bluuebunny/crossref_metadata_2025 huggingface dataset:
The Influence of Articulatory Suppression on Reading Among Chinese Children with Developmental Dyslexia: An Eye-Movement and Case-Control Study
Authors: Li Xiuhong , Li Weidong , Liu Buyun , Zhang Jinxin , Ma Jingwen , Xie Chuanbo , Wu Jing , Jing Jin
Published: July 2020

Background: In Western countries, phonological processing deficit was regard as a core deficit in developmental dyslexia (DD). As Chinese is a logographic language, it’s still controversial whether and how the articulatory suppression influences reading ability and processing of Chinese children with DD. The study aimed to examine how the phonological loop influences reading ability and processing in Chinese children with DD.Methods: This study included 30 children with DD and 37 children without DD. Two types of articles (i.e., scenery prose and narrative story) and two conditions (under the conditions of articulatory-suppression and silent reading) were applied. An eye-link II High-Speed Eye Tracker was used to track a series of eye-movement parameters. The data was analyzed by the linear Mixed-Effects model. Results: Compared with children without DD, Children with DD had lower reading achievement (RA), frequency of saccades (FS) and frequency of fixations (FF), longer reading time (RT) and average fixation duration (AFD), slower reading speed (RS), shorter average saccade amplitude (ASA) and fixation distance (FD), more number of fixations (NF) and number of saccades (NS). There were significant interactions between participant group and articulatory suppression on RT and FD. We also observed interaction effects between article types and articulatory suppression on RA, AFD, ASA, and FS.Conclusion: Children DD exhibit abnormal phonological loop and eye movements while reading. The role of the articulatory suppression on reading varies with the presentation of DD and the article type.
Uniportal VATS Pleural Biopsy in the Diagnosis of Exudative Pleural Effusion: Awake or Intubated?
Authors: Gokce Mertol , Altinsoy Bulent , Piskin Ozcan , Bahadir Burak
Published: July 2020

Background
The aim of this study is to compare the diagnostic efficacy and safety of video-assisted thoracoscopic surgery (VATS) with awake VATS (AVATS) pleural biopsy in undiagnosed exudative pleural effusions.
Methods
The diagnostic efficacy of pleural biopsy by uniportal VATS under general anesthesia or AVATS under local anesthesia and sedation performed by the same surgeon in patients with undiagnosed exudative pleural effusion between 2007 and 2020 were retrospectively evaluated. Test sensitivity, specificity, positive predictive value and negative predictive value were compared as well as age, gender, comorbidities, procedure safety, additional pleural-based interventions, duration time of operation and length of hospital stay.
Results
Of 154 patients with undiagnosed exudative pleural effusion, 113 (73.37%) underwent pleural biopsy and drainage with VATS, while 41 (26.62%) underwent AVATS pleural biopsy. Sensitivity, specificity, positive predictive value and negative predictive value were 92%, 100%, 100%, and 85.71% for VATS, and 83.3%, 100%, 100%, and 78.9% for AVATS, respectively. There was no significant difference in diagnostic test performance between the groups, (p = 0.219). There was no difference in the rate of complications [15 VATS (13.3) versus 4 AVATS (9.8%), p = 0.557]. Considering additional pleural-based interventions, while pleural decortication was performed in 13 (11.5%) cases in the VATS group, no pleural decortication was performed in AVATS group, (p = 0.021). AVATS group was associated with shorter duration time of operation than VATS (22.17 + 6.57 min. versus 51.93 + 8.85 min., p < 0.001). Length of hospital stay was relatively shorter in AVATS but this was not statistically significant different (p = 0.063).
Conclusions
Uniportal AVATS and VATS have a similar diagnostic efficacy and safety profile in the evaluation of undiagnosed exudative pleural effusions. However, AVATS is associated with shorter operation time and relatively shorter hospital stay implying that AVATS may provide improved recovery time, less major complications, and thus increased patient satisfaction. VATS is easier and safer in patients with low or no pleural effusion and facilitates to perform pleural decortication in the presence of pleural thickening. Considering the general condition of the patient, the amount of pleural effusion and the experience of the operator AVATS may be a diagnostic choice in selected cases.
UBE2T is upregulated, predicts poor prognosis, and promotes cell proliferation and invasion via inhibiting autophagy in ovarian cancer
Authors: Huang Hongyan , Huang Wei , Xiao Yuzhen , Wang Lei , Zhang Tingting , Fang Xiaoling , Xia Xiaomeng
Published: July 2020

Background: Aberrant upregulation and oncogenic roles of UBE2T have been revealed in several cancers. However, the expression, clinical significance, and functions of UBE2T has not been explored in ovarian cancer (OC).Methods: In this study, the mRNA and protein expression of UBE2T in OC were detected via analyzing the online databases and immunohistochemical staining. Moreover, relations of UBE2T expression with clincopathological features and prognosis OC patients were further analyzed. Besides, the effects of UBE2T knockdown on growth, proliferation, and invasion of OC cells were investigated by CCK-8, plate clone formation, and Transwell assays. Finally, the underlying mechanism of UBE2T associated functions in OC was analyzed.Results: The results indicated that UBE2T was significantly upregulated in OC tissues. UBE2T expression was notably correlated with clinical features such as primary T stage, TNM stage in OC patients. UBE2T, acting as an independent prognostic indicator, was inversely associated with prognosis of OC patients. UBE2T knockdown remarkably suppressed the growth, proliferation, and invasion of OC cells indicating by impaired cell viability, less cell clones and invasive cells. Mechanistically, the oncogenic roles of UBE2T was exerted by inhibiting autophagy via maintaining AKT/mTOR activity in OC.Conclusion: Collectively, our findings confirm UBE2T upregulation predicts poor prognosis and promotes malignant progression via suppressing autophagy in OC, suggesting the promising values of UBE2T both in diagnosis and treatment of OC.
Safety and effectiveness of percutaneous microwave ablation using combined computed tomography and ultrasound-guided imaging in patients with hepatocellular carcinoma: A prospective study
Authors: Zhao Wenpeng , Guo Jiang , Li Honglu , Cai Liang , Duan Youjia , Hou Xiaopu , Du Hongliu , Shao Xihong , Diao Zhenying , Li Changqing
Published: July 2020

