bluuebunny/crossref_metadata_2025 huggingface dataset:
Plasmacytoid urothelial carcinoma of renal pelvis with positive zinc finger E–box–binding homeobox 1: a case report
Authors: Takada-Owada Atsuko , Nozawa Yumi , Onozaki Masato , Noda Shuhei , Jamiyan Tsengelumaa , Nakazato Yoshimasa , Tokura Yuumi , Kamai Takao , Ishida Kazuyuki
Published: September 2020

BackgroundThe tumor transformation mechanism of a plasmacytoid urothelial carcinoma remains unexplained. We describe the case of a plasmacytoid urothelial carcinoma of the renal pelvis in which the expression of zinc finger E–box–binding homeobox 1 (ZEB1), a key nuclear transcription factor in an epithelial–mesenchymal transition, is involved in tumor transformation.Case presentationThe patient had a left nephrectomy with the clinical diagnosis of left pelvic renal cancer. The resected specimen showed that the tumor surface comprised a noninvasive papillary urothelial carcinoma with the carcinoma in situ, and the invasive area comprised a plasmacytoid urothelial carcinoma characterized by the presence of single dyscohesive malignant cells that resembled plasma cells in a loose myxoid stroma. The noninvasive urothelial carcinoma was positive for cytokeratin and E–cadherin, and negative for vimentin and ZEB1. In contrast, the invasive plasmacytoid urothelial carcinoma was positive for cytokeratin and also vimentin and ZEB1, and negative for E–cadherin. Additionally, this component was immunoreactive for CD138 and CD38 that are immunohistochemical markers for plasma cells.ConclusionWe suggest that ZEB1 is involved in the plasmacytoid transformation by repressing the E–cadherin in a plasmacytoid urothelial carcinoma.
Noise Sensitivity Associated with Nonrestorative Sleep in Chinese Adults: A cross-sectional Study
Authors: Li Sha , Fong Daniel Yee Tak , Wong Janet Yuen Ha , McPherson Bradley , Lau Esther Yuet Ying , Huang Lixi , IP Mary Sau Man
Published: September 2020

Background: Nonrestorative sleep (NRS) is associated with various psychological and physical health issues. Noise exposure and noise sensitivity have been proposed to contribute to NRS. This study aimed to examine the relationship between noise, noise sensitivity, NRS, and physiological sleep parameters among Chinese adults.Methods: A cross-sectional household study was conducted with Chinese adults in Hong Kong. We administered a battery of questionnaires, including the Nonrestorative Sleep Scale and the Weinstein Noise Sensitivity Scale for assessing NRS and noise sensitivity, respectively, as well as other instruments for assessing sociodemographics, lifestyle factors, social support, somatic symptoms, stress, anxiety, and depression. Nocturnal noise level was measured for one week by a noise dosimeter. Physiological sleep parameters were also measured by actigraphy during the night-time for a week.Results: A total of 500 (66.4% female) adults with an average age of 39 years participated in this study. There was no significant association between nocturnal noise and NRS (b = -0.09, 95% CI: -0.28, 0.10). However, one unit increase of noise sensitivity was associated with 0.08 increase in NRS (95% confidence interval [CI]: 0.01, 0.15), both on a 0–100 scale, after adjusting for sociodemographics, lifestyle factors, nocturnal noise, social support, somatic symptoms, stress, anxiety, and depression. This relationship remained after adjusting for sleep parameters. Nevertheless, nocturnal noise was significantly negatively associated with total time in bed (b = -1.46, 95% CI: -2.51, -0.40), and total sleep time (b = -1.26, 95% CI: -2.18, -0.34). None of the obtained physiological sleep parameters were associated with NRS.Conclusions: NRS was associated with noise sensitivity while physiological sleep parameters were influenced by nocturnal noise level.
Identification of potential prognostic markers for osteosarcoma by integrated analysis
Authors: Ge Yuxiang , Ding Wang , Bian Chong , Gu Huijie , Xu Jun , Yin Xiaofan
Published: September 2020

Background: Osteosarcoma (OS), one of the utmost common and malignant cancer, accounts for over 30% among skeletal sarcomas. Although great efforts have been made, the mechanism of OS still remains largely unknown. Here, we intend to identify gene modules and candidate biomarkers for clinical diagnosis of patients with OS, and reveal the mechanisms of OS progression.Methods: Weighted gene co-expression network analysis (WGCNA) was conducted to build a co-expression network and investigate the relationship between modules and clinical traits. Functional enrichment analysis was performed on module genes. Protein-protein interaction (PPI) network was constructed to identify the hub gene and the expression level of hub genes was validated based on another dataset.Results: A total of 9854 genes were included in WGCNA, and 17 gene modules were constructed. Gene module related with OS in sacrum was mainly enriched in skeletal system development, bone development and extracellular structure organization. Furthermore, we screened the top 10 hub genes and further validated 5 of the 10 (MMP13, DCN, GNG2, PCOLCE and RUNX2), the expression of which were upregulated as compared with normal tissues.Conclusion: The hub gene we identified show great promise as prognostic markers for the management of OS and our findings also provide new insight for molecular mechanism of OS.
Individualized flow-controlled ventilation compared to best clinical practice pressure-controlled ventilation: a prospective randomized porcine study.
Authors: Spraider Patrick , Martini Judith , Abram Julia , Putzer Gabriel , Glodny Bernhard , Hell Tobias , Barnes Tom , Enk Dietmar
Published: September 2020

