bluuebunny/crossref_metadata_2025 huggingface dataset:
Long-Term Effects of Collagen-Binding Mesenchymal Stem Cells Affinity Peptide on Skin Regeneration and Scar Formation Running Title: MSC Capturing Collagen and Skin Regeneration
Authors: Wang Huili , Yan Xin , Lin Yue , Wang Shuqin , Jiang Yanan , Tan Qian
Published: August 2020

The medical significance of mesenchymal stem cells (MSCs) is not only providing a promising strategy for cutaneous wound healing, but also bringing alternative for the patients whose wounds or burns were difficult to treat and heal. In our previous researches, we produced a fusion protein (Collagen/CBD-E7 peptide) which had high affinity to MSCs and then bound it to collagen scaffold with a CBD (collagen-binding domain). When applied to full-thickness skin defect porcine models, MSCs could be specifically raised to target area which helps accelerate coalescence at early stage. However, scar is an indispensable part of the tissue repair, arising after almost every dermal injury with abnormal appearance and functional disturbance. It usually takes one to three years for the scars to pale and mature. Thus, in this study, we focused on the structure repair of skin defect more than one year after the wounds healing. We found that at the 16w after operation, the proportion of collagen type III was more than collagen type I in Collagen/CBD-E7 peptide group, which indicates a higher healing quality comparatively. While at the 64w, the ratio between collagen type I and collagen type III reached a balance of natural skin tissues. In addition, cutaneous appendages were observed in Collagen/CBD-E7 peptide scaffold group at the 16w and 64w after surgery. From this point of view, the functional collagen scaffold treatments may be able to improve the cosmetic outcome of injury, burns or trauma, and scars are no longer an inevitable consequence of skin healing. This will also imply that humans would no longer be suffering from the scars caused by skin trauma, which is of significant orthopaedic meaning.
Associations Between Farmers’ Market Shopping Behaviors and Objectively-Measured and Self-Reported Fruit and Vegetable Intake in a Diverse Sample of Farmers’ Market Shoppers: A Cross-Sectional Study
Authors: Kelley Casey J. , Hanson Karla L. , Marshall Grace A. , Volpe Leah C. , Pitts Stephanie Jilcott , Rafferty Ann P. , Seguin-Fowler Rebecca
Published: August 2020

Background: Fruit and vegetable (FV) intake is associated with reduced risk of numerous chronic diseases. The community food environment can support FV intake through enhanced access via food outlets, such as farmers’ markets. This paper examines cross-sectional associations between farmers’ market shopping behaviors and objectively-measured and self-reported FV intake to better understand whether farmers’ market shopping behavior relates to FV intake among farmers’ market shoppers. Methods: Farmers’ market shoppers were surveyed at 17 farmers’ markets in rural North Carolina and New York City. A questionnaire assessed self-reported FV intake and three measures of farmers’ market shopping behavior: (1) frequency, (2) variety of FV purchased, and (3) dollars spent on FV. Skin carotenoid status, a non-invasive biomarker for FV intake, was objectively measured using pressure-mediated reflection spectroscopy. Associations between shopping behaviors at farmers’ markets and FV intake were examined using regression models that controlled for individual demographics (age, sex, race, smoking status, education, income, and site). Results: Farmers’ market shoppers in New York City purchased a greater variety of FV and had higher skin carotenoid scores than in North Carolina. There was a positive, statistically significant association between self-reported frequency of shopping at farmers’ markets and both self-reported and objectively assessed FV intake. We also observed that variety of FV purchased and farmers’ market spending were positively associated with self-reported FV intake, but not skin carotenoid status.Conclusion: Those who shop more frequently at a farmers’ markets, purchase a greater variety of FV, and spend more money on FV have higher self-reported, and in some cases, higher objectively measured FV intake. Further research is needed to understand these associations and test causality.
Butterfly Fragment in the Femoral Shaft Fractures Treated by Intramedullary Nail: Do We Need to Reduce It or Not?
Authors: Dabak Tayyar Kürşat , Ci̇van Osman , Özdemi̇r Hakan
Published: August 2020

Background: Limited data is available regarding the effect of gap size, fragment size and position of fragment on union in fragmented femur shaft fracture. The aim of the study is to analyze the effect of these parameters on union and determine cut-off values that necessitate reduction of fragment. Methods: Total of 59 patients with fragmented femur shaft fracture were reviewed and the effect of fragment size, gap size and fragment position on union were evaluated on 3rd, 6th and 12th month graphies from medical record of patients. Union rate was determined due to Radiographic Union Score of Femur. Patients were divided into small gap ( 10 mm) or large gap (10 mm), reverse fragment or non-reverse fragment and small fragment (50 mm) or large fragment (50mm) groups. Kruskal–Wallis Variance Analysis and Mann Whitney U test was used for comparisons among groups. The post-hoc Mann Whitney U-Test with Bonferroni Correction was used when the Kruskal Wallis Variance Analysis determined a significant difference.Results: In comparison of union scores of groups in regarding gap size and fragment size, there was not significant difference between groups at 3rd, 6th and 12th months. Union scores in the 3rd month (p=0,011) and 6th month (p=0,039) were lower in the reverse group than non-reverse group. But there was not statistically significant difference between two groups at 12th month (p=0.819). There was no significant difference in union rates in respect to intramedullary nail types. There was an indirect correlation between age and mean union score at 12th month. Conclusions: we could not determine any cutoff value regarding gap width and fragment size in the treatment of the femoral shaft fractures by IMN. Although there was a tendency to decrease in union scores due to the increase in the gap size, any significant difference was not determined. Only the reverse position of fragment had an adverse effect on the union until 6th months but the union score of reverse group reached the result of the non-reverse group by 12th months.
Predictors of malnutrition among elderly people above 65 Years in East Ethiopia: Neglected public health concern
Authors: Abdu Abdu Oumer , Dagne Imam , Ali Ahmed
Published: August 2020