Background

We prospectively evaluated the safety and effectiveness of percutaneous microwave ablation (MWA) using combined computed tomography (CT) and ultrasound (US)-guided imaging in patients with BCLC-A1-3 hepatocellular carcinoma (HCC) given that they have shortcomings when used alone.
Methods

We included 88 consecutive patients with single HCC who were treated with transcatheter hepatic arterial chemoembolization (TACE). The patients were divided into 3 groups at random by using draw lots 1 week after TACE. The combination group (34 patients) received MWA under the guidance of CT and US, while the single group (CT group, 30 patients; US group, 24 patients) received MWA under the guidance of CT or US alone. Contrast-enhanced MRI or CT scans were performed in all patients 1, 3, 6 and 12 months after the procedure. The study endpoints included the treatment time, puncture time, local recurrence rate, and adverse events.
Results

The median diameter of the lesions was 3.1 (1.5–4.2) cm. The median treatment time was 38.6 (30–45) min and 36.7 (30–47) min in the combination group and US group, respectively. The median puncture number was 1.2 (1–2) times and 1.1 (1–2) times, respectively. Both were significantly less than in the CT group (45.8 min and 4.2 times). The local recurrence rate was 5.9% in the combination group, which was significantly inferior to that in the US group (16.7%). The grade C complication rate in the combination group was 5.9%, while it was 13.3% and 8.3% in the CT group and US group, respectively. There was a statistically significant difference between the combination group and CT group.
Conclusions

Using CT- and US-guided microwave ablation in patients with BCLC-A1-3 hepatocellular carcinoma appeared to be much better in terms of security and efficiency than the use of microwave ablation under the guidance of CT or US alone.
Analyses of the Duration times of COVID-19 Epidemic at Various Time-Points in 11 Severely Affected Countries
Authors: Chen Cao , Shi Qi , Dong Xiao-Ping
Published: July 2020

Background COVID-19 pandemic has affected more than 200 different countries and territories and caused more than 4.5 million infected cases and 310,000 deaths worldwide. Methods We collected the daily reported infected cases in 11 mostly affected countries from governmental and professional websites, including China, South Korea, France, USA, Italy, Germany, Spain, UK, Iran, Turkey and Russia. The duration times of the epidemic from the day with more than 100 cases (>100) to the day with less than 100 cases (<100) in the individual countries were comparably analyzed based on the alterations of the numbers and ratios of the daily reported cases. Meanwhile, the daily Rt values each country were separately calculated. Results We found that the duration times of decreasing period were much longer than that of increasing period. Compared with other countries, China and South Korea showed remarkably short duration times, which was likely associated with the strictly implementation of the control measures. The Rt values of all tested countries reduced to around 1.0 on the day with the largest number of cases. Conclusion The alteration of the daily Rt value seems to be related more closely with the changes of the ratios of daily cases, rather than the absolute numbers of daily cases in one country, meanwhile the implementation of strictly tailored control measures will greatly reduce the duration of the COVID-19 epidemic.
Management of liver trauma in urban university hospitals in India: an observational multicentre cohort study
Authors: Sinha Yash , Khajanchi Monty U , Prajapati Ramlal P , Dharap Satish , Soni Kapil Dev , Kumar Vineet , Mahindrikar Santosh , Roy Nobhojit
Published: July 2020

Background
Low- and Middle-Income Countries (LMICs) contribute to 90% of injuries occurring in the world. Liver is the one of the commonest organ injured in abdominal trauma. This study aims to highlight the demographic and management profile of liver injury patients, presenting to four urban Indian university hospitals in India.
Methods
This is a retrospective registry-based study. Data of patients with liver injury either isolated or concomitant with other injuries was used using the ICD-10 code, S36.1 for liver injury. The severity of injury was graded based on the World Society of Emergency Surgery (WSES) grading for liver injuries.
Results
A total of 368 liver injury patients were analysed. 89% were males, with road traffic injuries being the commonest mechanism. As per World Society of Emergency Surgery (WSES) liver injury grade, there were 126 (33.7%) grade I, 87(23.6%) grade II, 67(18.2%) grade III & 88 (24.5%) grade IV injuries. The overall mortality was 16.6%. 262 patients (71.2%) were managed non-operatively (NOM) & 106 (38.8%) were operated. 90.1% of those managed non-operatively, survived.
Conclusion
In this multi-centre cohort of liver injury patients from urban university hospitals in India, the commonest profile of patient with a was a young male, with a blunt injury to the abdomen due to a road traffic accident. Success rate of non-operative management of liver injury is comparable to other countries.
An evaluation of the implementation of a UK school-based running programme
Authors: Chalkley Anna , Routen Ash C. , Harris Jo P. , Cale Lorraine A. , Gorely Trish , Sherar Lauren B.
Published: July 2020

