bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of Hemodialysis and Post-Dialysis Period on Granular Activity Levels
Authors: Larkin John W , Han Maggie , Han Hao , Guedes Murilo H , Gonçalves Priscila Bezerra , Poli-de-Figueiredo Carlos Eduardo , Cuvello-Neto Américo Lourenço , Barra Ana Beatriz L , de Moraes Thyago Proença , Usvyat Len A , Kotanko Peter , Canziani Maria Eugenia F , Raimann Jochen G , Pecoits-Filho Roberto
Published: April 2020

Background: Physical activity (PA) is typically lower on hemodialysis (HD) days. Albeit intradialytic inactivity is expected, it is unknown whether recovery after HD contributes to low PA. We investigated the impact of HD and post-HD period on granular PA relative to HD timing. Methods: We used baseline data from the HDFIT trial conducted from August 2016 to October 2017. Accelerometry measured PA over one week in patients who received thrice-weekly high-flux HD (vintage 3 to 24 months), were clinically stable, and had no ambulatory limitations. PA was assessed on HD days (0 to ≤24 hours after start HD), first non-HD days (>24 to ≤48 hours after start HD) and second non-HD day (>48 to ≤72 hours after start HD). PA was recorded in blocks/slices: 4 hours during HD, 0 to ≤2 hours post-HD (30 minute slices), and >2 to ≤20 hours post-HD (4.5 hour slices). Blocks/slices of PA were captured at concurrent/parallel times on first/second non-HD days compared to HD days. Results: Among 195 patients (mean age 53±15 years, 71% male), step counts per 24-hours were 3919±2899 on HD days, 5308±3131 on first non-HD days (p<0.001), and 4926±3413 on second non-HD days (p=0.032). During concurrent/parallel times to HD on first and second non-HD days, patients took 1308 and 1128 more steps (both p<0.001). Patients took 276 more steps and had highest rates of steps/hour 2-hours post-HD versus same times on first non-HD days (all p<0.05). Consistent findings were observed on second non-HD days. Conclusions: PA was higher within 2-hours of HD versus same times on non-HD days. Lower PA on HD days was attributable to intradialytic inactivity. The established PA profiles are of importance to the design and development of exercise programs that aim to increase activity during and between HD treatments. Trial Registration: HDFIT was registered 20 April 2016 on ClinicalTrials.gov (NCT02787161) https://clinicaltrials.gov/ct2/show/NCT02787161.
Theoretical characterisation of strand cross-correlation in ChIP-seq
Authors: Anzawa Hayato , Yamagata Hitoshi , Kinoshita Kengo
Published: April 2020

Background: Strand cross-correlation profiles are used for both peak calling pre-analysis and quality control (QC) in chromatin immunoprecipitation followed by sequencing (ChIP-seq) analysis. Despite its potential for robust and accurate assessments of signal-to-noise ratio (S/N) because of its peak calling independence, it remains unclear what aspects of quality such strand cross-correlation profiles actually measure. Results: We introduced a simple model to simulate the mapped read-density of ChIP-seq and then derived the theoretical maximum and minimum of cross-correlation coefficients between strands. The results suggest that the maximum coefficient of typical ChIP-seq samples is directly proportional to the number of total mapped reads and the square of the ratio of signal reads, and inversely proportional to the number of peaks and the length of read-enriched regions. Simulation analysis supported our results and evaluation using 790 ChIP-seq data obtained from the public database demonstrated high consistency between calculated cross-correlation coefficients and estimated coefficients based on the theoretical relations and peak calling results. In addition, we found that the mappability-bias-correction improved sensitivity, enabling differentiation of maximum coefficients from the noise level. Based on these insights, we proposed virtual S/N (VSN), a novel peak call-free metric for S/N assessment. We also developed PyMaSC, a tool to calculate strand cross-correlation and VSN efficiently. VSN achieved most consistent S/N estimation for various ChIP targets and sequencing read depths. Furthermore, we demonstrated that a combination of VSN and pre-existing peak calling results enable the estimation of the numbers of detectable peaks for posterior experiments and assess peak calling results. Conclusions: We present the first theoretical insights into the strand cross-correlation, and the results reveal the potential and the limitations of strand cross-correlation analysis. Our quality assessment framework using VSN provides peak call-independent QC and will help in the evaluation of peak call analysis in ChIP-seq experiments.
Synchronous dissection of chloroplast and mitochondrial genomes clarifies the intra- and inter-genus phylogeny for the agriculturally important genus Brassica
Authors: Qiao Jiangwei , Zhang Xiaojun , Chen Biyun , Huang Fei , Xu Kun , Huang Qian , Huang Yi , Hu Qiong , Wu Xiaoming
Published: April 2020