Background A nutritional problem, especially under nutrition is one of the common public health problems in elderly causing greater mortality and economic loss in developing countries. However, evidences on the risk factors for increased nutritional risk among elderly is not well stated in Ethiopia. This study aimed to assess the nutritional status and predictors of malnutrition among elderly (> = 65 years) in Eastern Ethiopia.Methods Community based survey was conducted among randomly selected 592 elderly age above 65 years of age in Harari region selected using multistage sampling Pretested full Mini Nutritional Assessment (MNA) tool was used to classify as malnourished (MNA score <17), at risk of malnutrition (MNA score of 17 to 23.5) and otherwise normal. Validated geriatric depression scale short form (15 items) was employed to screen for depression. Statistical tables, frequency, percentage and graphs. Ordinary logistic regression was employed to identify predictors of malnutrition and plum method was used to generate odds ratio. Level of statistical significance was declared at P value less than 5%. Chi-square test, crude and adjusted odds ratio with 95% confidence was reported. Results A total of 592 respondents with response rate of 93.4% were interviewed. A total of 306 (51.7%) and 93 (15.7%) were found to be at risk of malnutrition and malnourished respectively. The predicted log odds of being malnourished was higher among those from rural residents (AOR = 2.08: 1.25-3.45), not on working (AOR = 1.31: 95% CI: 0.87-1.95) and did not have health insurance (AOR = 1.58; 95% CI; 0.97-2.58). Those with chronic pain (AOR = 1.70; 95% CI: 1.15-2.51), previous hospitalization (AOR = 1.59: 95% CI: 1.27-2.38) and not able to cover their personal expense (AOR =1.61: 95% CI: 1.12-2.30) were predictors of malnutrition. The relationship between previous hospitalizations with malnutrition among elderly is moderated significantly by the presence of chronic pain (β = 0.113, p = 0.015).Conclusions Malnutrition among old age is public health concern that needs attention. Economic vulnerability, residence, depression, presence of chronic disease and hospitalization were an important risk factors for malnutrition among old age.
WITHDRAWN: Humorous Dispositions Predicting Turnover among Early-Career Israeli Medical Clowns
Authors: Reizer Abira , Koslowsky Meni , Antilevich-Steg Rivki
Published: August 2020

Background: In recent years, medical clowning research has received increasing interest. However, the clowns’ dispositional factors associated with their turnover behavior have yet to be examined systematically.Objectives: The current study examined whether individual differences in humor predict turnover behavior. This was accomplished by investigating the mediating role of the medical clowns’ job satisfaction and the moderating role of previous traumatic experiences.Method: Israeli medical clowns (N = 111) participated in a three-stage longitudinal study. Humorous dispositions were measured during the first week of medical clowning training, job satisfaction was measured two months later, and turnover behaviors were measured after six months.Results: Findings revealed that higher humor appreciation was associated with actual turnover through the mediating role of job satisfaction, whereas humor creation directly increased turnover. In addition, previous traumatic experiences moderated the associations between humor appreciation and turnover.Conclusion: Overall, our research findings support the notion that a humorous disposition can aid in predicting medical clowning turnover. As humor can be observed in numerous settings, in medicine as well as in other fields, we suggest implementing procedures to decrease the turnover rate of medical clowns.
Assessment of Quality of Life Related to Radiation Proctitis in Patients Who Received Pelvic Radiotherapy
Authors: Seabra Marcela Krug , Jesus Rafaela Gomes de , Leão Tiago Pereira de , Friedman Gabriel Teitelbaum , Becker Alice Scalzilli , Azevedo Mariana Saadi de , Falkenberg Isabel Ghirardi , Margheti Luana Vieira , Obst Fernando Mariano , Fay André Poisl
Published: August 2020

Background: Radiotherapy is widely used in the treatment of several pelvic neoplasms, Radiation-related adverse events may result in intestinal, urinary, sexual, bone and dermatological disorders, impacting quality of life. The prevalence of radiation proctitis is probably underestimated. The aim of this study is to assess the quality of life associated with radiation proctitis in patients undergoing pelvic radiotherapy.Methods: A cohort of 40 consecutive patients from an academic institution in Brazil who received pelvic radiotherapy was analyzed. Patients completed questionnaires EORTC QLQ-C30 and EORTC QLQ-PRT20 at the beginning and at the end of treatment. Clinico-pathological features were also collected using standard templates. Results: Thirty-seven patients were included in the analysis. Thirty-two patients (80%) were male and had prostate cancer. Pelvic radiotherapy was associated with worsening bowel control (p=0.0171) leakage (p=0.0542) and pain (p=0.0074) in EORTC QLQ-PRT20. Patients had increased number of bowel movements per day after treatment (p=0.0036). Fatigue (p=0.0176) and diarrhea (p=0.0103) increased after radiation therapy. There was no statistical difference in global quality of life in patients who received radiotherapy. Conclusion: EORTC QLQ-PRT20 questionnaire is suitable for assessing the quality of life related to radiation proctitis in patients undergoing pelvic radiotherapy. This tool may help clinicians in the management and monitoring of treatment-related adverse events of this treatment modality.
Characteristics of Human Papillomavirus Infection Among Women With Cervical Cytological Abnormalities in the Zhoupu District, Shanghai City, China, 2014–2019
Authors: Li Ping , Liu Qing , Li Wei , Liu Zhou , Xing Baoling , Wu Suqin , Zhou Zhaoli , Sun Liping , Ren He , Li Hengfeng , Li Huaping
Published: August 2020

