bluuebunny/crossref_metadata_2025 huggingface dataset:
The relationship between immune status as measured by stimulated ex-vivo tumour necrosis factor alpha levels and the acquisition of nosocomial infections in critically ill mechanically ventilated patients.
Authors: Levin Gabrielle , Boyd J. Gordon , Day Andrew , Hunt Miranda , Maslove David , Norman Patrick , Callaghan Nicole O' , Sibley Stephanie , Muscedere John
Published: July 2020

Introduction: Immunological dysfunction is common in critically ill patients but its clinical significance and the optimal method to measure it are unknown. The level of tumor necrosis factor alpha (TNF-α) after ex-vivo whole blood stimulation with lipopolysaccharide (LPS) has been proposed as a possible method to quantify immunological function. We hypothesized that in a cohort of critically ill patients, those with a lower post-stimulation TNF-α level would have increased rates of nosocomial infections (NIs) and worse clinical outcomes. Methods: A secondary analysis of a phase 2 randomized, multi-centre, double-blinded placebo-controlled trial. As there was no difference between treatment and control arms in outcomes and NI rate, all the patients were analyzed as one cohort. On enrolment, day 4, 7, and weekly until day 28, whole blood was incubated with LPS ex-vivo and subsequent TNF-α level was measured. Patients were grouped in tertiles according to delta and peak TNF-α level. The primary outcome was the association between NIs and tertiles of TNF-α level post LPS stimulation; secondary outcomes included ICU and 90-day mortality, and ICU and hospital length of stay. Results: Data was available for 201 patients. Neither the post LPS stimulation delta TNF-α group nor the peak TNF-α post-stimulation group were associated with the development of NIs or clinical outcomes. Patients in the highest tertile for post LPS stimulation delta TNF-α compared to the lowest tertile were younger [61.1 years ± 15.7 vs. 68.6 years ± 12.8 standard deviations (SD) in the lowest tertile], had lower acuity of illness (APACHE II 25.0 ± 9.7 vs. 26.7 ± 6.1) and had lower baseline TNF-α (9.9 pg/mL ± 19.0 vs. 31.0 pg/mL ± 68.5). When grouped according to peak post-stimulation TNF-α levels, patients in the highest tertile had higher serum TNF-α at baseline (21.3 pg/mL ± 66.7 compared to 6.5 pg/mL ± 9.0 in the lowest tertile).Conclusion: In this prospective multicenter study, ex-vivo stimulated TNF-α level was not associated with the occurrence of NIs or clinical outcomes. Further study is required to better ascertain whether TNF levels and ex-vivo stimulation can be used to characterize immune function in critical illness and if other assays might be better suited to this task.
The current landscape of pre-exposure prophylaxis service delivery models for HIV prevention: a scoping review
Authors: Vanhamel Jef , Rotsaert Anke , Reyniers Thijs , Nöstlinger Christiana , Laga Marie , Landeghem Ella Van , Vuylsteke Bea
Published: July 2020

Background: Strengthening HIV prevention is imperative given the continued high HIV incidence worldwide. The introduction of oral PrEP as a new biomedical HIV prevention tool can be a potential game changer because of its high clinical efficacy and the feasibility of its provision to different key populations. Documenting the existing experience with PrEP service delivery in a variety of real-world settings will inform how its uptake and usage can be maximised. Methods: We conducted a scoping review using the five-step framework provided by Arksey and O’Malley. We systematically searched the existing peer-reviewed international and grey literature describing the implementation of real-world PrEP service delivery models reporting on four key components: the target population of PrEP services, the setting where PrEP was delivered, PrEP providers’ professionalisation and PrEP delivery channels. We restricted our search to English language articles. No geographical or time restrictions were set.Results: This review included 33 articles for charting and analysing of the results. The identified service delivery models showed that PrEP services mainly targeted people at high risk of HIV acquisition, with some models targeting specific key populations, mainly men who have sex with men. PrEP was often delivered centralised and in a clinical or hospital setting. Yet also community-based as well as home-based PrEP delivery models were reported. Providers of PrEP were mainly clinically trained health professionals, but in some rare cases community workers and lay providers also delivered PrEP. In general, in-person visits were used to deliver PrEP. More innovative digital options using mHealth and telemedicine approaches to deliver specific parts of PrEP services are currently being applied in a minority of the service delivery models in mainly high-resource settings.Conclusions: A range of possible combinations was found between all four components of PrEP service delivery models. This reflects differentiation of care according to different contextual settings. More research is needed on how integration of services in these contexts could be expanded and optimised to respond to key populations with unmet HIV prevention needs in different settings.
Geriatric Assessment for Older Adults with Sickle Cell Disease: protocol for a prospective cohort pilot study
Authors: Oyedeji Charity I , Hall Katherine , Luciano Alison , Morey Miriam , Strouse John Joseph
Published: July 2020

