bluuebunny/crossref_metadata_2025 huggingface dataset:
Epicardial Adipose Tissue as a New Target of Therapeutic Interventions
Authors: Druzhilov M. A. , Kuznetsova T. Y.
Published: September 2020

There is evidence of a correlation between epicardial adipose tissue and the presence and severity of coronary heart disease, the development of hypertrophy, impaired diastolic and systolic function of the left ventricle, enlargement, fibrosis and electrophysiological remodeling of the atria, the occurrence and severity of supraventricular arrhythmias. There is also a lot of evidence of the influence of both non-drug methods and drugs on the severity and functional activity of epicardial adipose tissue, which can be considered as a potentially modifiable factor of cardiovascular risk, the various therapeutic interventions target and a criterion for their effectiveness. Its unique characteristics suggest the advisability of pharmacological strategies aimed at regulating the expression of genes encoding the secretion of adipocytokines and adipocyte function, and a dynamic assessment of the severity of epicardial fat during therapy can be a tool to evaluate its effectiveness in various cardiovascular diseases.
In the Refractory Hypertension “Labyrinth”. Focus on Primary Hyperaldosteronism
Authors: Tsygankova O. V. , Batluk T. I. , Latyntseva L. D. , Akhmerova E. V. , Akhmedzhanov N. M.
Published: September 2020

Primary hyperaldosteronism is an existence of a functional autonomous source with increased aldosterone production (full or partial) in relation to the renin-angiotensin system. Increased production of aldosterone by the adrenal cortex is the most common form of a secondary hypertension despite the low attention of internists to the problem. The success of a treatment and a prognosis of these patients depend on correct choice of screening (aldosterone/renin ratio) and clarifying diagnostic methods. There are clear algorithms for conducting these tests in accordance with Russian and International recommendations in the respective groups of patients. The purpose of this case report is to demonstrate the long way to diagnosis of primary hyperaldosteronism in a young patient with refractory hypertension, right adrenal adenoma, and clinical (convulsions, weakness) and laboratory signs of hypokalemia. It should not only have made the diagnosis easy, but it could have also absolutely justified the surgical tactics. Unfortunately, the final verification of the disease by carrying out a saline test was accomplished 13 years after the debut of hypertension and 10 years after the primary visualization of the adrenal adenoma.
Prevalence and Characteristics of Blood Pressure Phenotypes in Patients with Hypertension and Chronic Respiratory Diseases (Study of Ambulatory Practice Data of a Cardiologist)
Authors: Kurekhyan A. S. , Smirnova M. I. , Gorbunov V. M. , Koshelyaevskaya Ya. N. , Deev A. D. , Loukianov M. M.
Published: September 2020

Diagnosis of the blood pressure (BP) phenotype is the most important indication for its ambulatory measurement because BP phenotype is associated with cardiovascular complications and death. The study of BP phenotypes is important for patients with hypertension (HT) and comorbidity, including asthma and chronic obstructive pulmonary disease (COPD). The combination of HT with these lower airway diseases (LAD) leads to the mutual influence of pathologies creates difficulties in the drugs choice and may affect BP phenotype in HT patients.

Aim. To compare in the prospective investigation various characteristics of BP phenotype in HT patients considering LAD (asthma or COPD).

Material and methods. The prospective cohort study of ambulatory patients with HT (n=156) was carried out. The part of these patients had asthma or COPD (n=69). The clinical measurements and 24-hour BP monitoring, spirometry, clinical and biochemical blood tests, standard examination were performed, initially and after 12 months. BP phenotype were determined by the ratio of clinical BP and ambulatory BP considering their threshold values. Standard statistical methods and multivariate analysis were used.

Results. Patients with LAD had 2 times more often prognostically unfavorable phenotypes: ineffective antihypertensive therapy (AHT) 37.3% vs 15.7% and masked AHT inefficiency 7.5% vs 4.5%; white coat HT on treatment (WCH) and effective AHT were less common(29.9% vs 42.7%; 25.5% vs 37.1%, respectively, p 148 mm Hg (b=2.733, p=0.040), LAD (b=1.015, p=0.011), serum total cholesterol (b=0.350, p=0.043), degree of nighttime diastolic BP decrease (for 13.1-18.0% b=-2.130, p=0.004; for 18.1-24.0% b=-2.509, p=0.001). The factors associated with masked AHT inefficiency in comparison to effective AHT were heart rate in orthostasis >87 beats/min(b=3,512, p=0.006) and SBP in orthostasis 141-148 mm Hg (b=3.405, p=0.004).

Conclusion. The prevalence of prognostically unfavorable BP phenotypes (ineffective AHT and masked AHT inefficiency) is two times higher in HT patients with LAD. The first is associated with LAD presence, sex, and serum cholesterol; both phenotypes interrelated with hemodynamic parameters including degree of nighttime diastolic BP decrease. We found no association between AHT and LAD therapy with the BP phenotypes in this study. However, larger works in this area are required, including analysis of outcomes in long-term prospective studies.
The Shamiri Group Intervention for Adolescent Anxiety and Depression: Study Protocol for a Randomized Controlled Trial of a Lay Provider-Delivered, School-Based Intervention in Kenya
Authors: Osborn Tom Lee , Venturo-Conerly Katherine E. , Wasil Akash R. , Rodriguez Micaela , Roe Elizabeth , Alemu Rediet , G. Susana Arango , Gan Jenny , Wasanga Christine , Schleider Jessica L. , Weisz John R.
Published: September 2020