Background: Human papillomavirus (HPV) infection is the main cause of precancerous lesions and cervical cancer in women. To determine the epidemiological characteristics as well as the relationship between the HPV genotype and cytology test results among women, we retrospectively collected and analyzed the data from Zhoupu District hospital in Shanghai, China.Methods: We made a retrospective analysis of human papillomavirus prevalence rate of 23,724 women between 2014 and 2019 in the District Zhoupu of Shanghai City in China. Their cervical exfoliations were collected. HPV genotype testing was performed using a commercial kit designed to detect 21 HPV subtypes including 15 high-risk HPV subtypes(16, 18, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66 ,68) and 6 low-risk HPV subtypes(6, 11, 42, 43, 44 and 81). And the thinPrep cytological test (TCT) was also performed at the same time.Results: Among all 23,724 cases, 3,816 (16.08%) women were infected with HPV. HPV52 (3.19%), HPV58 (2.47%) and HPV16 (2.34%) had higher prevalence. 3,480(91.20%) single-type infections were more common than 336(8.8%) multiple-type infections. Single-type infection was more frequently seen in women aged 50–60 years (16.63%) and <30 years (15.37%), and multiple-type infection was more common in those aged >= 60 (2.67%). Significant differences in secular trends from 2014 to 2019 were observed for subtypes HPV52, 58 and 16.HPV positive rates of women changed significantly along with the time period from 2014 to 2019.Among 4,502 TCT positive women, 15 (4.04%), 125 (2.64%) ,159 (1.54%), 4,202(17.71%) and 1(0.004%) had atypical squamous cells (ASC), high-grade squamous intraepithelial lesions (HSIL), low-grade squamous intraepithelial lesions (LSIL), atypical glandular cells (AGC) and cervical adenocarcinoma respectively. The HPV infection rates were 66.08%, 63.99%, 115.20%, 119.50%, and 31.72% for NILM, AGCs, HSILs LSILs and ASCs, respectively.Conclusions: HPV and TCT screening were a key step in the secondary prevention of cervical cancer. Further tracking the results of HPV and TCT was an important clinical strategy for the treatment of cervical precancerous lesions. The widespread use of preventive HPV vaccines can significantly reduce the incidence of pre-neoplastic and neoplastic cervical lesions.
Predicting in-silico electron ionization mass spectra using quantum chemistry
Authors: Wang Shunyang , Kind Tobias , Tantillo Dean J. , Fiehn Oliver
Published: August 2020

Compound identification by mass spectrometry needs reference mass spectra. While there are over 102 million compounds in PubChem, less than 300,000 curated electron ionization (EI) mass spectra are available from NIST or MoNA mass spectral databases. Here, we test quantum chemistry methods (QCEIMS) to generate in-silico EI mass spectra (MS) by combining molecular dynamics (MD) with statistical methods. To test the accuracy of predictions, in-silico mass spectra of 451 small molecules were generated and compared to experimental spectra from the NIST 17 mass spectral library. The compounds covered 43 chemical classes, ranging up to 358 Da. Organic oxygen compounds had a lower matching accuracy, while computation time exponentially increased with molecular size. The parameter space was probed to increase prediction accuracy including initial temperatures, the number of MD trajectories and impact excess energy (IEE). Conformational flexibility was not correlated to the accuracy of predictions. Overall, QCEIMS can predict 70 eV electron ionization spectra of chemicals from first principles. Improved methods to calculate potential energy surfaces (PES) are still needed before QCEIMS mass spectra of novel molecules can be generated at large scale.
Impact of Corticosteroids and Immunosuppressive Therapies on Symptomatic SARS-CoV-2 Infection in a Large Cohort of Patients with Chronic Inflammatory Arthritis
Authors: Favalli Ennio Giulio , Bugatti Serena , Klersy Catherine , Biggioggero Martina , Rossi Silvia , De Lucia Orazio , Bobbio-Pallavicini Francesca , Murgo Antonella , Balduzzi Silvia , Caporali Roberto , Montecucco Carlomaurizio
Published: August 2020

Background: Prevalence and outcomes of Coronavirus Disease (COVID)-19 in relation to immunomodulatory medications are still unknown. The aim of the study is to investigate the impact of glucocorticoids and immunosuppressive agents on COVID-19 in a large cohort of patients with chronic immune-mediated inflammatory arthritis.Methods: The study was conducted in the arthritis outpatient clinic at two large Academic Hospitals in the COVID-19 most endemic area of Northern Italy (Lombardy). We circulated a cross-sectional survey exploring the prevalence of Severe Acute Respiratory Syndrome-Coronavirus-2 nasopharyngeal swab positivity and the occurrence of acute respiratory illness (fever and/or cough and/or dyspnea), administered face-to-face or by phone to consecutive patients from 25th February to 20th April 2020. COVID-19 cases were defined as confirmed or highly suspicious according to the World Health Organization criteria. The impact of medications on COVID-19 incidence was evaluated. Results: The study population included 2050 adults with chronic inflammatory arthritis receiving glucocorticoids, conventional-synthetic (cs), or targeted-synthetic/biological (ts/b) disease-modifying drugs (DMARDs). Laboratory-confirmed COVID-19 and highly suspicious infection were recorded in 1.1% and 1.4% of the population, respectively. Treatment with glucocorticoids was independently associated with increased risk of COVID-19 (adjusted OR [95% CI] ranging from 1.23 [1.04-1.44] to 3.20 [1.97-5.18] depending on the definition used). Conversely, patients treated with ts/bDMARDs were at reduced risk (adjusted OR ranging from 0.46 [0.18-1.21] to 0.47 [0.46-0.48]). No independent effects of csDMARDs were observed.Conclusions: During the COVID-19 outbreak, treatment with immunomodulatory medications appears safe. Conversely, glucocorticoids, even at low-dose, may confer increased risk of infection.Trial registration: retrospectively registered
Mining and Reuse on Design Knowledge of Non-standard Special Tool Based on Deep Learning
Authors: Wang Mingwei , Zhou Jingtao , Chen Xiaoying , Li Zeyu
Published: August 2020

