bluuebunny/crossref_metadata_2025 huggingface dataset:
Post-irradiation Hyperamylasemia Is a Prognostic Marker for Allogeneic Hematopoietic Stem Cell Transplantation Outcomes in Pediatric Population: a Retrospective Single-centre Cohort Analysis.
Authors: Baldo Francesco , Simeone Roberto , Marcuzzi Annalisa , Vidimari Rossella , Ciriello Francesca , Zanon Davide , Maestro Alessandra , Barbi Egidio , Maximova Natalia
Published: January 2021

Background: Total body irradiation (TBI) is a mandatory step for patients with acute lymphoblastic leukemia (ALL) undergoing allogeneic hematopoietic stem cell transplantation (HSCT). In the past, amylases have been reported to be a possible sign of TBI toxicity. We investigated the relationship between total amylases (TA) and transplant-related outcomes in pediatric recipients. Methods: We retrospectively analyzed the medical records of all the patients who underwent allogeneic HSCT between January 2000 and November 2019. Inclusion criteria were the following: recipient’s between 2 and 18, diagnosis of ALL, no previous transplantation, and use of TBI-based conditioning. Serum total amylase and pancreatic amylase were evaluated before, during and after transplantation. Cytokines and chemokines assays were retrospectively performed. Results: 78 patients fulfilled the inclusion criteria. 57 patients were treated with fractionated TBI and 21 with a single dose regimen. Overall survival (OS) was 62.8%. Elevated values of TA were detected in 71 patients (91%). TA were excellent in predicting the OS (AUC = 0.773; 95% CI = 0.66-0.86; P < 0.001). TA values below 374 U/L were correlated with a higher OS. The highest mean TA values (673 U/L) were associated with a high disease-progression mortality rate. TA showed high predictive performance for disease progression-related death (AUC = 0.865; 95% CI = 0.77 – 0.93; P < 0.0001). Elevated TA values were also connected with significantly higher levels of proinflammatory cytokines such as TNF-α, IL-6 and RANTES (P < 0.001).Conclusions: This study shows that TA is a valuable predictor of post-transplant OS and increased risk of leukemia relapse.
The combined healthy lifestyle score is a protective factor for cardiovascular disease: a representative national cohort study in Taiwan
Authors: Tsai Ming-Chieh , Yeh Tzu-Lin , Hsu Hsin-Yin , Hsu Le-Yin , Lee Chun-Chuan , Tseng Po-Jung , Chien Kuo-Liong
Published: January 2021

BackgroundThe protective effect of different healthy lifestyle scores for the risk of cardiovascular disease (CVD) was reported but the comparisons of performance were lack. We compared the performance measures of cardiovascular diseases from different healthy lifestyle scores among adult Taiwan.MethodsWe conducted a nationwide prospective cohort study of 6042 participants (median age 43 years, 50.2% women) in Taiwan’s Hypertensive, Hyperglycemia and Hyperlipidemia Survey, 2002 who were free of CVD at baseline. Simple and weighted Taiwan healthy lifestyle score was defined as combination of normal body mass index, Mediterranean diet, adequately physical activity, not smoking and regular healthy drinking and each dichotomous lifestyle factor. World Cancer Research Fund and the American Institute for Cancer Research (WCRF/AICR) cancer prevention recommended lifestyle and Life's Simple 7 following the guideline definition. The incidence of cardiovascular disease incidence among the 4 healthy lifestyle score each divided into 4 groups based on scores were estimated.ResultsDuring a median 14.3 years follow-up period, totally 520 cases developed CVD events. In multivariate-adjusted Cox proportional hazard models, adherence to highest category compared with lowest one of simple Taiwan lifestyle score for hazard ratio 0.43 (95% confidence interval [CI] 0.2, 0.94) and weighted Taiwan lifestyle score for 0.44 (95%CI 0.28, 0.68) were independently and significantly. In addition, age played a significant effect modifier for the protective effect of healthy lifestyle scores for CVD risk. Specifically, when the simple and weighted Taiwan healthy lifestyle score were added to the classical model, the Harrell’s C-statistic increasing from 0.85 to 0.86 (95% confidence interval [CI], 0.84, 087; Pdiff=0.02) in both lifestyle scores. The performance measures by integrated discriminative improvement showed significant increasing after adding simple Taiwan healthy lifestyle score (integrated discriminative improvement: 0.51, 95% CI 0.16, 0.86, P=0.002) and weighted Taiwan lifestyle score (integrated discriminative improvement: 0.38, 95% CI 0.01,0.74, P=0.021) information.Conclusions We demonstrated that healthy lifestyle scores with an inverse association with CVD, and the reduction of CVD risk was more for young adults than for old adult. Further investigations to study the mechanism of lifestyle role on CVD prevention are warranted.
Energy-Delay-Balanced Load Dispatching in Cloud-Assisted Edge Computing of Smart City
Authors: Zhang Ren , Wu Qianhong , Zhang Han , Qin Bo
Published: January 2021

