bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Efficacy and Safety of Statin-ezetimibe Combination Therapy With Statin Monotherapy in Patients With Diabetes: A Meta-analysis of Randomised Controlled Studies
Authors: Shin Kwang-Hee , Choi Hye Duck
Published: June 2021

Background and aims: Diabetic dyslipidaemia is characterised by very high levels of triglycerides, low high-density lipoprotein (HDL), and slightly elevated low-density lipoprotein (LDL) cholesterol. Additionally, the potentially increased risk of morbidity and mortality following atherosclerotic cardiovascular diseases should be considered in the treatment of dyslipidaemia in patients with diabetes. Methods: We performed a meta-analysis of the published data to compare the effects of statin-ezetimibe combination therapy and statin monotherapy on lipid and glucose parameters in patients with diabetes. Additionally, the safety based on the reported adverse events was compared between the two groups. Results: Seventeen articles were included in this meta-analysis. In the efficacy assessment, the combination treatment afforded a significantly greater reduction in LDL cholesterol than did statin monotherapy (standard difference in means = 0.894; 95% confidence interval 0.598–1.191). A significantly greater improvement effect was observed in the levels of HDL cholesterol, total cholesterol, triglyceride, and apolipoprotein B, but not apolipoprotein A1, with combination therapy than with statin monotherapy. Additionally, combination therapy reduced the fasting blood glucose levels more significantly than did statin monotherapy. In terms of safety, there were no significant differences in treatment-related adverse events between the two treatments. Conclusions: Statin-ezetimibe combination therapy appears to enhance LDL cholesterol and other lipid levels without an increased risk of adverse events, compared with statin monotherapy. The present meta-analysis presents valid evidence for appropriate drug regimens to treat dyslipidaemia in patients with diabetes.
Lymphadenectomy after neoadjuvant chemoradiation for esophageal adenocarcinoma: what is the optimal lymph nodes dissection?
Authors: Wu Yahua , Lin Mingqiang , Zhang Mengyan , Liu Tianxiu , Wang Zhiping , Li Jiancheng
Published: June 2021

Background

The optimal lymph nodes dissection (LND) for esophageal adenocarcinoma (EAC) patients who underwent neoadjuvant chemoradiotherapy (NCRT) is controversial.
Methods

Patients were selected from Surveillance Epidemiology and End Results database. Multivariable Cox analysis was used to identify predictors of overall survival (OS). Restricted Cubic Splines (RCS) was used to examine the relationship between the number of LND and OS.
Result

2,019 patients with non-metastatic EAC underwent NCRT were stratified into three groups according to LND using X-tile software: group 1: 1–8, group 2: 9–14, group 3: ≥15. In Multivariable Cox Regression analysis, the death risk was reduced by 22% (P = 0.001), 43% (P < 0.001) respectively, for patients in groups 2, 3 compared with those in group 1. The results were similar for patients with pathological lymph node-negative (ypN0) EAC patients. But for pathological lymph node-positive (ypN+) patients, a significantly reduced hazard was present only in group 3 (P < 0.001). RCS exhibited a nonlinear relationship between the number of lymph nodes removed and OS for ypN0 EAC (P = 0.002). The risk of death sharply dropped until around 24 nodes removed and then started to steadily increase afterward. However, for ypN + EAC, it showed a linear relationship between LND and OS (P = 0.205), with a better OS when an increase in the number of lymph nodes removed.
Conclusions

For ypN0 patients, the optimal LND was approximately 24 lymph nodes, with the number of lymph nodes removed beyond 24 nodes did not provide additional benefit. However, for ypN + patients, a more extensive lymphadenectomy could favor survival.
Psychological Distress and Social Support among Conflict Refugees in Urban, Semi-rural and Rural Settlements in Uganda: Burden and Mechanisms of Association
Authors: Lawoko Stephen , Nakidde Catherine , Lugada Eric , Ssematiko Maria , Ddamulira Dunstan P. , Masaba Andrew , Luswata Brian , Ochen Eric A. , Okot Betty , Muhangi Denis , Seruwagi Gloria
Published: June 2021

Background: Recent research shows that psychological distress is on the rise globally as a result of the COVID-19 pandemic and restrictions imposed on populations to manage it. We estimated the burden of psychological distress and scrutinized the role that social support may play in moderating psychological distress among conflict refugees in urban, semi-rural and rural settlements in Uganda during the COVID-19 pandemic.Methods: Cross-sectional survey data on psychological distress, social support, demographics, socio-economic and behavioral variables was gathered from 1014 adult refugees randomly sampled from urban, semi-rural and rural refugee settlementsin Uganda, using two-staged cluster sampling. Research instruments were checked for reliability using Cronbach’s Alpha. T-test, Analysis of Variance (ANOVA) and Multivariable Linear Regression were applied to analyse the data in SPSS-version 22. Statistical significance was assumed at p<0.05.Results: Refugees resident in rural/semi-rural settlements exhibited higher levels of psychological distress, lower levels of social interaction and lower levels of social attachment than peers resident in urban settlements. However, they reported, on the other hand, higher adequacy of social interaction and higher adequacy of social attachment than peers resident in urban settlements. Adequacy of social interaction and attachment were directly associated with psychological distress and acted as stress buffers in the relationship between psychological distress and rural/urban settlement. Conclusions: There is a settlement-inequality (i.e. rural vs. urban) in psychological distress and social support among conflict refugees in Uganda. Both the direct and buffering effects of adequacy of social interaction and attachment can explain the rural/urban discrepancy in psychological distress, with important implications for Mental Health and Psychosocial Support (MHPSS) interventions.
“What Are The Challenges of Treating Mentally Impaired Patients in The Era of a Pandemic?” : Qualitative Exploration Caregivers
Authors: Yusuf Ah , Acob Joel Rey U. , Tristiana Roro Dian , Nafisa Intan Faizatun , Putri Verantika Setya , Kotijah Siti , Solikhah Fitriana Kurniasari , Aditya Ronal Surya
Published: June 2021