Background: The life expectancy for people with sickle cell disease (SCD) has improved tremendously over the last 50 years. This population experiences hemolysis and vaso-occlusion in multiple organs that lead to complications such as cardiopulmonary disease, strokes, and avascular necrosis. These complications can limit mobility and aerobic endurance, similar to limitations that often occur in geriatric populations. These sickle-cell and age-related events lead to frequent hospitalization, which further increases the risk of functional decline. We have few tools to measure functional decline in people with SCD. The purpose of this paper is to describe a protocol to evaluate the feasibility of sickle cell disease geriatric assessment (SCD-GA).Methods/Design: We will enroll 40 adults with SCD (20 age 18-49 years and 20 age ≥ 50 years) in a prospective cohort study to assess the feasibility of SCD-GA. The SCD-GA includes validated measures from the oncology geriatric assessment enriched with additional physical and cognitive measures. The SCD-GA will be performed at the first study visit, 10 to 20 days after hospitalization, and at after 12-months (exit visit). With input from a multidisciplinary team of sickle cell specialists, geriatricians, and experts in physical function and physical activity, we selected assessments across 7 domains: functional status (11 measures), comorbid medical conditions (1 measure), psychological state (1 measure), social support (2 measures), weight status (2 measures), cognition (3 measures), and medications (1 measure). We will measure the proportion completing the assessment with feasibility as the primary outcome. Secondary outcomes include the proportion consenting and completing all study visits, duration of the assessment, acceptability, and adverse events.Discussion: We present the protocol and rationale for selection of the measures included in SCD-GA. We also outline the methods to determine feasibility and subsequently to optimize the SCD-GA in preparation for a larger multicenter validation study of the SCD-GA.
CD147 promotes collective invasion through cathepsin B in hepatocellular carcinoma
Authors: Wang Shi-Jie , Chao Dong , Wei Wei , Nan Gang , Li Jia-Yue , Liu Fen-Ling , Li Ling , Jiang Jian-Li , Cui Hong-Yong , Chen Zhi-Nan
Published: July 2020

Background

Mounting evidence suggests that solid tumors display the features of collective invasion, however, the molecular mechanisms are far from clear. This study aims to verify the role and the underlying mechanisms of CD147 in collective invasion in hepatocellular carcinoma.

Methods

Immunostaining was used to analyze human hepatocellular carcinoma specimens and three-dimensional cultures. Three-dimensional invasion model was established to mimic in vivo invasion. RNA-sequencing was used to identify downstream effectors.

Results

Human hepatocellular carcinoma undergone collective invasion and CD147 was observed to be upregulated at the invasive front of tumor cell groups. CD147 was demonstrated to promote collective invasion using the modified three-dimensional invasion model, which recapitulated the main features of collective invasion. Through transcriptome analysis and enzyme activity assay, we found that CD147 enhanced cathepsin B expression and activation. Upregulated cathepsin B in hepatocellular carcinoma cells facilitated migration and invasion, which mediated CD147-induced invasive phenotype in hepatocellular carcinoma. In terms of mechanism, we found that CD147 promoted cathepsin B transcription by activating β-catenin signaling as a result of reduced GSK-3β expression. Furthermore, we found that elevated expression of CD147 as well as cathepsin B were correlated with poor prognosis in patients with hepatocellular carcinoma.

Conclusions

CD147 promotes hepatocellular carcinoma cells collective invasion via upregulating cathepsin B expression and targeting CD147 would be valuable for the development of novel therapeutic modalities against invasion and metastasis of cancer.
The Impact of a Hospitalist Model in Perioperative Care of Elective Joint Replacement Patients: a 17 years-experience Report
Authors: Ferrari Matteo Carlo , Azzolini Elena , Strangio Giuseppe , Badalamenti Salvatore , Lagioia Michele
Published: July 2020

Background

Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. The aim of this report is to describe a 17-year experience of a hospitalist model in peri-operative co-management in more than 25,000 elective joint replacement patients.
Methods

A retrospective observational study about surgical co-management with hospitalists in a tertiary teaching referral hospital in Milan in relation to hospital lengths of stay (LOS), 30-days readmission rate, incidence of prosthetic joint infections (PJI) and patient related co-morbidities, number of medico-legal disputes and related costs, and medical customer satisfaction.
Results

Over a 17-year period LOS has been reduced from 10 to 5 days; readmission rates for total hip arthroplasty are 1.7% vs 3.7% (Italy) at 30 days; total infection rates for total knee arthroplasty are recorded at 0.8% vs 1.4% (Italy); obesity, diabetes, cardiovascular diseases and chronic obstructive pulmonary disease (COPD) and/or smoking result as the main co-morbidity in PJI; there have been only 113 medico-legal disputes out of approximately 19,000 surgeries and we report 95% overall medical customer satisfaction.
Conclusions

This is the first paper outside the US to highlight the impact of the hospitalists on patient satisfaction and the translation of the obtained benefits into savings. The evolution of the hospitalist model in surgical settings shows promising results in terms of patients’ safety and cut of health-related direct and indirect costs.
Flexible Thermoplastic Starch Films Functionalized With Copper Particles for Packaging of Food Products
Authors: López Olivia , Villanueva María E. , Copello Guillermo J. , Villar Marcelo A
Published: July 2020