As smart city develops, Cloud Assisted Mobile Edge computing (CAME) framework is popular because it has the advantage of low delay and cost. But the computing capacity of mobile users is constrained in energy consumption, especially how to overcome the tradeoff between system latency and energy. In this article, an energy-delay-balanced load dispatching algorithm is suggested by exploiting the Karush-Kuhn-Tucker (KKT) conditions. Its exponential complexity is circumvented by taking the advantage of the linear property of constraints, rather than directly figuring out the KKT conditions. Compared to the fair ratio algorithm and the greedy algorithm, our suggested one is proved to provide better performance by simulation, which can decrease the delay by 35% and 49% respectively on the basis of the same energy consumption. The results indicate that the designed algorithm provides desirable tradeoff between system latency and energy.
Does Medicaid Broaden the Choices of Patients with Low Socioeconomic Status? An Analysis of Bypassing Behaviors in Brooklyn
Authors: Lee Jae Bok
Published: January 2021

Background: Many governments worldwide have committed to extending choices in public service delivery. However, the extent to which policies ensure equity is unclear. We investigated whether Medicaid programs in the United States improve hospital accessibility among patients with low socioeconomic status, compared to those with non-low socioeconomic status who are non-Medicaid recipients or uninsured.Methods: We employed a difference-in-difference-in-differences approach using a rich dataset of information on inpatients and their choice of hospitals from Statewide Planning Research and Cooperative System and information on hospitals from the American Hospital Association in Brooklyn, New York, from 2003 to 2009Results: The findings indicated that Medicaid has failed to broaden the range of the hospital choices for patients with low socioeconomic status, assessed in terms of bypassing behaviors. Conclusions: Medicaid is a public program that offers choices driven by purchasing power. The findings of this study imply that this program has some limitations in alleviating existing socioeconomic inequities in available hospital choices.
Determinants of Facilitators, Barriers and Structural Factors on the Behavior to Physical Activity and Interventional Framework among Nulliparous Pregnant Women: A Qualitative Study Using Maxqda
Authors: kianfard leila , SHokravi Farkhonde Amin , Rakhshanderou Sakineh , Niknami Shamsaddin
Published: January 2021

BackgroundThe goal of this study was to recognize facilitators, barriers, and structural influences on behavior of physical activity among pregnant women.MethodsData analyses were done from 30 pregnant women (second and third trimester) and four of provider who were employed for this study (2020). Participants were answered to open-ended questions relating to the obstacles that deprived them of physical activity during pregnancy. ResultsThe barrier factors consist of lack of sufficient information about the advantages of physical activity, lack of suitable place, lack of access to economically and affordable classes. Social norms are pertinent to subjective norms and motivators. Facilitating factors included using the E-learning to educate pregnant women and awareness of the existence of sport classes.ConclusionIt is essential to comprehend why pregnant women meet obstacles for physical activity. Many of issues were raised: the need of sufficient information on the advantages of physical activity, the role of nurtures factors that need to be motivated in physical activity. Need for consultation to investigate structural problems in the community to provide facilities for pregnant women.
Interventions for Improving Outcomes in Patients With Multimorbidity in Primary Care and Community Setting: A Systematic Review
Authors: Smith Susan , Wallace Emma , Clyne Barbara , Boland Fiona , Fortin Martin
Published: January 2021