Introduction: Caregivers provide support for mental disorders in the form of care such as assistance in daily life activities, but during a pandemic it is a challenge in itself. Objective: To explore the caregiver's experience in caring for clients with mental disorders in remote areas during a pandemic. Methods: Using a phenomenological qualitative research design with 25 participants. The sampling technique used was purposive sampling with data collection techniques using in-depth interviews and field notes then analyzed using IPA (Interpretative Phenomenological Analysis). Results: This study found 6 themes, namely: Caregiver Workload and Tension, Threats to Caregivers' Physical and Psychological Well-Being, The Need for a Continuing Family Role, Holistic Care, Coping Strategy, Communication is getting harder.Conclusion: our research provides unique findings about the experience of treating mental disorders needs during the COVID-19 pandemic. Caregivers of mental disorders struggle with parenting difficulties during the pandemic, which poses a threat to their well-being and potential harm to the mental disorder survivor-caregiver relationship.
Effects of temperature and salinity interaction on Vibrio spp and Vibrio parahaemolyticus in the intercontinental Euro-African Atlantic
Authors: Ruiz-Cayuso Jesus , Trujillo-Soto Teresa , Rodriguez-Iglesias Manuel , Almagro-Moreno Salvador
Published: June 2021

Vibrionaceae include several human pathogens such as Vibrio cholerae, Vibrio vulnificus or Vibrio parahaemolyticus. The risk of vibriosis is increasing worldwide due to the effects of climate change and modified patterns of food consumption, leading to a considerable economic and public health interest in understanding the factors related to the greater abundance of vibrios. Fluctuations in Vibrio populations are strongly affected by changes in temperature and salinity, nonetheless, there is substantial variability in their effect and discrepancies in their specific roles. In this study, we analyzed the abundance, and spatiotemporal distribution of Vibrio in the Euro-African Atlantic area, focusing the investigation on associations with environmental factors and with an emphasis on V. parahaemolyticus. Using membrane-filtration, cultures and MALDI-TOF mass spectrometry, 191 samples from 12 locations were analysed and a biochemical and proteomic profile created. We developed two multivariate linear regression models for the density of Vibrio spp (adjusted R2 = 0.32 and 0.27) and a logistic regression model for the occurrence of V. parahaemolyticus (R2Nagelkerke = 0.32, Accuracy = 77%). Including the interaction between sea surface temperature (SST) and salinity in linear regression helps to explain the discrepancies found in several studies on the effect of these variables on the abundance of vibrios.
Bisphenol S Leads to Cytotoxicity-Induced Antioxidant Responses and Oxidative Stress in Isolated Rainbow Trout (Oncorhyncus Mykiss) Hepatocytes
Authors: Kaptaner Burak , Yılmaz Can , Aykut Handan , Doğan Emine , Fidan Ceylan , Bostancı Müşerref , Yıldız Fatoş
Published: June 2021

Background: Bisphenol S (BPS) is a chemical compound that is utilized in the plastic industry as an alternative to bisphenol A (BPA). The toxic effects of BPS in fish is less known and limited. Therefore, in the present study, it was aimed to investigate the influence of BPS on rainbow trout (Oncorhyncus mykiss) hepatocytes in vitro.Methods and Results: For this purpose, the hepatocytes of the fish were isolated, and then the cultured cells were treated with increasing concentrations of BPS (0, 15.63, 31.25, 62.50, 125, 250, and 500 µM) for 24 h. The cytotoxic impact of BPS was determined in the culture media using lactate dehydrogenase assay and then, the antioxidant defence indicators were assayed. The results showed that concentration-dependent increases were observed in the percentage of cytotoxicity. The superoxide dismutase activity was reduced, while the catalase and glutathione peroxidase activity was elevated with all of the BPS concentrations. The glutathione S-transferase (GST) activity was significantly increased with a BPS concentration of 31.25 µM or higher, while GST theta 1-1 activity was decreased with the same concentrations of BPS. The reduced glutathione content was decreased significantly with a BPS concentration of 31.25 µM or higher, and the malondialdehyde content increased with BPS concentrations of 125, 250, and 500 µM.Conclusions: The findings determined herein suggested that BPS causes cytotoxicity in fish hepatocytes and could lead to oxidative stress, resulting hepatotoxicity in fish. Thus, the utilization of BPS instead of BPA as safe alternative in industry should be re-evaluated in the future for environmental health.
Sarcopenia adversely impacts postoperative complications in living-donor liver transplantation recipients
Authors: Wu Mei-Yun , Lim Wei-Xiong , Cheng Yu-Fan , Chang Ching-Di , Hsu Hsien-Wen , Lin Chih-Che , Chen Chao-Long , Chang Wan-Ching , Yu Chun-Yen , Tsang Leung-Chit , Chuang Yi-Hsuan , Ou Hsin-You
Published: June 2021

Purpose

Despite technological and immunological innovations, living-donor liver transplant (LDLT) recipients still face substantial risk of postoperative complications. Sarcopenia is being recognized more and more as a biomarker that correlates with poor outcomes in surgical patients. The purpose of this study was to evaluate the relationship between sarcopenia and significant surgical complications in LDLT recipients.
Materials and Methods

This retrospective review included patients who had received LDLT at our institute from 2005 to 2017. Sarcopenia was assessed using the psoas muscle index (PMI) in cross-sectional images. ROC curve analysis was used to determine the ability of PMI to predict postoperative complications. Correlations between major postoperative complications and sarcopenia were evaluated using regression analysis.
Results