Background: Flow-controlled ventilation is a novel ventilation method which allows to individualize ventilation according to dynamic lung mechanic limits based on direct tracheal pressure measurement at a stable constant gas flow during inspiration and expiration. The aim of this porcine study was to compare individualized flow-controlled ventilation (FCV) and current guideline-conform pressure-controlled ventilation (PCV) in long-term ventilation.Methods: Anesthetized pigs were ventilated with either FCV or PCV over a period of ten hours with a fixed FiO2 of 0.3. FCV settings were individualized by compliance-guided positive end-expiratory pressure (PEEP) and peak pressure (Ppeak) titration. Flow was adjusted to maintain normocapnia and the inspiration to expiration ratio (I:E ratio) was set at 1:1. PCV was performed with a PEEP of 5 cm H2O and Ppeak was set to achieve a tidal volume (VT) of 7 ml/kg. The respiratory rate was adjusted to maintain normocapnia and the I:E ratio was set at 1:1.5. Repeated measurements during observation period were assessed by linear mixed-effects model.Results: In FCV (n=6) respiratory minute volume was significantly reduced (6.0 vs 12.7, MD -6.8 (-8.2 to -5.4) l/min; p<0.001) as compared to PCV (n=6). Oxygenation was improved in the FCV group (paO2 119.8 vs 96.6, MD 23.2 (9.0 to 37.5) torr; 15.97 vs 12.87, MD 3.10 (1.19 to 5.00) kPa; p=0.010) and CO2 removal was more efficient (paCO2 40.1 vs 44.9, MD -4.7 (-7.4 to -2.0) torr; 5.35 vs 5.98, MD -0.63 (-0.99 to -0.27) kPa; p=0.006). Ppeak and driving pressure were comparable in both groups, whereas PEEP was significantly lower in FCV (p=0.002). Computed tomography revealed a significant reduction in non-aerated lung tissue in individualized FCV (p=0.026) and no significant difference in overdistended lung tissue, although a significantly higher VT was applied (8.2 vs 7.6, MD 0.7 (0.2 to 1.2) ml/kg; p=0.025).Conclusion: Our long-term ventilation study demonstrates the applicability of a compliance-guided individualization of FCV settings, which resulted in significantly improved gas exchange and lung tissue aeration without signs of overinflation as compared to best clinical practice PCV.
Heart Rate at Discharge in Patients with Acute Decompensated Heart Failure is a Predictor of Mortality
Authors: Vollmert Thomas , Hellmich Martin , Gassanov Natig , Er Fikret , Yücel Seyrani , Erdmann Erland , Caglayan Evren
Published: September 2020

Aims Heart failure is a syndrome with increasing prevalence in concordance with the aging population and better survival rates from myocardial infarction. Morbidity and mortality are high in chronic heart failure patients, particularly in those with hospital admission for acute decompensation. Several risk stratification tools and score systems have been established to predict mortality in chronic heart failure patients. However, identification of patients at risk with easy obtainable clinical factors that can predict mortality in acute decompensated heart failure (ADHF) are needed to optimize the care-path. Methods and Results We retrospectively analyzed electronic medical records of 78 patients with HFrEF and HFmrEF who were hospitalized with ADHF in the Heart Center of the University Hospital Cologne in the year 2011 and discharged from the ward after successful treatment. 37.6±16.4 months after index hospitalization 30 (38,5%) patients had died. This mortality rate correlated well with the calculated predicted survival with the Seattle Heart Failure Model (SHFM) for each individual patient. In our cohort, we identified elevated heart rate at discharge as an independent predictor for mortality (p=0.016). The mean heart rate at discharge was lower in survived patients compared to patients who died (72.5±11.9 bpm vs. 79.1±11.2 bpm. Heart rate of 77 bpm or higher was associated with an almost doubled mortality risk (p=0.015). Heart rate elevation of 5 bpm was associated with an increase of mortality of 25% (p=0.022).Conclusions Patients hospitalized for ADHF seem to have a better prognosis, when heart rate at discharge is <77 bpm. Heart rate at discharge is an easily obtainable biomarker for risk prediction of mortality in HFrEF and HFmrEF patients treated for acute cardiac decompensation. Taking into account this parameter could be useful for guiding treatment strategies in these high-risk patients. Prospective data for validation of this biomarker and specific intervention is needed.
Biomechanical Study of the C5-C8 Cervical Extraforaminal Ligaments
Authors: Zhao Qinghao , Yang Yemei , Wu Penghuan , Huang Chengyan , Zhang Rusen , Li Qingchu , Shi Benchao
Published: September 2020

Background

The anatomical distribution of the extraforaminal ligaments in the cervical intervertebral foramina has been well studied. However, detailed descriptions of the biomechanical characteristics of these ligaments are lacking.

Methods

The paravertebral muscles were dissected, and the extraforaminal ligaments and nerve roots were identified. The C5 and C7 or C6 and C8 cervical nerve roots on both sides were randomly selected, and a window was opened on the vertebral lamina to expose the posterior spinal nerve root segments. Five needles were placed on the nerve root and the bone structure around the intervertebral foramen; the distal end of the nerve root was then tied with silk thread, and the weights were connected across the pulley. A weight load was gradually applied to the nerve root (50 g/ time, 60 times in total). At the end of the experiment, segments of the extraforaminal ligaments were selectively cut off to compare the changes in nerve root displacement.

Results

The displacement of the C5, C6, C7, C8 nerve roots increases with an increasing traction load, and the rate of change of nerve root displacement in the intervertebral foramen is smaller than that in the nerve root on the outside area (p <0.05). Extraforaminal ligaments can absorb part of the pulling load of the nerve root; the C5 nerve root has the largest load range.