Background

The adoption of school-based running programmes has rapidly increased in recent years. However, there is a lack of information on how these initiatives are implemented, and how generalisable and sustainable they are. This study evaluated the implementation of a school-based running programme, Marathon Kids (MK), over 7 months. The aim was to understand the context within which MK was implemented in each of the schools and the key elements of implementation including reach, fidelity and dose.
Methods

This study used a mixed method, single group before-and-after design strengthened by multiple interim measurements. Five state-funded primary schools in Leicestershire, UK participated, with 17 teachers and 189 (81 boys (47.4%) and 90 girls (52.6%)) Year 5 pupils (aged 9–10 years) from eight classes. During the 2016/2017 academic year, data were collected via measures at multiple levels (i.e. school and individual) and at multiple time points during implementation. Follow up qualitative data were also collected during 2017/2018.
Results

Marathon Kids achieved good reach, with all pupils opting to participate at some point during the academic year. All schools implemented MK with good fidelity, although the level of implementation varied between schools and over time. The average number of MK sessions held per week ranged from 0.94–3.89 with the average distance accumulated per pupil per week ranging from 0.02 to 2.91 kilometres and boys being more likely than girls to be classed as high-level participators. Despite an initial drop off in participation over time, all schools remained engaged in the programme and continued to implement MK until the end of the school year. Contextual features (e.g., staff capacity and resources) differed between schools and influenced the quality of implementation of MK and the frequency of delivery.
Conclusions

Marathon Kids is a simple, inexpensive and versatile physical activity programme which can be implemented by schools with relative at ease. However, schools are diverse settings, with unique challenges to ongoing delivery. Thus, planned adaptations, specific to each school’s context, is likely necessary to sustain participation in the longer term.
Teaching Pediatric Otoscopy Skills to the Medical Student in the Clinical Setting: Preceptor Perspectives and Practice
Authors: Paul Caroline Rose , Joyce Alanna Higgins , Dallaghan Gary Beck , Keeley Meg , Lehmann Corinne , Schmidt Suzanne , Simonsen Kari , Christy Cynthia
Published: July 2020

Background
Acute otitis media (AOM) is the most frequent indication for antibiotic treatment of children in the United States. Its diagnosis relies on visualization of the tympanic membrane, a clinical skill acquired through a deliberate approach. Instruction in pediatric otoscopy begins in medical school. Medical students receive their primary experience with pediatric otoscopy during the required pediatric clerkship, traditionally relying on an immersion, apprentice-type learning model. A better understanding of their preceptors’ clinical and teaching practices could lead to improved skill acquisition. This study investigates how pediatric preceptors (PP) and members of the Council on Medical Student Education in Pediatrics (COMSEP) perceive teaching otoscopy.
Methods
A 30-item online survey was administered to a purposeful sample of PP at six institutions in 2017. A comparable 23-item survey was administered to members through the 2018 COMSEP Annual Survey. Only COMSEP members who identified themselves as teaching otoscopy to medical students were asked to complete the otoscopy-related questions on the survey.
Results
Survey respondents included 58% of PP (180/310) and 44% (152/348) of COMSEP members. Forty-one percent (62/152) of COMSEP member respondents identified themselves as teaching otoscopy and completed the otoscopy-related questions. The majority agreed that standardized curricula are needed (PP 78%, COMSEP members 97%) and that all graduating medical students should be able to perform pediatric otoscopy (PP 95%, COMSEP members 79%). Most respondents reported usefulness of the American Academy of Pediatrics (AAP) AOM guidelines (PP 95%, COMSEP members 100%). More COMSEP members than PP adhered to the AAP’s diagnostic criteria (pediatric preceptors 42%, COMSEP members 93%). The most common barriers to teaching otoscopy were a lack of assistive technology (PP 77%, COMSEP members 56%), presence of cerumen (PP 58%, COMSEP members 60%), time to teach in direct patient care (PP 46%, COMSEP members 48%), and parent anxiety (PP 62%, COMSEP members 54%).
Conclusions
Our study identified systemic and individual practice patterns and barriers to teaching pediatric otoscopy. These results can inform education leaders in supporting and enabling preceptors in their clinical teaching. This approach can be adapted to ensure graduating medical students obtain intended core clinical skills.
Clinical Features and Histopathological Changes of Skeletal Muscle in Patients with COVID-19: Two Case reports
Authors: Liao Mei-Yan , Duan Ping , Pan Zhen-Yu , Cai Yu-Xiang , Fan Wei , Ping An-Song
Published: July 2020

BackgroundTo the best of our knowledge, muscle soreness is a common manifestation for the coronavirus disease-19 (COVID-19) patients, but the mechanism of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) injury to skeletal muscle remains unclear, there has been no publication focused on muscle involvement in COVID-19 patients.Case presentationWe present the case of two Chinese men with COVID-19, whose common symptoms were fatigue and muscle soreness. They went through different treatments, patient 1, 81-year-old, eventually died of multi-organ failure, and patient 2, 53-year-old, underwent amputation of the mid-lower section of left thigh. Laboratory tests in both patients showed abnormal biochemical parameters associated with skeletal muscle injury. We obtained skeletal muscle samples from these two patients, one from postmortem biopsy of gastrocnemius muscle and the other from a resected left lower limb due to thrombosis. The pathological findings in patient 1 were mainly scattered atrophic muscles, while fiber necrosis and minor inflammation were identified in patient 2, and the mild infiltrations were confirmed by CD68 and LCA staining to be predominantly macrophages and lymphocytes.ConclusionsWe report the clinical and laboratory features together with histopathological findings in skeletal muscle tissues from two COVID-19 cases and speculate that the SARS-CoV-2 may cause skeletal muscle injury. Due to the particularity of individual differences in case reports, the background of chronic neuromuscular disease in patient 1 and a minimal compartment syndrome caused by thrombosis in patient 2 need to be excluded prior to the conclusion that the skeletal muscles have been involved in COVID-19.
Radial EBUS combined with a GS and VBN for diagnosis of peripheral lung lesions: a retrospective study
Authors: Zhang Jian , Qu Shuo-Yao , Zhang Yan , Zhang Yong , Wang Ming-Ming , Chang Ning , Ti Xin-Yu
Published: July 2020