A total of 271 LDLT recipients were included. No significant differences were found between PMI and major postoperative complications in male patients. Female recipients with major postoperative complications had significantly lower mean PMI values (P = 0.028), and the PMI cut-off value was 2.63 cm2/m2. Postoperative massive pleural effusion requiring pigtail drainage occurred more frequently in the sarcopenia group than in the non-sarcopenia group (P = 0.003). One-, three-, five- and 10-year overall survival rates were significantly poorer in the sarcopenia group (n = 14) than in the non-sarcopenia group (n = 108), at 92.9% versus 97.2%, 85.7% versus 95.4%, 85.7% versus 92.5% and 70.1 versus 82.0%, respectively (P = 0.041).
Conclusions

Sarcopenia is associated with a significantly higher risk of major postoperative complications in females. PMI and sarcopenia together are predictive of major postoperative complications and survival rates in female LDLT recipients.
Oogenesis and lipid metabolism in the deep-sea sponge Phakellia ventilabrum: an histological, lipidomic and transcriptomic approach
Authors: Koutsouveli Vasiliki , Balgoma David , Checa Antonia , Hedeland Mikael , Riesgo Ana , Cárdenas Paco
Published: June 2021

Background Sponges contain an astounding diversity of lipids which serve in several biological functions, including yolk formation in their oocytes and the embryos. On animal reproduction, lipids constitute one of the main energy storage forms for the adult and the offspring. The study of lipid metabolism during reproduction can provide information on food-web dynamics and energetic needs of the populations in their habitats, however, there are no studies focusing on the lipid metabolism of sponges during seasonal reproduction. The deep-sea sponge Phakellia ventilabrum (Demospongiae, Bubarida) is a key species of North-Atlantic sponge grounds, but its reproductive biology is not known. In this study, we used histological sections, lipidome profiling (UHPLC-MS), and transcriptomic analysis (RNA-seq) with goal to i. assess the reproductive strategy and seasonality of this species, ii. examine the relative changes in the lipidome signal, and the gene expression patterns (RNA-seq) of enzymes participating in lipid metabolism in female specimens during gametogenesis.Results P. ventilabrum is an oviparous and most certainly gonochoristic species, reproducing in May and September in the different studied areas. Half of specimens were reproducing, generating two to five oocytes per mm2. Oocytes accumulated both protein and lipid droplets. As oogenesis progressed, the signal of most of the unsaturated and monounsaturated triacylglycerides increased, as well as of few other phospholipids. Most of the other lipids and especially those with > 3 unsaturations showed a decrease in signal during the oocyte maturation. In parallel, we detected upregulated genes in female tissues related to triacylglyceride biosynthesis and others related to fatty acid beta-oxidation.Conclusions Triacylglycerides are probably the main type of lipid forming the yolk since this lipid category has the most marked changes, while some other phospholipids may also have a role in oogenesis. In parallel, other lipid categories were oxidized, leading to fatty acid beta-oxidation to cover the energy requirements of female individuals during oogenesis. Variations in the signal of most lipids between the different locations and months suggest that sponges, apart from their own mechanisms of lipid biosynthesis, exploit the food availability in their surroundings to cover the energetic demands in their physiological processes.
Combining Sarcopenia and [18F] FDGPET/CT Derived Metabolic Parameters in Patients with Adenocarcinoma Esophageal Cancer Might Improve Outcome Prediction
Authors: Anconina Reut , Ortega Claudia , Metser Ur , Liu Zhihui Amy , Suzuki Chihiro , McInnis Micheal , Darling Gail Elizabeth , Wong Rebecca , Taylor Kirsty , Yeung Jonathan , Chen Eric Xueyu , Swallow Carol Jane , Bajwa Jaspreet , Jang Raymond Woo-Jun , Elimova Elena , Veit-Haibach Patrick
Published: June 2021

Purpose

To determine the prognostic value of sarcopenia measurements done on staging [18F] FDG PET/CT together with metabolic activity of the tumor in patients with adenocarcinoma esophagogastric cancer with surgical treatment.
Methods

Patients with early stage, surgically treated esophageal adenocarcinoma and available pre-treatment PET/CT were included. The standard uptake value (SUV) and SUV normalized by lean body mass (SUL) were recorded. Skeletal muscle index (SMI) was measured at the L3 level on the CT component of the PET/CT. Sarcopenia was defined as SMI < 34.4cm2/m2 in women and < 45.4cm2/m2 in men.
Results

Of the included 145 patients. 30% were sarcopenic at baseline. On the univariable Cox proportional hazards analysis, ECOG, surgical T and N staging, Lymphovascular Invasion (LVI) positive lymph nodes and sarcopenia were significant prognostic factors concerning RFS, and OS. On multivariable Cox regression analysis, surgical N staging (p = 0.025) and sarcopenia (p = 0.022) remained significant poor prognostic factors for OS and RFS. Combining the clinical parameters with the imaging derived nutritional evaluation of the patient but not metabolic parameters of the tumor showed improved predictive ability for OS and RFS.
Conclusion

Combining the patients’ imaging derived sarcopenic status with standard clinical data, but not metabolic parameters offered an overall improved prognostic value concerning OS and RFS.
QSAR Modeling of a Ligand-based Pharmacophore Derived from Hepatitis B Virus Surface Antigen Inhibitors
Authors: Mohebbi Alireza , Askari Fatemeh Sana , Shaddel Reyhane , Mirarab Azam , Oladnabi Morteza
Published: June 2021