Background Developing low-cost, socio-culturally appropriate, and scalable interventions for youth depression and anxiety symptoms in low-income regions such as countries in Sub Saharan Africa is a global mental health priority. We developed and intend to evaluate one such intervention for adolescent depression and anxiety in Kenya. The intervention, named Shamiri (a Swahili word for ‘thrive’), draws upon evidence-based components of brief interventions that involve nonclinical principles rather than treatment of psychopathology (e.g. growth mindset, gratitude and virtues).Methods 420 Kenyan adolescents (ages 13-18) with clinically elevated depression and/or anxiety symptoms will be randomized to either the four-week Shamiri group intervention or a group study-skills control intervention of equal duration and dosage. Participating adolescents will meet in groups of 8-15, led by a high-school graduate trained to deliver Shamiri as a lay-provider. Adolescents will self-report primary outcome measures (depression—measured by the PHQ-8, and anxiety symptoms—measured by the GAD-7) and secondary outcome measures (perceived social support, perceived academic control, self-reported optimism and happiness, loneliness, and academic grades) at the 2-week intervention midpoint, 4-week post-intervention endpoint, and 2-week post-intervention follow-up. We predict that adolescents in the Shamiri group, when compared to the study-skills control group, will show greater improvements in primary outcomes and secondary outcomes. Discussion Results may suggest that a brief, lay-provider delivered, school-based intervention may reduce depression and anxiety symptoms, improve academic outcomes and other psychosocial outcomes in adolescents with clinically-elevated symptoms in Sub-Saharan Africa.Trial RegistrationPan African Clinical Trials Registry. Trial ID: PACTR201906525818462. Registered 12th June 2019.
A blended eHealth intervention for insomnia following acquired brain injury study protocol for a randomized controlled trial
Authors: Ford Marthe , Geurtsen Gert J. , Groet Erny , Bennekom Coen A.M. Van , Someren Eus J.W. Van
Published: September 2020

Background: Up to a third of stroke patients and patients with traumatic brain injury suffer from insomnia, including problems to fall asleep or stay asleep at night. Insomnia may exacerbate other brain damage-related problems, for example regarding cognitive functioning and emotional well-being, may lead to poorer quality of life, and may complicate recovery processes. Cognitive behavioral therapy for insomnia, delivered face-to-face or online, is found to be effective in the general population. However, despite the high prevalence and serious consequences of insomnia following acquired brain injury, studies on the efficacy of face-to-face cognitive behavioral treatment in this population are scarce, and this applies even more for studies on online cognitive behavioral therapy. Therefore, this study aims to evaluate the efficacy of a newly developed guided online cognitive behavioral therapy for insomnia following acquired brain injury.Methods: A multicenter, prospective, randomized, open-label, blinded end point study (PROBE) will be conducted, in which 48 patients diagnosed with stroke or traumatic brain injury, and insomnia will be randomly allocated to the online cognitive behavioral therapy for insomnia treatment group or the treatment as usual group. The treatment consists of 6 online cognitive behavioral therapy sessions given on a weekly basis and personalized feedback after each session, combined with 2 face-to-face sessions. Outcomes will be assessed at baseline, immediately after the intervention period and at 6 weeks follow up. The primary outcome is the insomnia severity assessed with the insomnia severity index. Secondary outcome measures include sleep quality, sleep features derived from the sleep diary, fatigue, anxiety and depression, subjective cognitive functioning and societal participation.Discussion: This study will provide insight on the efficacy of online cognitive behavioral therapy for insomnia following stroke and traumatic brain injury.Trial Register: Netherlands Trial Register, NTR7082, 12 March 2018
Traffic police officers’ use of first aid skills at work: a qualitative content analysis of focus group discussions in Dar es Salaam, Tanzania
Authors: Ndile Menti Lastone , Saveman Britt-Inger , Lukumay Gift G. , Mkoka Dickson A. , Outwater Anne H. , Backteman-Erlanson Susann
Published: September 2020

Background: The World Health Organisation (WHO) recommends involving lay people in prehospital care. Several training programmes have been implemented to build lay responder first aid skills. Findings show that most programmes significantly improved participants’ first aid skills. However, there is a gap in knowledge of what factors influence the use of these skills in real situations. The current study aimed to describe police officers’ views on and experiences of factors that facilitate or hinder their use of trained first aid skills at work. Methods Thirty-four police officers participated in five focus group discussions. A structured interview guide was used to collect data. Interviews were audio-recorded and transcribed verbatim. Data were analysed using qualitative content analysis. Results: We identified five categories of facilitators or hindrances. Training exposure was considered a facilitator; work situation and hospital atmosphere were considered hindrances; and the physical and social environments and the resources available for providing first aid could be either facilitators or hindrances. Conclusion: Practical exposure during training is perceived to improve police officers’ confidence in applying their first aid skills at work. However, contextual factors related to the working environment need to be addressed to promote this transfer of skills.
Personal values in adolescence and their associations with metabolic biomarkers in adulthood: a population-based study in Japan
Authors: Sasaki Natsu , Watanabe Kazuhiro , Kawakami Norito
Published: September 2020

