion. Methods: 201 patients with MIBI uptake lesion on parathyroid 99mTc-MIBI SPECT/CT from January 2015 to July 2019 were enrolled in this study. All patients who underwent surgical resection were classified into two groups: primary hyperparathyroidism (PHPT) and non-PHPT in terms of the pathological findings. Radiological performance of 99mTc-MIBI SPECT/CT, serum Ca and serum PTH were comparable between the two groups.Results: 201 patients (135 females; median age, 53.0 years; age range, 29 – 79 years) were included. Pathological findings were as follows: PHPT was in 126 (62.7%) patients, including parathyroid adenoma in 106 patients, parathyroid cancer in 12 patients and parathyroid hyperplasia in 8 patients, while non-PHPT were in 75 (37.3%) patients, including thyroid adenoma in 14 patients, thyroid papillary cancer in 15 patients and thyroid nodular goiter in 46 patients. In the following multivariable logistic regression analysis, serum Ca and diameter of the shortest axis of the lesion were the independent factors for differentiating PHPT from non-PHPT. In receiver operating characteristic (ROC) analyses, the cut-off value of serum Ca differentiating PHPT from non-PHPT was 2.6 mmol/L, yielding the area under the ROC curve (AUC) of 0.931, sensitivity of 85.7%, specificity of 89.2%; the cut-off value of diameter of the shortest axis of the lesion was 20.4mm, yielding AUC of 0.728, sensitivity of 62.2%, specificity of 87.1%.Conclusion: Parathyroid 99mTc-MIBI SPECT/CT combined with serum Ca and serum PTH contributed to the differential diagnosis of PHPT from non-PHPT, evenly can assist the determination of the specific pathology of MIBI uptake lesion before surgery.
Quantitative evaluation of dental bio-aerosols using particle count values. Part 1: the effect of High Volume Aspiration and natural ventilation.
Authors: Haigh Andre , Vasant Ronuk , O'Hooley Dominic
Published: August 2020

AimRoutine dental treatments are frequently associated with aerosol generating procedures (AGP). Recently dental AGP have attracted significant attention as a possible vector for the transmission of SARS-CoV-2 and attempts have been made to establish when a surgery may be safely decontaminated following a dental AGP — the ‘fallow time’. There is a paucity of research in the dental literature regarding the near real time generation and dispersion of dental aerosol following a dental AGP. Study aims are to: (1) monitor dental aerosol generation and dispersal through semi-continuous particle count values (PCV), and (2) use this information to delineate a range of suitable fallow times.MethodFollowing baseline measurements, five identical dental AGP were conducted on a dental manikin for each of three groups: (SEO) saliva ejector only, (HVA) high volume aspiration, (WO) high volume aspiration with windows open. For each procedure PCV were recorded every 2.2 minutes with a Light Scattering Airborne Particle Counter (LSAPC) for 3.3 hours. Eleven dependent variables were analysed, including baseline PCV, total PCV, peak PCV, time taken to return to one sample standard deviation of baseline PCV, and a time series extending from 15 minutes to 3 hours after cessation of AGP. Due to heterogeneity, the data was analysed with Krushkall-Wallis test and Dunn-Bonferroni post hoc.ResultsBetween group mean baseline PCV were not statistically significant. Compared with SEO, WO had a statistically significant impact on peak PCV (p=.009) and HVA had a statistically significant impact on total PCV (p=.006). With the exception at 2 and 3 hours, PCV throughout the time series were statistically significantly lower for WO and HVA in comparison with SEO. WO PCV were influenced by outdoor aerosol levels.Four of the five SEO procedures failed to return to baseline PCV within 3.3 hours. Following AGP, the mean time for the HVA procedures to return to baseline PCV was 17.12 minutes, 95% CI [4.96 to 29.28]. The effect of HVA on the time taken to return to baseline PCV was very large (Glass’s Δ= -4.943, CLES=1.00).ConclusionThere is a significant benefit in opening windows during AGP. The effect of HVA on reducing fallow time is very large. Under the conditions of this study, PCV suggest that it might be safe to consider a fallow time of 29.28 minutes.
Staged Protocol for the Treatment of the Severe Open Tibia Plateau Fractures
Authors: Wang Wenjuan , Zhu Yanhui , Hu Xiaopeng , Jin Chen , Wang Xiang
Published: August 2020