Background: Functional cure for Hepatitis B virus (HBV) by inhibiting HBV surface antigen (HBsAg) is crucial. We aimed to develop a predictive quantitative structure-activity relationship (QSAR) model on a ligand-based pharmacophore (LBP) derived from already known HBsAg secretion inhibitors in the present study.Methods: A LBP model was developed using active HBsAg secretion inhibitors as both trainings- and test-sets using LigandScout v3.12 software. The best model with the highest score was used for high throughput screening (HTS) screening of a virtual library comprising 720,000 compounds. A QSAR model was developed by a stepwise multiple linear regression (MLR) on ~2700 descriptors with a confidence interval (CI) of 95%. The test set validated the QSAR model. The goodness of fit statistics evaluated the fitness of the model. A comparable R2 and adjusted R2 were considered as the lack of overfitting. Further RMSE and Q2 statistics were measured for testing the model on the validation set. Principal component analysis (PCA) was also evaluated to estimate the predictor variables' associations and impact on the model.Results: 34 active anti-HBsAg compounds were used to develop an LBP model. 9/34 of compounds with higher clustering pharmacophore-fit scores were tagged as the training set, and the rest of the inhibitors were used as the test set. The best model had a 0.8832 fit score. HTS resulted in 10 potential hit compounds with a fit score of 101.44±0.65. A QSAR model was developed with two response variables, including Yindex and GATS8m, with substantial variance information (p < 0.05). The model was well fitted (R2 = 0.9563, MSE = 0.0023). The model was not predictive on the test set (Q2 = 0.00, RMSE = 0.8153). The PCA results of two factors demonstrated a substantial variance data of both predictor variables. Conclusion: The present study showed a reliable pharmacophore modeling based on known active inhibitors of HBsAg and a well-fitted predictive QSAR model on the LBP. The model can be applied to the chemical libraries fitted to the LBP model, and the QSAR equation would estimate the biological activities of the hit compounds with 95.63% accuracy with only two Yindex and GATS8m descriptors.
Excellent Photocatalytic Rhodamine B Degradation for water Remediation Over Pr3+ Doped Bi2WO6 Microspheres
Authors: Zhang Xianghui
Published: June 2021

In this work, a serious of Pr3+ doped Bi2WO6 had been prepared by one-step hydrothermal method without using any additive. XRD results showed that the Pr3+ doped Bi2WO6 possessed pure orthorhombic phase. XRD patterns shifted to higher angles with the doping amount of Pr3+ increasing indicated that Pr3+ was doped into the lattice of Bi2WO6. UV-vis DRS results revealed that the band gap was narrowed by Pr3+ doping. SEM and TEM images showed that the Pr3+ doped Bi2WO6 presented 3D flower-like microspheres constructed by many nanosheets. The photocatalytic activities of the as-prepared samples were evaluated by using rhodamine B (RhB) as the target organic pollutant. It was found that 1% Pr-Bi2WO6 exhibited excellent photocatalytic performance, as well as good stability and reusability. The improved photocatalytic activity can be ascribed to the optimum optical absorption activity, the larger specific surface area and the morphology of microspheres which resulted in the effective separation of the photogenerated electron hole pairs. In addition, the photocatalytic mechanism had been discussed according to the radical-trapping experiments.
Impaired T Lymphocyte Subsets Early Predict Acute Kidney Injury in Sepsis Patients
Authors: Li Guanglan , Zhang Yu , He Ganyuan , Hao Wenke , Hu Wenxue
Published: June 2021

Objective: Acute kidney injury (AKI) is a frequent complication of sepsis patients and is associated with high morbidity and mortality. Early recognition of sepsis-associated AKI (SA-AKI) is crucial to provide supportive treatment and improve prognosis. Thus, the objective is to analyze the early discriminative predictive information regarding T lymphocyte subsets of SA-AKI.Methods: We evaluated the relationships of T lymphocyte subsets and clinical parameters of sepsis patients, and assessed their potential roles in SA-AKI diagnosis. The following T lymphocyte subsets were studied: total T lymphocyte (CD3+), helper T lymphocyte (T helper, CD3+CD4+), cytotoxic T lymphocyte (CTL, CD3+CD8+), totally activated T lymphocyte (CD3+HLADR+), early activated T lymphocyte (CD4+CD69+, CD8+CD69+), regulatory T lymphocyte (Treg, CD4+CD25+, CD8+CD25+).Results: A total of 171 patients with sepsis were enrolled. The incidence of AKI was 80.1%. The percentages of total T lymphocyte, CTL, and totally activated T lymphocyte of SA-AKI patients were lower than those of sepsis patients without AKI (61.95±19.65 % vs 68.80±18.57 %, 19.95±17.22 % vs 26.48±18.31 %, 19.00±14.21 % vs 30.88±28.86 %, respectively, P<0.05). There were no significant differences in the percentages of T helper, early activated T lymphocyte, and Tregs between SA-AKI group and non-SA-AKI group. Univariate logistic regression analysis showed that percentages of total T lymphocyte, CTL, and totally activated T lymphocyte were protective factors for SA-AKI. Multivariate logistic regression analysis revealed that percentage of totally activated T lymphocyte had a negative association with SA-AKI independently (OR: 0.952, 95% CI: 0.926-0.978, P=0.000). Moreover, ROC analysis showed that total T lymphocyte, CTL, and totally activated T lymphocyte had discriminatory abilities, with areas under the curve (AUC) value of 0.638, 0.615, and 0.661, respectively (P<0.05). Conclusions: Impaired total T lymphocyte, CTL, and totally activated T lymphocyte could contribute to early diagnosis for SA-AKI.
Nanog/NFATc1/Osterix signaling pathway-mediated promotion of bone formation at the tendon-bone interface after ACL reconstruction with De-BMSCs transplantation
Authors: Tie Kai , Cai Jinghang , Qin Jun , Xiao Hao , Shangguan Yangfan , Wang Hui , Chen Liaobin
Published: June 2021