Background: Personal values, which are formed in early life, can have an impact on the health outcome later in life. Objective: The aim of this study is to investigate the relationship between personal values in adolescence and bio-indicators related to metabolic syndrome (MetS) in adulthood.Participant and Methods: The longitudinal data was used from the Japanese Study on Stratification, Health, Income, and Neighborhood (J-SHINE) in 2012 and 2017. Personal values in adolescence were retrospectively obtained in 2017 from a self-reporting questionnaire, composed of value priorities and commitment to the values. Venous samples were collected in 2012 for low and high-density lipoprotein (LDL, HDL) cholesterol and hemoglobin A1c (HbA1c). Body mass index (BMI), waist circumference and systolic and diastolic blood pressure (SBP, DBP) were also measured. The associations of each variable were examined by partial correlation analysis. In addition, multiple linear regression analysis was conducted to examine overall associations between personal values and the sum of standardized scores (Z-score) of the biomarkers as a proxy of MetS. Results: The total population (n=668) included 261 men and 407 women. Among men, the personal value priority of “Having influence on society” was associated with high HDL cholesterol (partial r=0.13, p=0.032) and “Cherishing familiar people” with low waist circumference (r=-0.129, p=0.049), low SBP, and high DBP (r=-0.135, p=0.039; r=0.134, p=0.041). In women, “Not bothering others” was associated with high SBP and low DBP (r=0.125, p=0.015; r=-0.123, p=0.017). "Economically succeeding" were associated with worse outcome (β=0.162, p=0.042).Conclusions: Although some significant associations were found between personal values in adolescence and MetS-related markers in adulthood, overall associations were not strong. Culturally prevailing values were likely to be associated with a good outcome of metabolic health.
Oncogenic miR-20b-5p contributes to malignant behaviors of breast cancer stem cells by bidirectionally regulating CCND1 and E2F1
Authors: Xia Liqin , Li Feng , Qiu Jun , Feng Zhongming , Xu Zihan , Chen Xiewan , Chen Zhengtang , Sun Jian-Guo
Published: September 2020

Background: Breast cancer is the leading cause of cancer mortality in women worldwide. Therefore, it is of great significance to identify the biological mechanism of tumorigenesis and explore the development of breast cancer to achieve a better prognosis for individuals suffering from breast cancer. MicroRNAs (miRNAs) have become a hot topic in cancer research, but the underlying mechanism of its involvement in cancer remains unclear.Methods: The miRNA profile between breast cancer stem cells (BCSCs, CD44 + CD24 -/low ) and control MCF-7 breast cancer cells was obtained in a previous study. Based on biological analysis, miR-20b-5p was hypothesized to be a key factor due to the malignant behavior of BCSCs. Then, agomir-20b-5p and antagomir-20b-5p were transfected into MCF-7 and T47D breast cancer cells to detect cell migration, wound healing and proliferation, and lentivirus vectors silencing or overexpressing miR-20b-5p were transfected into T47D-CSCs to detect proliferation and apoptosis. The effect of miR-20b-5p on xenograft growth was investigated in vivo by transfection of a lentivirus-overexpression vector into T47D cells. The target genes were predicted by the online programs picTar, miRanda and TargetScan and verified by dual luciferase assay, and changes in protein expression were detected by western blot.Results: MiR-20b-5p had the highest degree in both the miRNA-gene network and miRNA-GO network to regulate BCSCs. Overexpression of miR-20b-5p significantly promoted the migration and wound healing ability of MCF-7 cells and T47D cells compared with the control ( P < 0.05). In addition, miR-20b-5p facilitated the proliferation of MCF-7 cells and T47D-CSCs ( P < 0.05) and inhibited the apoptosis of T47D-CSCs ( P < 0.05). Moreover, miR-20b-5p promoted xenograft growth compared with the control group ( P < 0.05). Accordingly, potential targets of both CCND1 and E2F1 were predicted by bioinformatics analysis. MiR-20b-5p directly targeted both CCND1 and E2F1 in a dual luciferase assay, while antagomir-20b-5p downregulated the protein levels of CCND1 and E2F1.Conclusions: Oncogenic miR-20b-5p was confirmed to promote the malignant behaviors of breast cancer cells and BCSCs. The underlying mechanism lies in that miR-20b-5p overall enhanced both CCND1 and E2F1 targets via bidirectional regulation probably involving direct downregulation and indirect upregulation.
Signs and symptoms do not predict, but may help rule out acute Q fever in favour of other respiratory tract infections, and reduce antibiotics overuse in primary care
Authors: Hackert Volker Heinz , Dukers-Muijrers Nicole H.T.M. , Hoebe Christian J.P.A.
Published: September 2020