Background

More and more peripheral pulmonary lesions (PPL) have been found following the increased utilization of chest CT in China. But how to identify the nature of PPL accurately, safely and economically is the concern of Chinese doctors. The combination of radial endobronchial ultrasonography with a guide sheath and virtual bronchoscopic navigation was a deluxe scheme to indicate the pathology of peripheral pulmonary lesions in nation’s current medical level. This study aimed to compare the diagnostic yield, safety and health economics of EBUS-GS-VBN versus radial ultrasonic small probe plus thin bronchoscopy (EBUS) for diagnosis of PPLs.
Methods

This study was a single-institution retrospective review of PLLs examined by using EBUS-GS-VBN or radial EBUS between March 2018 and September 2018 consecutive. The diagnostic yields, accuracy, operation time, complications, factors influencing the diagnostic outcome, tissue genetic test rate and medical cost were analyzed separately.
Results

there was no significant difference in the diagnostic yield between the two groups (92.31% vs 88.57%, p = 0.594). Although the searching time of EBUS-GS-VBN was shorter (1.47 ± 0.49 min vs 2.12 ± 1.36 min, p < 0.001), procedure time was extended (24.07 ± 5.53 min vs 17.41 ± 4.38 min, p < 0.001). The diagnosis yield of malignancy and benign disease were equal (84.62% vs 100% and 95.35% vs 84%). There was no difference in the rate of gene testing between the two groups (75% vs 70.58%), while the incidence of Intrapulmonary hemorrhage in the EBUS-GS-VBN group was significantly descended. Moreover, the average expense of EBUS-GS-VBN was higher than that of EBUS-GS (6315 ± 1817 RMB vs 3128 ± 1086RMB).
Conclusion

When performing TBLB of PLLs, we found EBUS-GS-VBN to be similar to EBUS in accuracy. Although the founding lesion time of EBUS-GS-VBN group were significantly shorter, the total examination time was longer. Furthermore, the complications of EBUS-GS-VBN group were fewer. There was no difference in genetic testing between the two groups. It is worth noting that the cost and radiation exposure was lower of EBUS group patients.
Trial registration:
retrospectively registered
Comparative analysis of clinical presentation of community-acquired pneumonia induced by Chlamydia psittaci and Legionella Diagnosed through Metagenomic Next-Generation Sequencing
Authors: Su Shanshan , Zeng Jiahao , Li Yunlei , Lin Pengcheng , Chen Junjie , Chen Chengshui , Zhou Ying , Li Yuping
Published: July 2020

Background

Legionella and Chlamydia psittaci cause atypical community-acquired pneumonia, which mimic each other. Our aim was to compare the clinical characteristics of Legionella pneumonia (LP) and psittacosis and assess whether metagenomic next-generation sequencing (mNGS) is an effective method for early diagnosis.
Methods

We conducted a retrospective study and compared seventeen patients with Chlamydia psittaci pneumonia and nine patients with LP, diagnosed by mNGS. This study was carried out in the First Affiliated Hospital of Wenzhou Medical University, China, from July 2018 to May 2020. mNGS was carried out from bronchial alveolar lavage fluid (BALF) and/or lung tissues.
Results

76.5% of psittacosis cases and 0% of legionellosis cases had an avian exposure history (p < 0.001). Compared with LP patients, psittacosis patients had significantly higher hemoglobin (118.9 ± 20.2 vs. 93.2 ± 23.2 g/L, p = 0.007), serum sodium (138.9 ± 5.4 vs. 133.9 ± 6.5 mmol/L, p = 0.047), and higher proportion of elevated aspartate aminotransferase levels (88.2 vs. 44.4%, p = 0.028). Other clinical parameters were similar in psittacosis and LP patients: normal or slightly elevated leucocytes (10.5 vs. 9.5 × 109/L, p > 0.05), neutrophils (9.4 vs. 8.3 × 109/L, p > 0.05), and procalcitonin (0.8 vs 5.1 ng/mL, p > 0.05); highly increased C-reactive protein levels (205.1 vs. 234.9 mg/L, p > 0.05); and decreased lymphocytes (0.7 vs. 0.6 × 109/L, p > 0.05). Extra-pulmonary manifestations and mortality (11.8% in psittacosis vs. 22.2% in LP group, p = 0.591) were also similar in both the groups. mNGS detected Chlamydia psittaci in 17/17 BALF samples, and Legionella in 8/8 BALF samples and 1/1 lung tissue sample.
Conclusions

Apart from sharing many features with legionellosis, psittacosis is a vital differential diagnosis for LP, especially in patients with avian exposure history. mNGS is a sensitive and promising method for early diagnosis of both psittacosis and LP.
The Association between Childhood Conditions and Heart Disease Among Middle-Aged and Older Population in China: A Life Course Perspective
Authors: Zhang Jingyue , Lu Nan
Published: July 2020