Aiming at the problems of design difficulty, low efficiency and unstable quality of non-standard special tools, facing the strong correlation between part machining features and tools, this article takes the two-dimensional engineering drawings of tools and parts as research objects, proposes the research on mining and reuse on design knowledge of non-standard special tool based on deep learning. Firstly, a dual-channel deep belief network is established to complete the feature modeling of machining features and tool features; secondly, the deep belief network is used to realize the association relationship mining between the machining features and tool features; thirdly, both the key local features of the tool and the overall similar design case of the tool are reused through association rule reasoning; finally, the non-standard special turning tool is used as an example to verify the effectiveness of the proposed method.
Magnetic resonance imaging and ultrasound for prediction of residual tumor size in early breast cancer within the ADAPT subtrials
Authors: Graeser Monika , Schrading Simone , Gluz Oleg , Strobel Kevin , Herzog Christopher , Umutlu Lale , Frydrychowicz Alex , Rjosk-Dendorfer Dorothea , Würstlein Rachel , Culemann Ralph , Adams Jascha , Nitzsche Henrik , Prange Anna , Kümmel Sherko , Grischke Eva-Maria , Forstbauer Helmut , Braun Michael , Potenberg Jochem , Schumann Raquel von , Aktas Bahriye , Kolberg-Liedtke Cornelia , Harbeck Nadia , Kuhl Christiane , Nitz Ulrike
Published: August 2020

Background: Prediction of histological tumor size by post-neoadjuvant therapy (NAT) ultrasound and magnetic resonance imaging (MRI) was evaluated in different breast cancer subtypes.Methods: Imaging was performed after 12-week NAT in patients enrolled into three neoadjuvant WSG ADAPT subtrials. Imaging performance for prediction of tumor size was analyzed across increasing size ranges (≤10, ≤20 and ≤30 mm) and summarized using positive (PPV) and negative predictive values (NPV).Results: 248 and 588 patients had MRI and ultrasound, respectively. Tumor size was over- or underestimated by <10 mm in 4.4% and 21.8% of patients by MRI and in 10.2% and 15.8% by ultrasound. Overall, PPV (correctly predicted tumor size ≤10, ≤20 or ≤30 mm) of MRI and ultrasound increased from 0.61 and 0.72 for ≤10 mm tumors to 0.88 and 0.96 for ≤30 mm tumors; NPV (correctly predicted tumor size >10, >20 or >30 mm) decreased from 0.89 and 0.74 to 0.69 and 0.22. Across all tumor size ranges, ultrasound demonstrated higher PPV than MRI in HR+/HER2+ tumors while both methods had a similarly low PPV in HR-/HER2- and HR-/HER2+ tumors. MRI had a higher NPV than ultrasound with the exception of HR-/HER2- tumors measuring ≤10 and ≤20 mm where both methods had similar NPV. Conclusions: Ultrasound is less likely than MRI to underestimate the size of HR+/HER2+ tumors while MRI is associated with a lower risk to overestimate the size of HR+/HER2+ and HR-/HER2+ tumors. These findings may help to select the most optimal imaging approach for planning surgery after NAT. Trial registration: Clinicaltrials.gov, NCT01815242 (registration March 21, 2013, NCT01817452 (registration March 25, 2013), NCT01779206 (registration January 30, 2013).
A large-scale database of T-cell receptor beta (TCRβ) sequences and binding associations from natural and synthetic exposure to SARS-CoV-2.
Authors: Nolan Sean , Vignali Marissa , Klinger Mark , Dines Jennifer N. , Kaplan Ian M. , Svejnoha Emily , Craft Tracy , Boland Katie , Pesesky Mitch , Gittelman Rachel M. , Snyder Thomas M. , Gooley Christopher J. , Semprini Simona , Cerchione Claudio , Mazza Massimiliano , Delmonte Ottavia M. , Dobbs Kerry , Carreño-Tarragona Gonzalo , Barrio Santiago , Sambri Vittorio , Martinelli Giovanni , Goldman Jason D. , Heath James R. , Notarangelo Luigi D. , Carlson Jonathan M. , Martinez-Lopez Joaquin , Robins Harlan S.
Published: August 2020

We describe the establishment and current content of the ImmuneCODE™ database, which includes hundreds of millions of T-cell Receptor (TCR) sequences from over 1,400 subjects exposed to or infected with the SARS-CoV-2 virus, as well as over 135,000 high-confidence SARS-CoV-2-specific TCRs. This database is made freely available, and the data contained in it can be downloaded and analyzed online or offline to assist with the global efforts to understand the immune response to the SARS-CoV-2 virus and develop new interventions.
Repositioning of ligands that target spike glycoprotein as potential drugs against SARS-CoV-2
Authors: Ramírez-Salinas Gema Lizbeth , Martínez-Archundia Marlet , Correa-Basurto José , García-Machorro Jazmín
Published: August 2020