Background : The genus Brassica mainly comprises three diploid and three recently derived allotetraploid species, which are highly important vegetable, oil or ornamental crops cultivated worldwide. Despite being extensively studied, the origination of B. napus and the detailed interspecific relationships within Brassica genus remains unresolved and somewhere confused. By synchronous sequencing of both the chloroplast DNA and mitochondrial DNA, the whole Brassica phylogeny and the origination of the predominant nap -type B. napus have been clarified based on a large plant population, which maximally integrated the known Brassica species. Results : The phylogenetic analyses based on a data set including 72 de novo assembled whole chloroplast genomes, delineated a comprehensive evolutional atlas inside and around Brassica genus. Different from the monophyletical maternal origin of B. juncea and B. carinata from cam-type B. rapa and B. nigra , respectively, the natural B. napus has multiplex maternal origins. It contains three major cytoplasmic haplotypes: the cam -type which directly inherited from B. rapa , polima -type which is close to cam -type as a sister, and the predominant nap -type. Intriguingly, nap -type seems phylogenetically integrated with certain sparse C-genome wild species , thus implying that which may have primarily contributed the cytoplasm and the corresponding C subgenome to B. napus . Human breeding creation of the B. napus cytoplasmic male sterile lines (e.g., mori and nsa ) have dramatically disturbed the concurrent inheritance between mtDNA and cpDNA. Strong parallel evolution among genera Raphanus , Sinapis, Eruca , Moricandia with Brassica indicates their uncomplete divergence from each other. Conclusions : The elaborated phylogenetic relationships and overall variation data obtained herein can substantially facilitate to develop novel Brassica germplasms and to improve the Brassica crops.
Both comorbidity and worse performance status are associated with poorer overall survival after external beam radiotherapy for prostate cancer
Authors: Lehtonen Miikka , Heiskanen Lauri , Reinikainen Petri , Kellokumpu-Lehtinen Pirkko-Liisa
Published: April 2020

Background: In this retrospective study, we evaluated the biochemical recurrence rate, metastatic disease progression, and prostate cancer-specific and overall survival in patients curatively treated with external beam radiotherapy (EBRT) for early prostate cancer (PC). We also examined the prognostic effect of comorbidity by Charlson Comorbidity Index (CCI) and overall performance status by Eastern Clinical Oncology Group (ECOG) score. Methods: A total of 665 men treated between 2008 and 2013 were enrolled from Tampere University Hospital, Finland. Prostate-specific antigen (PSA) tests and hospital records were used to determine the 5-year survival for each aforementioned endpoint using a Kaplan-Meyer estimate. To analyze the impact of the selected prognostic factor, we used a Cox regression model to calculate the corresponding hazard ratio (HR) and 95 % confidence interval (CI). Results: With a median follow-up-time of 7.12 years, the 5-year overall survival (OS) after EBRT was 88.9 % [86.5 %-91.3 %], prostate cancer-specific survival (PCSS) was 97.9 % [96.7 %-99.1%], metastasis-free survival (MFS) 94.8 % [93.0 %-96.6 %] and biochemical recurrence-free survival (BRFS) 88.7 % [86.2 %-91.2 %]. Both CCI (HR = 1.38, [1.25-1.51]) and ECOG score (HR = 1.63, [1.29-2.05]) declined OS, as well as Gleason score and T score (P < 0.05). Gleason score and T grade also associated to worse PCSS, MFS and BRFS. Conclusions: CCI and ECOG score are useful tools in evaluating the overall life expectancy of the patient after EBRT for PC. T-stage and Gleason score remain still the major prognostic factors.
Role of the ADCY9 gene in cardiac abnormalities of the Rubinstein-Taybi syndrome
Authors: Wu Yueheng , Xia Yu , Li Ping , Qu Hui-Qi , Liu Yichuan , Yang Yongchao , Lin Jijin , Zheng Meng , Tian Lifeng , Wu Zhuanbin , Huang Shufang , Qin Xianyu , Zhou Xianwu , Chen Shaoxian , Liu Yanying , Wang Yonghua , Li Xiaofeng , Zeng Hanshi , Hakonarson Hakon , Zhuang Jian
Published: April 2020

Background ： Rubinstein–Taybi syndrome (RSTS) is a rare, congenital, plurimalformative, and neurodevelopmental disorder. Previous studies have reported that large deletions contribute to more severe RSTS phenotypes than those caused by CREBBP point mutations, suggesting a concurrent pathogenetic role of flanking genes, typical of contiguous gene syndromes, but the detailed genetics are unclear.
Results ： This study presented a rare case of Rubinstein-Taybi (RT) syndrome with serious cardiac abnormalities. Based on the clinical and genetic analysis of the patient, the ADCY9 gene deletion was highlighted as a plausible explanation of cardiac abnormalities. In adcy9 morphant zebrafish, cardiac malformation was observed. Immunofluorescence study disclosed increased macrophage migration and cardiac apoptosis. RNA sequencing in zebrafish model highlighted the changes of a number of genes, including increased expression of the mmp9 gene which encodes a matrix metalloproteinase with the main function to degrade and remodel extracellular matrix.
Conclusions ： In this study, we identified a plausible new candidate gene ADCY9 of CHD through the clinical and genetic analysis of a rare case of Rubinstein-Taybi (RT) syndrome with serious cardiac abnormalities. By functional study of zebrafish, we demonstrated that deletion of adcy9 is the causation for the cardiac abnormalities. Cardiac apoptosis and increased expression of the MMP9 gene are involved in the pathogenesis.
The growing impact of older patients in the Emergency Department: a 5-year retrospective analysis in Brazil
Authors: Gomes João Carlos Pereira , Dias Roger Daglius , Barros Jacson Venancio , Velasco Irineu Tadeu , Filho Wilson Jacob
Published: April 2020