Background: Heart disease is a severe health problem among adult populations in China. The prevalence rates of heart disease increase with age. The pathogenic causes of heart disease are often related to conditions in early life. Using a nationally representative data from adults aged 45 or older in China, we examined the association between childhood conditions and heart disease in later life from a life course perspective.Methods: The data used in this study were derived from China Health and Retirement Longitudinal Study; specifically, the life history module and 2015 wave. Face-to-face interviews were used to collect data from respondents aged 45 or older. Missing data were handled by multiple imputation, generating a final analytic sample of 19,800. Doctor-diagnosed heart disease was the main dependent variable. Random-effects logistic regression models were conducted to test the hypotheses.Results: A total of 16.6% respondents reported being diagnosed with heart disease by doctors. Regarding childhood socioeconomic status, 8.2% of the respondents considered that they were (a lot) better off than their neighbors, and 31.1% considered that their health status in childhood was better than their peers. More than 90% of respondents did not have severe illnesses during their childhood, and around 80.3% had access to health resources nearby in childhood. Socioeconomic status, self-rated health, and severe illnesses in childhood were significantly associated with heart disease after controlling for conditions in adulthood and older age (socioeconomic status: odds ratio (OR) = 0.950; self-rated health: OR = 0.923; severe illnesses: OR = 1.191).Conclusions: Childhood conditions play important roles in influencing the onset of heart disease in middle and older age in China. Poor childhood conditions should be considered as screening criteria to identify populations at risk of heart disease. Community-based preventive strategies and interventions should also be implemented to enhance health in later life.
Stakeholders’ perception and intervention preferences regarding comprehensive sexuality education in male adolescents: a qualitative study from Iran
Authors: gelehkolaee keshvar samadaee , Maasoumi Raziyeh , Azin Seyed Ali , Nedjat Saharnaz , Parto Moslem , Hajiabadi Ilia Zamani
Published: July 2020

Background A coherent sexuality education program for adolescents is part of their sexual and reproductive rights and can help them have a healthier future. Therefore, the aim of this study was to explore the perceptions and intervention preferences of Iranian stakeholders regarding comprehensive sexuality education (CSE) in male adolescents based on the IMB model (Information, Motivation, Behavioral skills).Methods This qualitative study was conducted using directed content analysis. Iindividual interviews and focused group discussions (FGDs) were used for data collection. The data were collected through in-depth semi-structured interviews with stakeholders in two schools and the Education Department in Sari and the Ministry of Health and Ministry of Education in Tehran from March 2019 to August 2019. Data saturation was achieved after 28 interviews and 1 FGDs with 9 participants. Finally, two sets of data were coded and analyzed using directed content analysis.Results In this study, five themes emerged as (1) role of institutions; (2) role of organizations; (3) need for stakeholder’s partnership; (4) need for adolescent sexuality socialization management; and (5) need for enhancing the teachers’ professional competence, which seemed to influence the implementation of CSE in male adolescents. Participants also expressed a number of intervention preferences for CSE.Conclusions The results of this study revealed the need for a CSE program for adolescents' sexuality socialization. The finding showed that teachers required training to enhance their professional competence about sexuality issues. Therefore, it is necessary to design and implement culture-appropriate skill based programs to enhance the teachers’ professional competence regarding the adolescents’ sexual health.
Short-term Assessment of Radial Artery Grafts With Multidetector Computed Tomography
Authors: Qiao En , Wang Yuetang , Yu Jun , Wang Xu , Luo Xinjin , Wang Wei
Published: July 2020

Background

The clinical use of radial artery (RA) in coronary artery bypass grafting (CABG) is still limited worldwide, although it has been recommended by several guidelines, and the application of multidetector computed tomography (MDCT) in the evaluation of graft patency is still to be verified. This study aims to report the short-term results of RA in CABG with MDCT.
Methods

The study population consists of 41 consecutive patients undergoing elective CABG with the RA graft between 2007 to 2008, with MDCT performed to evaluate graft patency during follow-up, and target vessels for the RA were non-left anterior descending coronary arteries with > 70% stenosis.
Results

MDCT could clearly show the structure and patency of grafts, even for complex coronary artery revascularization. A total of 150 distal anastomoses were assessed by MDCT during follow-up (mean, 8.9 ± 5.1 months). Functional graft patency of the left internal mammary artery (LIMA) was 92.9% (39/42), with the RA patency of 84.4% (38/45) and the patency of saphenous vein graft (SVG) of 81.1% (30/37). And the RA targeting the left coronary artery system might have better patency than that of the RA targeting the right coronary artery system (25/29, 86.2% vs 13/16, 81.3%, p = 0.686).
Conclusions

MDCT could provide excellent visualization of grafts in CABG. The short-term patency rate of RA grafts is good, and the RA might be associated with better patency when targeted to the left but not the right coronary artery.
Evaluating Measles Incidence Rates Using Machine Learning and Time Series Methods in the Center of Iran; 1997-2020
Authors: Nazari Javad , Fathi Parnia-Sadat , Sharahi Nahid , Taheri Majid , Amini Payam , Almasi-Hashiani Amir
Published: July 2020