Biodegradable films based on thermoplastic corn starch (TPS) and copper particles with antimicrobial capacity were developed. Copper nanoparticles (Cu) and silica coated copper microparticles (Si-Cu) in the range of 0.25 to 5 % were used. Composite films were obtained by melt-mixing and subsequent thermo-compression. Particles distribution within TPS matrix and the presence of some pores and cracks, induced by Si-Cu particles, was evaluated by SEM. The presence of both fillers gave to composite films a brown pigmentation and decreased their transparency; these effects were more pronounced at higher particles concentrations. Regarding mechanical properties, copper particles at 1 and 5 % acted as reinforcing agents increasing the maximum tensile strength but their presence lead to a decrease in elongation at break, affecting films ductility. Composites inhibited the growth of Gram+ and Gram- bacteria, demonstrating their antimicrobial capacity. Copper effectively migrated to a simulant of aqueous foods and naked particles concentration in the simulant medium resulted higher than the minimum inhibitory concentration for bacteria. The characteristics and properties of developed composite films make them an interesting material for food primary packaging, mainly for meat fresh products.
Effect of ambient temperature on outpatient admission for osteoarthritis and rheumatoid arthritis in a subtropical Chinese city
Authors: Zhao Desheng , Cheng Jian , Bao Ping , Zhang Yanwu , Liang Fengjuan , Wang Hao , Wang Xu , Fang Shiyuan , Su Hong
Published: July 2020

Background
Current findings on the impact of weather conditions on osteoarthritis (OA) and rheumatoid arthritis (RA) are sparse and not conclusive. This study aimed to investigate the relationship between temperature change and OA/RA admission.
Methods
Daily OA/RA admission and meteorological data from 1 January 2014 to 31 December 2017 in Hefei, China, were collected. We quantified the relationship between ambient temperature and OA/RA admission using a distributed lag nonlinear model (DLNM). The effect modifications by gender and age were also examined.
Results
Sudden temperature decrease was significantly associated with RA admission (25th percentile of temperature versus 50th percentile of temperature), with the acute and largest effect at current days lag (RR: 1.063, 95%CI: 1.010–1.118). However, no association between temperature and OA admission was observed. When conducting subgroup analyses by individual characteristics, we found that females and patients aged 41–65 years were more vulnerable to temperature decrease than males, patients aged 0–40 and ≧ 66 years, respectively.
Conclusions
This study suggested that sudden temperature decrease was a risk factor for increase RA admission. Females and patients aged 41–65 years were particularly vulnerable to the effect of temperature decrease.
The Statistical shape model as a quality assurance measure in the treatment of complex midface fractures: A Case control study
Authors: Fuessinger Marc Anton , Steffen Schwarz , Mathieu Gass , Philipp Poxleitner , Leonard Brandenburg , Stefan Schlager , Christian Metzger Marc
Published: July 2020

BackgroundComplex bilateral midface fractures necessitate a surgically challenging procedure to preserve or restore the occlusion and the sensitive eye area. In this case control study, we aim to show the potential of a statistical shape model (SSM) for measuring the quality of the midface reconstruction, compared to the estimated preoperative situation.MethodsAn individualized SSM was postoperatively registered on 19 reconstructed complex bilateral midface fractures. Using this SSM, the distances from the simulated preoperative situation to the postoperative positions of the fracture segments were calculated. The fracture lines for Le Fort II, Le Fort III, and NOE fractures were chosen as reference points for the distance measurements.ResultsThe SSM could be registered on all 19 complex bilateral midface fractures. All analyzed fractures show a dorsal impaction (negative values) of the midface. Le Fort II fractures show deviation values of − 0.98 ± 4.6 mm, Le Fort III fractures show values of − 3.68 ± 3.6 mm, NOE type 2 fractures show values of − 0.25 ± 4.6 mm, and NOE type 1 fractures show values of − 0.25 ± 4.6 mm.ConclusionThe SSM can be used to measure the quality of the achieved reduction of complex bilateral midface fractures based on the estimated preoperative situation.Trial registrationDRKS00009719
Response To Pretransplant Downstaging Therapy Predicts Patient Outcome After Liver Transplantation For Hepatocellular Carcinoma With Portal Vein Tumor Thrombus
Authors: Yang Zhe , Wang Shuo , Sun Jingqi , Zhuang Li , Li Qiyong , Xu Xiao , Zheng Shusen
Published: July 2020

Background: Tumor viability and areas of necrosis after pretransplant downstaging therapy is predictive of patient outcome, but has not been evaluated in hepatocellular carcinoma (HCC) recipients with portal vein tumor thrombus (PVTT). Methods: Recurrence-free survival (RFS) and overall survival (OS) were compared among PVTT-HCC patients receiving pretransplant downstaging therapy with and without well response (radiographic tumor necrosis >50%). Multivariable predictors of well response to downstaging were identified.Results: Of 107 patients, downstaging was attempted in 48, and 15 had well response to pretransplant therapy. Compared with poor response and non-downstaged patients, well response patients had significantly superior 1-, 2-, and 3-year RFS (72%, 72%, and 72% vs 30.4%, 22.6%, and 22.6%; P = 0.002) and OS (100%, 90.9%, and 90.9% vs 66.3%, 47.7%, and 47.7%; P = 0.008). Pre-transplant alpha-fetoprotein (AFP) level <1000ng/mL and radiographic tumor necrosis >50% were independent favorable factors for lower HCC recurrence rate and better overall survival after liver transplantation (LT). Multivariable predictors of well response to downstage included well-moderate differentiated tumor on explant and multiple combined pretransplant locoregional and systematic therapies. Conclusions: For HCC patients with PVTT and receive pretransplant downstaging therapy, achieving well response is predictive of significantly better posttransplant outcomes and patients can have acceptable survival with LT after successful downstaging. Combined locoregional and systematic therapies may help to improve the responsiveness to downstaging.
Investigation of Wash Fluid Preheating on the Effectiveness of Online Compressor Washing in Industrial Gas Turbines
Authors: Agbadede Roupa , Kainga Biweri
Published: July 2020