Conclusions

Cervical extraforaminal ligaments can disperse the tension load on the nerve root and play a role in protecting the nerve root. The protective effect of the C5 nerve root was the strongest, and this may anatomically explain why the C5 nerve roots are less prone to simple avulsion.
Perceived Efficacy of COVID-19 Prevention Measures and Intention to Use Among Chronic Disease Patients in Northeast Ethiopia, 2020
Authors: Dires Abebe , Addis Sisay Gedamu , Tesema Yemiamrew Getachew
Published: September 2020

Background: The novel corona virus disease outbreak which was first detected in China is caused by sever acute respiratory syndrome corona virus 2. In Ethiopia, poor perception about COVID-19 prevention methods might be one of determinant factor to the low utilization of adopted prevention measures and increasing of cases. However, it was unknown to what extent individuals were perceived the efficacy of those measures. Hence, this study was aimed to assess perceived efficacy of COVID-19 preventive measures and intention to carry out those methods among chronic disease patients. Methods: Institutional based cross sectional study was conducted among 413 chronic disease patients from 21 July - 5 August, 2020. A pre-tested interviewer administered structured questionnaire was used for data collection. Both binary and multivariable logistic regression analyses were used and in multivariable analysis, variables were declared statistically significant at p-value of < 0.05. Results: In overall, 42.1% of participants had low perception to the efficacy of COVID-19 prevention measures and 28.3% had low intention to carry out those prevention measures. In this study, young adults (AOR=2.48; 95% CI: 1.42-4.31), male gender (AOR=2.75; 95% CI: 1.73-4.37), uneducated (AOR=3.42; 95% CI: 1.47-7.94) and face mask non-users (AOR=1.64; 95% CI: 1.03-2.61) were significantly associated with low perceived efficacy of COVID-19 prevention methods. However, male gender (AOR=2.06; 95% CI: 1.28-3.31), rural residents (AOR=1.89; 95% CI: 1.16-3.07) and patients with longer duration of chronic disease (AOR= 2.19; 95% CI: 1.19-4.01) were significantly associated with low intention to carry out COVID-19 prevention methods.Conclusion: In this study, significant proportion of patients (42%) had low perception about the efficacy of COVID-19 prevention measures and nearly one-third of participants (28.3%) had low intention to carry out those measures. Thus, interventions aimed to enhance patients’ attitude and behavioral changes on COVID-19 prevention measures have to be provided.
Gene Therapy for Aromatic L-Amino Acid Decarboxylase Deficiency by MR-Guided Direct Delivery of AAV2-AADC to Midbrain Dopaminergic Neurons
Authors: Pearson Toni , Gupta Nalin , Sebastian Waldy San , Imamura-Ching Jill , Viehoever Amy , Grijalvo-Perez Ana , Fay Alex , Seth Neha , Lundy Shannon , Seo Youngho , Pampaloni Miguel , Hyland Keith , Smith Erin , deOliveiraBarbosa Gardenia , Heathcock Jill , Minnema Amy , Lonser Russell , Elder J.Bradley , Leonard Jeffrey , Larson Paul , Bankiewicz Krystof
Published: September 2020

Background: Aromatic L-amino acid decarboxylase (AADC) deficiency is a rare genetic disorder characterized by deficient synthesis of dopamine and serotonin. It presents in early infancy, and causes severe developmental disability and lifelong motor, behavioral, and autonomic symptoms including oculogyric crises (OGC), sleep disorder, and mood disturbance.Objective: We investigated the safety and efficacy of delivery of a viral vector expressing AADC (AAV2-hAADC) to the midbrain in children with AADC deficiency. Design, Setting and Participants: Seven (7) children, aged 4-9 years underwent convection-enhanced delivery (CED) of AAV2-hAADC to the bilateral substantia nigra (SN) and ventral tegmental area (VTA) (total infusion volume: 80 µL per hemisphere) in 2 dose cohorts: 1.3 x 1011 vg (n=3), and 4.2 x 1011 vg (n=4). Six (6) subjects were treated at UCSF Benioff Children’s Hospital in San Francisco and 1 at The Ohio State University.Results: Direct bilateral infusion of AAV2-hAADC was well-tolerated and achieved target coverage of 98% and 70% of the SN and VTA, respectively. Dopamine metabolism was increased in all subjects and FDOPA uptake was enhanced within the midbrain and the striatum. OGC resolved completely in 6 of 7 subjects by Month 3 post-surgery. Eighteen (18) months after surgery (n=5), 4/5 subjects gained the ability to sit independently and 2/5 could walk with 2-hand support.Conclusion: Midbrain gene delivery in children with AADC deficiency is feasible and safe, and leads to substantial clinical improvements in symptoms and motor function.Trial Registration: ClinicalTrials.gov Identifier NCT02852213
Fe(II) and tannic acid-cloake MOF as carrier of artemisinin for supply of ferrous ions to enhance treatment of triple-negative breast cancer
Authors: Li Zihaoran , Wu Xinghan , Wang Wenyu , Gai Chengcheng , Zhang Wei-Fen , Li Wentong , Ding Dejun
Published: September 2020