Background: Measles is a feverish condition labeled among the most infectious viral illnesses in the globe. Despite the presence of a secure, accessible, affordable and efficient vaccine, measles continues to be a worldwide concern. Methods: This study uses machine learning and time series methods to assess factors that placed people at a higher risk of measles. This historical cohort study contained the Measles incidence in Markazi Province, the center of Iran, from April 1997 to February 2020. Logistic regression, linear discriminant analysis, random forest, artificial neural network, bagging, support vector machine, and naïve Bayes were used to make the classification. Zero-inflated negative binomial regression for time series was utilized to assess development of measles over time. Results: The prevalence of measles was 14.5% over the recent 24 years and a constant trend of almost zero cases was observed from 2002 to 2020. The order of independent variable importance were recent years, age, vaccination, rhinorrhea, male sex, contact with measles patients, cough, conjunctivitis, ethnic, and fever. Younger age, less probability of contact and no fever is associated with less odds of zero cases. Only 7 new cases were forecasted for the next two years. Bagging and random forest were the most accurate classification methods. Conclusion: Even if the numbers of new cases are almost zero during the recent years, it has been showed that age and contact are responsible for non-occurrence of measles. October and May are prone to have new cases for 2021 and 2022.
Clinical Features and Long-term Survivals of Metastatic Hepatic Neuroendocrine Neoplasms Secondary to Gastro-entero-pancreatic Site: An Analysis by Applying the World Health Organization 2017 Grading Classification
Authors: Yang Min , Zeng Lin , Hou Sheng-zhong , Ke Neng-wen , Tian Bo-le , Liu Xu-bao , Xiang Bo , Zhang Yi
Published: July 2020

Background and Purpose

Hepatic neuroendocrine neoplasms (NENs) are very rare, in which metastatic hepatic NENs (MH-NENs) secondary to gastro-entero-pancreatic NENs (GEP-NENs) account for their majority. In 2017, World Health Organization (WHO) redefined GEP-NENs into G1 neuroendocrine tumors (NETs), G2 NETs and G3 NETs and G3 neuroendocrine carcinomas (G3 NECs), which has not been rigorously validated for MH-NENs secondary to GEP-NENs.
Method:

Data of patients who were surgically treated and clinicopathologically diagnosed as MH-NENs secondary to GEP-NENs at West China Hospital of Sichuan University from January 2006 to December 2018 were retrospectively analyzed by applying the WHO 2017 grading classification.
Results

We identified 150 patients with MH-NENs secondary to GEP-NENs, including 10 patients with WHO 2017 G1 NETs, 26 with G2 NETs, 33 with G3 NETs and 81 with G3 NECs. The estimated 3-year overall survival for each new grading group was 100%, 79.4%, 49.5% and 20.7%, respectively. Survival of G1 NETs or G2 NETs was significantly better than that of G3 NETs (P = 0.013, P = 0.037; respectively) and G3 NECs (P = 0.001, P < 0.001; respectively). Patients with G3 NECs present notably worse survival than those with G3 NETs (P = 0.012), while survival comparison between G1 NETs and G2 NETs wasn’t statistically different (P = 0.131). The WHO 2017 grading classification was effective independent predictor of survival for MH-NENs secondary to GEP-NENs (hazard ratio: 4.234; 95% confidence intervals: 1.984–6.763; P = 0.003).
Conclusion

Our demonstration revealed that the WHO 2017 grading classification could well stratify MH-NENs secondary to GEP-NENs into prognostic groups and supported its wide use in clinical practice.
Clinicopathological and prognostic features of early gastric cancer patients after surgery: a retrospective study
Authors: Qi Jing , Zhu Congbo , Liu Weihang , Liu Sheng , Cai Gaoqiang , Liao Guo-Qing
Published: July 2020

Background: Despite the decline in the incidence of gastric cancer, the incidence of early gastric cancer has increased. Hence, understanding the clinicopathological and prognostic features of early gastric cancers could help us understand the development of gastric cancer and improve the prognosis of early gastric cancer. Methods: A total of 244 patients diagnosed with early gastric cancer after surgery at Xiangya Hospital Central South University were retrospectively analyzed. Results: General data showed that in patients with a mean age of 54.30±10.68 years (M:F = 1.6:1), the median tumor size was 2.203±1.245 cm. A total of 15.6% of patients had lymph node metastasis. By univariate analysis, the longest diameter of the tumor, T stage, total number of dissected lymph nodes, number of metastatic lymph nodes, metastatic-to-total dissected lymph node (LN) ratio, vascular invasion, NLRc, and MLRc were associated with disease-free survival; tumor size, invasive depths, vascular invasion, NLRc, MLRc, NWRc and LWRc were associated with lymph node metastasis. Additionally, the longest diameter of tumor and total number of dissected lymph nodes were independent factors for early gastric cancer patients; tumor size, invasive depths, vascular invasion and NLRc were independent risk factors for lymph node metastasis in EGC. Conclusion: The longest diameter of the tumor and total number of dissected LNs were independent prognostic factors for EGC patients. Additionally, the longest diameter of the tumor, tumor invasive depths, vascular invasion and NLRc were the independent risk factors for lymph node metastasis in EGC patients.
Prevalence and risk factors of erectile dysfunction in men of infertile couples: A cross-sectional study from an in vitro fertility center in the northern Vietnam
Authors: The Son Trinh , Xuan Su Hoang , Van Ai Hoang , Ba Trinh Nguyen , Le Hoang , Van Trang Quan , Duc Minh Pham , Vinh Dung Dang , Thi Cuc Le , Thanh Tung Nguyen , Anh Tuan Ngo , Thu Trang Vu Thi , Van De Doan , Nhu Binh Do , Do Quyet
Published: July 2020