Background: Bone formation plays an important role in early tendon-bone healing after anterior cruciate ligament reconstruction (ACLR). Dedifferentiated osteogenic bone marrow mesenchymal stem cells (De-BMSCs) have enhanced osteogenic potential. This study aimed to investigate the effect of De-BMSCs transplantation on the promotion of bone formation at the tendon-bone interface after ACLR and to further explore the molecular mechanism of the enhanced osteogenic potential of De-BMSCs.Methods: BMSCs from the femurs and tibias of New Zealand White rabbits were subjected to osteogenic induction and then cultured in medium without osteogenic factors; the obtained cell population was termed De-BMSCs. De-BMSCs were induced to undergo osteo-, chondro- and adipo-differentiation in vitro to examine the characteristics of primitive stem cells. An ACLR model with a semitendinosus tendon was established in rabbits, and the animals were divided into a control group, BMSCs group and De-BMSCs group. At 12 weeks after surgery, the rabbits in each group were sacrificed to evaluate tendon-bone healing by histologic staining, micro–computed tomography (micro-CT) examination, and biomechanical testing. During osteogenic differentiation of De-BMSCs, an siRNA targeting nuclear factor of activated T cells 1 (NFATc1) was used to verify the molecular mechanism of the enhanced osteogenic potential of De-BMSCs.Results: De-BMSCs exhibited some properties similar to BMSCs, including multiple differentiation potential and cell surface markers. Bone formation at the tendon-bone interface in the De-BMSCs group was significantly increased, and biomechanical strength was significantly improved. During the osteogenic differentiation of De-BMSCs, the expression of Nanog and NFATc1 was synergistically increased, which promoted the interaction of NFATc1 and Osterix, resulting in increased expression of osteoblast marker genes such as COL1A, OCN, and OPN.Conclusions: De-BMSCs transplantation could promote bone formation at the tendon-bone interface after ACLR and improve the biomechanical strength of the reconstruction. The Nanog/NFATc1/Osterix signaling pathway mediated the enhanced osteogenic differentiation efficiency of De-BMSCs.
A Prognostic Model for Hepatocellular Carcinoma Patients Based on Signature Ferroptosis-related Genes
Authors: Wan Sizhe , Lei Yiming , Li Mingkai , Wu Bin
Published: June 2021

BackgroundWith the increasing number of HCC patients, it is necessary to accurately predicting the prognosis of these patients. Ferroptosis has been confirmed to be closely related to HCC progression. However, there is still a challenge in predicting the survival of HCC patients through ferroptosis-related genes.MethodThe RNA-seq data and corresponding clinical data of HCC from TCGA database were downloaded to establish a prognosis model, and data of ICGC and GSE14520 as the validation set. The risk score was constructed with 5 genes identified by univariate and LASSO Cox regression analysis. Then, risk score, TNM stage and cirrhosis were included to construct a nomogram, through univariate and multivariate Cox regression analysis.Results5 genes were identified from 70 ferroptosis-related DEGs to construct a gene signature to predict HCC patient survival from TCGA cohort. PCA and heatmap results show that there are obvious differences in patients with different score groups. Then, we included risk score, TNM stage and cirrhosis to construct a nomogram to further predict the overall survival of the patients. Survival analysis indicates that overall survival of the low- risk group is significantly higher than that of the high-risk group. Similarly, the data in the GSE14520 cohort also confirmed good performance for the nomogram. Furthermore, KEGG and GO functional enrichment analyses indicates the difference in overall survival between groups is closely related to immune-related pathways. Finally, through analyzing the immune status of all patients, we found that compared with patients in the low-risk group, “Macrophages M0”, “T cells CD8”, and “T cells regulatory” of the high-risk group were significantly higher.ConclusionThe nomogram based on ferroptosis-related genes has a good performance for the prognosis of HCC patients. The model may provide a reference for evaluation of HCC patients by targeting ferroptosis.
The clinical features of pulmonary artery involvement in Takayasu arteritis and its relationship with ischemic heart diseases and infection
Authors: Mukoyama Hiroki , Shirakashi Mirei , Tanaka Nozomi , Iwasaki Takeshi , Nakajima Toshiki , Onizawa Hideo , Tsuji Hideaki , Kitagori Koji , Akizuki Shuji , Nakashima Ran , Murakami Kosaku , Tanaka Masao , Morinobu Akio , Yoshifuji Hajime
Published: June 2021

BackgroundPulmonary artery involvement (PAI) in Takayasu arteritis (TAK) can lead to severe complications, but the relationship between the two has not been fully clarified.MethodsWe retrospectively investigated 166 consecutive patients with TAK who attended Kyoto University Hospital from 1997 to 2018. The demographic data, clinical symptoms and signs, comorbidities, treatments, and imaging findings were compared between patients with and without PAI. TAK was diagnosed based on the American College of Rheumatology Classification Criteria (1990) or the Japanese Clinical Diagnostic Criteria (2008). PAI was identified using enhanced computed tomography, magnetic resonance imaging, or lung scintigraphy.ResultsPAI was detected in 14.6 % (n = 24) of total TAK patients. Dyspnea (25.0 % vs. 8.6 %; p = 0.043), pulmonary hypertension (PH) (29.2 % vs. 0.7 %; p < 0.001), ischemic heart disease (IHD) (29 % vs. 9.3 %; p = 0.018), respiratory infection (25.0 % vs. 6.0 %; p = 0.009) and nontuberculous mycobacteria (NTM) infection (20.8 % vs. 0.8 %; p < 0.001) were significantly more frequent, and renal artery stenosis (0 % vs. 17 %; p = 0.007) was significantly less frequent in TAK patients with PAI than in those without PAI. PAI was an independent risk factor for NTM in multivariate analysis (odds ratio, 36.16; confidence interval: 3.61-361.82; p = 0.002).ConclusionsTAK patients with PAI more frequently have dyspnea, PH, IHD, and respiratory infection, including NTM, than TAK patients without PAI.
Severe Weather Disasters in China Linked to Long-Term Solar Activity During the Last 2000 Years
Authors: Liu Jann-Yenq , Chen Yuh-Ing , Lee Po-Han , Huang Chi Shen , Fang Tzu-Wei
Published: June 2021