This study presents an investigation of wash fluid preheating on the effectiveness of online compressor washing in industrial gas turbines. Crude oil was uniformly applied on the compressor cascade blades surfaces using a roller brush, and carborundum particles were ingested into the tunnel to create accelerated fouled blades. Demineralized water was preheated to 500C using the heat coil provided in the tank. When fouled blades washed with preheated demineralized and the one without preheating were compared, it was observed that there was little or no difference in terms of total pressure loss coefficient and exit flow angle. However, when the fouled and washed cases were compared, there was a significant different in total pressure loss coefficient and exit flow angle.
Incidence of Intoxication Events and Patient Outcomes in Taiwan: a Nationwide Population-based Observational Study
Authors: Chen Chun Kuei , Chan Yi-Ling , Su Tse-Hsuan
Published: July 2020

Background Intoxicated patients were frequently managed in the emergency departments (ED) with few studies at national level. The study aimed to reveal the incidence, outcomes of intoxications and trend in Taiwan.Methods Adults admitted to an ED due to an intoxication event between 2006 and 2013 were identified using the Taiwan National Health Insurance Research Database. The rate of intoxication and severe intoxication events, mortality rate, hospital length of stay (LOS), and daily medical costs of these patients were analyzed. Changes over time were analyzed using Joinpoint models. Subgroup analyses were used to assess the effect of sex, age, and presence of a prior psychiatric illness.Results A total of 20,371 ED admissions due to intoxication events were identified during the study period, and the incidence decreased with annual percentage change of 4.7% from 2006 to 2013. The mortality rate, hospital LOS, and daily medical costs were not decreased over time. Males and geriatric patients had more severe intoxication events, greater mortality rates, and greater daily medical costs. Patients with psychiatric illnesses had higher mortality rates and a longer hospital LOS, but lower daily medical expenses.Conclusion From 2006 to 2013, there was a decline in the incidence of ED admission for intoxication events in Taiwan. Males, geriatric patients, and those with psychiatric illnesses had greater risks for severe intoxication and mortality.
A Pan-cancer analysis of GPR183 correlated with tumor immunity
Authors: Yang Yi , Li Lixing , Shen Lu , Wang Yanjing , Zhang Hai , Wang Ting , Cao Wenjiao
Published: July 2020

Background G-protein-coupled receptors(GPRs) are the largest family of membrane proteins in the human genome, positively involving in human physiological and metabolic activities. Drugs targeted to GPRs have developed fast. However, there are still few GPR-targeted drugs for cancer treatment. GPR183, an orphan seven-transmembrane receptor, have been widely studied in immune regulation. Yet, its role in tumor immunity remains mysterious.Results In our study, we performed a pan-cancer analysis of GPR183. Though statistically significantly differed between tumor and normal samples in various cancers, the expression of GPR183 showed a dual trend. Besides, we applied integrated network analysis to predict GPR183 related genes and analyzed their function with GO and Pathway analysis. GPR183 was strongly associated with immune responses. Moreover, we evaluated the prognostic value of GPR183 in various cancers and found it related to the prognosis of BRCA, SKCM, LUSC, LGG and UVM. We further explore its immunoregulatory function based on differentially expressed genes. Finally, we estimated the tumor immune infiltration associated with GPR183 expression using “TIMER”. The GPR183 expression was highly correlation with macrophages and dendritic cells infiltration.Conclusions GRP183 showed a multiple immunoregulatory role in tumor progression. GPR183 was related to prognosis of five cancer types(BRCA, SKCM, LUSC, LGG and UVM). We also found GPR183 had intimate connection to PD-1 signals. GPR183 might become a potential therapeutic target for cancer treatment.
The Impact of Integrating Environmental Health into Medical School Curricula: A Survey-Based Study
Authors: Ihde Erin , Kligler Benjamin , Zipp Genevieve Pinto , Rocchetti Carmela
Published: July 2020