Background: The average age of the global population is rising at an increasing rate. There is a disproportional increase in Emergency Department (ED) visits by older people worldwide. In the Brazilian health system, complex and severely ill patients and those requiring specialized urgent procedures are referred to tertiary level care. As far as we know, no other study in Latin America has analyzed the impact of demographic changes in tertiary ED attendance. Aim: To describe the sociodemographic characteristics and outcomes of tertiary Brazilian ED users.Methods: Design: Observational cross-sectional analytic study. Setting: Emergency Department, tertiary university hospital, São Paulo, Brazil. Participants: patients aged 18 years or older attending a tertiary ED (2009-2013). The primary outcomes were hospitalization and mortality; the secondary outcome was ICU admission. Age was categorized as ‘young adults’ (18-39y), ‘adults’ (40-59y), ‘young-older adults’ (60-79y), and ‘old-older adults’ (80-109y). Other variables included sex, reason for attendance, time of ED visit, mode of presentation, type of hospitalization, main procedure, length of hospital stay (LOS) and length of ICU stay (ICU-LOS). We calculated descriptive statistics, built generalized linear mixed models for each outcome and estimated Odds Ratios (95% CI) for the independent categorical variables. The significance level was 5% with Bonferroni correction. Results: Older age-groups represented 26.6% of 333,028 ED visits, 40.7% of admissions, 42.7% of ICU admissions and 58% of all deaths. Old-older patients accounted for 5.1% of ED visits, 9.5% of admissions and 10.1% of ICU admissions. Hospitalization, ICU admission and mortality rates increased with older age in both sexes. LOS and ICU-LOS were similar across age-groups. The proportions of visits and admissions attributed to young adults decreased annually, while those of people aged 60 or over increased. The ORs for hospitalization, ICU admission and mortality associated with the old-older group were 3.49 (95% CI = 3.15-3.87), 1.27 (1.15-1.39) and 5.93 (5.29-6.66) respectively, with young adults as the reference.Conclusions: In tertiary ED, age is an important risk factor for hospitalization and mortality, but not for ICU admission. Old-older people are at the greatest risk and demand further subgroup stratification.
Clinical Correlates of Insomnia in Patients with Persistent Post-Traumatic Headache Compared with Migraine
Authors: Kim Soo-Kyoung , Chong Catherine D , Dumkrieger Gina , Ross Katherine , Berisha Visar , Schwedt Todd J.
Published: April 2020

Background
Close associations between insomnia with other clinical factors have been identified in migraine, but there have been few studies investigating associations between insomnia and clinical factors in patients with persistent post-traumatic headache (PPTH). The study objective was to contrast the severity of insomnia symptoms in PPTH, migraine, and healthy controls, and to identify factors associated with insomnia in patients with PPTH vs. migraine.

Methods

In this cross-sectional cohort study, 57 individuals with PPTH attributed to mild traumatic brain injury, 39 with migraine, and 39 healthy controls were included. Participants completed a detailed headache characteristics questionnaire, the Migraine Disability Assessment Scale (MIDAS), Insomnia Severity Index (ISI), Hyperacusis Questionnaire (HQ), Allodynia Symptom Checklist, Photosensitivity Assessment Questionnaire, Beck Depression Inventory (BDI), State-Trait Anxiety Inventory, Post-Traumatic Stress Disorder (PTSD) checklist, Ray Auditory Verbal Learning Test, and the Trail Making Test A and B to assess headache characteristics, disability, insomnia symptoms, sensory hypersensitivities, and neuropsychological factors. Fisher’s test and one-way ANOVA or Tukey’s Honest Significant Difference were used to assess group differences of categorical and continuous data. Stepwise linear regression analyses were conducted to identify clinical variables associated with insomnia symptoms.

Results

Those with PPTH had significantly higher ISI scores (16.7 ± 6.6) compared to migraine patients (11.3 ± 6.4) and healthy controls (4.1 ± 4.8) ( p < 0.001). For those with PPTH, insomnia severity was most strongly correlated with the BDI (Spearman's rho ( Common.EditSubmissionSteps.Transform.EquationText ) = 0.634, p < 0.01), followed by Trait Anxiety ( Common.EditSubmissionSteps.Transform.EquationText = 0.522, p < 0.01), PTSD ( Common.EditSubmissionSteps.Transform.EquationText  = 0.505, p < 0.01), HQ ( Common.EditSubmissionSteps.Transform.EquationText  = 0.469, p < 0.01), State Anxiety ( Common.EditSubmissionSteps.Transform.EquationText  = 0.437, p < 0.01), and MIDAS scores ( Common.EditSubmissionSteps.Transform.EquationText = 0.364, p < 0.01). According to linear regression models, BDI, headache intensity, and hyperacusis scores were significantly positively associated with insomnia severity in those with PPTH, while only delayed memory recall was negatively associated with insomnia severity in those with migraine.

Conclusions

Insomnia symptoms were more severe in those with PPTH compared to migraine and healthy control cohorts. Depression, headache intensity, and hyperacusis were associated with insomnia in individuals with PPTH. Future studies should determine the bidirectional impact of treating insomnia and its associated symptoms.
Retraction and force analysis of transporting bone segment during Ilizarov bone transport
Authors: Ma Yunhong , Yin Qudong , Wu Yongwei , Wang Zongnan , Sun Zhenzhong , Gu Sanjun , Rui Yongjun , Han Xiaofei
Published: April 2020