Purpose: The aim of this study was to investigate the prevalence and risk factors of erectile dysfunction (ED) in men of infertile couples from an in vitro fertility center in the northern Vietnam. Methods: A total of 138 men of infertility couples were enrolled in this study from January to May, 2018. The International Index of Erectile Function questionnaire scale was used to access the severity of ED and several related factors were also collected to determine risk factors. Results: The prevalence of ED among men of infertile couples was 18.1%, including 13 mild ED (9.4%), 7 mild to moderate ED (5.1%), 2 moderate ED (1.4%) and 1 severe ED (0.7%). Using logistic regression analysis, we showed that risk factors associated ED were smoking above 5 pack/years with OR = 3.16, CI = 0.98 – 10.18, p = 0.05; not graduating junior high school, OR = 5.11, CI = 1.11 – 23.8, p = 0.03, and azoospermia, OR = 7.55 , CI = 2.18 – 26.16, p = 0.001. We observed relatively high OR in men with smoking under 5 pack/years (OR = 2.51), abnormal semen analysis (hypospermia, oligozoospermia, asthenozoospermia, or teratozoospermia) (OR=2.36), but there was not significant differences compared with reference group. Conclusion: The prevalence of ED among men of infertile couples in this study was higher than infrtile men. Low level of education, smoking in a long period, and azoospermia were the main risk factors of ED in men. Further large-scale studies are needed to extend the results.
Resolvin E1 accelerates pulp repair by regulating inflammation and stimulating dentin regeneration in dental pulp stem cells
Authors: Chen Jie , Xu Huaxing , Xia Kun , Cheng Shuhua , Zhang Qi
Published: July 2020

Background
Unresolved inflammation and tissue destruction are considered to underlie failure of dental pulp repair. As key mediators of the injury response, dental pulp stem cells (DPSCs) play a critical role in pulp tissue repair and regeneration. Resolvin E1 (RvE1), a major dietary omega-3 polyunsaturated fatty-acid metabolite, is effective in resolving inflammation and activating wound healing. However, whether RvE1 facilitates injured pulp-tissue repair and regeneration through timely resolution of inflammation and rapid mobilization of DPSCs is unknown. Therefore, we established a pulp injury model and investigated the effects of RvE1 on DPSC-mediated inflammation resolution and injured pulp repair.
Methods
A pulp injury model was established using eight-week-old Sprague-Dawley rats. Animals were sacrificed on days 1, 3, 7, 14, 21, and 28 after pulp capping with a collagen sponge immersed in PBS with RvE1 or PBS. Hematoxylin-eosin and Masson’s trichrome staining, immunohistochemistry, and immunohistofluorescence were used to evaluate the prohealing properties of RvE1. hDPSCs were incubated with lipopolysaccharide (LPS) to induce an inflammatory response, and the expression of inflammatory factors after RvE1 application was measured. Effects of RvE1 on hDPSC proliferation, chemotaxis, and odontogenic differentiation were evaluated by CCK-8 assay, transwell assay, alkaline phosphatase (ALP) staining, alizarin red staining, and quantitative PCR, and possible signaling pathways were explored using western blotting.
Results
In vivo, RvE1 promoted injured pulp repair and reparative dentin formation. Further, it enhanced dentin sialoprotein and nestin expression and accelerated pulp inflammation resolution by suppressing TNF-α and CD68 expression. RvE1 enhanced the recruitment of CD146+ and CD105+ DPSCs to the damaged molar pulp mesenchyme. Isolated primary cells exhibited the mesenchymal stem cell immunophenotype and differentiation. RvE1 promoted hDPSC proliferation and chemotaxis. RvE1 significantly attenuated pro-inflammatory cytokine (TNF-α, CD68, IL-6, and IL-1β) release and enhanced ALP activity, nodule mineralization, and especially, expression of the odontogenesis-related genes DMP-1, DSPP, and BSP in LPS-stimulated DPSCs. RvE1 regulated Akt, ERK, and rS6 phosphorylation.
Conclusions
RvE1 promotes pulp inflammation resolution and dentin regeneration and positively influences the proliferation, chemotaxis, and differentiation of LPS-stimulated hDPSCs. This response is, at least partially, dependent on Akt, ERK, and rS6-associated signaling. RvE1 has promising application potential in regenerative endodontics.
Caspase-11 regulates lung inflammation in response to house dust mites
Authors: khweek Arwa Abu , Joldrichsen Marisa R. , Kim Eunsoo , Attia Zayed , Krause Kathrin , Daily Kylene , Estfanous Shady , Hamilton Kaitlin , Badr Asmaa , Anne Midhun N. K. , Eltobgy Mostafa , Carafice Cierra , Zhang Xiaoli , Gavrilin Mikhail A. , Boyaka Prosper N. , Amer Amal O.
Published: July 2020