Suppression of tumor development by inducing ferroptosis may provide a potential remedy for triple-negative breast cancer (TNBC), which is sensitive to intracellular oxidative imbalance. Recently, artemisinin (ART) and its derivatives have been investigated as potential anticancer agents for the treatment of highly aggressive cancers via the induction of ferroptosis by iron-mediated cleavage of the endoperoxide bridge. Poor water solubility and insufficient availability of intracellular ferrous ions, limit the further application of ART in antitumor therapy. In this study, ferrous-supply nanocarrier was constructed based on tannic acid (TA) and ferrous ion (Fe2+)-coated on the zeolitic imidazolate framework-8(ZIF) with ART encapsulated (TA-Fe/ART@ZIF). via supramolecular coordination. Following the internalization of the as-prepared nano-system in cells, acidic degradation of the vehicles would facilitate the release of ART and accumulation of Fe2+. The results revealed that the newly developed nano-drug system displayed a high level of intracellular ROS generation, and markedly enhanced ferroptosis. This work provides a novel approach to enhance the potency of ferroptotic nanomedicine and new directions for TBNC therapy.
Effects of Endplate Healing Morphology on Intervertebral Disc Degeneration after Pedicle Screw Fixation for Thoracolumbar Fractures
Authors: Su Yunshan , Ren Dong , Liu Dehang , Li Junfei , Wang Tianci , Qi Wei , Wang Yunpeng , Wang Pengcheng
Published: September 2020

Background: The cartilage endplate plays an important role in the stress distribution and nutrition metabolism of intervertebral disc. The healing morphology of the endplate after spinal fracture and its effect on the intervertebral disc degeneration are still unclear. Methods: 51 patients with single-level thoracolumbar fractures underwent posterior open reduction and pedicle screw fixation. Combined with the initial CT and MRI images, the endplate injury was defined as three types, which are unilateral endplate injury, bilateral endplate injury and no endplate injury. According to the location of the injury in the endplate, it was further divided into endplate central injury and endplate peripheral injury. The degree of post-traumatic disc lesions and disc degeneration during follow-up were classified based on the Sander classification and the Pfirrmann classification, respectively. According to the T1 image of MRI in the final follow-up, the healing morphology of endplates was classified into three types including the increased endplate curvature, the irregular healing and the traumatic Schmorl nodes. Results: Cartilage endplate fractures are closely related to the degree of degeneration of the intervertebral disc (P=0.003). Injuries in different parts of the endplate have no significant effect on the intervertebral disc degeneration (P=0.204). The healing morphology after endplate fracture significantly affected the degree of intervertebral disc degeneration (P=0.001). The comparison of groups showed that the effects of irregular healing and traumatic Schmorl nodes on disc degeneration were not statistically different, but were significantly different from those with increased curvature. Conclusions: Increased endplate curvature, irregular healing and traumatic Schmorl nodes are three common forms of healing. The irregular healing and the traumatic Schmorl nodes are closely related to intervertebral disc degeneration. The existence and severity of the endplate injury can provide valuable information for individualized clinical decision-making processes.
Effects of Full Replacement of Dietary Fishmeal with Insect Meal from Tenebrio Molitor on Rainbow Trout Gut and Skin Microbiota.
Authors: Terova Genciana , Gini Elisabetta , Gasco Laura , Moroni Federico , Antonini Micaela , Rimoldi Simona
Published: September 2020

Background: Aquaculture must continue to reduce dependence on fishmeal (FM) and oil in feeds to ensure sustainable sector growth. Therefore, the use of novel aquaculture feed ingredients is growing. In this regard, insects can represent a new world of sustainable and protein-rich ingredients for farmed fish feeds. Accordingly, we investigated the effects of full replacement of FM with Tenebrio molitor (TM) larvae meal in the diet of rainbow trout (Oncorhynchus mykiss) on fish growth performance and gut and skin microbiota. Methods: A feeding trial was conducted with trout of about 80 g mean initial weight that were fed for 22 weeks with two isonitrogenous, isolipidic, and isoenergetic extruded experimental diets. Partially defatted TM meal was included in the diets to replace 0% (TM 0) and 100% (TM 100) of FM. To analyse the microbial communities, the Illumina MiSeq platform for sequencing of 16S rRNA gene and Qiime pipeline were used to identify bacteria in the gut and skin mucosa, and in the diets. Results: The data showed no major effects of full FM substitution with TM meal on bacterial species richness and diversity in both, gut mucosa- and skin mucus-associated microbiome. Skin microbiome was dominated by phylum Proteobacteria and especially by Gammaproteobacteria class that constituted approximately half of the bacterial taxa found. The two dietary fish groups did not display distinctive features, except for a decrease in the relative abundance of Deefgea genus (family Neisseriaceae) in trout fed with insect meal. The metagenomic analysis of the gut mucosa indicated that Tenericutes was the most abundant phylum, regardless of the diet. Specifically, within this phylum, the Mollicutes, mainly represented by Mycoplasmataceae family, were the dominant class. However, we observed only a weak dietary modulation of intestinal bacterial communities. The only changes due to full FM replacement with TM meal were a decreased number of Proteobacteria and a reduced number of taxa assigned to Ruminococcaceae and Neisseriaceae families. Conclusions: the data demonstrated that TM larvae meal is a valid alternative animal protein to replace FM in the aquafeeds. Only slight gut and skin microbiota changes occurred in rainbow trout after total FM replacement with insect meal. The mapping of the trout skin microbiota represents a novel contribution of the present study. Indeed, in contrast to the increasing knowledge on gut microbiota, the skin microbiota of major farmed fish species remains largely unmapped but it deserves thorough consideration.
Vietnamese People’s Well-Being During the COVID-19 Pandemic: An Online Survey
Authors: Hoang Tuyen Dinh , Colebunders Robert , Fodjo Joseph Nelson Siewe , Nguyen Nhan Phuc Thanh , Tran Trung Dinh , Vo Thang Van
Published: September 2020