Background: Previous research rarely reported the cause and relevant factors of retraction of transporting bone segment (TBS). The purpose of this study is to analyze the force and cause of retraction of TBS during Ilizarov bone transport after removal of its fixator. Methods: 37 cases with tibial bone defect treated by Ilizarov bone transport, in whom the fixator of TBS was removed before mature of mineralization of the distraction callus or union of the docking site, were analyzed retrospectively. Bivariate correlation was used to analyze relationship between retraction distance of TBS and age, gender, disease course, length of bone defect, times of pre-operation, size of TBS, transport distance, cause of removal, timing and time interval of removal of TBS fixator. Risk factors with significant level were further identified using multivariate linear regression. Results: Bivariate correlation analysis showed the timing of removal was negatively correlated while the time interval, cause of removal, transport distance and size of TBS were positively correlated with the transport distance（all p<0.05), however the age, gender, disease course, length of bone defect and times of pre-operation were not correlated with the transport distance（p>0.05). Multivariate linear regression analysis showed the timing of removal, transport distance and size of TBS were significant risk factors for the retraction distance (p<0.05), of which, the timing of removal had the greatest impact, followed by the transport distance and size of TBS, however the cause of removal and time interval were not significant for the retraction (p>0.05). Conclusion: The traction force of the TBS endured from soft tissue , not from the distraction callus, is elastic and can induce a retraction of TBS when its fixator is removed in advance. The retraction distance is related to the size of TBS, transport distance and timing of removal, especially the timing of removal is an independent risk factor.
Association between serum vitamin D and uric acid in the eastern Chinese population: a population-based cross-sectional study
Authors: Chen Yingchao , Cheng Jing , Chen Yi , Wang Ningjian , Xia Fangzhen , Chen Chi , Han Bing , Lu Yingli
Published: April 2020

Background

Uric acid (UA) is the end product of purine metabolism, which is thought to be related to many human diseases, such as nephrolithiasis, gout, cardiovascular disease (CVD), type 2 diabetes mellitus, metabolic syndrome. However, the relationship between serum UA (SUA) and 25(OH)D is still unclear in the eastern Chinese population.

Methods

We did a population-based observational investigation, which included 12,770 residents living in eastern China. Ultimately, data from 9,220 subjects were analyzed. Serum 25(OH)D, SUA, fasting plasma glucose(FPG), fasting insulin, HbA1c and other metabolic parameters were tested. Waist circumference (WC), weight and height were also measured. Questionnaires were collected from these subjects for information on smoking and drinking status.

Results

We enrolled 9,220 Chinese adults, including 3,681 males (age 55.57±13.23 years) and 5,539 females (age 54.31±12.83 years). The levels of SUA were 352.07±79.25 nmol/L and 269.29±64.68 nmol/L in males and females, respectively. The proportion of adults with hyperuricemia (HUA) was 12.26% in the total population. Levels of SUA were positively associated with 25(OH)D, and the incidence of HUA increased 9.4% for every 10 nmol/L increase in 25(OH)D (P<0.001).

Conclusions

SUA was positively associated with 25(OH)D in the eastern Chinese population. Higher levels of serum 25(OH)D may be a potential predictor of HUA.
Ventriculoperitoneal shunt insertion in human immunodeficiency virus infected adults: a systematic review and meta-analysis
Authors: Loan James JM , Poon Michael TC , Tominey Steven , Mankahla Ncedile , Meintjes Graeme , Fieggen Graham
Published: April 2020

Background Hydrocephalus is a common, life threatening complication of human immunodeficiency virus (HIV)-related central nervous system opportunistic infection which can be treated by insertion of a ventriculoperitoneal shunt (VPS). In HIV-infected patients there is concern that VPS might be associated with unacceptably high mortality. To identify prognostic indicators, we aimed to compare survival and clinical outcome following VPS placement between all studied causes of hydrocephalus in HIV infected patients.Methods The following electronic databases were searched: The Cochrane Central Register of Controlled Trials, MEDLINE (PubMed), EMBASE, CINAHL Plus, LILACS, Research Registry, the metaRegister of Controlled Trials, ClinicalTrials.gov, African Journals Online, and the OpenGrey database. We included observational studies of HIV-infected patients treated with VPS which reported of survival or clinical outcome. Data was extracted using standardised proformas. Risk of bias was assessed using validated domain-based tools. Results 723 unique study records were screened. Nine observational studies were included. Three included a total of 75 patients with tuberculous meningitis (TBM) and six included a total of 49 patients with cryptococcal meningitis (CM). All of the CM and two of the TBM studies were of weak quality. One of the TBM studies was of moderate quality. One-month mortality ranged from 62.5-100% for CM and 33.3-61.9% for TBM. These pooled data were of low to very-low quality and was inadequate to support meta-analysis between aetiologies. Pooling of results from two studies with a total of 77 participants indicated that HIV-infected patients with TBM had higher risk of one-month mortality compared with HIV non-infected controls (odds ratio 3.03; 95% confidence-interval 1.13- 8.12; p=0.03). Conclusions The evidence base is currently inadequate to inform prognostication in VPS insertion in HIV-infected patients. A population-based prospective cohort study is required to address this, in the first instance.
Reaching hard-to-reach men through home-based couple HIV testing among pregnant women and their male partners in Western Kenya: A qualitative study
Authors: Krakowiak Daisy , Makabong’o Pamela , Goyette Marielle , Kinuthia John , Osoti Alfred Onyango , Asila Victor , Gone Molly Ann , Mark Jennifer , Farquhar Carey
Published: April 2020

Background
Globally only 79% of HIV positive adults know their status and men in sub-Saharan Africa are considered a particularly hard-to-reach population for HIV testing. Home-based HIV couple testing during the antenatal period is a safe and effective method that has been used to test male partners of pregnant women. The goal of this qualitative study was to identify elements that made couple testing successful and describe important characteristics of this home-based intervention from couples’ perspectives.

Methods
Couples who received scheduled home-based couple testing during pregnancy in Kisumu, Kenya, were purposively sampled based on HIV status from January to May 2015. An interviewer administered all of the in-depth interviews and two coders were directly involved in the data analysis and reconciled codes several times in the process.