Historical records truthfully document human life and environment associated with climate changes. We quantify official historical records of China dating back last two thousand years to examine the disasters due to anomalous temperatures of cold or hot, irregular precipitations of wet or drought, and floods in inland/coastal or Northern/Southern areas in four seasons that possibly linked to solar activities during 1-1825 CE (Common Era). Statistical results show that extreme cold weather occurs particularly in the Winter and Spring during low solar activity (LSA) periods. Irregularities precipitations, including heavy rain/hail/snow and severe drought are significantly frequent during LSA periods, while floods on inland and coastal river basins tend to occur more frequently in LSA and high solar activity (HSA) periods, respectively. The two disasters frequently happen in Summer and Autumn, which suggests that the irregular precipitations could cause the floods. The disasters occur significantly in the Nouthern China, which suggests that the climate boundary of the Qinling–Huaihe Line along at about 33°N plays an important role. In total, the disasters due to the anomalously cold temperatures, irregular precipitations, and floods tend to occur during the LSA periods.
Incidence of De Quervain’s Thyroiditis in an Area With High Prevalence of Sars-Cov-2 Infection
Authors: Pirola Ilenia , Gandossi Elena , Rotondi Mario , Marini Fiorella , Cristiano Alessandra , Chiovato Luca , Castellano Maurizio , Ferlin Alberto , Cappelli Carlo
Published: June 2021

Purpose: To evaluate the possible association between Covid-19 infection and subacute thyroiditis. Patients and Methods: We reviewed the medical and imaging records of patients referred to our outpatient setting dedicated to “thyroid emergency” (“bollini verdi”) from April 2020 to October 2020 of our Department. This out-patient clinic is devoted to patients who required an evaluation for severe hypothyroidism, thyrotoxicosis and neck discomfort or pain. All patients with a newly diagnosed subacute thyroiditis were selected. A retrospective collection of the data of all patients receiving a diagnosis of subacute thyroiditis was performed taking into account the same period of time (April-October) starting from 2016.Results: During the COVID-19 outbreak in our Region, (April 2020 to October 2020), 396 patients attended the out-patient emergency clinic. Among them, 10 (2.7%) patients received a diagnosis of subacute thyroiditis. In a single patient, a 44 yr old man, Covid-19 pulmonary infection had been diagnosed seven weeks before the diagnosis of subacute thyroiditis. All of the remaining patients were and still are Covid-19 free as confirmed by phone interview. The percentage of patients who received diagnosis of subacute thyroiditis in the same period starting from 2016 was superimposable (2.9%, 2.9%, 2.6% and 3.0% in 2016, 2017, 2018 and 2019, respectively). Conclusions: Our data do not demonstrate an increase of the incidence of subacute thyroiditis in Brescia areas, a region with the highest prevalence of COVID-19 in Italy during the period of the pandemic outbreak.Trial registration: no. 4631
Effect of Interventions to Reduce Malaria Incidence Among Military Personnel on Active Duty: Study Protocol for a Cluster Randomised Controlled Trial of the Impact of Etofenprox-treated Uniforms, Permethrin-treated Uniforms and DEET Insect Repellent
Authors: Msellemu Daniel , Ross Amanda , Temu Lucky , Moshi Irene , Hofer Lorenz , Mwanziva Charles , Kohi Yadon M , Moore Sarah J
Published: June 2021

Background: While there is strong evidence that permethrin-treated clothing and topical insect repellents are protective against insect bites, there are few studies assessing the impact on malaria infection. This study will evaluate the impact of the protective efficacy of bite prevention methods on the incidence of malaria infection among military personnel in an operational setting. Permethrin-treated uniforms will be compared to etofenprox-treated uniforms, with both clothing treatments used in conjunction with DEET insect repellent. An additional study arm will test permethrin uniforms with placebo lotion to determine if there is any additional protective effect of using DEET with insecticide-treated clothing. Method: A cluster randomised double-blind placebo-controlled trial is planned to evaluate the effectiveness of the interventions on preventing malaria infections in soldiers on active duty at Mgambo National Service Camp in Tanga, Tanzania. The arms are (1) permethrin-treated uniform with 30% DEET liposome formula; (2) permethrin-treated uniform with placebo lotion; (3) candidate insect repellent system, i.e., etofenprox-treated uniform with 30% DEET liposome formula; and (4) placebo, i.e., untreated uniforms with placebo lotion. The primary outcome is the incidence of Plasmodium falciparum malaria infection detected by polymerase chain reaction (PCR) by active case detection using surveys every 2 weeks for 12 months. Rapid diagnostic tests will be used for diagnosis of participants with symptoms. The unit of randomisation will be combania: companies formed by recruits aged 18 to 25 years; combania do activities together and sleep in the same dormitory. Unequal randomisation will be used to optimise statistical power for the primary comparison between permethrin-treated uniforms with DEET and etofenprox-treated uniforms with DEET. Discussion: This trial will estimate the effects of permethrin with DEET compared to those of the new fabric treatment etofenprox with DEET and any additional effect of using DEET. The results will inform strategies to protect military personnel and civilians who have more outdoor or occupational malaria exposure than the general public. Trial registration: clinicaltrials.gov Registration number NCT02938975.
Sensitivity and Specificity of Two WHO Approved SARS-CoV2 Antigen Assays in Detecting Patients with SARS-CoV2 Infection
Authors: Jeewandara Chandima , Guruge Dinuka , Pushpakumara Pradeep , Madushanka Deshan , Jayadas Tibutius , Chathuranga Indika , Abeyratne Inoka , Danasekara Saubhagya , Pathmanathan Thilagaraj , Jayathilaka Deshni , Somathilaka Gayasha , Kuruppu Heshan , Gomes Laksiri , Gunasekara Vijith , Wijayamuni Ruwan , Ogg Graham , Malavige Gathsaurie Neelika
Published: June 2021