The worldwide health emergency of the SARS-CoV-2 pandemic and the absence of a specific treatment for this new coronavirus have led to the use of computational strategies (drug repositioning) to search for treatments. The aim of this work is to identify FDA-approved drugs with the potential for binding to the spike structural glycoprotein at the hinge site, receptor binding motif (RBM), and fusion peptide (FP) using molecular docking simulations. It was identified drugs that binding to amino acids crucial for down to up conformational change, receptor recognition, and fusion of the viral membrane with the cell membrane. Results show some drugs that bind to hinge site amino acids (Varenicline, or even steroids as Betamethasone) while other drugs bind to crucial amino acids for RBM (Naldemedine, Atovaquone, Cefotetan) or FP (Edarbi, Maraviroc, Difluprednate); and highlights the Saquinavir that binds both the RBM and the FP. Therefore, these drugs could inhibit spike glycoprotein and prevent viral entry (possible anti-COVID-19 drugs). Several drugs are in clinical studies; focused on another pharmacological target (candesartan, Atovaquone, Losartan, Maviroc and Ritonavir) in this work we propose an additional target, the spike glycoprotein. These results can impact in the proposal of treatments that can inhibit the first steps virus replication cycle.
Decreased T Cell Levels in Critically Ill Coronavirus Patients: single-center, prospective and observational study
Authors: Wang Changsong , Liu Zhiyu , Xu Jingjing , Liu Haitao , Luo Yunpeng , Kang Kai , Li Xueting , Yang Wei , Fei Dongsheng , Zhao Mingyan , Yu Kaijiang
Published: August 2020

Background: Since Dec. 2019, COVID-19 pandemic has been outbreak. T cells play an important role in dealing with various disease-causing pathogens. However, the role of T cells played in COVID-19 patients is still unknown. Our study aimed to describe immunologic state of the critical ill COVID-19 patients. Methods: 63 patients with confirmed COVID-19 pneumonia admitted Department of Intensive Care Unit of the First Affiliated Hospital of Harbin Medical University. The immunologic characteristics（lymphocyte apoptosis, the expression of PD-1 and HLA-DR in T cells, T cell subset levels, redistribution and the production of inflammatory factors）as well as their laboratory parameters were compared between severe group and critical group.Results: The level of T cells in peripheral blood was decreased in critical patients compared with that in severe patients, but the expression levels of PD-1 (CD4+: 24.71% VS 30.56%; CD8+: 33.05% VS 32.38%) and HLA-DR (T cells: 36.28% VS 27.44%; monocytes: 20.58% VS 23.83%) in T cells were not significantly changed, and apoptosis and necrosis were not different in lymphocytes (apoptosis: 1.04% VS 1.27%; necrosis: 0.67% VS 1.11%), granulocytes, or monocytes between those two groups.Conclusions: There is severe immunosuppression in critical ill COVID-19 patients. Redistribution of T cells might be the main reason for lymphocytic decline. Decreasing the infiltration of T lymphocytes in the lung may be beneficial for the treatment of COVID-19. Trial registration: The study was approved by the Ethics Committee of the First Affiliated Hospital of Harbin Medical University. Code number: kyk2020003.
Low Diaphragm Muscle Mass Predicts Adverse Outcome in Patients Hospitalized for Covid-19 Pneumonia
Authors: Corradi Francesco , Isirdi Alessandro , Brusasco Claudia , Santori Gregorio , Falcone Marco , Gargani Luna , Romei Chiara , Barbieri Greta , Guarracino Fabio , Vetrugno Luigi , Landoni Giovanni , Forfori Francesco
Published: August 2020

Purpose: The aim of this study was to evaluate whether measurement of diaphragm thickness by ultrasonography may be a clinically useful noninvasive method for identifying patients at risk of adverse outcomes defined as need of invasive mechanical ventilation or death. Methods: We retrospectively reviewed the records of consecutive of 77 patients with laboratory-confirmed Covid-19 infection admitted to our intermediate care unit in Pisa between March 5 and March 30, 2020, with follow up until hospital discharge or death. Logistic regression was used identify variables potentially associated with adverse outcomes and those P<0.10 were entered into a multivariate logistic regression model. Cumulative probability for lack of adverse outcomes in patients with or without low baseline diaphragm muscle mass was calculated with the Kaplan–Meier product-limit estimator.Results: The main findings of this study are that 1) patients who developed adverse outcomes had thinner diaphragm than those who did not (2.0 vs 2.2 mm, p:0.001), 2) DT and lymphocyte count were independent significant predictors of adverse outcomes, with end-expiratory DT being the strongest (-708, OR: 0.492, p: 0.018).Conclusion: Diaphragmatic ultrasound may be a valid tool to evaluate the risk of respiratory failure. Evaluating the need of mechanical ventilation treatment should be based not only on PaO2/FiO2, but on a more comprehensive assessment including DT because if the lungs become less compliant a thinner diaphragm, albeit free of intrinsic abnormality, may become exhausted, thus contributing to severe respiratory failure.
Is Quarantine for COVID-19 Pandemic Associated with Psychological Burden in Primary Ciliary Dyskinesia? A Prospective Study.
Authors: Riccio Maria Pia , Borrelli Melissa , Fioretti Maria Teresa , Bene Margherita Del , Bravaccio Carmela , Poeta Marco , Santamaria Francesca
Published: August 2020