Results
Twenty-one couples were enrolled: 9 concordant HIV-negative couples, 8 HIV discordant couples, 3 HIV concordant HIV-positive couples, and 1 whose concordance status was unknown. Median age at the time of home-based couple testing was 24 and 28 years for women and men, respectively. Median relationship duration was 3 years and couples had a median of two pregnancies. The major themes that emerged were that home-based couple testing 1) removed the female burden of requesting couple testing, 2) overcame logistical barriers associated with clinic-based testing, 3) encouraged participants to overcome their fear of testing and disclosure, 4) provided privacy in the home, and 5) provided quality time with the health advisors. Importantly, some women appreciated individual testing at the clinic before couple testing and some couples preferred skilled, anonymous health advisors delivering the intervention rather than known community health workers.

Conclusions
The results of this qualitative study suggest that home-based couple testing during pregnancy overcame many of the barriers that limit men’s access to and uptake of clinic-based testing. It encouraged participants to overcome their fear of testing and disclosure through a setting that afforded privacy and quality time with skilled health advisors. These qualitative results may help design effective partner and couple HIV testing programs in the antenatal setting and alongside or within other assisted partner notification services.
One-Bone Forearm Reconstruction and Distal Radioulnar Joint Fusion for Emergency One-stage Operation in Traumatic Major Bone Defect of Forearm
Authors: Wang Yapeng , Zhou Ming , Wu Yongwei , Ma Yunhong , Liu Jun , Rui Yongjun
Published: April 2020

B ackground : Major bone defects in forearm caused by severe trauma is a real challenge for orthopedic surgeons. This study aimed to evaluate the role of one-bone forearm (OBF) reconstruction combined with distal radioulnar joint fusion (DRUJF) as a rescue option under this difficult situation.
Methods: In total, 18 patients with major bone defects in forearm caused by severe trauma were selected from 2003 to 2017 and followed up for 2 to 16 years. All patients were managed in the Emergency Department and received emergency one-stage OBF combined with DRUJF. In addition, patient demographics, surgical techniques, clinical outcomes and complications were collected from the medical records.
Results: The mean age of patients was 41.5 years (ranging from 23 to 58 years), with 11 males and 7 females. The mean time to union was 5.8 months; 17 patients had complete union, and 1 patient had infection with nonunion requiring secondary procedures. According to the criteria of Chen, 3 patients had a grade-I functional outcome, 14 patients had a grade-II functional outcome, and 1 patient had a grade-III functional outcome. Based on the Peterson scoring system, the outcome was excellent for 3 patients, good for 13 patients, fair for 1 patient, and poor for 1 patient.
Conclusion: OBF construction combined with DRUJF was an alternative surgical procedure as the emergency stage-one intervention for the treatment of traumatic major bone defects in forearm, which may be more functionally and cosmetically superior than forearm amputation.
A comparison among PCNL, Miniperc and Ultraminiperc for lower calyceal stones between 1 and 2 cm : A prospective, comparative, multicenter and randomised study.
Authors: Bozzini Giorgio , Aydogan Tahsin B , New Alexander Müller , Sighinolfi Maria Chiara , Besana Umberto , Calori Alberto , Lorenzo Berti , Govorov Alexander , Pushkar Dmitry Y , Pini Giovannalberto , Pastore Antonio Luigi , Romero-Otero Javier , Rocco Bernardo , Buizza Carlo
Published: April 2020

Background
Conventional Percutaneous Lithotripsy (PCNL) has been an effective, successful and easy approach for especially >1 cm sized calyceal stoneshowever risks of complications and nephron loss are inevitable. Our aim is to compare the efficacy and safety of PCNL, MiniPerc(MP) and UltraMiniPerc(UMP) for lower calyceal stones between 1 and 2 cm with a multicenter prospective randomized study.
Methods
Between January 2015 and June 2018, 132 consecutive patients with single lower calyceal stone were enrolled.Patients were randomized in three groups; A: PCNL; B: MP; C: UMP. 44 patients for the Group A, 47 for Group B and 41 for Group C.Exclusion criteriaswere the presence of coagulation impairments, age of <18 or >75, presence of infection or serious comorbidities. Patients were controlled with computerized tomography scan after 3 months. A negative CTor an asymptomatic patient with stone fragments < 3 mm size were the criteria to assess the stone-free status. Patient characteristics, stone free rates (SFR)s, complications and re-treatment rates were analyzed.
Results
The mean stone size were 16.38, 17.82 and 15.23mm respectively in Group A, B and C(p=0.34). The overall SFR was significantly higher in Group A (86.3%) and B (82.9%) as compared to Group C (78%)(p<0.05). The re-treatment rate was significantly higher in Group C (12.1%) and complication rates was higher in Group A (13.6%) as compared to others(p<0.05). The hospitalization was significantly shorter in Group C compared to Group A(p=0.04).
Conclusions
PCNL and MP showed higher efficacythan UMP to obtain a better SFR. Auxiliary and re-treatment rates were higher in UMP. On the other hand for such this kind of stones PCNL had more complications. Overall evaluation favors MP as a better indication in stones 1-2 cm size.
Micronutrient-rich dietary intake is associated with a reduction in the effects of particulate matter on blood pressure among electronic waste recyclers at Agbogbloshie, Ghana
Authors: Takyi Sylvia Akpene , Basu Nil , Arko-Mensah John , Botwe Paul , Nti Afua Asabea Amoabeng , Kwarteng Lawrencia , Acquah Augustine , Tettey Prudence , Dwomoh Duah , Batterman Stuart , Robins Thomas , Fobil Julius N.
Published: April 2020