Introduction Open tibia plateau fractures is one of the most challenging problems in fracture surgery and often results in high rates of complications. Staged protocol for treatment of these complex injuries is preferred and appears low rates of complications. The aims of this study is to analyse the results of staged protocol for treatment of severe open tibia plateau fractures. Materials and Methods 11 patients with grade III (Gustilo) open tibial plateau fractures (Schatzker V and VI) were treated by staged protocol. The time from first stage operation to the definitive internal fixation, time of bone union and range of motion were investigated. And incision necrosis, surgical site infection, internal fixation related complications, and non-union were recorded. At the last follow-up visit, the independent knee assessments were carried out using the Rasmussen’s clinical and radiologic scores. Results The articular surfaces fragments reduction and limb alignment correction were satisfactorily obtained in all the patients during the first stage operation. The mean time from first stage operation to the definitive internal fixation was 24.7 days (19–34 days). All the patients achieve union at a mean of 5.2 months (range, 3–8 months). The average knee range of motion was 116.4° (100°–130°). No cases of these patients incurred deep infection. The Rasmussen’s radiologic scores revealed the mean scores were 15.5 (range 12 to 18). And the mean Rasmussen clinical score was 26.1 (22–29). Conclusions The staged management technique is a safe method associated with good clinical and radiological outcomes in severe open tibial plateau fractures. And we emphasizes the important of the articular surfaces fragments reduction and fixation and limb alignment correction during the first stage operation.
Uptake and Correlates of Chlamydia and Gonorrhea Testing among Female Sex Workers in Southern China: A Cross-sectional Study
Authors: Zhao Peizhen , Wang Ya-Jie , Cheng Huan-Huan , Zhang Ye , Tang Wei-Ming , Yang Fan , Zhang Wei , Zhou Ji-Yuan , Wang Cheng
Published: August 2020

Background: Female sex workers (FSW) are at high risk of chlamydia and gonorrhea infection. However, there is a limited literature examining their testing uptake to date. The aim of this study was to assess the uptake and determinants of chlamydia and gonorrhea testing among FSW in Southern China.Methods: A cross-sectional study with convenience sampling was conducted in five cities in Southern China. We collected data on socio-demographic characteristics, sex behaviors, chlamydia and gonorrhea testing in the past twelve months and the utilization of health care services from participants through face-to-face interviews. Multivariable logistic regression was performed to identify factors associated with chlamydia and gonorrhea testing, respectively.Results: Overall, 1207 FSWs were recruited, with the mean age of 30.7±6.8 years old, and an average number of clients per week of 7.0(4.0-10.0). 65.4% participants consistently used condoms with clients in the past month. Only 7.5% and 10.4% had been tested for chlamydia and gonorrhea in the past twelve months, respectively. Multivariable analysis indicated that FSW who worked at low titers (adjusted Odds Ratio (aOR)=2.36, 95%CI:1.23-10.14), had more clients in past month (aOR=1.03, 95%CI:1.01-1.05), used condoms consistently (aOR=1.79, 95%CI:1.12-2.86), had STD symptoms (aOR=4.09,95%CI:2.62-6.40), had HIV testing (aOR=5.16, 95%CI:3.21-8.30) or syphilis testing (aOR=6.90, 95%CI:4.21-11.22) in the past year were more likely to have received chlamydia testing. In addition, FSW who had more clients in the past month (aOR=1.02,95%CI:1.00-1.04), had STD symptoms (aOR=3.33, 95%CI:2.03-5.46), had HIV (aOR=3.94, 95%CI:2.34-6.65) and syphilis testing (aOR=3.27, 95%CI:1.96-5.46) in the past year were more likely to have gonorrhea testing.Conclusions: The chlamydia and gonorrhea testing uptake are low among Chinese FSW. Integrating chlamydia and gonorrhea testing promotion strategies into HIV testing promotion programs may help bridge the gap among FSW.
Acometimento neonatal do pênfigo vulgar: relato de caso
Authors: Melo Mariana das Neves , Pegas Elisangela
Published: August 2020