Background Inclusion of environmental health (EH) in medical education serves as a catalyst for preparing future physicians to address issues as complex as climate change and health, water pollution and lead contamination. However, previous research has found EH education to be largely lacking in U.S. medical education, putting future physicians at risk of not having the expertise necessary to address patients' environmental illnesses, nor speak to prevention. Environmental health disparities fit well under the larger umbrella of social determinants of health, which still remain largely omitted from medical school curricula. Methods Environmental health (EH) knowledge and skills were incorporated into the first-year medical school curriculum at Hackensack Meridian School of Medicine, via a thread of two-hour interactive large group learning sessions with follow up activities. In year 1, students took the Environmental Health in Med School (EHMS) survey before and after the EH thread. This survey was designed to evaluate medical students’ attitudes, awareness and professionalism regarding environmental health. Results suggested a dramatic ceiling effect on students’ responses to the EHMS survey, making it difficult to detect any change from before to after the intervention. Our conclusion was that the current generation of medical students at this school is already extremely aware of and concerned about the impact of environmental issues on health. Based on the outcomes of the EHMS survey, a new Environmental Health Survey II (EHS II) was created for Year 2, to measure students' perceptions of preparedness to discuss EH with future patients. The two surveys were both created by the research team and designed to help inform subsequent content revisions to ensure learning objectives were met. ResultsResults for the four questions on the EHS II pre-survey (84 respondents) and on the post-survey (79 respondents) showed a statistically significant positive change in students’ self-reported sense of preparedness to discuss environmental health with their patients following the curriculum intervention. ConclusionsA relatively brief six-week environmental health module combining didactic and experiential elements can significantly increase medical students’ self-reported sense of preparedness to discuss environmental health issues, including climate change, with their patients.
Simulation-Based Curriculum Development: Lessons Learnt in Global Health Education
Authors: Sawaya Rasha , Mrad Sandra , Rajha Eva , Saleh Rana , Rice Julie
Published: July 2020

Background: Simulation based medical education (SBME) allows learners to acquire clinical skills without exposing patients to unnecessary risk. This is especially applicable to Emergency Medicine training programs where residents are expected to demonstrate proficiency in the management of time critical, low frequency, and highly-morbidity conditions. This study aims to describe the process through which a SBME curriculum was created, in a limited simulation resource setting at a 4-year Emergency Medicine (EM) residency program at the American University of Beirut Medical Center. Methods: A case-based pilot simulation curriculum was developed following Kern’s 6 step approach to curriculum design. The curricular objectives were identified through an anonymous survey of the program’s residents and faculty. Curriculum outcomes were assessed, and the curriculum was revised to address curricular barriers. Evaluations of the revised curriculum were collected during the simulation sessions and through a whole revised curriculum evaluation at the end of the first year of its implementation. Results: 14/20 residents (70%) and 8/8 faculty (100%) completed the needs assessment from which objectives for the pilot curriculum were developed and implemented through 6 2-hour sessions over a 1-year period. Objectives were not met and identified barriers included cost, scheduling, resources, and limited faculty time. The revised curriculum addressed these barriers and 24 40-minute sessions were successfully conducted during the following year. The sessions took place 3 at a time, in 2-hour slots, using the same scenario to meet the objectives of the different learners’ levels. 91/91 evaluations were collected from participants with overall positive results. The main differences between the pilot and the revised curricula included: a better understanding of the simulation center resources and faculty’s capabilities. Conclusion: Simulation-based education is feasible even with limited-resources. However, understanding the resources available, and advocating for protected educator time are essential to implementing a successful EM simulation curriculum.
Identification of A Novel Six Autophagy-Related Genes Signature for The Prognostic and A miRNA-Related Autophagy Predictor for Anti-PD-1 Therapy Responses in Prostate Cancer
Authors: Wu Lei , Yue Guojun , Quan Wen , Luo Qiong , Peng Dongxu , Zhang Guihai
Published: July 2020

Background: Autophagy is a highly conserved homeostatic process in the human body that is responsible for the elimination of aggregated proteins and damaged organelles. Several autophagy-related genes (ARGs) contribute to the process of tumorigenesis and metastasis of prostate cancer (PCa). Also, miRNAs have been proven to modulate autophagy by targeting some ARGs. However, their potential role in PCa still remains unclear.Methods: An univariate Cox proportional regression model was used to identify 17 ARGs associated with the overall survival (OS) of PCa. Then, a multivariate Cox proportional regression model was used to construct a 6 autophagy-related prognostic genes signature. Patients were divided into low-risk group and high-risk group using the median risk score as a cutoff value. High-risk patients had shorter OS than low-risk patients. Furthermore, the signature was validated by ROC curves. Regarding mRNA and miRNA, 12 differentially expressed miRNAs (DEMs) and 1073 differentially expressed genes (DEGs) were detected via the GEO database. We found that miR-205, one of the DEMs, was negatively regulated the expression of ARG (NKX2-3). Based on STRING analysis results, we found that the NKX2-3 was moderately related to the part of genes among the 6 autophagy-related genes prognostic signature. Further, NKX 2-3 was significantly correlated with OS and some clinical parameters of PCa by cBioProtal. By gene set enrichment analysis (GSEA). Lastly, we demonstrated that the association between NKX2-3 and tumor mutation burden (TMB) and PDCD1 (programmed cell death 1) of PCa.Results: We identified that the six ARGs expression patterns are independent predictors of OS in PCa patients. Furthermore, our results suggest that ARGs and miRNAs are inter-related. MiR-205 was negatively regulated the expression of ARG (NKX2-3). Further analysis demonstrated that NKX2-3 may be a potential biomarker for predicting the efficacy of anti-PD-1 therapy in PCa.Conclusions: The current study may offer a novel autophagy-related prognostic signature and may identify a promising miRNA-ARG pathway for predicting the efficacy of anti-PD-1 therapy in PCa.
First Report on Molecular Basis of Potato Leaf Roll Virus Aggravation by Combined Effect of Tuber and Prevailing Aphid
Authors: Kumar Ravi Ranjan , Ansar Md. , Rajani Kumari , Kumar Jitesh , Ranjan Tushar
Published: July 2020