Background: Informal recycling of electronic waste (e-waste) releases particulate matter (PM) into the ambient air. Human exposure to PM has been reported to induce adverse effects on cardiovascular health. However, the impact of PM on the cardiovascular health of e-waste recyclers in Ghana has not been studied. Although intake of micronutrient-rich diet is known to modify these PM-induced adverse health effects, no data are available on the relationship between micronutrient status of e-waste recyclers and the reported high-level exposure to PM.Objectives: We investigated whether intake of micronutrient-rich diets ameliorates the adverse effects of ambient exposure to PM2.5 on blood pressure (BP).Methods: This study was conducted from March 2017 to October 2018; involving the measurement of breathing zone PM2.5 using real-time monitor. Dietary micronutrient (Fe, Ca, Mg, Se, Zn, and Cu) intake was assessed using a 2-day 24-hour recall, whiles cardiovascular indices such as systolic BP (SBP) and diastolic BP (DBP) and pulse pressure (PP) were measured using a sphygmomanometer. Ordinary least-squares regression models were used to estimate the joint effects of ambient exposure to PM2.5 and dietary micronutrient intake on cardiovascular health outcomes. The results: Fe was consumed in adequate quantities. However, Ca, Se, Zn, Mg, and Cu were inadequately consumed among e-waste recyclers and controls. Dietary Ca and Fe intake were associated with reduced SBP and PP of e-waste recyclers. Although PM2.5 levels were higher in e-waste recyclers, the controls exceeded the WHO 24-hour guideline value (25µg/m3). Exposure to 1µg/m3 of PM2.5 was associated with increased HR of e-waste recyclers by 0.06 bpm; implying informal recycling of e-waste may be a risk factor for tachycardia. Also, dietary Fe intake was associated with a reduction in systolic blood pressure levels of e-waste recyclers.Conclusions: Consistent adequate dietary Fe intake was associated with reduced effects of PM2.5 on SBP of e-waste recyclers overtime. However, as all other micronutrients are essential in ameliorating adverse effects of PM on cardiovascular health, nutrition-related policy dialogues are necessary to educate informal e-waste recyclers and the general population on specific nutrients of concern and their impact on the exposure to ambient air pollutants.
Impacts of hydraulic fracturing on surface and groundwater water resources: A case study from Louisiana, USA.
Authors: Unruh Hanz Gunter , Habib Emad Hosny , Borrok David
Published: April 2020

Background: Unconventional oil and gas reservoirs, frequently referred to as shale plays , have been gaining more attention in recent years. Hydraulic fracturing is performed to extract fossil fuels from unconventional reservoirs. Besides possible environmental implications, a better understanding of the potential stress that fracking may cause to water resources at the local or regional scale is still needed. The goal of this study is to assess the impact of current and projected future water demands for fracking on water resources in two main shale plays in Louisiana, USA. Methods: The analysis is performed in Louisiana’s two main shale plays, the Haynesville Shale and the Tuscaloosa Marine Shale, using the Water Supply Stress Index (WaSSI) framework. WaSSI is used to evaluate the stress at a fine watershed scale (HUC12) for annual-average conditions. The study analyzes different scenarios of historical and two future projected fracking conditions that simulate different extraction rates. In each fracking scenario, stresses on both surface and groundwater are evaluated separately. The study is based on a multitude of water supply and withdrawals datasets assembled and disaggregated to the watershed scale. Results: Under existing conditions, the impact of fracking water demands on surface water resources is within the low stress category in most watersheds in both shale plays. This impact remains low under more aggressive future fracking scenarios. In contrast, groundwater resources appear to be highly vulnerable under both the historical and projected fracking scenarios, especially in the Haynesville Shale where 20 out of the 94 watersheds become medium or highly stressed. If groundwater resources remained as a main source for fracking water, the number of stressed watersheds increased to 39 and 86 under the two projected future fracking scenarios. The least exploited Tuscaloosa Marine Shale remains mostly under low stress, except in the most aggressive future fracking scenario. Conclusions: Surface water resources in Louisiana’s shale plays seem abundant enough for fracking activities to rely on this source instead of groundwater whenever possible. Groundwater resources in Louisiana are clearly vulnerable to fracking activities, especially for the Haynesville shale play, under current and future projected fracking conditions.
Increase expression of IL-17A, IL6, STAT3, TGF-β and VEGF in Bladder Cancer: potential biomarkers?
Authors: Liu Yanbo , Xiao Zishen , Yang Jijuan , Lin Jiayu , Shen Weigao , An Liping , Ge He , Wang Zhenjiang , Sun Xin , Sun Ying
Published: April 2020