Background: Primary ciliary dyskinesia (PCD) is a rare disorder with variable disease progression. Information on the psychological impact of the Coronavirus Disease 2019 (COVID-19) quarantine in PCD, a condition with characteristics of personal and familiar increased stress due to frequent pulmonary exacerbations and high risk of lung function deterioration, is lacking. We designed a prospective study to assess the psychological burden and parental stress during the COVID-19 lockdown in Italy in a PCD population.Methods: Questionnaires assessing psychological well-being were administered to 10 PCD patients <15 years-old’s mothers (Group A: Parenting Stress Index-Short Form), to 17 PCD patients >=15 years-old (Group B: Psychological General Well-Being Index) and to 27 controls. We compared the PCD pulmonary exacerbations from the beginning of the outbreak and the frequency of weekly chest physiotherapy sessions during quarantine to the same period in 2019. Results: Seventy percent of Group A cases did not present parental stress levels. Ninety percent of Group B subjects did not show scores indicating distress. Groups A and B showed no significant difference versus controls in parental stress and psychological well-being, respectively. In the whole PCD population pulmonary exacerbations from the beginning of outbreak were less than in the same period of 2019 (p<0.05), and weekly chest physiotherapy sessions significantly increased during the quarantine compared to the same period of 2019 (p<0.05).Conclusions: We found that during COVID-19 quarantine, a PCD population in Italy neither developed psychological distress nor had a psychological burden significantly different than controls. We speculate that the low pulmonary exacerbation rate, explained by lower exposure to infectious triggers or by improved compliance to weekly chest physiotherapy, likely contributes to the psychological well-being of PCD patients and their families. The evaluation of the psychological burden and parental stress is a valuable tool for measuring the emotional impact of PCD and ultimately improving the medical care to PCD patients and their families, especially when exceptional events such as a pandemic occur.
Electrochemical performance of La2NiO4+δ-Ce0.55La0.45O2-δ as a promising bifunctional oxygen electrode for reversible solid oxide cells
Authors: Li Pengzhang , Yang Wei , Tian Chuanjin , Zhao Wenyan , Lü Zhe , Xie Zhipeng , Wang Chang-An
Published: August 2020

In this work, La2NiO4+δ-xCe0.55La0.45O2-δ (denoted as LNO-xLDC) with various LDC contents (x = 0, 10, 20, 30 and 40, wt %) were prepared and evaluated as bifunctional oxygen electrodes for reversible solid oxide cells (RSOCs). Compared with the pure LNO, the optimum composition of LNO-30LDC exhibited the lowest polarization resistance (Rp) of 0.53 and 0.12 Ω·cm2 in air at 650 and 750 oC, respectively. The enhanced electrochemical performance of LNO-30LDC oxygen electrode was mainly attributed to the extended triple phase boundary and more oxygen ionic transfer channels. The hydrogen electrode supported single cell with LNO-30LDC oxygen electrode displayed peak power densities of 276, 401 and 521 mW·cm-2 at 700, 750 and 800 oC, respectively. Moreover, the electrolysis current density of the single cell demonstrated 526.39 mA·cm-2 under 1.5 V at 800 oC, and the corresponding hydrogen production rate was 220.03 ml·cm-2·h-1. The encouraging results indicated that LNO-30LDC was a promising bifunctional oxygen electrode material for RSOCs.
Development a quantitative segmentation model to assess the effect of comorbidity on patients with COVID-19
Authors: Zhang Cui , Yang Guangzhao , Cai Chunxian , Xu Zhihua , Wu Hai , Guo Youmin , Xie Zongyu , Shi Hengfeng , Cheng Guohua , Wang Jian
Published: August 2020

Background: The coronavirus disease 2019 (COVID-19) has brought a global disaster. Quantitative lesions may provide the radiological evidence of the severity of pneumonia and further to assess the effect of comorbidity on patients with COVID-19.Methods: 294 patients with COVID-19 were enrolled from February, 24, 2020 to June, 1, 2020 from six centers. Multi-task Unet network was used to segment the whole lung and lesions from chest CT images. This deep learning method was pre-trained in 650 CT images (550 in primary dataset and 100 in test dataset) with COVID-19 or community acquired pneumonia and Dice coefficients in test dataset were calculated. 50 CT scans of 50 patients (15 with comorbidity and 35 without comorbidity) were random selected to mark lesions manually. The results will be compared with the automatic segmentation model. Eight quantitative parameters were calculated based on the segmentation results to evaluate the effect of comorbidity on patients with COVID-19.Results: Quantitative segmentation model was proved to be effective and accurate with all Dice coefficients more than 0.85 and all accuracies more than 0.95. Of the 294 patients, 52 (17.7%) patients were reported having at least one comorbidity, 14 (4.8%) having more than one comorbidity. Patients with any comorbidity were older (P<0.001), had longer incubation period (P<0.001), were more likely to have abnormal laboratory findings (P<0.05) and be in severity status (P<0.001). More lesions (including larger volume of lesion, consolidation and ground-glass opacity) were shown in patients with any comorbidity than patients without comorbidity (all P<0.001). The more comorbidities patients have, the poorer CT manifestation is. The median volume of lesion, consolidation and ground-glass opacity in diabetes mellitus group was largest among the three prevalently single comorbidity groups.Conclusions: Multi-task Unet network can make quantitative CT analysis of lesions to assess the effect of comorbidity on patients with COVID-19, further to provide the radiological evidence of the severity of pneumonia. More lesions were found in CT images of cases with comorbidity. The more comorbidities patients have, the poorer CT manifestation is.
Effects Of Mechanical In-Exsufflation On Mucus Clearance In Critically Ill Patients On Invasive Mechanical Ventilation
Authors: Martinez-Alejos Roberto , Martí Joan-Daniel , Bassi Gianluigi Li , Gonzalez-Anton Daniel , Pilar-Diaz Xabier , Reginault Thomas , Wibart Philippe , Gabarrus Albert , Quinart Alice , Torres Antoni
Published: August 2020