Objective
The Potato Leaf Roll Virus (PLRV) is one of the most devastating virus causing severe yield loss worldwide in potato. The comprehensive observations were made to study the PLRV infestation in major potato growing areas of Bihar (India) and further detailed molecular basis of PLRV aggravation was established.
Results
Although population of aphids were found comparatively lower with maximum symptomatic plants, our molecular data further confirms the presence of PLRV in all possible symptomatic tissues such as tuber, shoot and leaf. For the first time, we have proposed molecular basis of aggravation of PLRV, where tuber acts as a reservoir during off-season and further transmitted by aphids.
Health behaviors and health services accessibility factors associated with diabetes: a propensity score matching analysis
Authors: Cinaroglu Songul
Published: July 2020

Introduction: This study aims to explore diabetes prevalence and to identify the associated health behaviors and accessibility factors. Despite increasing burden of diabetes in Turkey, there is a lack of information regarding associated factors with diabetes.Methods: Data gathered from TurkStat-Health Survey for the year 2014. 1996 individuals who had reported diabetes were matched to similar non-diabetes participants in terms of socio-demographic characteristics and comorbidities by using 1:1 nearest matching based on estimated propensity scores.Results: The weighted point prevalence of diabetes among adults was 8.98%. Compared with smokers, non-smokers were less likely to develop diabetes (OR:0.96; 95% CI:0.95–0.97). Individuals engaging in regular physical activity were less likely to have experienced diabetes than individuals not engaging in any physical activity (OR:0.51; 95% CI:0.41–0.52). Conclusions: Improving the health behaviors of individuals and promoting a culture of exercise and healthy food consumption are necessary strategies to fight against diabetes in Turkey. Collaborations between health professionals will provide many lights for effective clinical decision making and preparations of diabetes self-management programs. Crisper understanding of associated health behaviors and health services accessibility factors associated with diabetes is beneficial to develop better nursing plans for patients.
An Abdominal-sacral Approach With Preoperative Embolisation For Vulvar Solitary Fibrous Tumour: A Case Report
Authors: Takahashi Akimasa , Kasei Ryo , Amano Tsukuru , Nishimura Hiroki , Deguchi Mari , Yoshino Fumi , Kimura Fuminori , Moritani Suzuko , Murakami Takashi
Published: July 2020

Background: Solitary fibrous tumours (SFTs) in the female genital tract are uncommon. Resection of these tumours is controversial because it can cause life-threatening haemorrhage. We report a case of vulvar SFT that was excised in a combined abdominal-sacral approach after preoperative embolisation.Case Presentation: At another hospital, an inoperable intrapelvic tumour was diagnosed in a 34-year-old woman. Computed tomography and magnetic resonance imaging showed that the uterus, urinary bladder and rectum were compressed laterally by a pelvic tumour with a maximum diameter of 11 cm. This mass was hypervascular and had a well-defined border. Transperineal biopsy was performed, and immunostaining revealed that the mass was an SFT. The tumour was supplied by feeding vessels from the right iliac arteries. First, we embolised the feeding vessels. Second, we performed surgical resection in a combined abdominal-sacral approach; no blood transfusion was necessary, and no perioperative complications occurred. The final pathological diagnosis was SFT that was positive for CD34 and signal transducer and activator of transcription 6 according to immunohistochemical staining.Conclusion: During a year of follow-up, the disease did not recur. Treatment of pelvic SFT should aim at complete resection through various approaches after careful measures are taken to prevent haemorrhage.
Small Nucleolar RNA and Small Nucleolar RNA Host Gene Signatures as Biomarkers for Pancreatic Cancer
Authors: Han Shuwen , Xie Yangyang , Yang Xi , Dai Siqi , Dai Xiaoyu
Published: July 2020

Objective: The objective of this study was to identify key molecules including small nucleolar RNAs (snoRNAs) and small nucleolar RNA host genes (SNHGs) involved in pancreatic cancer.Methods: First, we screened the differentially expressed snoRNAs (DEsnoRNAs) and trend-related snoRNAs based on the cancer genome atlas (TCGA) dataset for pancreatic cancer, and then performed methylation correlation analysis, survival analysis, and extraction of snoRNA host genes for Gene ontology (GO) functional and the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis. Next, DESNHGs and trend-related SNHGs were screened according to the TCGA dataset for pancreatic cancer, and a competing endogenous RNA (ceRNA) network was constructed for pathway and functional enrichment analysis. Results: A total of eight DEsnoRNAs and 93 trend-related snoRNAs were extracted. Then, ten host genes of the snoRNAs were identified. Functional analysis suggested that the ten host genes were significantly enriched in several GO terms including mitotic chromosome condensation and endocytosis pathway. SNORA38B was considered to associate with survival and prognosis. The SNORD17 and SNORA11 were considered to negatively correlate with methylation. In addition, two trend-related SNHGs were extracted. Additionally, a ceRNA network was constructed with 11 miRNAs, one lncRNAs, and one mRNA. SNHG24 mainly correlated with GnRH secretion and neuroactive ligand-receptor interaction in pancreatic cancer. Conclusion: The identified snoRNAs and SNHGs could serve as potential markers for the early detection of pancreatic cancer.
Using Techno-Economic Modelling to Determine the Minimum Cost Possible for a Microbial Palm Oil Substitute
Authors: Karamerou Eleni E. , Parsons Sophie , McManus Marcelle C. , Chuck Christopher
Published: July 2020