Background: Bladder cancer is the most common urinary system malignant disease all over the world. Our former research results showed that IL-17 family relative cytokines involved in the occurrence and development of bladder cancer, moreover A variety of inflammatory cells (such as lymphocyte, macrophage, mast cell and neutrophil ) infiltrated in bladder cancer tissues and were closely related to bladder cancer.Results: Immunohistochemistry (HIS) was employed to measure expression and location of IL-17A, IL-6, STAT3 and VEGF in pathological specimens of bladder cancer patients with different degree of malignancy (n=80), cystitis (n=23) and relative normal adjacent tissues (n=4). ELISA was used for measuring concentrations of MMP-9, TGF-β, VEGF and IFN-γ in serum samples collected from patients with bladder cancer (n=34) and control subjects (n=5). Immunoreactivity for IL-17A, IL-6, STAT3 and VEGF significant increased in tissues of bladder cancer compared with that of cystitis and normal adjacent tissues (p = 0.001. respectively), which was positively associated with the degrees of malignancy of the cancer. Serum concentrations of TGF-β and VEGF were significantly higher in patients with bladder cancer compared with that of controls (p=0.002 and p=0.0001 respectively), while concentrations of MMP-9 and IFN-γ were not significantly different between the groups of subjects. In the meanwhile, serum concentrations of MMP-9, TGF-β, VEGF, but not IFN-γ were significantly higher in patients with high degree of malignancy (stage Ⅲ and Ⅳ) than that of patients with low malignancy (stage Ⅰ and Ⅱ) (p=0.001, p=0.030, and p=0.011 respectively).Conclusion: Elevated expression of IL-17A, IL-6, STAT3 in tissues and of TGF-β, VEGF in serum might be considered as potential biomarkers for clinical stages of bladder carcinoma progress.Trial registration: ISRCTN, ISRCTN2012BH006. Registered 10 January 2012
Impact of three methods of ischemic preconditioning on ischemia-reperfusion injury in a pig model of liver transplantation
Authors: Belon Alessandro Rodrigo , Tannuri Ana Cristina Aoun , Moreira Daniel Albuquerque , Silva Alessandra Matheus , Serafini Suellen , Guimarães Raimundo Renato , Faria Caroline Silverio , Alexandre Alcione Sanches , Gonçalves Josiane de Oliveira , Paes Vitor Ribeiro , Tannuri Uenis
Published: April 2020

Background. Ischemic preconditioning (IPC), either direct (DIPC) or remote (RIPC), is a procedure aimed at reducing the harmful effects of ischemia-reperfusion injury. Aims. To assess the local and systemic effects of DIPC, RIPC, and both combined, in the pig liver transplant model. Methods. Twenty-four pigs underwent orthotopic liver transplantation and were divided into 4 groups according to the procedures applied: direct donor preconditioning; indirect preconditioning at the recipient and a group with direct donor and indirect recipient preconditioning. The following parameters were recorded: donor and recipient weight, graft-to-recipient weight ratio (GRWR), surgery time, hot and cold ischemia time, and intraoperative hemodynamic values. Blood samples were collected before native liver removal (BL) and at 0h, 1h, 3h, 6h, 12h, 18h, and 24h post-reperfusion and the following biochemical tests were performed: aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), creatinine, BUN, lactate, total and direct bilirubin. Histopathological examination of liver, gut, kidney, and lung fragments were performed, as well as molecular analyses for expression of the apoptosis-related BAX (pro-apoptotic) and Bcl-XL (anti-apoptotic) genes, eNOS (endothelial nitric oxide synthase) gene, and IL-6 gene related to inflammatory ischemia-reperfusion injury, using real-time polymerase chain reaction (RT-PCR). Results. There were no differences between the groups regarding biochemical and histopathological parameters. We found a reduced ratio between the expression of the pro-apoptotic BAX gene and the expression of the anti-apoptotic Bcl gene in the livers of animals with IPC versus the control group. Conclusions. DIPC, RIPC or a combination of both produce local beneficial effects only at the molecular level but do not translate into biochemical or histological changes.
Fast Auto-Align ment Underwater Wireless Optical Communications Employing Orbital Angular Momentum Modes
Authors: Cai Chengkun , Zhao Yifan , Zhang Jieying , Wang Lulu , Wang Jian
Published: April 2020

Underwater wireless communication plays an increasingly important role in more and more emerging ocean and sea activities. Traditional underwater acoustic communication is limited by low transmission capacity (tens of Kbit/s). Underwater wireless optical communication (UWOC) provides high bandwidth (GHz). Yet the challenge is not only its continuous capacity scaling, but its resistance to environment disturbance, which is an intrinsic weakness of wireless optical communications with high directivity. Here, we propose and demonstrate fast auto-alignment underwater wireless optical communications employing orbital angular momentum (OAM) modes. The OAM multiplexing, an alternative approach of space-division multiplexing, enables capacity scaling. The fast auto-alignment system, having two stages for thorough alignment, facilitates stable and reliable communication link against vibration. Two OAM modes multiplexing transmission link with 4-Gbit/s aggregate capacity is demonstrated in the experiment under four different vibration conditions assisted by the fast auto-alignment system with a response time of 244 Hz. The demonstrations may open up new perspective to robust stable underwater wireless optical communications exploiting spatial modes in practical environment.
Novel flexible cap for application of transcranial electric stimulation: a usability study
Authors: Hunold Alexander , Ortega Daniela , Schellhorn Klaus , Haueisen Jens
Published: April 2020

Background﻿Advances in transcranial electric stimulation (TES) were hampered by the conventional rubber electrodes manually attached to the head with rubber bands. This procedure limited montages to a few electrodes, was error prone with respect to electrode configurations and was burdensome for participants and operators. A newly developed flexible cap with integrated textile stimulation electrodes was compared to the conventional setup of rubber electrodes fixated by rubber bands, with respect to usability and reliability. Two operators applied both setups to twenty healthy volunteers participating in the study. Electrode position and impedance measures as well as subjective evaluations from participants and operators were obtained throughout the stimulation sessions. ResultsOur results demonstrated the superiority of the flexible cap by means of significantly higher electrode configuration reproducibility and a more efficient application. Both, operators and volunteers evaluated the flexible cap as easier to use and more comfortable to wear when compared to the conventional setup. ConclusionIn conclusion, the new cap improves existing and opens new applications scenarios for TES.
Establishment of age group classification for risk stratification in glioma patients
Authors: Lin Zhiying , Yang Runwei , Liu Yawei , Li Kaishu , Yi Guozhong , Li Zhiyong , Guo Jinglin , Zhang Zhou , Peng Junxiang , Qi Songtao , Huang Guanglong
Published: April 2020