BackgroundMultimorbidity, defined as the co-existence of two or more chronic conditions, presents significant challenges to patients, healthcare providers and health systems. Despite this, there is ongoing uncertainty about the most effective ways to manage patients with multimorbidity. This review aimed to determine the effectiveness of interventions designed to improve outcomes in people with multimorbidity in primary care and community settings, compared to usual care.MethodsWe searched eight databases and two trials registers up to 9th September 2019. Two review authors independently screened and selected studies, extracted data, evaluated study quality and judged the certainty of the evidence (GRADE). Interventions were grouped by their predominant focus into care-coordination/self-management support, self-management support and medicines management. Main outcomes were health related quality of life (HRQoL) and mental health. Meta-analyses were conducted, where possible, but the synthesis was predominantly narrative.ResultsWe included 16 RCTs with 4,753 participants, the majority being older adults with at least three conditions. There were eight care-coordination/self-management support studies, four self-management support studies and four medicines management studies. There was little or no evidence of an effect on primary outcomes of HRQoL (MD 0.03, 95% CI -0.01 to 0.07, I2 = 39%) and mental health or on secondary outcomes with a small number of studies reporting that care coordination may improve patient experience of care and self-management support may improve patient health behaviours. Overall the certainty of the evidence was graded as low due to significant variation in study participants and interventions. Conclusions There are remaining uncertainties about the effectiveness of interventions for people with multimorbidity, despite the growing number of RCTs conducted in this area. Our findings suggest that future research should consider patient experience of care, optimising medicines management and targeted patient health behaviours such as exercise.
Key Factors Contributing to The Anchorage Loss of Maxillary First Molars: A Retrospective Study of 726 Extraction Cases
Authors: Su Hong , Xu Kaiyuan , Han Bing , Chen Gui , Xu Tianmin
Published: January 2021

Background: Anchorage control is one of the key components in the treatment of extraction cases. However, why anchorage loss happens is still an unanswered question. The purpose of this study was to investigate the most important factors contributing to the anchorage loss of maxillary first molars in premolar extraction cases. The study enrolled 726 upper premolar extraction cases, including 214 male patients and 512 female patients, and the average age was 14 (range: 9-45 years old).Factors including physiological characteristics, treatment mechanics and cephalometric variables were collected and their influences on the angulation changes of maxillary first molars were analyzed. Results: The average angulation change of maxillary first molar after treatment was 2.81°, meaning the molar tipped forward during treatment by 2.81°. The change of UM/PP showed statistically significant difference in different sex ( male 3.84°±5.26 ° vs female 2.38°±5.10°), age (adult -0.05°±4.73 ° vs teenager 3.46°±5.07°), and molar relationship(Class II 3.28°±5.15°vs Class I 2.36°±5.19°). There are six variables accounted in the regression analysis (R=0.608, R²=37.0%). Among them, the pre-treatment molar tipping (Standardized Coefficients：-0.65) and the pre-treatment incisor/molar height ratio (Standardized Coefficients：-0.27)were the most important factors influencing anchorage loss during treatment.Conclusion: Compared with treatment-related factors, the patient’s physiological characteristics play a more important role in anchorage loss. The pre-treatment angulation of the maxillary first molar is the most contributing factor of the maxillary molar angulation changes, which are often predisposing anchorage loss.
A Potential Misdiagnosis in the COVID-19 Pandemic Era: A Case Report of Superimposed Thrombosis or Tumor Recurrence
Authors: Zoroufian Arezou , Mohseni-Badalabadi Reza , Mahalleh Mehrdad , Ghorashi Seyyed Mojaba , Momtahen Sharam , Omidi Negar
Published: January 2021

Background: The clinical manifestation of coronavirus disease 2019 (COVID-19) overlap with other disorders especially cardiovascular diseases (CVD). The prevailing conditions in the COVID-19 pandemic can distract us from other differential diagnoses.Case presentation: We report a 58 years old female presented with syncope episodes and dyspnea on exertion (DOE) with the left atrial (LA) mass, candidate for surgical removal and mitral valve replacement. Nearly 3 months later, she developed dyspnea, fever, and a sore throat cause to admit her with suspected COVID-19. During diagnostic evaluation, a larger LA mass detected that seemed to be COVID-19 induced organized thrombus with prosthetic mitral valve malfunction. The mass resected and immunohistochemistry revealed liposarcoma.Conclusions: The unusual early recurrence of liposarcoma and misdiagnosis with COVID-19 induced thrombosis is the hallmark of the present case that we keep other causes in mind besides COVID-19.
Development of a Framework for Managing Severe Burns Through a 17-year Retrospective Analysis of Burn Epidemiology and Outcomes
Authors: Chen Ling , He Xiaochong , Xian Jishu , Liao Jianmei , Chen Xuanji , Luo Yue , Wang Zonghua , Li Ning
Published: January 2021