BackgroundThe COVID-19 pandemic, alongside the restrictive measures implemented for its control, may considerably affect people’s lives particularly vulnerable persons such as children, elderly and people with underlying diseases. This study aimed to assess the well-being of Vietnamese people after COVID-19 lockdown measures were lifted and life gradually returned to normal in Vietnam.MethodsAn online survey was organized from 21st to 25th April 2020 among Vietnamese residents aged 18 and over. Data were collected concerning the participants’ health status, COVID-19 preventive behaviour, and consequences of the preventive measures. The WHO-5 Well-Being Index was used to score participants’ well-being.ResultsA total of 1922 responses were analyzed (mean age was 31 years; range: 18-76). Factors associated with a high well-being score included older age, eating healthy food, practising physical exercise, working from home, and adherence to the COVID-19 preventive measures. Female participants, persons worried about their relatives’ health, and smokers were more likely to have a low well-being score.ConclusionsThe Vietnamese people continued to follow COVID-19 preventive measures even after the lockdown was lifted. Most respondents scored high on the well-being scale. However, the emergence of a new COVID-19 outbreak with an epicenter in Da Nang city is expected to increase public anxiety and mental health problems. It is clear that together with preventive measures, developing strategies to guarantee the well-being of the Vietnamese people’s is equally important.
Establishing a Postgraduate Programme in Nutritional Epidemiology to Strengthen Resource Capacity, Academic Leadership and Research in the Democratic Republic of Congo
Authors: Ali Mapatano Mala Mala , Haskins Lyn , John Vaughn , Hatløy Anne , Luthuli Silondile , Maphumulo Sphindile , Engebretsen Ingunn M.S. , Tylleskär Thorkild , Mutombo Paulin , Horwood Christiane
Published: September 2020

BackgroundLow- and middle-income countries (LMIC) face considerable health and nutrition challenges, many of which can be addressed through strong academic leadership and robust research translated into evidence-based practice. A North-South-South partnership between three universities was established to implement a master’s programme in nutritional epidemiology at the Kinshasa School of Public Health (KSPH), Democratic Republic of Congo (DRC). The partnership aimed to develop academic leadership and research capacity in the field of nutrition in the DRC. In this article we describe the educational approach and processes used, and discuss successes, challenges, and lessons learned. MethodsSelf-administered questionnaires, which included both open and closed questions, were sent to all graduates and students on the master’s programme to explore students’ experiences and perceptions of all aspects of the educational programme. Quantitative data was analysed using frequencies, and a thematic approach was used to analyse responses to open-ended questions. ResultsA two-year master’s programme in Nutritional Epidemiology was established in 2014, and 40 students had graduated by 2020. Key elements included using principles of authentic learning, deployment of students for an internship at a rural residential research site, and support of selected students with bursaries. Academic staff from all partner universities participated in teaching and research supervision. The curriculum and teaching approach were well received by most students, although a number of challenges were identified. Most students reported benefits from the rural internship experience but were challenged by the isolation of the rural site, and felt unsupported by their supervisors, undermining students’ experiences and potentially the quality of the research. Financial barriers were also reported as challenges by students, even among those who received bursaries. ConclusionThe partnership was successful in establishing a Master Programme in Nutritional Epidemiology increasing the number of nutrition researchers in the DRC. This approach could be used in other LMIC settings to address health and nutrition challenges.
Impact of A Two-Year Trial of Nutritional Ketosis on Indices of Cardiovascular Disease Risk in Patients With Type 2 Diabetes
Authors: Athinarayanan Shaminie J. , Hallberg Sarah J. , McKenzie Amy L. , Lechner Katharina , King Sarah , McCarter James P. , Volek Jeff S. , Phinney Stephen D. , Krauss Ronald M.
Published: September 2020

Background: We have previously reported that in patients with type 2 diabetes (T2D) consumption of a very low carbohydrate diet capable of inducing nutritional ketosis over two years (continuous care intervention, CCI) resulted in improved body weight, glycemic control, and multiple risk factors for cardiovascular disease (CVD) with the exception of an increase in low density lipoprotein cholesterol (LDL-C). In the present study, we report the impact of this intervention on markers of risk for atherosclerotic cardiovascular disease (CVD), with a focus on lipoprotein subfraction particle concentrations as well as carotid-artery intima-media thickness (CIMT). Methods: Analyses were performed in patients with T2D who completed 2 yrs of this study (CCI; n=194; usual care (UC): n=68). Lipoprotein subfraction particle concentrations were measured by ion mobility at baseline, 1, and 2 yrs and CIMT was measured at baseline and 2 yrs. Principal component analysis (PCA) was used to assess changes in independent clusters of lipoprotein particles.Results: At two years, CCI resulted in a 23% decrease of small LDL IIIb and a 29% increase of large LDL I with no change in total LDL particle concentration or ApoB. The change in proportion of smaller and larger LDL was reflected by reversal of the small LDL subclass phenotype B in a high proportion of CCI participants (48.1%) and a shift in the PC representing the atherogenic lipoprotein phenotype characteristic of T2D from a major to a secondary component of the total variance. The increase in LDL-C in the CCI group was mainly attributed to larger cholesterol-enriched LDL particles. CIMT showed no change in either the CCI or UC group.Conclusion: Consumption of a very low carbohydrate diet with nutritional ketosis for 2 yrs in patients with type 2 diabetes lowered levels of small LDL particles that are commonly increased in diabetic dyslipidemia and are a marker for heightened CVD risk. A corresponding increase in concentrations of larger LDL particles was responsible for higher levels of plasma LDL-C. The lack of increase in total LDL particles, ApoB, and in progression of CIMT, provide supporting evidence that this dietary intervention did not adversely affect risk of CVD.
Prevalence and Correlates of Pregnancy Self-Testing Among Pregnant Women Attending Antenatal Care in Western Kenya
Authors: Nganga Nina Njeri , Dettinger Julia , Kinuthia John , Baeten Jared , John-Stewart Grace , Gómez Laurén , Ochieng Ben , Marwa Mary , Mugwanya Kenneth , Mugambi Melissa
Published: September 2020