Os pênfigos são dermatoses bolhosas autoimunes, em que há a produção de autoanticorpos direcionados contra moléculas de adesão dos epitélios, levando à perda da coesão celular. As doenças bolhosas intraepidérmicas são compostas pelo grupo dos pênfigos: pênfigo foliáceo clássico, pênfigo foliáceo endêmico, pênfigo eritematoso, pênfigo vulgar, pênfigo vegetante, pênfigo herpetiforme (variante clínica dos pênfigos vulgar e foliáceo), pênfigo por IgA, pênfigo paraneoplásico e pênfigo induzido por medicamentos. Devido à transferência placentária dos anticorpos IgG, existem casos de recém-nascidos com diagnóstico de Pênfigo Neonatal. Este  artigo relata o caso de uma paciente recém-nascida de mãe com diagnóstico prévio de Pênfigo Vulgar com lesões exulceradas extensas na região perineal, couro cabeludo, cervical posterior e dorso, e também lesões bolhosas nos pés.Descritores: Pênfigo; Recém-Nascido; Dermatopatias; Doenças Autoimunes.ReferênciasSmolinski KN, Shah SS, Honig PJ, Yan AC. Neonatal cutaneous fungal infections. Curr Opin Pediatr. 2005;17(4):486-93.Zhao CY, Chiang YZ, Murrell DF. Neonatal autoimmune blistering disease: a systematic review. Pediatr Dermatol. 2016;33(4):367-74.Bellelli AG, Mantero NM, Rueda ML, Navacchia D, Cao G, Liloo L et al. Pénfigo vulgar de la infancia, a propósito de un caso [Childhood pemphigus vulgaris, a case report]. Arch Argent Pediatr. 2016;114(6):e457-60. Ali HS. Pemphigus vulgaris during pregnancy - a case report. J Pak Assoc Dermatol. 2011;21(4):301-3.Hanna S, Kim M, Murrell DF. Validation studies of outcome measures in pemphigus. Int J Womens Dermatol. 2016;2(4):128-39.Ibrahim SB, Yashodhara BM, Umakanth S, Kanagasabai S. Pemphigus vulgaris in a pregnant woman and her neonate. BMJ Case Rep. 2012;2012:bcr0220125850.Kodagali SS, Subbarao SD, Hiremagaloor R. Pemphigus vulgaris in a neonate and his mother. Indian Pediatr. 2014;51(4):316-17.Fainaru O, Mashiach R, Kupferminc M, Shenhav M, Pauzner D, Lessing JB. Pemphigus vulgaris in pregnancy: a case report and review of literature. Hum Reprod. 2000;15(5):1195-97.Abrams ML, Smidt A, Benjamin L, Chen M, Woodley D, Mancini AJ. Congenital epidermolysis bullosa acquisita: vertical transfer of maternal autoantibody from mother to infant. Arch Dermatol. 2011;147(3):337-41.Goldberg NS, DeFeo C, Kirshenbaum N. Pemphigus vulgaris and pregnancy: risk factors and recommendations. J Am Acad Dermatol. 1993;28(5 Pt 2):877-79.
Estimation of Bcl-2 and Ki-67 in Gingival Epithelium of Epileptic Patients
Authors: Salama Mohamed Helmy , Algendy Abdelraheem R. , Shaikh Saleem
Published: August 2020

Abstract
 
Introduction: Gingival overgrowth is one of several oral side effects of phenytoin, a potent antiepileptic drug.  Several mechanisms have been elucidated to understand the pathogenesis of drug induced gingival overgrowth. The frequency of gingival overgrowth associated with chronic phenytoin therapy remains controversial. and the possible subclinical effects of this drug on the gingival epithelium should be investigated histopathologically and immunohistochemically.
Purpose of the study: To investigate the Bcl-2 for apoptosis rate and Ki-67 for the epithelial proliferative activity in epileptic patients.
Materials and methods: Twenty four samples of gingival tissue from epileptic patients treated with phenytoin and in eight samples of gingival tissue from healthy patients who didn’t use phenytoin (control) were evaluated for Bcl-2 and Ki-67 immunohistochemically.
Results: The results revealed moreproliferative activity of the overlying epithelium and an increased pattern of Bcl-2 and Ki-67 in phenytoin users compared to controls.
Conclusion: These results concluded that the increased epithelial thickness observed in phenytoin induced gingival overgrowth is associated with increased apoptotic rate and mitotic activity , especially in the oral epithelium.
 
Keywords: Gingival overgrowth, Bcl-2, Ki-67, Phenytoin.
A rare case of masseter muscle cysticercosis in a young female patient managed conservatively
Authors: Dodia Hardik , Solanki Karnadev , Shah Bhaumik
Published: August 2020

Cysticercosis is caused by Taenia solium larvae infestation. Isolated oral cysticercosis is a very rare presentation of this disease. Here is a case of masseter cysticercosis in a young woman who presented with painful cheek swelling. Diagnosis is confirmed with history, clinical examination and MRI.  Luckily patient got cured with conservative management.
Antibacterial Investigation using Spectrophotometric Assay of the Polar Leaf Extracts of Ficus capensis (Moraceae)
Authors: Musa Achimugu Dickson , Dorgu Sandra Tombiah , Ogbiko Cyril , Ikko Jeremiah , Shuaib Muhammad Hausa , Nwodo Okwesili Fred Chiletugo , Krastel Philipp
Published: August 2020

This study was designed to explore new antibacterial agent(s) from the defatted methanol and water extracts of Ficus capensis. The extracts were obtained using various solvents, namely, cyclohexane, dichloromethane, methanol, and water by serial exhaustive extraction, after which both extracts were challenged with pure clinical isolates of Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, Staphylococcus aureus, Acinetobacter baumannii, and Burkolderia cepacia viz-a-viz standard antibiotics of chloramphenicol, gentamicin, and amoxicillin at 25 μg/ml, 50 μg/ml, and 100 μg/ml concentrations using spectrophotometric method. Using the zone of inhibition as an inhibitory parameter, both extracts of F. capensis showed promising antimicrobial activity in a concentration-dependent manner comparable to the standard antibiotics for all tested microorganisms. This research holds promise for the exploration of various potentially active secondary metabolites which would help in developing pharmaceuticals, especially antibacterial drugs, for combating common microbial infections. This validates the use of the plant leaves in the treatment of broad-spectrum microbial infections in ethnomedicine.
Comparative performance evaluation of self-adaptive differential evolution with GA, SCE and DE algorithms for the automatic calibration of a computationally intensive distributed hydrological model
Authors: Nandi Saswata , Janga Reddy M.
Published: August 2020