Background Burns are one of the most common injuries in daily life for all ages of population. This study was to investigate the epidemiology and outcomes among burn patients in one of the largest burn centers in the southwest of China. Methods The study was performed at the Institute of Burn Research in the first affiliated with the Army Medical University (AMU). A total of 17939 burn patients were included in this retrospective study. Information regarding demographic, burn characteristics, and the burn severity of ABSI were collected, calculated and compared.Results The age ranged from 257 days to 95 years old. Scalding and flame were the two most common causes to burn injuries, comprising of 91.96% in total. Limbs, head/face/neck, and trunk were the most frequently occurred burn sites, with the number and the percent of 12324 (68.70%), 7989 (44.53%), and 7771 (43.32%), respectively. The average total body surface area (TBSA) was 13.64±16.83% (median 8%) with a range of 0.1~100%. A total of 874 (4.9%) patients had TBSA >50%. The presence of a burn with an inhalation injury was confirmed in 543 patients (3.03%). The average LOS was 32.11±65.72 days (median: 17days). Eventually, the retrospective analysis resulted in the development of a framework of burn management continuum used for developing strategies to prevent and manage severe burns.Conclusions The annual number of burn injuries has kept decreasing, which was partially attributed to the increased awareness and education of burn prevention and the improved burn-preventative circumstances. However, the burn severity and the economic burden were still in a high level. And the gender difference and age difference should be considered when making individualized interventions and rehabilitative treatments.
Impact of social capital, gender and education on the utilization of public health services: A Cross sectional study based on the China Migrant Dynamic Survey
Authors: Yang Zhen , Jiang Chenghua
Published: January 2021

Background: China is making every effort to promote equal access to public health services(PHS) for the internal migrants. Studies have demonstrated that the impact of social capital on PHS is different among subgroups of people. Clarifying these differences will help China accurately promote the equalization of PHS for the internal migrants and provide reference for other developing countries.Methods: Data from the China Migrant Dynamic Survey of 2017, involving 130642 migrants in 31 provinces were used to clarify the complex relationship between social capital and the utilization of National Essential Public Health Services (NEPHS). Social capital was divided into regional cognitive social capital (RCSC), regional structural social capital (RSSC), individual cognitive social capital (ICSC), and individual structural social capital (ISSC). Then, multi-level logistic regression was conducted to analyze their impacts on the utilization of NEPHS of the migrants, and whether such effects are moderated by gender and education. Results: The results suggest: (1) There are significant differences in the levels of CSC, SSC, and NEPHS utilization between different genders and educational subgroups of the migrants, among which the educational difference is more prominent. (2) An interaction exists between the levels and dimensions of social capital and NEPHS projects. Also, the impact of SSC on NEPHS is always greater than that of CSC at the same level. (3) The effects of RCSC, RSSC, ICSC, and ISSC on NEPHS utilization by migrants are not moderated by gender. However, education could weaken the relationship between RCSC and health education, ISSC and health education, and RSSC and health records but strengthen the correlation between RSSC and health education. Conclution: This study demonstrated complex interactions between the dimensions and levels of social capital, NEPHS projects, and the population characteristics of migrants. As the government strives towards the equalization of NEPHS, these interactions should be fully considered.
Klinefelter Syndrome with Azoospermia：Identiﬁcation of a Neocentromic Y Chromosome with No Detectable DYZ3 Centromeric Sequence
Authors: Wu Qiong , Zhou Yu-Lin , Kong Hui , GE Yun-Sheng , Shen Yan-Yan , Guo Qi-Wei , Huang Xin-Li
Published: January 2021