Objective: Age is associated with the prognosis of glioma patients, but there is no uniform standard of age-group classification to evaluate the prognosis of glioma patients. In this study, we aimed to establish an age group classification for risk stratification in glioma patients. Methods: A total of 1502 patients diagnosed with gliomas at Nanfang Hospital between 2000 and 2018 were enrolled. The WHO grade of glioma was used as a dependent variable to evaluate the effect of age on risk stratification. The evaluation model was established by logistic regression, and the Akaike information criterion (AIC) value of the model was used to determine the optimal cutoff points for age-classification. The differences in gender, WHO grade, pathological subtype, tumor cell differentiation direction, tumor size, tumor location, and molecular markers between different age groups were analyzed. The molecular markers included GFAP, EMA, MGMT, p53, NeuN, Oligo2, EGFR, VEGF, IDH1, Ki-67, 1p/19q, PR, CD3, H3K27M, and TS. Results: The proportion of men with glioma was higher than that of women with glioma (58.3% vs 41.7%). Analysis of age showed that appropriate classifications of age group were 0-14 years old (pediatric group), 15-47 years old (youth group), 48-63 years old (middle-aged group), and ≥64 years old (elderly group).The proportions of glioblastoma and large tumor size (4-6 cm) increased with age (p = 0.000, p = 0.018, respectively ). Analysis of the pathological molecular markers across the four age groups showed that the proportion of patients with larger than 10% area of Ki-67 expression or positive PR expression increased with age (p = 0.000, p = 0.017, respectively). Conclusion: Age was effective evaluating the risk of glioblastoma in glioma patients. Appropriate classifications of age group for risk stratification were 0-14 years old (pediatric group), 15-47 years old (young group), 48-63 years old (middle age group) and ≥ 64 years old (elderly group). There was significant heterogeneity in WHO grade, tumor size, tumor location and some molecular markers among the four age groups.
Analysis of the early therapeutic effects and healing outcomes of segmental bone defects in the ankle joint treated with the induced membrane/wrapped bone grafting technique
Authors: Zhao Wenbin , Wang Maopeng , Lin Xingshi , Tu Feng , Zhao Dongfeng
Published: April 2020

BackgroundThe current research explores the early therapeutic efficacy and healing outcomes of segmental bone defects in the ankle joint treated with induced membrane technique. MethodsA segmental bone defect model of ankle joint was first constructed by removing 2mm bone from the ankle joint of the rat, and then the induced membrane treatment was performed in two steps: the first step was to implant polymethyl methacrylate bone cement after thorough debridement, followed by the second step to remove bone cement after membrane formation and to replace with the rat’s autologous cancellous bone. The physiological indicators (body temperature and body weight) of the rats and the TNF-α and CRP in the blood were monitored post-surgery, and the efficacy was analyzed based on the above combining Micro-CT and X-ray analysis. Postoperative histological analysis of the tissue morphology of partial induced membrane was performed in rats at 2, 4, 6, and 8 weeks to evaluate the tissue status at the sites of bone defect. ResultsResults showed that the rats survived well after operation: the body temperature slowly decreased, and the CRP was also gradually reduced to normal; the 12-week Micro-CT and palpation indicated a satisfying bone healing trend; histological studies found calcified tissue in the second week post-operation, and vascular network was established in the induced sites at 8 weeks.ConclusionThe study proves that the induced membrane technique can effectively treat segmental bone defects of ankle joint, and is less prone to infection.
Dynamic Changes of Chest CT Follow-up In Coronavirus Disease-19 (COVID-19) Pneumonia: Relationship To Clinical Typing
Authors: Liu Nian , He Guanghong , Yang Xiongxiong , Chen Jianxin , Wu Jie , Ma Min , Lu Wenying , Li Qiang , Cheng Tao , Huang Xiaohua
Published: April 2020

ObjectivesTo investigate the CT changes of different clinical types of COVID-19 pneumonia.MethodsThis retrospective study included 50 confirmed patients with COVID-19 from 16 January 2020 to 25 February 2020. We analyzed the clinical and CT characteristics of the patients between the moderate group and the severe and critical group, and the dynamic changes of severity with the CT follow-up time.ResultsThere were no differences in the occurrence rate of CT characteristics between the moderate group (n=34) and the severe and critical group (n=16) in the initial CT (all p >0.05). There were differences in the CT score of right lung and total CT score at the initial CT between the two groups (all p <0.05). There was a quadratic relationship between total CT score and CT follow-up time in the severe and critical group (r2=0.137, p=0.008), the total CT severity score peaked at the second follow-up CT. There was no correlation between total CT score and CT follow-up time in the moderate group (p >0.05). The total CT score of the severe and critical group was different between the initial and first follow-up, the second and third follow-ups, the third and fourth follow-ups, and the fourth and fifth follow-ups CT (all p<0.05). The total CT score of the moderate group was different between the second and third follow-ups CT (p<0.05).ConclusionsCOVID-19 pneumonia with the severe and critical types progressed rapidly with the greatest severity at the second follow-up CT, and the moderate type was relatively stable.