Asthma is an inflammatory lung disorder characterized by mucus hypersecretion, cellular infiltration, and bronchial hyper-responsiveness. House dust mites (HDM) are the most prevalent cause of allergic sensitization. Canonical and noncanonical inflammasomes are multiprotein complexes that assemble in response to pathogen or danger-associated molecular patterns (PAMPs or DAMPs). Murine caspase-11 engages the noncanonical inflammasome. We addressed the role of caspase-11 in mediating host responses to HDM and subsequent allergic inflammation using caspase-11−/− mice, which lack caspase-11 while express caspase-1. We found that HDM induce caspase-11 expression in vitro. The presence of IL-4 and IL-13 promotes caspase-11 expression. Additionally, caspase-11−/− macrophages show reduced release of (KC, IL-6 and IL-12) cytokines, and express lower levels of costimulatory molecules (e.g., CD40, CD86 and MHCII) in response to HDM stimulation. Notably, HDM sensitization of caspase-11−/− mice resulted in similar levels of IgE responses and hypothermia in response to nasal HDM challenge compared to WT. However, analysis of cell numbers and cytokines in bronchiolar alveolar fluid (BALF), as well as histological lung tissue showed altered inflammatory responses and reduced neutrophilia in the airways of the caspase-11−/− mice. These findings indicate that caspase-11 regulates airway inflammation in response to HDM exposure.
The Immunoreactivity Patterns of BRAF VE1 and Its Diagnostic Value in Brain Tumors
Authors: Li Hainan , Fan Chongzhu , Chen Wendan , Liu Minting , Xiang Xuan , Zhang Zhenbin , Jiang Guangyu , Wang Lei , Li Zhi
Published: July 2020

Background: BRAF mutations have been detected in a high proportion of melanoma, papillary thyroid carcinoma, and various primary brain tumors. But the sensitivity and specificity of immunohistochemical detection of BRAF-V600E mutant protein were not evaluated in brain tumors. The aim of this study was to assess the utlity of BRAF-V600E IHC compared to molecular biology on a large series of brain tumors, in order to provide a useful reference for the use of BRAF-V600E IHC in clinical practice.Methods and results: We analyzed the BRAF-V600E immunoreactivity pattern and its expression profile by immunohistochemistry (IHC) in 122 patients diagnosed with different tumors of brain including gangliocytoma/ganglioma(GC/GG), pleomorphic xanthoastrocytomas(PXA), epithelioid glioblastoma(E-GBM), dysembryoplastic neuroepithelial tumour(DNT), pilocytic astrocytoma(PA), and papillary craniopharyngioma(p-CPG). VE1 immunostaining of 52 cases showed clear cytoplasmic diffuse positive pattern in majority tumor cells. 14 cases were presented with clear granular cytoplasmic positive pattern in single tumor cell or tumor cell cluster. 22 cases displayed equivocal positive with undefined location. 34 cases were negative. Including 81 immunopositive cases and 29 immunonegative cases were further confirmed by Real-time PCR. And 63 of 81 immunopositive cases were confirmed with BRAF-V600E mutation (77.8%), and all of 29 negative cases were confirmed to have wild-type BRAF (100%). Interestingly, only the cases showing clear immunoreactivity patterns (e.g cytoplasmic) with clean background had immunostaining results consistent with the molecular detection results, regardless of the number of positive cells (61/61,100%). However, samples with indeterminate immunoreactivity patterns were most likely to have false positive results (18/20, 90%). Conclusions: VE1 immunostaining could replace molecular detection to some extent, on the premise of mastering the key points in the interpretation of BRAF VE1 immunostaining: 1) As long as the positive signal was accurately located in the cytoplasm of tumor cells, the sample was considered to have BRAF V600E mutation, disregarding the number of positive cells; 2) Tissue samples that had no signal of BRAF VE1 expression with clear background could be confirmed with wild-type BRAF-V600E; 3) Some equivocal positive with uniform “coating” or nucleus positive cases were often considered as false-positive and usually required further molecular detection.
The hidden secrets of a neutral pH – Blood-Gas-Analysis of postoperative patients according to the Stewart approach
Authors: Janssen Joost , Fessem Joris M.K. van , Ris Tijmen , Stolker Robert Jan , Klimek Markus
Published: July 2020

Background
The superiority of either the traditional or Stewart based approach to acid-base balance has focused primarily on analyzing metabolic acidemia, with little attention given to patients with neutral pH. In this study, we evaluate metabolic disturbances in patients in the immediate postoperative period focusing on patients with neutral pH, while comparing the Stewart and traditional approach.
Methods
We conducted a single center retrospective observational cohort study. Over a 17 month period, data on arterial blood gas analysis, electrolytes and albumin on the morning after surgery were retrieved from patients admitted to the postsurgical high dependency unit (HDU). Albumin corrected anion gap (AG), apparent (SIDa) and effective strong ion difference (SIDe) and strong ion gap (SIG) were calculated.
Results
Out of 1207 HDU admissions, 400 cases had a complete set of laboratory-data including albumin of which 281 presented with neutral pH (7.35 ≤ pH ≤ 7.45), 64 with acidemia (pH < 7.35) and 55 with alkalemia (pH > 7.45). In pH neutral patients the following acidifying disturbances were found: SIDa was lowered in 101 (36%), SIG was raised in 60 (21%). Base excess (BE) was decreased in 16 (6%) and corrected AG raised in 107 (38%). The alkalizing effect of hypoalbuminemia was present in 137 (49%). Out of 134 cases with normal BE and corrected AG, SIDa was lowered in 58 (43%). Out of 136 cases with normal SIDa and SIG, none had lowered BE and 28 increased AG (21%). Length of stay was significantly longer in patients with hypoalbuminemia, lowered SIDa and increased corrected AG, but not decreased BE (Hypoalbuminemia: 16 days vs. 10 days, P < 0.001. Low SIDa: 15 days vs. 12 days, P = 0.015. Increased AG: 16 days vs. 11 days, P < 0.001. Low BE: 14 days vs. 13 days, P = 0.736).
Conclusions
Metabolic disturbances, characterized mainly by the presence of lowered SIDa, increased AG and hypoalbuminemia, are frequent in our population with apparent neutral acid-base balance based on pH and base excess. These changes on the morning after surgery are associated with increased length of stay.