Background Palm oil is the most commonly used crop oil worldwide, and is used predominantly for food, in the chemical industry and for biofuels. It is mainly cultivated in areas with biodiverse and carbon-rich rainforest which has given rise to large increases in greenhouse gas (GHG) emissions and significant impacts to biodiversity. There is therefore substantial interest in finding an alternative to palm oil. Heterotrophic single cell oils (SCOs) are one potential replacement as these are able to mimic the lipid profile of palm oil in a way that other terrestrial and exotic crop oils cannot. But, despite a large experimental research effort in this area, there are only a handful of techno-economic modelling publications. As such, there is little understanding of whether SCOs are, or could ever be, a potential competitive replacement to palm oil. To help address this question we designed a detailed model that coupled a hypothetical heterotroph (using the very best possible biological lipid production) with the largest and most efficient chemical plant design possible. Results Our base case gave a lipid selling price of $2.01 / kg for ~8,000 tonnes / year production, that could be reduced to $1.54 /kg on increasing production to ~48,000 tonnes of lipid a year. A range of scenarios to further reduce this cost were then assessed, including using a thermotolerant strain (reducing the cost from $1.54 /kg to $1.47 /kg), zero cost electricity ($ 1.48/kg), using non-sterile conditions ($1.05 / kg), wet extraction of lipids ($1.48 / kg), continuous production of extracellular lipid ($0.76 /kg) and selling the whole yeast cell, including recovering value for the protein and carbohydrate ($1.14 /kg). If co-products were produced alongside the lipid then the price could be effectively reduced to $0, depending on the amount of carbon funnelled away from lipid production, as long as the co-product could be sold in excess of $1/kg. Conclusions The model presented here represents an ideal case that which while not achievable in reality, importantly would not be able to be improved on, irrespective of the scientific advances in this area. From the scenarios explored, however, it should still be possible to produce lower cost SCOs, but research must start to be applied in three key areas, firstly designing products where the whole cell is used, displacing products that contain palm oil rather than attempting to produce an exact refined palm oil substitute. Secondly, further work on the product systems that produce lipids extracellularly in a continuous processing methodology or finally that create an effective biorefinery designed to produce a low molecular weight, bulk chemical, alongside the lipid. All other research areas will only ever give incremental gains rather than leading towards an economically competitive, sustainable, microbial oil.
Variable stiffness identification and configuration optimization of industrial robots for machining tasks
Authors: Jiao Jiachen , Tian Wei , Zhang Lin , Li Bo , Hu Junshan , Li Yufei , Li Dawei , Zhang Jianlong
Published: July 2020

Industrial robots are increasingly used in machining tasks because of their high flexibility and intelligence. However, the low structural stiffness of the robot seriously affects the positional accuracy and machining quality of robot operation equipment. Studying robot stiffness characteristics and optimization methods is an effective way to improve robot stiffness performance. Accordingly, aiming at the poor accuracy of stiffness modeling caused by approximating stiffness of each joint as constant, a variable stiffness identification method is proposed based on space gridding. Then, a task-oriented axial stiffness evaluation index is proposed to realize quantitative assessment of the stiffness performance in the machining direction. Besides, by analyzing the redundant kinematic characteristics of the robot machining system, a configuration optimization method is further come up with to maximize the index. For a large number of points or trajectory processing tasks, a configuration smoothing strategy is proposed to achieve fast acquisition of optimized configurations. Finally, experiments on a KR500 robot are conducted to verify the feasibility and validity of proposed stiffness identification and configuration optimization methods.
The Trochanteric Double Contour is a Valuable Landmark for Assessing Femoral Offset Underestimation on Standard Radiographs: A Retrospective Study
Authors: Blümel Stefan , Stadelmann Vincent A. , Brioschi Marco , Küffer Alexander , Leunig Michael , Rüdiger Hannes A.
Published: July 2020

Background: Inaccurate projection on standard pelvic radiographs leads to the underestimation of femoral offset—a critical determinant of postoperative hip function—during total hip arthroplasty (THA) templating. We noted that the posteromedial facet of the greater trochanter and piriformis fossa form a double contour on radiographs, which may be valuable in determining the risk of underestimating femoral offset. We evaluate whether projection errors can be predicted based on the double contour width.Methods: Plain anteroposterior (AP) pelvic radiographs and magnetic resonance images (MRIs) of 64 adult hips were evaluated retrospectively. Apparent femoral offset, apparent femoral head diameter and double contour widths were evaluated from the radiographs. X-ray projection errors were estimated by comparison to the true neck length measured on MRIs after calibration to the femoral heads. Multivariate analysis with backward elimination was used to detect associations between the double contour width and radiographic projection errors. Femoral offset underestimation below 10% was considered acceptable for templating.Results: The narrowest width of the double line between the femoral neck and piriformis fossa is significantly associated with projection error. When double line widths exceed 5 mm, the risk of projection error greater than 10% is significantly increased compared to narrower double lines, and the acceptability rate for templating drops below 80% (p = 0.02).Conclusion: The double contour width is a potential landmark for excluding pelvic AP radiographs unsuitable for THA templating due to inaccurate femoral rotation.
Development of an Immune-Related Gene Pairs Signature for Predicting Clinical Outcome in Lung Adenocarcinoma
Authors: Wu Chunlei , Hu Quanteng , Ma Dehua
Published: July 2020