Background: From early 2009, the Dutch region of South Limburg experienced a massive outbreak of Q fever, overlapping with the influenza A(H1N1)pdm09 pandemic during the second half of the year and affecting approximately 2.9% of a 300,000 population. Acute Q fever shares clinical features with other respiratory conditions. Most symptomatic acute infections are characterized by mild symptoms, or an isolated febrile syndrome. Pneumonia was present in a majority of hospitalized patients during the Dutch 2007-2010 Q fever epidemic. Early empiric doxycycline, guided by signs and symptoms and patient history, should not be delayed awaiting laboratory confirmation, as it may shorten disease and prevent progression to focalized persistent Q fever. We assessed signs’ and symptoms’ association with acute Q fever to guide early empiric treatment in primary care patients.Methods: In response to the outbreak, regional primary care and hospital-based specialty physicians tested a total of 1218 subjects for Q fever. Testing activity was bimodal, a first “wave” lasting from March to December 2009, followed by a second “wave” which lasted into 2010 and coincided with peak pandemic influenza activity. We approached all 253 notified acute Q fever cases and a random sample of 457 Q fever negative individuals for signs and symptoms of disease. Using data from 140/229(61.1%) Q fever positive and 194/391(49.6%) Q fever negative respondents from wave 1, we built symptom-based models predictive of Q-fever outcome, validated against subsets of data from wave 1 and wave 2. Results: Our models had poor to moderate AUC scores (0.68% to 0.72%), with low positive (4.6-8.3%), but high negative predictive values (91.7-99.5%). Male sex, fever, and pneumonia were strong positive predictors, while cough was a strong negative predictor of acute Q fever in these models. Conclusion: Whereas signs and symptoms of disease do not appear to predict acute Q fever, they may help rule it out in favour of other respiratory conditions, prompting a delayed or non-prescribing approach instead of early empiric doxycycline in primary care patients with non-severe presentations. Signs and symptoms thus may help reduce the overuse of antibiotics in primary care during and following outbreaks of Q fever.
Difference Analysis of the Contribution of E-commerce and Modern Logistics to Regional Economy Based on Wireless Network
Authors: Tang Xiaodong , Wang Gangyi
Published: September 2020

The rapid development of e-commerce has greatly promoted the development of modern logistics. The application level of e-commerce and the application status of modern logistics largely determine the development of a regional economic structure. Under such circumstances, it is particularly important to comprehensively strengthen the research on the impact of e-commerce and modern logistics on the network regional economy. China is as one of the most active regions over the world. Therefore, in this paper, we take the network regional economic as the research object. Firstly, we obtain relevant regional logistics nodes and e-commerce information through wireless networks. Secondly, based on information acquisition, we propose an empirical analysis of the development status of the logistics industry and e-commerce, and we also explain their contributions to regional economic growth. Finally, this paper proposes countermeasures to further increase the contribution of logistics and e-commerce to economic growth. This will provide a reference for building a regionally coordinated logistics e-commerce system and realizing regional economic integration.
Descriptive study of how proportioning marks determines the performance of nursing students in a pharmacology course.
Authors: Doggrell Sheila
Published: September 2020

Background: In programs with higher proportions of marks allocated to ongoing assessment, the students have higher overall marks than those with a lower proportion allocated to assessment. Little or no attention has been made to how the allocation affects the academic success of students in individual courses. The purpose of this study was to determine how the allocation of marks to examinations, tutorials and an assignment affects the performance of nursing students in a pharmacology course. Methods: For students who passed a pharmacology course (i) the marks for examinations and ongoing assessment (tutorials and/or an assignment) were compared, and (ii) regression line and correlation analysis was undertaken to determine any association between these marks. In addition, for completing students, modelling was undertaken to determine the effects of changing the allocation of marks on passing and failing rates.Results: Nursing students who passed a pharmacology course obtained significantly lower marks in examinations than ongoing assessment, and for the ongoing assessment, lower marks in the assignment than tutorials. Regression line analysis showed that the marks in ongoing assessment (tutorials and/or the assignment) versus examination marks were a poor line-fit. The correlation coefficients between ongoing assessment and examinations were weak to moderate. A high percentage of students passed the course (> 90%) and, modelling for completing students, showed that decreasing the marks for examination would have led to slightly more students passing the pharmacology course with higher grades. In contrast, increasing the marks for examination would have dramatically decreased the number of students passing the course, and their grades.Conclusions: The allocation of marks can have a major effect on student performance. As ongoing assessment is only a weak or moderate indicator of performance in examination this has implications for students who rely on passing examinations for their advancement. For instance, nursing students in some countries (e.g. USA) are required to pass examinations prior to registration, whereas in others (e.g. Australia) they are not. Consideration needs to be given as to whether it is appropriate for nursing students who fail examinations to pass courses/programs.
Cepharanthine and Curcumin inhibited mitochondrial apoptosis induced by PCV2
Authors: Xu Yinlan , Zheng Jiangang , Sun Panpan , Guo Jianhua , Zheng Xiaozhong , Sun Yaogui , Fan Kuohai , Yin Wei , Li Hongquan , Sun Na
Published: September 2020

Background: Porcine circovirus type 2 (PCV2) is an immunosuppressive pathogen with high prevalence rate in pig farms. It has caused serious economic losses to the global pig industry. Due to the rapid mutation of PCV2 strain and co-infection of different genotypes, vaccination could not eradicate the infection of PCV2. It is necessary to screen and develop effective new compounds and explore their anti-apoptotic mechanism. The 13 natural compounds were purchased, with a clear plant origin, chemical structure and content and specific biological activities.Methods: The maximum no-cytotoxic concentration (MNTC) and 50% cytotoxic concentration (CC50) for 13 tested compounds were determined by the cytopathologic effect (CPE) assay and (3-(4,5-dimethyithiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) method in PK-15 cells, respectively, qPCR and Western blot were used to detect the anti-PCV2 effect of compounds. Western blot method, AnnexinV-FITC /PI, JC-1, and ROS Kits were respectively used to detect the anti-PCV2 induced apoptosis mechanism of Cepharanthine and Curcumin. In this study, Ribavirin was used as a positive control.Results: MNTC and CC50 of 13 compounds were obtained. Compared with the PCV2 infected group, the expression of Cap treated with Paeonol (0.4 mg/mL and 0.2 mg/mL), Cepharanthine (0.003 mg/mL, 0.0015 mg/mL and 0.00075 mg/mL) and Curcumin (0.02 mg/mL, 0.001 mg/mL and 0.005 mg/mL) were significantly lower in a dose-dependent manner. The expression of cleaved caspase-3 and Bax were up-regulated in the treated with Cepharanthine or Curcumin, while the expression of Bcl-2 was down-regulated, ROS value and MMP value were decreased to different degrees and the apoptosis rate was reduced.Conclusion: Paeonol, Cepharanthine and Curcumin have significant antiviral effect. And the PCV2-induced Mitochondrial apoptosis was mainly remitted by Cepharanthine and Curcumin.
Quality of life, social support and self-efficacy in women after a miscarriage
Authors: Iwanowicz-Palus Grażyna , Mróz Mariola , Bień Agnieszka
Published: September 2020