Background Individuals with rare cytogenetic variants have contributed to our understanding of the genetics of sex chromosome and its disorders. Here, we report on a 23 years old man with a de novo 47,XX,+mar.ish der(Y)neo(Y)(pter-->p11.2::q11.23-->neo-->q11.23-->qter)(DYZ3-,SRY+,WCPY+) chromosome complement, accompanying with azoospermia and some of other clinical features suggestive of Klinefelter's Syndrome. The constitution of the patient was verified by GTG-banding, QFQ-banding, Fluorescence in Situ Hybridization and Polymerase Chain Reaction. Accordingly, we report the finding of a structurally abnormal chromosome Y with no detectable DYZ3 centromeric sequence and with no detection of AZF a, AZF b and AZF c, with clinical features suggestive of Klinefelter's Syndrome. This is the first reported case of Klinefelter's Syndrome involving a neocentromic Y among previously described cases with a neocentromere. Case presentation we report on a 23 years old man with a de novo 47,XX,+mar.ish der(Y)neo(Y)(pter-->p11.2::q11.23-->neo-->q11.23-->qter)(DYZ3-,SRY+,WCPY+) chromosome complement, accompanying with azoospermia and some of other clinical features suggestive of Klinefelter's Syndrome. The constitution of the patient was verified by GTG-banding, QFQ-banding, Fluorescence in Situ Hybridization FISH and Polymerase Chain Reaction PCR. Conclusions It can be inferred that a neocentromic Y is formed by identification of FISH, PCR and the fact that this markerof Y chromosome is present in 100% of peripheral blood cells and has been efficiently retained through cell divisions despite the absence of the endogenous cen­tromere region. To our knowledge, this is the first reported case of Klinefelter's Syndrome involving a neocentromic Y among previously described cases with a neocentromere, which adds to the catalog of chromosomal aberrations. The present study not only improves the understanding of karyotype/phenotype relationships between neocentric marker Y chromosomes and KFS male infertility, but also supports the hypothesis that the combined application of molecular cytogenetic analysis might help to identify breakpoints, origins, and the constitution of the marker chromosomes.
A New Strategy to Uncover Fragile X Proteomic Biomarkers Using the Nascent Proteome of Peripheral Blood Mononuclear Cells (PBMCs)
Authors: Dionne Olivier , Corbin François
Published: January 2021

Background: Fragile X syndrome (FXS) is the most prevalent inherited cause of intellectual disabilities and autism spectrum disorders. FXS result from the loss of expression of the FMRP protein, an RNA binding protein that regulate the expression of key synaptic effectors. FXS is also characterized by a wide array of behavioral, cognitive and metabolic impairments. The severity and penetrance of those comorbidities are extremely variable, meaning that a considerable phenotypic heterogeneity is found among fragile X individuals. Unfortunately, clinicians currently have no tools at their disposal to assay patient’s prognosis upon diagnosis. Since the absence of FMRP was repeatedly associated with an aberrant translational metabolism, we decided to study the nascent proteome in order to screen for potential proteomic biomarkers of FXS.Method: We used a BONCAT (Bioothogonal Non-canonical Amino Acids Tagging) method coupled to label-free mass spectrometry to purify and quantify nascent proteins of peripheral blood mononuclear cells from 7 fragile X male patients that do not express FMRP and 7 age-matched controls. Candidate biomarkers were confirmed by Western blot. Results: The proteomic analysis identified several proteins which were either up or downregulated in absence of FMRP in FXS individuals as compared to controls. Eleven of those proteins were considered as potential biomarkers, from which 5 were further validated by Western blot. The gene ontology enrichment analysis highlighted molecular pathway that may contribute to FXS physiopathology. Conclusions: Our results showed that the nascent proteome is well suited for the discovery of FXS biomarkers. In fact, taking advantage of a key alteration in FXS physiopathology led us to successfully identified 11 potential biomarkers.
Acetylshikonin Suppresses Diffuse Large B-Cell Lymphoma Cell Growth By Targeting The TOPK Signaling Pathway
Authors: Cui Jieke , Guo Rong , Wang Yingjun , Song Yue , Song Xuewen , Zeng Chong , Li Hongwen , Li Jiwei
Published: January 2021

Background: Diffuse large B-cell lymphoma (DLBCL) is one of the most common causes of cancer death worldwide, and responds badly to the existing treatment. Thus, identifying the novel therapeutic targets of DLBCL are urgent. Methods and results: In this study, we found that the T-lymphokine-activated killer cell-originated protein kinase (TOPK) was highly expressed in DLBCL cells and tissues. The TOPK expression were analyzed by bioinformatics analysis, immunohistochemistry (IHC) and western blot analysis. TOPK knockdown inhibited cell growth and induced apoptosis of DLBCL cells with MTS and flow cytometry. Further experiments demonstrated that acetylshikonin, the targeted compound of TOPK, could attenuate the cell growth and aggravate the cell apoptosis through TOPK/extra cellular signal-regulated kinase (ERK)-1/2 signaling using MTS, flow cytometry and western blot analysis. In addition, we demonstrated that TOPK overexpression signiﬁcantly reduced the acetylshikonin effect on cell proliferation and apoptosis in U2932 and OCI-LY8 cells using MTS, flow cytometry and western blot analysis. Conclusions: Taken together, the present study suggests that the targeted inhibition of TOPK by acetylshikonin may be a promising approach to the treatment of DLBCL.
Forecasting of Future Medical Care Expenditure in Japan Using a System Dynamics Model
Authors: Inoue Sachie , Xu Hua , Maswana Jean-Claude , Kobayashi Makoto
Published: January 2021