In sub-Saharan Africa little is known about how often women use pregnancy self-tests or characteristics of these women despite evidence that pregnancy self-testing is associated with early antenatal care (ANC) attendance. Understanding the characteristics of women who use pregnancy self-tests may facilitate early access to ANC and preventive interventions in pregnancy. We conducted a cross-sectional survey on an ongoing pre-exposure prophylaxis (PrEP) implementation study which enrolled pregnant women to determine the prevalence and factors associated with pregnancy self-testing among women in western Kenya. Overall in our study population, the prevalence of pregnancy self-testing was 22% and higher among women who were employed, currently in school, had previous pregnancy complications, received services from urban health facilities, and had partners who had at least attended secondary school. The most reported reasons for non-use of pregnancy self-tests included not thinking it was necessary, lack of knowledge, and lack of money to pay for the test. Future research should focus on understanding the knowledge and attitudes of women toward pregnancy self-testing.
Ultrasound-guided Inferior Alveolar Nerve Block for Trismus in Temporomandibular Disorders: A Case Report
Authors: Kojima Yuki , Sendo Ryozo , Ohno Sachi , Sugimura Mitsutaka
Published: September 2020

Background: Temporomandibular disorder (TMD) is a broad term that encompasses pain and/or dysfunction of the masticatory musculature and TM joints (TMJs). Its most important feature is pain, followed by limited jaw movement, and joint sounds. When it progresses to a chronic condition, the symptoms are extremely difficult to manage, often requiring multiple interventions. Case presentation: Our patient, a woman in her 50s, developed TMD after a traffic accident that occurred 30 years previously. The patient presented with severe trismus due to TMJ pain (maximum mouth opening was 20 mm). She was scheduled to undergo extraction of a right lower molar and three upper anterior teeth owing to progressing caries. However, it was anticipated that the treatment would be difficult since the patient could not open her mouth adequately. Therefore, we considered relieving the trismus to facilitate dental treatment. Based on the findings, the cause of the TMD was considered to be pain in the masticatory muscles during mouth opening. Ultrasound-guided inferior alveolar nerve block (IANB) was performed on both sides using ropivacaine. Three minutes after the IANB, the pain during mouth opening disappeared and the maximum mouth opening improved to 40 mm. Dental treatment could be performed without difficulty, and the patient could maintain the mouth open throughout the treatment.Conclusions: Treatment methods for chronic TMD are limited and it is necessary to consider the exact aetiology before deciding upon a treatment option. In our case, ultrasound-guided IANB proved to be an effective modality for relieving TMD-related trismus.
Identification of Molecular Markers Associated with Diagnosis and Prognosis in Lung Adenocarcinoma by Bioinformatics Analysis
Authors: Wei Zimeng , Zang Linnan , Zhao Min
Published: September 2020

Background：Lung adenocarcinoma (LUAD) is the main histological subtype of lung cancer. However, the molecular mechanism underlying LUAD is not yet clearly defined, but elucidating this process in detail would be of great significance for clinical diagnosis and treatment. Our aim is to identify the candidate key genes and pathways associated with diagnosis and prognosis in LUAD.Methods：In this study, three gene expression profiles GSE118370, GSE32863 and GSE43458 were retrieved from Gene Expression Omnibus database (GEO), and the common differentially expressed genes (DEGs) were identified by online GEO2R analysis tool. Subsequently, the enrichment analysis of function and signaling pathways of DEGs in LUAD were performed by gene ontology (GO) and The Kyoto Encyclopedia of Genes and Genomics (KEGG) analysis. The protein-protein interaction (PPI) networks of the DEGs were established through the Search Tool for the Retrieval of Interacting Genes (STRING) database and hub genes were screened by plug-in CytoHubba in Cytoscape. Afterwards, the miRNAs and the hub genes network was constructed via miRWalk. Finally, receiver operating characteristic (ROC) curve and Kaplan-Meier plotter were performed to analyze the diagnosis and prognosis efficacy of hub genes. Results: A total of 311 DEGs were identified, including 74 up-regulated and 238 down-regulated genes. GO analysis results showed that DEGs were mainly enriched in biological processes including composition of extracellular matrix, regulation of angiogenesis and so on. KEGG analysis results revealed DEGs were mainly enrolled in cell adhesion signaling pathway. Subsequently, 10 hub genes, CDC20, CENPF, TPX2, TOP2A, KIAA0101, CDCA7, ASPM, ECT2, UBE2T and COL1A1, were identified. And TOP2A, CDCA7, TPX2 and COL1A1 showed strong relationships with each other and the miRNAs nearby in miRNAs-mRNA network obtained by miRWalk website. Finally, all these 10 hub genes were found significantly related to the diagnosis and prognosis of LUAD (p<0.05). Conclusions: The identification of hub genes in this study will help us to understand the pathogenesis of LUAD, especially the molecular mechanisms of its development. Our results suggested that TOP2A, CDCA7, TPX2 and COL1A1 might present predictive value for the development and prognosis in LUAD, and might be used as potential molecular markers for the diagnosis and treatment of LUAD.
T4 Reduces Cisplatin Resistance by Inhibiting AEG-1 Gene Expression in Lung Cancer Cells
Authors: Song Tianjiao , Lin Xiaohong , Huang Pingting , Chen Yuqing , Chen Limin
Published: September 2020