Background Pregnancy loss is typically experienced as a traumatic, critical event, which may lead to secondary psychological health disorders. Its burden involves both the experience of loss and related medical issues, which are associated with pain, hospitalization, limitation in one’s social roles, decreased sense of security, and changes in one’s perceived quality of life. The purpose of the present study was to evaluate levels of quality of life (QoL), social support and self-efficacy among women who had suffered a miscarriage. Methods The study was performed using a diagnostic survey method with questionnaires administered to 610 patients hospitalized due to spontaneous pregnancy loss in hospitals in Lublin (Poland). The instruments used were: the Berlin Social Support Scales (BSSS), the Generalized Self-Efficacy Scale (GSES), the WHOQoL–BREF questionnaire, and a standardized interview questionnaire. Results Respondents rated their overall QoL (3.90 points) higher than their overall perceived health (3.66). In terms of social support, the highest scores were noted for perceived available instrumental support (M = 3.78), perceived available emotional support (M = 3.68) and actually received support (M = 3.60). The mean generalized self-efficacy score among the women after pregnancy loss was 30.29. Respondents’ QoL was significantly correlated with multiple social support subscales and self-efficacy (p < 0.05). Conclusions Women after a miscarriage perceive their overall QoL as better than their overall health, while reporting the poorest QoL in the psychological domain. They also have a high level of self-efficacy. Regarding the types of social support, perceived available support, both instrumental and emotional, and actually received support was rated highly. Social support and self-efficacy contributed to better perceived QoL among the respondents. Keywords miscarriage, pregnancy loss, quality of life, social support, general self-efficacy
Clinical features and neuropsychiatric comorbidities in pediatric patients with tic disorders: A retrospective chart review study from South Korea
Authors: Park Eu Gene , Kim Young-Hoon
Published: September 2020

Background: Tic disorders are childhood-onset neuropsychiatric disorders characterized by multiple motor or vocal tics with frequent comorbidities and a broad spectrum of phenotypic presentations. In this study, we aimed to investigate the clinical characteristics and comorbid neuropsychiatric conditions in pediatric patients with tic disorders. Methods: We retrospectively reviewed the medical records of 119 pediatric patients (89 males, 30 females) who were diagnosed with tic disorders according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) at Uijeongbu St. Mary’s Hospital, Republic of Korea, between January 2012 and July 2019.Results: The mean age of tic onset was 6.9 years (range, 1–14) and the mean age at diagnosis was 8 years (range, 1–17). The mean lag between tic onset and diagnosis was 13.3 months (range, 0.25–132). The most common, first-presenting tics were eye blinking (50.4%), followed by jaw or lip movement (29.4%) and throat clearing (29.4%). Thirty-seven (31.1%) patients had at least one co-occurring neuropsychiatric disorder at the time of tic diagnosis. Subtypes of tic disorders, types of initial tics, and presence of neuropsychiatric comorbidities were not associated with tic severity. Tic severity was associated with greater functional impairment and tic noticeability (p <0.05). A relatively shorter time to diagnosis was associated with tic severity (Spearman’s ρ = –0.14, p = 0.11).Conclusions: The evolving nature of tic expression and severity, high prevalence of neuropsychiatric comorbidities, and associated functional impairments emphasize the importance of comprehensive assessment during the disease course for determining and prioritizing goals of treatment.
Clinical characteristics and poor predictors of anti-NXP2 antibody-associated Chinese JDM children
Authors: Wang Xinning , ding Yuchuan , Zhou Zhixuan , Hou Jun , Xu Yingjie , Li Jianguo
Published: September 2020

Background. Juvenile dermatomyositis (JDM) is a rare and sometimes fatal disease in children. The anti-NXP2 antibody is one of the most common antibodies and muscle ischaemia associated with NXP2 autoantibodies was a severe subtype of JDM.Further information is needed regarding clinical characteristics and factors associated with poor prognosis. But there are no reports about clinical characteristics and high risk factor of poor prognosis. For the first time, we introduced the clinical characteristics and poor predictors of anti-NXP2 antibody-associated juvenile dermatomyositis in Chinese children.Methods. Twenty-six patients with anti-NXP2 antibody-related JDM from 85 JDM Chinese patients were diagnosed from January 2016 to November 2019 . Logistic regression was used to analyze the risk factors for refractory cases and mortality.Results. The ratio of male to female was 1:1.9.. The median age of onset was 4.5 (1-13) years. Twenty-four cases (92.3%) had rash and muscle weakness. Treatments included glucocorticoids, immunosuppressive agents, biological agents (7 cases), plasma exchange, Janus kinase inhibitor (7 cases) and autologous stem cell transplant (1 case). Refractory JDM patients (11/26,42.3%) were associated with edema, skin ulcer, muscle strength<=grade 3, CD4/CD8 ratio <1.4 and ferritin >200ug/ml. Among 6 cases (6/26, 23.1%) with severe gastrointestinal involvement, 5 cases died and 1 case survived after autologous stem cell transplant (ASCT). The risk factors for gastrointestinal involvement and mortality were edema, skin ulcer, severe muscle weakness (dysphagia/ hoarseness/ soft voice), BMI<15 and ANA positive.Conclusions. . Edema, skin ulcer and severe muscle weakness predicted refractory disease, GI involvement, and mortality in anti-NXP2 antibody-positive JDM of Chinese children. Decreased CD4/CD8 ratio and high ferritin related with refractory cases, and very low BMI and ANA (+) are probably, associated with gastrointestinal involvement and mortality .
Comparison of Clinical, Para-clinical and Laboratory Findings in Survived and Deceased Patients with COVID-19: Diagnostic Role of Inflammatory Indications in Determining the Severity of Illness
Authors: Rokni Mohsen , Ahmadikia Kazem , Asghari Somaye , Mashaei Shahabodin , Hassanali Fahimeh
Published: September 2020