Background:Japanese society is facing marked changes due to the aging population and concomitant rapid increase in the national medical care expenditure. To maintain a sustainable national health insurance system, it is important to pursue the efficient allocation of medical care resources. The aim of this study was to construct a system dynamics (SD) model to estimate the future medical care expenditure and to address the dynamic issues of health care that should be resolved. In particular, the measures for promoting the spread of generic drug (GE drug) usage in Japan and reducing cancer-related medical expenses were investigated regarding their future impact on medical finances.Methods:The SD model was constructed to estimate the medical care expenditure from FY 2018 to FY 2050. The change in the future GE drug quantity share was analyzed by using a regression equation, and the target value of the GE quantity share was set exceeding 90% by referring to trends in other countries. The impact of the increase in medical expense for cancer and the change in the future national medical care expenditure were also estimated assuming the current tendency of increase in the medical expense for cancer continues.Results:It was estimated that the annual total medical care expenditure in FY 2050 would arrive at 58.9–64.2 trillion JPY (1.3-1.5-times higher than that in FY 2018) with different trends in age groups. The cumulative total medical care expenditure was expected to decrease by about 787.0-989.4 billion JPY if the impact of the spread of GE drug usage was considered. On the other hand, due to the continuous increase in the cancer-related medical expense, the cumulative total medical care expenditure was estimated to increase about 7,554.3–11,715.0 billion JPY.Conclusions:If the cancer-related medical expense continues to increase in the future, an increase of 686.4-1,104.2 billion JPY in FY2050 is expected which suggests that this disease field should be prioritized regarding the measures to maintain medical finances. This study may serve as a reference for designing a policy in countries that will enter a super-aging society in the future such as that in Japan.Trial registration: Not applicable
Investigation of Leish-111f Epitopes to Design a New Multi-epitope Vaccine Against Leishmania Major Using Immunoinformatics Approaches
Authors: Rabienia Mahsa , Daneshi Rasoul , Mortazavidehkordi Nahid , Ghanbariasad Ali , Abdollahi Abbas , Roudbari Zahra , Farjadfar Akbar
Published: January 2021

BackgroundSince the incidence of various types of leishmaniasis, no definitive treatment has been considered for the disease, and due to its high prevalence worldwide, this issue has caused many concerns. Cutaneous leishmaniasis is the most common form of the disease which, can cause malignant lesions on the skin. Vaccination for the prevention and treatment of leishmaniasis can be the most effective way to combat this disease. In this study, we designed a new multi-epitope vaccine using immunoinformatics tools, which confirmed its effectiveness in the in silico.MethodsSequences Leish-111f protein (TSA, Leif, and LMSTI1) of Leishmania major (L. major) were downloaded from GenBank and with the help of immunoinformatic tools, was designed a new multi-epitope vaccine antigen of L. major.ResultTh and Tc epitopes of the leish-111f protein were predicted using bioinformatics tools. The final multi epitope was consisted of 18 CTL epitopes that joined by AAY linker. There are also 9 HTL epitopes in the structure of the final vaccine that were joined by GPGPG linker. The profilin adjuvant was also added into the construct by AAY Linker. There were 613 residues in the structure of the final construct. The multi epitope was stable and non-allergic. the data obtained from the binding of final multi-epitope vaccine-TLR11 residues (band lengths and weighted scores) showed that the ligand and the receptor have a high affinity to bind to each other. Moreover, in silico cloning approach, was improved the expression of proposed vaccine in E. coli host. Codon adaptation index and GC percent were calculated 1.0 and 53.35, respectivelyConclusionBased on these results, we hope that the multi-epitope vaccine, which contains the most appropriate epitopes of a strong Leishmania major immunogen, along with an adjuvant capable of binding to TLR11, will further stimulate the immune system against the L.major.
The yearly financing need of providing paid maternity leave in the informal sector in Indonesia
Authors: Siregar Adiatma , Pitriyan Pipit , Hardiawan Donny , Zambrano Paul , Vilar-Compte Mireya , Belismelis Graciela Ma Teruel , Moncada Meztli , Tamayo David , Carroll Grace , Perez-Escamilla Rafael , Mathisen Roger
Published: January 2021