BackgroundLung cancer is one of the deadliest diseases in the world. Most lung cancer patients are resistant to chemotherapy drugs. In our study, we investigated whether T4 can reduce the resistance of lung cancer cells to chemotherapeutic drugs through the action of AEG-1.Materials and Methods1.A549 and A549/DDP cells were respectively transfected with overexpressing AEG-1 and knockdown AEG-1 plasmid. A549 and A549/DDP cells were added 0、25、50、100、200nM T4 respectively. 200nM T4 was selected for following experiments. A549/DDP cells were divided into A549/DDP empty group, T4 group, T4+AEG-1 overexpressing group. CCK8 assay was used to detect the proliferation of cells in each group. RT-qPCR and Western blotting were used to detect the expression of AEG-1 and MDR-1.ResultsAs expected, the expression of AEG-1 in A549 and A549/DDP cells is positively correlated with cisplatin resistance. When AEG-1 protein was overexpressed in A549 cells, the lethal effect of cisplatin on A549 cells was attenuated (all P<0.05). After AEG-1 protein was knocked down in A549/DDP cells, cisplatin was applied to the A549/DDP cells. The lethal effect was significantly increased compared to that in the control cells (all P<0.05). The expression of AEG-1 protein gradually decreased with increasing concentration of T4 in A549 and A549/DDP cells; The resistance to cisplatin was reduced after the addition of T4 to A549/DDP cells (P<0.05), and this effect was enhanced after transfection with the AEG-1 plasmid. ConclusionIn summary, T4 is important for increasing the sensitively of lung cancer cells to cisplatin. AEG-1 may be a key protein involved in this effect and may have an important impact on the survival rate of chemotherapy in patients with lung cancer in the future.
Osthole Induces Apoptosis, Secondary Necrosis and Mitophagy Via NQO1-Mediated ROS Overproduction in HeLa Cells
Authors: Huangfu Mengjie , Wang Juan , Yu Dan , Qin Jianli , Guan Xiao , Zhou Luwei , Dou Tong , Liu Yisa , Wang Lin , Li Xumei , Fu Minglei , chen xu
Published: September 2020

Background: Osthole is a natural coumarin which has been proved to inhibit growth of cancer cells by inducing cancer cells death, while its mechanism of anticancer remains unclearly. In our study, we found that osthole activated multiple forms of cell death including apoptosis, secondary necrosis and mitophagy in receptor interacting protein kinase (RIP) 3-deficient cervical cancer HeLa cells. Methods: Cell viability was detected by MTT assay. Cell membrane integrity was detected by LDH release assay and PI staining. Cell apoptosis and necrosis were detected by flow cytometry assay. Reactive oxygen species (ROS) was detected by DCFH-DA staining and mitochondrial membrane potential (MMP) was detected by JC-1 staining using flow cytometry. The expression of proteins was detected by western blotting assay and proteomics. Xenograft tumor model was used to evaluate the effect of osthole in vivo.Results: Our study showed osthole caused HeLa cells apoptosis and secondary necrosis, which is a phenomenon of the apoptotic cells’ plasma membrane breakdown. And when Hela cells pretreatment with Z-DEVD-FMK, an irreversible caspase-3 inhibitor, not only inhibited osthole-induced apoptosis but also necrosis. Moreover, we found that Z-DEVD-FMK reversed the effect of osthole on the induction of cleaved the N-terminal fragment of GSDME in Hela cells. Furthermore, inhibition of NAD (P) H: quinone oxidoreductase 1 (NQO1) by osthole induced the overproduction of reactive oxygen species (ROS). ROS inhibitor N-Acetyl-L-cysteine (NAC) not only reduced osthole-induced apoptosis, but also reversed its effect on the necrotic induction and the GSDME N-terminal generation. It was shown that osthole decreased mitochondrial membrane potential (MMP) and increased the expression of PTEN-induced putative kinase 1 (PINK1) and Parkin, which indicated that the activation of mitophagy induced by osthole. Meanwhile, as well as apoptosis and secondary necrosis, mitophagy was also restrained by NAC. Conclusions: In conclusion, all these data suggested that osthole induced apoptosis, secondary necrosis and mitophagy via NQO1-mediated ROS overproduction.
Catalytic asymmetric Nakamura reaction by gold(I)/chiral N,Nʹ-dioxide-indium(III) synergistic catalysis
Authors: Hu Xinyue , Tang Xiaoxue , Zhang Xiying , Lin Lili , Feng Xiaoming
Published: September 2020

Intermolecular addition of enols and enolates to unactivated alkynes was proved to be a simple and powerful method for carbon-carbon bond formation. Up to date, a catalytic asymmetric version of alkyne with 1,3-dicarbonyl compound has not been realized. Herein, we achieve the first catalytic asymmetric intermolecular addition of 1,3-dicarbonyl compounds to unactivated 1-alkynes. A range of β-ketoamides with a cyclic all-carbon quaternary center and acyclic quaternary center with a fluorine substituent were synthesized in excellent yields with good enantioselectivities attributing to the synergistic activation of chiral N,N′-dioxide-indium(III) Lewis acid and achiral gold(I) π-acid. Besides, a possible catalytic cycle and transition state models were proposed to illustrate the origin of process based on the experimental investigations.
Bio-Electric Impedance Analysis and Anthropometric Obesity Indices as Predictors of Dyslipidaemia Among Adults at A Tertiary Institution in Lusaka, Zambia.
Authors: Mutengo Katongo Hope , Chipimo Peter J. , Chanda Duncan M. , Hamooya Benson M. , Moyo Sikhulile , Kamanga Brown C.
Published: September 2020