Background: Mechanical insufflation-exsufflation (MI-E) is a non-invasive technique performed through the CoughAssist In-Exsufflator to simulate cough and remove mucus from proximal airways. To date, the effects of MI-E on critically ill patients on invasive mechanical ventilation (MV) are not fully elucidated. The purpose of this study was to compare the efficacy and safety of MI-E combined or not to manual chest physiotherapy (CPT) in these patients.Methods: This cross-over clinical study enrolled consecutive patients who were sedated, intubated and on MV > 48h with expected maintenance of these criteria > 24h. Over a 24-hour period, patients randomly performed two sessions of manual CPT with or without additional MI-E before tracheal suctioning. Following each procedure, volume of retrieved mucus (ml) was assessed to evaluate efficacy. We evaluated respiratory flows, pulmonary mechanics and hemodynamics before, during, and after treatment. In addition, safety of MI-E was also appraised.Results: 26 patients were included. In comparison to CPT, mucus volume retrieved was significantly higher during CPT+MI-E (0.42 [0; 1.39] ml vs 2.29 [1; 4.67] ml; p < 0.001). The respiratory system compliance immediately improved from pre and post Crs values in CPT+MI-E group (55.7 ml/cmH2O [38.3; 67.4] vs. 68.6ml/cmH2O [47.8;94.9]; p<0.001). Although, such increase was not significantly different between CPT and CPT+MI-E group (p=0.057). Heart rate significantly increased in both groups (p < 0.005) immediately after each intervention. Additionally, a significant impact on oxygenation was observed in the CPT+MI-E group when comparing the baseline values with the values one-hour post-intervention (p<0.05). Finally, several transitory hemodynamic variations occurred during both interventions, but these were non-significant and considered clinically irrelevant.Conclusion: In mechanically ventilated patients, MI-E increases the amount of secretions that can be retrieved post-CPT, without causing clinically significant adverse events.Clinical Trials Registration Number: NCT03316079 (24/11/2015; retrospectively registered)
Prognostic value of Onodera’s Nutritional Index for intermediate and high risk gastrointestinal stromal tumors treated with or without TKIs
Authors: Wang Feng , Tao Tingting , Yu Heng , Xu Yingying , Xia Xuefeng , Wang Meng , Zong Liang , Guan Wenxian
Published: August 2020

Background

Immunoinflammatory and nutritional markers such as peripheral blood neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and onodera’s prognostic nutritional index (OPNI) have gained considerable attention and revealed preliminaryly as prognostic markers in gastrointestinal stromal tumor (GIST).
Methods

In this study, we firstly investigated the prognostic value of OPNI in GIST treated with or without TKIs based on the propensity score matching (PSM) method. All of the patients had received surgical resection for primary GIST, The data from 2010 to 2018 were initially and retrospectively identified from our gastrointestinal center. Recurrence-free survival (RFS) was calculated by the Kaplan-Meier method and compared by the log-rank test.
Results

These patients who were treated with TKIs and those who did not were divided into two groups, and we used propensity score matching method to make them have more unified baseline data. Multivariate Cox proportional hazard regression models were applied to identify associations with outcome variables.A total of 563 GISTs were initially chosen and 280 of them were included for analysis under an inclusion criteria. After PSM, there were 200 patients included. Multivariate analyses identified OPNI was an independent prognostic marker, and was associated with primary site, tumor size, mitotic index, tumor rupture, necrosis, and modified NIH risk classification. Low OPNI (< 44.05; HR 0.433; 95% CI 0.236–0.794; P = 0.007) were associated with worse RFS.
Conclusions

Preoperative OPNI is a novel and useful prognostic marker for GISTs both treated with or without TKIs.
Effects of long-term particulate matter exposure on platelet counts in adults of Northeast China
Authors: Zhang Hehua , Zhao Yuhong
Published: August 2020

Associations between air pollution exposure and platelet counts have been inconsistent in previous studies, and there have been few studies of effects of long-term exposure in Asian populations. We explored the associations between long-term PM2.5 (particulate matter < 2.5 µm) exposure and platelet counts using a prospective cohort study in Northeast China. We used a logistic regression model to analyze the effects of different PM2.5 increments and platelet count elevation. Mixed linear models were used to analyze the association between PM2.5 concentration and platelet counts. Interaction and stratified analyses were also conducted. Results showed that every 1 µg/m3 increment of PM2.5 exposure was associated with 0.29% (95%CI: 0.25–0.32%) increase in platelet counts and 10% (95%CI: 8–12%) higher risk of platelet elevation. Effects of long-term PM2.5 exposure on platelet elevation were stronger in male participants, of Han ethnicity, and without diabetes. Our findings add more evidence to the potential biological mechanisms responsible for the effect of air pollution exposure on cardiovascular disease.
Stiffness Model of the Armature Assembly in a Jet Pipe Pressure Servo Valve
Authors: Yin Yaobao , He Chengpeng , Li Jing
Published: August 2020

The armature assembly of the jet pipe pressure servo valve plays an important role in connecting the torque motor and the jet pipe amplifier. A stiffness model of its complex structure is very necessary for analyzing the dynamic/static performance of the jet pipe pressure servo valve. At the present work, the component parts in the armature assembly are simplified into linear elastic beams. The simplified armature assembly is a fourfold statically indeterminate structure under the premise of small deformation. The unknown forces and moments are solved by using the section continuity condition as the additional supplement equation, and the functional relationship between the electromagnetic torque produced from the torque motor and the armature rotation angle /the nozzle displacement is derived based on the Castigliano's Theorem. The finite element model of the armature assembly is also established to calculate the deformation under different loads and different spring tube lengths. The simulated displacements with the finite element method are consistent with the theoretical results. The experimental results of the recovery pressure of the jet pipe valve verified the theoretical model. The proposed stiffness calculation method can be used as a reference for designing and optimizing the armature assembly in the jet pipe pressure servo valve.
Are preoperative high soluble programmed death ligand 1 levels responsible for patients’ poor prognoses in hepato-biliary-pancreatic cancer?
Authors: Okada Rei , Otsuka Yuichiro , Tsuchiya Masaru , Maeda Tetsuya , Ishii Jun , Kubota Yoshihisa , Funahashi Kimihiko , Kaneko Hironori , Shimada Hideaki
Published: August 2020