Background: SARS-CoV-2 rapid antigen (Ag) detection kits are widely used in addition to quantitative real-time PCR (RT-qPCR), as they are cheaper with a rapid turnaround time. As there are many concerns regarding their sensitivity and specificity, in different settings, we evaluated two WHO approved rapid Ag kits in a large cohort of Sri Lankan individuals. Methods: Paired nasopharangeal swabs were obtained from 4845 participants for validation of the SD-Biosensor rapid Ag assay and 3625 for the Abbott rapid Ag assay, in comparison to RT-qPCR. A short questionnaire was used to record symptoms at the time of testing, and blood samples were obtained from 2721 of them for detection of SARS-CoV-2 specific antibodies. Results: The overall sensitivity of the SD-Biosensor Ag kit was 36.5% and the Abbott Ag test was 50.76%. The Abbott Ag test showed specificity of 99.4% and the SD-Biosensor Ag test 97.5%. At Ct values <25, the sensitivity was 71.3% to 76.6% for the SD-Biosensor Ag test and 77.3% to 88.9% for the Abbott Ag test. The Ct values for all genes (RdRP, S, E and N) tested with all RT-qPCR kits were significantly lower for the positive results of the Abbott Ag test compared to the SD-Biosensor test. 209 (48.04%) individuals who had antibodies gave a positive RT-qPCR result, and antibody positivity rates were higher at Ct values >30 (46.1 to 82.9%). 32.1% of those who gave a positive result with the SD-Biosensor Ag test and 26.3% of those who gave positive results with the Abbott Ag test had SARS-CoV-2 antibodies at the time of detection. Conclusions: Both rapid Ag tests appeared to be highly sensitive in detecting individuals at lower Ct values, in a community setting in Sri Lanka, but it will be important to further establish the relationship to infectivity.
Sub-Chronic Cadmium Exposure in Drinking Water Dysregulates Lipid and Glucose Metabolisms in Apoe (-/-) Mice: Molecular Insights Into the Etiology of Atherosclerosis
Authors: OKPARA Edozie Samuel , Yu Wan , Huang Haibin , Jia Song , Zhu Wei , YANG Guangyu , YANG Xingfen
Published: June 2021

Background: Exogenous exposure to cadmium is associated with cardiovascular diseases, including atherosclerosis, but experimental evidence elucidating the molecular events involved is still unclear, hence this study. We investigated whether sub-chronic cadmium exposure alone could cause a disruption in lipid and glucose metabolisms and whether the combined effect of these dysregulations could progressively lead to atherosclerosis in ApoE (-/-) mice. Methods: Experiments were performed in male ApoE (-/-) mice (8 weeks 25 ± 3g; n=60), which were randomly placed into four (4) groups according to body weight and administered cadmium (CdCl2) 0, 50, 100 and 200 mg/L, respectively in drinking water consecutively for 4 months. After treatment, changes in body weight were evaluated and mice plasma was analyzed for LDL, HDL, TCHO, TG, insulin and glucose levels. The collected samples were sent for histological examination in the 4th month and two-way ANOVA was used for statistical analysis. Results Levels of plasma LDL increased in all treatment groups but was statistically significant in the 4th month across all treatment groups when compared both with the blank control group and the first month mice. Plasma HDL levels were lowered in all treatment groups in the 2nd and 4th months when compared with the 1st month mice. Statistically significant decreases in plasma HDL levels were also observed in the 2nd month in the group receiving CdCl2 (100mg/L and 200mg/L) when compared with the blank control. TCHO and TG levels increased but was statistically significant in the former in the 1st, 2nd and 4th month at CdCl2 (100mg/L and 200mg/L) and in the latter at the same dose only in the 4th month. Moreover, fasting plasma glucose and insulin were elevated and lowered, respectively. Histological examination of aortal root also showed a dose-dependent increase in plaque formation, being most visible in the treatment group receiving CdCl2 (200mg/L). Conclusion: In line with our hypothesis, sub-chronic oral exposure of ApoE (-/-) mice to cadmium dysregulated their glucose and lipid profiles and the combined effect of this may be a contributory molecular event in the development of atherosclerosis. Keywords: Cadmium. Atherosclerosis. Glucose dysfunction. ApoE (-/-) mice. Lipid dysfunction. Atherosclerotic plaques
Primary Testicular Mantle Cell Lymphoma in a 23-Year-Old Man: A Case Report and Review of the Literature
Authors: Gao Yanan , Cheng Runfen , Pan Yi , Zhai Qiongli
Published: June 2021

Background: Primary testicular mantle cell lymphoma (PTMCL) is a very rare disease, mostly occurred in elderly men, usually diagnosed at an advanced stage. Mantle cell lymphoma (MCL) has a distinctive immunophenotype, positive for CD5 and cyclin D1, but negative for CD10 and CD23. The genetic hallmark of MCL is t(11;14)(q13;q32). Case presentation: Here we reported a case of 23-year-old man who presented with a tumor in the testis. Surgical excision and pathological examination revealed the lesion was a primary testicular mantle cell lymphoma with aberrant expression of CD10 and loss of CD5. Conclusion: This study reports the first case of PTMCL in a 23-year-old man with aberrant expression of CD10 and loss of CD5, summarizes PTMCL reported in PUBMED and found that CD5 might be an independent factor that influences not only the diagnosis but also the prognosis of MCL.
Narrowing the Gap of Inequity in the Indonesia’s National Social Health Insurance Scheme, 2014-2018
Authors: Thabrany Hasbullah , Nugraha Ryan R. , Setiawan Ery , Purwaningrum Farah
Published: June 2021