Objective Dyslipidaemia and obesity have a synergistic effect on the development of cardiovascular diseases (CVDs). Anthropometric measurements have often been used as surrogate markers for obesity indices with diverse results. We evaluated the best obesity index for predicting dyslipidaemia among anthropometric measurements and body fat measurements with bio-electric impedance analysis (BIA). Results Among 116 adults, 62 (53.4%) were female. The median age was 39 years (quartile (Q)1, Q3: 20.8, 65.4). Waist circumference (odds ratio (OR) 4.54; 95% CI 1.56, 13.19; p=0.005) and total body fat percentage (OR 0.34; 95% CI 0.13, 0.91; p=0.031) measurements of obesity indices were significantly associated with dyslipidaemia.
Biochar Application for Rice Cultivation in Salt-Affected Soils
Authors: Prasertsuk Sirapat , Wijitkosum Saowanee
Published: September 2020

In many areas, soil salinization is a major threat to ecosystems, agriculture, and food security. Human activities and climate change contribute to its increasing prevalence. In Thailand, Nakhon Ratchasima is the most severely affected province in the country’s Northeast region, and was selected for this study. The underlying geology and human activities both contribute to the problem in this area. The roots of field crops bring saline groundwater up into the rhizosphere. Evaporation at the soil surface leads to salinization, reducing crop growth, and, ultimately, rendering the soil barren. This research aimed to improve the quality of saline soil using rice husk biochar (RHB) to enable rice cultivation and limit evaporation. The study examined the effect of RHB incorporation on improving the soil properties. Jasmine rice variety KDML 105 was planted in cement rings (80 cm diameter) filled with saline sodic soil at pH 10.6, with a total sodium content of 0.83%, electrical conductivity (EC) of 68.6 dS/m, and sodium adsorption ratio (SAR) of 11707. The results indicated that RHB can significantly reduce the soil salinity, EC, Na+ content, and SAR value, while elevating the levels of available macronutrients, such as nitrogen, calcium, and magnesium. In addition, the study found that incorporation of RHB at a rate of 1.5 kg/cement ring was optimal for growing Jasmine Rice (KDML105) under these conditions.
Management reorganization of a Radiology ward during the Covid-19 pandemic in a University Hospital structured inpavilions.
Authors: Marzocchi Guido , Gentilini Mattia , Gianstefani Alice , Giostra Fabrizio , Grassi Giuliano Orazio , Monteduro Francesco
Published: September 2020

Objective: The aim of the recent management reorganization of the Emergency Room and Radiology ward was to face the recent Coronavirus pandemic in the most rational way possible, to preserve the essential role of these Units in the complex context of a pavillions structured Hospital. Methods: The most challenging management criticalities posed by the recent Coronavirus pandemic were individually analyzed and dealt with. The pavilions structure of our Hospital, biohazard management, shortage of personnel and shortage or temporary inadequacy of personal protective equipment were addressed as the most urgent and important problems.Results: A strategic use of the Radiology Information System and Picture Archiving And Communication System (RIS-PACS), dedicated ambulances with specific disinfection procedures, the institution of dedicated pavilions, wards, checkpoints and different paths for COVID-19 (Coronavirs Disease 2019) and non COVID-19 patients, frequent sanification procedures, serological screening for employees and emergency dedicated staff recruitment were put to place as a result of said analysis.Nevertheless, all of these goals couldn’t have been achieved without a constant sense of responsibility of the employees involved.Conclusions: A rational analysis of the most critical problems associated with a pandemic is vital to provide a fast and effective response, and represents a valuable wealth of experience in case of future pandemics.
A comparison of clinical and laboratory manifestations of thrombotic events in patients with COVID-19 and other respiratory viral infections.
Authors: Tan Chuen Wen , Tan Jing Yuan , Wong Wan Hui , Cheong May Anne , Ng Ian Matthias , Conceicao Edwin Philip , Low Guek Hong Jenny , Ng Heng Joo , Lee Lai Heng
Published: September 2020

COVID-19 caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) and other respiratory viral (non-CoV-2-RV) infections are associated with thrombotic complications. The differences in prothrombotic potential between SARS-CoV-2 and non-CoV-2-RV have not been well characterised. We compared the thrombotic rates between these two groups of patients directly and further delved into their coagulation profiles. In this single-center, retrospective cohort study, all consecutive COVID-19 and non-CoV-2-RV patients admitted between January 15th and April 10th 2020 were included. Coagulation parameters studied were prothrombin time and activated partial thromboplastin time and its associated clot waveform analysis (CWA) parameter, min1, min2 and max2. In the COVID-19 (n=181) group there were two (1.0 event/1000-hospital-days) thrombotic events while one (1.8 event/1000-hospital-day) was reported in the non-CoV-2-RV (n=165) group. All of these events were myocardial infarction occurring in the intensive care unit. Coagulation parameters did not differ throughout the course of mild COVID-19. However, CWA parameters were significantly higher in severe COVID-19 compared with mild disease, suggesting hypercoagulability (min1: 6.48%/s vs 5.05%/s, P<0.001; min2: 0.92%/s2 vs 0.74%/s2, P=0.033). In conclusion, the thrombotic rates were low and did not differ between COVID-19 and non-CoV-2-RV patients. The hypercoagulability in COVID-19 is a highly dynamic process with the highest risk occurring when patients were most severely ill. Such changes in haemostasis could be detected by CWA. In our population, a more individualized thromboprophylaxis approach, considering clinical and laboratory factors, is preferred over universal pharmacological thromboprophylaxis for all hospitalized COVID-19 patients and such personalized approach warrants further research.