Background

Several reports showed that high soluble programmed death-ligand 1(sPD-L1) level was a risk factor for poor prognosis in various tumors. To date, the clinicopathologic and prognostic impact of sPD-L1 level in patients with hepato-biliary-pancreatic cancer have not been determined.
Methods

A total of 119 patients (66 patients with hepatocellular carcinoma, 23 patients with cholangiocarcinoma, 30 patients with pancreatic cancer) who were treated at the Toho University Omori Hospital (Tokyo, Japan) from 2008 to 2016 were retrospectively analyzed. sPD-L1 levels were measured using an enzyme-linked immunosorbent assay for PD-L1 to evaluate clinicopathologic and prognostic impact.
Results

sPD-L1 levels were significantly higher in low-albumin group than normal albumin group. According to stages in hepatocellular carcinoma and cholangiocarcinoma, there were no significant differences in sPD-L1 levels, which gradually increased according to stage in pancreatic cancer. Using a cut-off value of 81.6 pg/ml for sPD-L1level, the high sPD-L1 group showed significantly worse prognosis than the low sPD-L1 group in patients with pancreatic cancer. Multivariate analysis identified sPD-L1 level ≥ 81.6 mg/dl (p = 0.047) as an independent predictor of poor overall survival in patients with pancreatic cancer.
Conclusion

High sPD-L1 levels were independently associated with poor prognosis. However, this association in hepatocellular carcinoma or cholangiocarcinoma was not clear.
Bidirectional association between serum carcinoembryonic antigen and metabolic syndrome among Chinese male population: two cohort studies
Authors: Liu Ya-Fei , Du Zhao-Hui , Ji Jia-Dong , Li Jing-Ru , Bi De-Ming , Tang Fang
Published: August 2020

Purpose: Previous studies have shown that serum carcinoembryonic antigen (CEA) was independently associated with metabolic syndrome (MetS) risk. However, these studies were mainly cross-sectional analyses and cause has not been clarified. In the current study, we conducted two bidirectional cohort studies to investigate the bidirectional associations between CEA and MetS using a Chinese male sample cohort.Methods: The initial longitudinal cohort included 9,629 Chinese males from January 2010 to December 2015. Two bidirectional cohorts were conducted in the study: subcohort A (from CEA to MetS, n=6,439) included participants without MetS at baseline to estimate the risk of developing incident MetS; subcohort B (form MetS to CEA, n=8,533) included participants without elevated CEA level (Hyper-CEA) at baseline to examine the risk of developing incident Hyper-CEA. Hazard ratios were estimated using Cox proportional hazards models.Results: In subcohort A, the incidence densities of MetS were 85.47 and 99.25 per 1000 person-years with and without Hyper-CEA, respectively. Comparing without Hyper-CEA at baseline, participants with Hyper-CEA had a 0.89 (95% CI, 0.71 to 1.12)-fold hazard ratio of developing incidence MetS (P=0.326). In subcohort B, the incidence densities of Hyper-CEA were 33.42 and 29.13 per 1000 person-years for those with and without MetS, respectively. Participants with MetS had no significantly associated with incident Hyper-CEA (hazard ratio, 1.02; 95% CI, 0.84 to 1.22; P=0.864) in the general Chinese participants. Meanwhile, in the stratified analysis, MetS was might significantly associated with increased incident Hyper-CEA in men with age > 65-year and nonsmoking.Conclusion: CEA has no association with incident MetS. CEA should be interpreted carefully in MetS patients. Meanwhile, we need pay more attention to MetS in nonsmoking elderly men. They might have a higher risk of developing cancer.
Sema4C Induces the Endothelial-Mesenchymal Transition of Tumor-Associated Lymphatic Endothelial Cells in Cervical Cancer via the ERK Pathway
Authors: Wang Hongyan , Peng Jin , Liu Xijiang , Li Chengcheng , Gao Min
Published: August 2020

Background: The endothelial-mesenchymal transition (EndMT) is a process that increases the promigratory abilities of endothelial cells (ECs). Although lymphatic endothelial cells (LECs) plays a positive role in tumor lymphatic metastasis, the regulation of LECs undergoing EndMT remains poorly understood. Previous study indicated that Semaphorin 4C (Sema4C) could be a marker of LECs in cervical cancer. Here, we try to understand the mechanism that Sema4C could promote LECs to get mesenchymal characters and enhance lymphatic metastasis in cervical cancer. Methods: The co-location of Sema4C and lymphatic marker LYVE1 was verified by confocal laser scanning. Primary tumor-associated LECs (TLECs) were distinguished from cervical cancer by flow cytometry from a mouse xenograft cervical tumor model. The promigratory ability was assessed using the Transwell test. Lentivirus infection was used to alter the expression of Sema4C in TLECs and the infection efficiency was tested by confocal laser scanning. The phospho-extracellular signal-regulated kinase (p-ERK) signaling pathway was measured using the ERK inhibitor (PD98059) ,as well as quantitative PCR and Western blot analysis. Results: Sema4C and LYVE1 co-located on TLECs. Primary TLECs were successfully separated and cultured. Overexpressing Sema4C by lentivirus infection stimulated the invasive capacity of TLECs and downregulated E-cadherin, whereas knocking down Sema4C had the opposite effects. TLECs pro-migratory ability was found to depend on the extracellular signal-regulated kinase (ERK) signaling pathway, as the ERK inhibitor (PD98059) reversed Sema4C-induced E-cadherin expression and migration ability. Conclusion: The results of this study suggest that the Sema4C-ERK-E-cadherin pathway appears to be critical for the EndMT of TLECs, which might promote lymph node metastasis. Thus, Sema4C could be a promising target for the treatment of cervical cancer with lymphatic metastasis.