Background: Lung adenocarcinoma (LUAD) is the main pathological subtype of Non-small cell lung cancer. The aim of this study was to establish an immune-related gene pairs (IRGPs) signature for predicting the prognosis of LUAD patients.Methods: We downloaded the gene expression profile and immune-related gene set from TCGA and ImmPort database, respectively, to establish IRGPs. Then, IRGPs were subjected to univariate Cox regression analysis, LASSO regression analysis and multivariable Cox regression analysis to screen and develop a IRGPs signature. The receiver operating characteristic curve (ROC) was applied for evaluating the predicting accuracy of this signature by calculating the area under ROC (AUC) and data from GEO was used to validate this signature. Results: A IRGPs signature with 8 IRGPs was constructed. The AUC for 1- and 3-year overall survival in TCGA set was 0.867 and 0.870, respectively. Similar result was observed in the AUC of GEO set and Total set (GEO set [1-year: 0.819; 3-years: 0.803]; Total set [1-year: 0.845; 3-years: 0.801]). Survival analysis of three sets demonstrated high-risk LUAD patients exhibited poorer prognosis. The multivariable Cox regression indicated that risk score was independent prognostic factors.Conclusions: We developed a novel IRGPs signature for predicting prognosis of LUAD.
Nothing Wrong About Change: The Adequate Choice of the Dependent Variable and Design in Prediction of Intervention Success
Authors: Mattes André , Roheger Mandy
Published: July 2020

Background Investigating predictors of intervention success is a common approach in medical research. In the light of an individualized medicine, it is important not only to investigate the effects of certain pharmacological and nonpharmacological interventions, but also to examine specific individual characteristics of participants who do or do not benefit from these interventions. However, results on specific predictors of intervention success in the overall field are mixed and inconsistent due to different and sometimes inappropriate statistical methods used. Therefore, the present paper gives a guidance on the appropriate use of multiple regression analyses to identify predictors of pharmacological and nonpharmacological interventions.Methods We simulated data based on a predefined true model and ran a series of different analyses to evaluate their performance in retrieving the true model coefficients. The true model consisted of a 2 (between: experimental vs. control group) x 2 (within: pre- vs. post-treatment) design with two continuous predictors, one of which predicted the success in the intervention group and the other did not. In analyzing the data, we considered four commonly used dependent variables (post-test score, absolute change score, relative change score, residual score), five regression models, eight sample sizes, and four levels of reliability.Results Our results indicated that a regression model including the investigated predictor, Group (experimental vs. control), pre-test score, and the interaction between the investigated predictor and the Group as predictors, and the absolute change score as the dependent variable seemed most convenient for the given experimental design. Although the pre-test score should be included as a predictor in the regression model for reasons of statistical power, its coefficient should not be interpreted because even if there is no true relationship, a negative and statistically significant regression coefficient commonly emerges.Conclusion Employing simulation methods, theoretical reasoning, and mathematical derivations, we were able to derive recommendations regarding the analysis of data in one of the most prevalent experimental designs in research on pharmacological and nonpharmacological interventions and external predictors of intervention success. These insights can contribute to the application of considered data analyses in future studies and facilitate cumulative knowledge gain.
Feasibility of continuous fever monitoring using wearable devices
Authors: Smarr Benjamin , Aschbacher Kirstin , Fisher Sarah M. , Chowdhary Anoushka , Dilchert Stephan , Puldon Karena , Rao Adam , Hecht Frederick M. , Mason Ashley E.
Published: July 2020

Elevated core temperature constitutes an important biomarker for COVID-19 infection; however, no standards currently exist to monitor fever using wearable peripheral temperature sensors. Evidence that sensors could be used to develop fever monitoring capabilities would enable large-scale health-monitoring research and provide high-temporal resolution data on fever responses across heterogeneous populations. We launched the TemPredict study in March of 2020 to capture continuous physiological data, including peripheral temperature, from a commercially available wearable device during the novel coronavirus pandemic. We coupled these data with symptom reports and COVID-19 diagnosis data. Here we report findings from the first 50 subjects who reported COVID-19 infections. These cases provide the first evidence that illness-associated elevations in peripheral temperature are observable using wearable devices and correlate with self-reported fever. Our analyses support the hypothesis that wearable sensors can detect illnesses in the absence of symptom recognition. Finally, these data support the hypothesis that prediction of illness onset is possible using continuously generated physiological data collected by wearable sensors. Our findings should encourage further research into the role of wearable sensors in public health efforts aimed at illness detection, and underscore the importance of integrating temperature sensors into commercially available wearables.