Background: Since December 2019, when a cluster of pneumonia cases due to SARS-CoV-2 initially emerged in Wuhan city and then rapidly spread throughout the world, the necessity for data concerning the clinical and paraclinical features of Iranian patients with COVID-19 was highlighted. Therefore, we aimed to compare the clinical, paraclinical and laboratory evidences of deceased patients with survival group. Methods: We extracted data regarding 233 patients with laboratory-confirmed COVID-19 from Buali Hospital in Iran; clinical/paraclinical and inflammatory indexes data were collected and analyzed. The data of laboratory examinations and chest CT findings were compared between deceased and survived patients. Results: The mean age of the patients was 49.8 years and 64% of our patients were male. The acute respiratory distress syndrome occurred in 64 patients, 52 who were admitted to the ICU, which all of them underwent invasive mechanical ventilation, and 28 who died. Lymphopenia (79%), neutrophilia (79%), and thrombocytopenia (21%) were the most frequently observed laboratory findings of the deceased group on admission. Most patients (68%) had a high systematic immune-inflammation (SII) index of >500 and increased C-reactive protein level (88%). Levels of inflammatory indexes such as neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and SII were documented to be significantly elevated in the deceased group when compared with the patients who survived (P< 0.0001, P< 0.001, P< 0.0001, respectively). The most commonly presented symptoms were fever (70%) and cough (63%) on admission. Headache was uncommon (11%). Ground-glass opacity with consolidation (mixed) was the most common radiologic finding on chest CT (51%). No radiographic or CT abnormality was found in 15 of 204 patients (7%). Conclusion: Small fraction of patients with COVID-19 may present without fever and abnormal radiologic findings. Elevated NLR, PLR and SII can be considered as prognostic and risk stratifying factor of severe form of disease.
Gut microbiota composition and functional prediction in diarrhea-predominant irritable bowel syndrome
Authors: Mei Lijun , Zhou Jiaoli , Su Yimo , Mao Kunhong , Wu Jing , Zhu Caicai , He Ling , Cui Ying
Published: September 2020

Background: Irritable bowel syndrome (IBS) is common and difficult to treat and its pathogenesis is closely related to gut mircobiota. However, differences in gut mircobiota of patients in different regions make it more difficult to elucidate the mechanism of IBS. We performed an analysis of gut microbiota composition and functional prediction in Chinese patients with diarrhea-predominant IBS (IBS-D).Methods: Fecal samples were obtained from 30 IBS-D patients and 30 healthy controls (HCs) in Nanchang, China. Using 16S gene sequence profiles, we analyzed the abundance of dominant microbiota at different taxonomy levels. Based on 16S information, Phylogenetic Investigation of Communities by Reconstruction of Unobserved States (PICRUSt) was used to predicting the function of gut microbiota.Results: Compared to HCs, gut microbiota richness but not diversity was decreased in IBS-D patients. The abundant phyla Firmicutes, Fusobacteria and Actinobacteria decreased significantly, and Proteobacteria increased significantly in IBS-D patients. PICRUSt indicated that function expression of gut microbiota in IBS-D patients was up-regulated in metabolism of cofactors and vitamins, xenobiotics biodegradation and metabolism, and down-regulated in environmental adaptation, cell growth and death.Conclusions: Compared with the normal population in China, IBS-D patients are characterized by complex and unstable gut microbiota, which may influence inflammation and metabolism of the host.
Research on the Dynamic Compensation Method of the Shock Wave's Evaluation Pressure Sensor
Authors: Wang Wei
Published: September 2020

Due to the steep and changing fast rising edge of explosion shock wave signal, it asks for good dynamic characteristic of sensor and test system. As far as the development of the sensor level, they are difficult to achieve dynamic characteristic requirement of approximate distortionless transmission, so cause a large dynamic error in the actual test. This paper, aiming at providing theoretical support for technology guarantee and service of the shock wave testing system of national shooting range, conducts a research on the method of dynamic characteristic compensation of pressure sensor facing the power evaluation of the blast shock wave. The research proposes and studies the filter design method of dynamic compensation of pressure sensor based on PFQPSO (the progressive function quantum-behaved particle swarm optimization) algorithm, which belongs to inverse modeling. The dynamic compensation can be realized without knowing the model of sensor, so the extra error caused by dynamic modeling of sensors can be avoided. using 8510 series sensor can be used with lower natural frequency and lower measurement range from Endevco Company, this research has had experiment and modeling on the dynamic characteristics of shock tubes as well as design of dynamic compensation filter. Based on the analysis and confirmation, this study illustrates the possibility and effectiveness of this method.
Symptomatology of Coronavirus Disease 2019 (COVID-19) - Lessons from a meta-analysis across 13 countries
Authors: Gamakaranage Champika Saman Kumara , Hettiarachchi Dineshani , Ediriweera Dileepa , Jayasinghe Saroj
Published: September 2020