Recently, physically-based hydrological models have been gaining much popularity in various activities of water resources planning and management, such as assessment of basin water availability, floods, droughts, and reservoir operation. Every hydrological model contains some parameters that must be tuned to the catchment being studied to obtain reliable estimates from the model. This study evaluated the performance of different evolutionary algorithms, namely genetic algorithm (GA), shuffled complex evolution (SCE), differential evolution (DE), and self-adaptive differential evolution (SaDE) algorithm for the parameter calibration of a computationally intensive distributed hydrological model, variable infiltration capacity (VIC) model. The methodology applied and tested for a case study of the upper Tungabhadra River basin in India and the performance of the algorithms is evaluated in terms of reliability, variability, efficacy measures in a limited number of function evaluations, their ability for achieving global convergence, and also by their capability to produce a skilful simulation of streamflows. The results of the study indicated that SaDE facilitates an effective calibration of the VIC model with higher reliability and faster convergence to optimal solutions as compared to the other methods. Moreover, due to the simplicity of the SaDE, it provides easy implementation and flexibility for the automatic calibration of complex hydrological models.
Operating cost reduction by electricity profiling and demand management
Authors: Hasan Kazi N. , Court Daniel , Curtis Rod , Kashyap Sumukh , Jankovic Sava , Asayhe Aderajew , AlAbdali AbdulRahman , Anastassiou Marcos
Published: August 2020

Like many other industries, water utilities use a high amount of electricity to operate water and wastewater treatment plants and incur a large percentage of their operating cost as electricity bills. This study investigates the electricity usage profile of a water utility and employs demand management strategies for cost reduction. Two cost reduction strategies are verified in this research – (i) fixed price contract, and (ii) electricity time-of-use shifting. An illustrative case study has been presented with two years of interval data from eight selected sites of an Australian/Victorian water utility. The study results suggest that by employing the demand management strategies, up to 22% cost reduction could be achieved from annual electricity bills. The study recognizes that the solution could be customized for each individual site based on the site-specific electricity usage profile.
Nickel(II) Chromite Nanoparticles: An Eco-Friendly and Reusable Catalyst for Synthesis of 2,4-Diamino-6-aryl-pyrimidine-5-yl Cyanides under Ultrasonic Radiation
Authors: Saeedi Bahareh , Abdolmohammadi Shahrzad , Mirjafary Zohreh , Kia-Kojoori Reza
Published: August 2020

Background:

One of the principal factors in the field of research in green chemistry is to drive chemical reactions using ultrasonication as a versatile synthetic tool. Moreover, nanostructured metal salts occupy an important position as low cost, efficient, heterogeneous, and green catalysts in chemical reactions. Pyrimidine has also acquired significance because it is a core structure in a variety of natural and non-natural agents, many of which display versatile biological activities and medical applications.

Objective:

The aim of this study was to explore the role of nickel(II) chromite nanoparticles (NiCr2O4NPs) as a green and recyclable catalyst for the synthesis of 2,4-diamino-6-arylpyrimidine- 5-yl cyanides under ultrasonic radiation.

Methods:

A direct cyclocondensation reaction of guanidine nitrate, aromatic aldehydes, and malononitrile was performed using NiCr2O4NPs as an effective heterogeneous catalyst under ultrasonic radiation at room temperature conditions to prepare 2,4-diamino-6-aryl-pyrimidine-5-yl cyanides in high yields. The described catalyst was prepared successfully according to a simple hydrothermal route and fully characterized by the X-Ray diffraction (XRD) technique, dispersive energy X-Ray (EDS) analysis, scanning electron microscopy (SEM), and dynamic light scattering (DLS).

Results:

A number of 2,4-diamino-6-aryl-pyrimidine-5-yl cyanides were effectively synthesized in high yields (94-98%) within short reaction times (15 min). All synthesized compounds were well characterized by IR,1H and13C NMR spectroscopy, and also by elemental analyses.

Conclusion:

In conclusion, a simple, efficient, and green synthesis of 2,4-diamino-6-arylpyrimidine- 5-yl cyanides was developed using NiCr2O4NPs as a green nanocatalyst, and under ultrasound radiation as a green tool. The mild reaction conditions, avoiding the use of toxic solvents or reagents, high atom economy, high yields, and simple workup are the attractive features of this new protocol.