Background. Indonesia is nearing its 7-year implementation of its national health insurance scheme, or the Jaminan Kesehatan Nasional (JKN), as a facilitator for achieving universal health coverage (UHC). Despite its long-running system, it is contentious as to whether JKN has been narrowing the gap of inequity in its delivery. This paper aims to explore on whether the national health insurance scheme in Indonesia have been promoting equity of access towards health services.Methods. This study analyzes findings from JKN statistic data of 2014-2018 published by Government of Indonesia. Using a retrospective design, this study identified membership and utilization of health services within JKN, based on different membership enrollment groups as proxy for income.Results. JKN has been expanding its enrollment significantly within 5 years, during year 2014 to 2018. Moreover, the study concludes that there was increased access for outpatient in all membership groups. Inpatient care was increased in low-income group, but not in high-income group. Result also showed inpatient access was correlated with adequate supply side intervention, particularly hospital beds.Conclusion. JKN has been successful in narrowing the inequity gap, particularly by serving the low-income group better in terms of access. Going forward, equity needs to be incorporated into JKN achievement indicator, particularly to accelerate Indonesia’s effort to realize universal health coverage.
Randomized Trial of a Portable HEPA Air Cleaner Intervention to Reduce Asthma Morbidity among Latino Children in an Agricultural Community
Authors: Drieling Rebecca , Sampson Paul D. , Krenz Jennifer E. , French Maria I. Tchong , Jansen Karen L. , Massey Anne E. , Farquhar Stephanie A. , Min Esther , Perez Adriana , Riederer Anne M. , Torres Elizabeth , Younglove Lisa R. , Aisenberg Eugene , Andra Syam S. , Kim-Schulze Seunghee , Karr Catherine J.
Published: June 2021

BackgroundData on pediatric asthma morbidity and effective environmental interventions in agricultural settings are few.ObjectivesTo evaluate the effectiveness of HEPA air cleaners on asthma morbidity among a cohort of rural Latino children.MethodsSeventy-five children with poorly controlled asthma and residing in non-smoking homes were randomly assigned to asthma education alone or along with HEPA air cleaners placed in their sleeping area and home living room. Asthma Control Test (ACT) score, asthma symptoms in prior two weeks, unplanned clinical utilization for asthma, creatinine-adjusted urinary leukotriene E4 (uLTE4 [ng/mg]), and other secondary asthma outcomes were assessed at baseline, six and 12 months later. Multivariable-adjusted generalized estimating equations examined differences between groups based on repeated measures. Incident rate ratios of ever experiencing the metrics of poorer asthma health during follow-up (suboptimal asthma management) were estimated using Poisson regression models.ResultsMean intervention group child age was 9.2 years, control mean age was 8.6, and two-thirds of participants were male. In repeated measures analysis, intervention participants were less likely to have an ACT score representing poorly controlled asthma (IRR: 0.45 [95% CI: 0.21–0.97]). In Poisson models, intervention participants had reduced risk of ever experiencing an ACT score representing poorly controlled asthma (IRR: 0.43 [95% CI: 0.21–0.89]), ever having any asthma symptoms in the past two weeks (IRR: 0.71 [95% CI: 0.52–0.98]), and lower risk of any unplanned clinical utilization over the year of follow-up (IRR: 0.35 [95% CI: 0.13–0.94]) compared to control participants. There was a suggestion of greater decrease in uLTE4 (ng/mg creatinine) levels among intervention participants (-10% [95% CI: -20% -1%]).DiscussionHEPA air cleaners may provide additional benefit for child asthma health even in settings with strong asthma education programs and in areas where traditional asthmagens (traffic, tobacco smoke) are not prominent factors.Trial RegistrationClinicalTrials.gov Identifier: NCT04919915. Date of retrospective registration: May 19, 2021.
Determining the significance of anti-K1 in hemolytic disease of the newborn (HDN)
Authors: Strohm P. , O’Shaughnessy R. , Moore J. , Blazina J. , Kennedy M.
Published: June 2021

Anti-K1 is capable of causing severe hemolytic disease of the newborn (HDN), but few cases are seen due to the low frequency of the antigen. A total of 1,215 pregnancies from 1962 to 1989 were reviewed. There were 404 non-anti-D clinically significant antibodies, of which 103 (25%) were anti-K1. Anti-K1 was detected in nine of the women at delivery, of whom two had antigen-positive infants who were clinically unaffected. Antigen typing was done on 64 of the 85 lathers. Forty-seven were K: -1 and 17 were K: 1,2; 21 were unavailable Antibody titers were done on the mothers in the latter two groups. Women with titers < 32 were followed by titration studies; all delivered clinically unaffected infants, four of whom were K:l. Women with titers >32 had amniocentesis performed for optical density values (ΔOD450) or, after November 1987, were offered an alternative test, cordocentesis, to type the fetus and to do hemoglobins if the fetus was antigen-positive. Two women had severely affected infants requiring multiple intrauterine transfusions starting at 20-23 weeks. Six others delivered antigen-positive infants who did not require transfusions, although all had positive direct antiglobulin tests (DATs). We conclude that titration studies are reliable tools to evaluate anti-K1 sensitisation when the titer is < 32. Cordocentesis can detect antigennegative fetuses, which then reduces the need for titrations and amniocentesis.
Immunohematology
1991;2:40–42.