Background: COVID-19 pandemic has resulted in varying clinical manifestations and mortality rates. There is no consensus on the symptomatology that would guide researchers and clinicians. Objective: The objective was to identify symptoms and their frequencies of COVID-19 with a meta-analysis of studies from several countries. Data sources: A systematic review using PubMed and Google Scholar data sources and reference tracing were used to identify 7176 articles. Eligibility criteria: Suitable articles were selected manually with selection criteria and 14 original articles included in meta-analysis. Data abstraction and analysis: PRISMA guidelines, used for data abstraction and a table was generated by feeding it with numbers and proportions of each symptom described. A meta-analysis was carried out using random effect models on each symptom separately across the studies and their prevalence rates and 95% confident intervals were calculated.Results: Selected 14 studies, either cross-sectional or cohort studies are analyzed. There were 2,660 confirmed cases of COVID-19. The majority were from China (n=2,439, 91.7%) and remainder from the Netherlands, Italy, Korea and India and one article from Europe. There was a total of 32 symptoms identified from the meta-analysis and additional 7 symptoms were identified from reference searching. The most common symptoms were (prevalence >50%): fever (79.56%, 95% CI: 72.17-86.09%), malaise (63.3%, 95% CI: 53.1 – 73.0%), cough (56.7. %, 95% CI: 48.6 - 64.6 %) and cold (55.6%, 95% CI: 45.2 – 65.7%). Symptoms of intermediate incidence (5-49%) were; anosmia, sneezing, ocular pain, fatigue, sputum production, arthralgia, tachypnea, palpitation, headache, chest tightness, shortness of breath, chills, myalgia, sore throat, anorexia, weakness, diarrhea, rhinorrhea, dizziness, nausea, altered level of consciousness, vomiting and abdominal pain. Rare symptoms (<5%): tonsil swelling, haemoptysis, conjunctival injection, lymphadenopathy and rash. Conclusion and implications of key findings: We found (25/32, from meta-analysis) symptoms to be present in =>5% of cases which could be considered as “typical” symptoms of COVID-19. The list of symptoms we identified is different from those documents released by the WHO, CDC, NHS, Chinese CDC, Institute Pasteur and Mayo Clinic. The compiled list would be useful for future researchers to document a comprehensive picture of the illness.
Expectant management of pneumothorax in intubated COVID 19 positive patients: A case series
Authors: Elder Colby , Bawa Sheina , Anderson Douglas , Atkinson Stephen , Etzel Joshua , Moritz Troy
Published: September 2020

Background: There is an increasing amount of literature describing the pathogenesis of coronavirus disease 2019 (COVID-19) pneumonia and its associated complications. Historically, a small pneumothorax has been shown to be successfully treated without chest tube insertion, but this management has yet to be proven in COVID-19 pneumonia patients. In addition, pneumothorax in an intubated patient with high positive end-expiratory pressure (PEEP) provides additional uncertainty with pursuing non-operative management. Case Presentation: In this series we report four cases of patients with respiratory distress who tested positive for COVID-19 via nasopharyngeal swab and developed ventilator-induced pneumothoraces which were successfully managed with observation alone.Conclusions: Management of patients with COVID-19 pneumonia on positive pressure ventilation who develop small stable pneumothoraces can be safely observed without chest tube insertion.
In Vitro, Evaluation of Anticancer and Anti-dermatophytes Activities of Some Egyptian Medicinal Plants 
Authors: El-Bondkly Esraa Ahmed Mohamed , El-Gendy Mervat Morsy , El-Bondkly Aya Ahmed Mohamed , El-Shenawy Fareed Shawky , El-Bondkly Alaa Ahmed Mohamed
Published: September 2020

In this investigation three ancient Egyptian medical plants; Plantago albicans L., Thymelaea hirsuta (L.) Endl. and Urginea maritima (L.) were chosen to explore their biochemical properties, anticancer and antimycotic activities against clinical dermatophytes. Growing of Trichophyton soudanense, Trichophyton erinacei, Microsporum audouinii, Microsporum gypseum, Microsporum gallinae, Microsporum ferrogenium, Microsporum cookie, Microsporum racemosum, Microsporum persicolor and Microsporum canis were totally inhibited by the 100 µg/mL of P. albicans methanolic extract. Whereas the growth of T. soudanense, T. erinacei, Trichophyton rubrum, Trichophyton tonsurance and Trichophyton mentagrophytes and Epidermophyton floccosum were 100% inhibited by the methanolic extract of T. hirsiuta at 100 µg/mL concentration, however its acetone extract was more active against Microsporum species. The highest fungi toxicity against all dermatophytic fungi was detected in both methanol and acetone extract of U. maritima at a concentration ranged between 50 to 100 µg/mL. Methanolic extract of P. albicans inhibited the viability of HCT-116, HepG-2, MCF-7 and HeLa cell lines by (41%, 40%, 80% and 81%); (30%, 20%, 66% and 70%); (19%, 0%, 49% and 57%); (5%, 0%, 35% and 45%) and (0%, 0%, 21% and 40%) at 25, 50, 100, 200 and 300 µg/mL, respectively. Moreover, the cells death after treatment with the same concentrations of T. hirsuta methanol extract were (10%, 20%, 23% and 60%); (16%, 40%, 58% and 80%); (40%, 50%, 80% and 100%); (51%, 65%, 100% and 100%) and (49%, 82%, 100% and 100%) in HCT-116, HepG-2, MCF-7 and HeLa cells, respectively. Viability of HCT-116, MCF-7 and HepG-2 cell lines was totally suppressed with 100 µg/mL whereas the HeLa cell growth was reduced to 10% and totally killed at 100 and 200 µg/mL, respectively of U. maritima methanolic extract. All data approve the significance of Egyptian ethnomedical plants as potent source of diverse bioactive pharmaceutical metabolites.
Texture indices of 4′-[methyl-11C]-thiothymidine uptake predict p16 status in patients with newly diagnosed oropharyngeal squamous cell carcinoma: Comparison with 18F-FDG uptake
Authors: Ihara-Nishishita Ayumi , Norikane Takashi , Mitamura Katsuya , Yamamoto Yuka , Fujimoto Kengo , Takami Yasukage , Ibuki Emi , Kudomi Nobuyuki , Hoshikawa Hiroshi , Toyohara Jun , Nishiyama Yoshihiro
Published: September 2020

Background: In oropharyngeal squamous cell carcinoma (OPSCC), human papillomavirus (HPV)/p16 status is important as a prognostic biomarker. Purpose: We evaluated the relationship between 4¢-[methyl-11C]thiothymidine (11C-4DST) and 18F-FDG PET texture indices and p16 status in patients with newly diagnosed OPSCC. Methods: We retrospectively reviewed the collected data of 256 consecutive, previously untreated patients with primary head and neck tumors enrolled between November 2011 and October 2019. Complete data on both 11C-4DST and 18F-FDG PET/CT studies before therapy, patients with OPSCC, and p16 status were available for 34 patients. Six of them were excluded because they did not exhibit sufficient 11C-4DST and/or 18F-FDG tumor uptake to perform textural analysis. Finally, 28 patients with newly diagnosed OPSCC were investigated. The maximum standardized uptake value (SUVmax) and 6 texture indices (homogeneity, entropy, short-run emphasis, long-run emphasis, low-gray-level-zone emphasis, and high-gray-level-zone emphasis) were derived from PET images. The presence of p16 expression in tumor specimens was examined by immunohistochemistry and compared with the PET parameters. Results: Using 11C-4DST, the expression of p16 was associated with a higher homogeneity (P = 0.012), lower short-run emphasis (P = 0.005), higher long-run emphasis (P = 0.009), and lower high-gray-level-zone emphasis (P = 0.042) values. There was no significant difference between 18F-FDG PET parameters and p16 status. Conclusion: Texture indices of the primary tumor on 11C-4DST PET, but not 18F-FDG PET, may be of value in predicting the condition’s p16 status in patients with newly diagnosed OPSCC.
Investigation of The Optimal Surgical Approach to Brucella Lumbar Spondylitis Treatment: A Comparative Study
Authors: Jia Chenguang , Gao Jianguo , Li Zhuo , Dong Zhaoliang , Yao Liming , Wang Lianbo , Yao Xiaowei
Published: September 2020

Background: The optimal surgical approach in treating lumbar brucellosis (LBS) has not been determined. This study aims to compare the surgical efficacy of anterior approach and combined posterior and anterior approach in treating LBS.Method: A retrospectively cohort study included LBS patients undergoing lumber surgery in the Department of Orthopedics, Department of Orthopedics, Hebei Province from June 2012 to June 2016. According surgical approach, patients were divided into two groups; patients with one-stage anterior approach were classified into group A, and the rest of patients with combined posterior and anterior approach were group B. The operative time, intraoperative blood loss and, hospitalization stay were recorded to compare the surgical risk of two groups. In terms of treatment efficacy, visual analogue scale (VAS), bone graft fusion, erythrocyte sedimentation rate (ESR) and Oswestry disability index (ODI) were assessed and compared before and after surgery.Results: Eight-nine patients with LBS were included into the study. Fifty cases were males, and 39 patients were female. The mean age of this cohort was 61.9 ± 12 years, ranging from 23 to 78 years. Forty-nine patients were divided into group A, undergoing anterior debridement and bone graft fusion. Forty patients underwent posterior fixation combined with anterior approach (group B). The operation time of group A was 30 minutes shorter than that of group B. Group A had less intraoperative blood loss (800 vs. 900 ml; P <0.001). Hospital stay was four days shorter in group A. At the last follow-up, all patients were in good condition with ASIA Level E and ESR returned to normal. The bone fusion rate of Bridwell bone was 89.29% (45/49) and 80.00% (38/40) of group A and group B, respectively. In terms of surgical efficacy, there was no significant difference in VAS score between the two groups before and after operation (P > 0.05). Conclusions: One-stage anterior approach and combine posterior-anterior approach had no significant difference in terms of clinical efficacy. Individualized surgical treatment should be suggested in patients with complicated LBS and ineffective therapeutic treatment. Trial registration: This study has been retrospectively registered in local ethical Institution Review Board(No:[2020]068).