BackgroundThe economic cost of not breastfeeding in Indonesia is estimated at US$1.5–9.4 billion annually, the highest in South East Asia. Half of the 33.6 million working women of reproductive age (WRA) in Indonesia (15-49 years) are informal employees, meaning they are working as casual workers or they are self-employed (small scale business) and assisted by unpaid/family worker(s). No specific maternity protection entitlements are currently available for WRA working informally in Indonesia. This study aims to estimate the financing need of providing maternity leave cash transfer (MCT) for WRA working in the informal sector in Indonesia.MethodThe costing methodology used is the adapted version of the World Bank methodology by Vilar-Compte et al, following pre-set steps to estimate costs using national secondary data. We used the 2018 Indonesian National Socio-Economic Survey to estimate the number of women working informally who gave birth within the last year. The population covered, potential cash transfer’s unitary cost, the incremental coverage of the policy in terms of time and coverage, and the administrative costs were used to estimate the cost of MCT for the informal sector. ResultAt 100% coverage for 13 weeks of leave, the yearly financing need of MCT ranged from US$175million (US$152/woman) to US$669million (US$583/woman). The share of the yearly financing need did not exceed 0.5% of Indonesian Gross Domestic Product (GDP).ConclusionThe yearly financing need of providing MCT for eligible WRA working in the informal sector is economically attractive as it amounts to less than 0.5% of GDP nominal of Indonesia. While such a program would be perceived as a marked increase from current public health spending at the onset, such an investment could substantially contribute to the success of breastfeeding and substantial corresponding public health savings given that more than half of working Indonesian WRA are employed in the informal sector. Such policies should be further explored while taking into consideration realistic budget constraints and implementation capacity.
Predicting the Incidence of COVID-19 Using Data Mining
Authors: Ahouz Fatemeh , golabpour amin
Published: January 2021

Background: The high prevalence of COVID-19 has made it a new pandemic. Predicting both its prevalence and incidence throughout the world is crucial to help health professionals make key decisions. In this study, we aim to predict the incidence of COVID-19 within a two-week period to better manage the disease. Methods: The COVID-19 datasets provided by Johns Hopkins University, contain information on COVID-19 cases in different geographic regions since January 22 and are updated daily. Data from 252 such regions were analyzed as of March 29, 2020, with 17,136 records and 4 variables, namely latitude, longitude, date, and records . In order to design the incidence pattern for each geographic region, the information was utilized on the region and its neighboring areas gathered two weeks prior to the designing. Then, a model was developed to predict the incidence rate for the coming two weeks via a Least-Square Boosting Classification algorithm. Results: The model was presented for three groups based on the incidence rate: less than 200, between 200 to 1000, and above 1000. The model evaluation error rates were 4.71%, 8.54%, and 6.13%, respectively. Also, comparing the forecast results with the actual values in the period in question showed that the proposed model predicted the number of globally confirmed cases of COVID-19 with a very high accuracy of 98.45%. Conclusion: Using data from different geographical regions within a country and discovering the pattern of prevalence in a region and its neighboring areas, our boosting-based model was able to accurately predict the incidence of COVID-19 within a two-week period.
Risk factors for developing high-output ileostomy: a retrospective study
Authors: Jian'an Xiao , Bai Dongxiao , Li Lei , Shen Zhiling , Huang Tianchen , Wang Qingbing , Wang Yanjun , Zhang Yong , Guo Zhipeng , Li Kan
Published: January 2021

Background Prophylactic ileostomy and colostomy have been widely used to reduce the risk and complications of anastomotic leakage with high-risk colorectal cancer after operation. However, prophylactic ileostomy itself has some complications, and ileostomy high out-put syndrome is one of them. This study was performed to explore the risk factors of HOS in ileostomy.Methods A total of 114 patients with HOS were screened out from 494 eligible ileostomy patients in the last five years. The clinical and pathological data were analyzed. The relationship between HOS and clinicopathological data was analyzed. Multivariate analysis was performed by logistic regression.Results There was no clear correlation between the occurrence of HOS with sex, age, gross typing, histological grade, location of tumors, lymph node metastasis and TNM stage (p>0.05). Preoperative complications including inflammatory bowel disease, diabetes mellitus and neoadjuvant chemoradiotherapy were risk factors for HOS (p<0.05). Total colectomy and abdominal infection were risk factors for HOS (p<0.05) during operation.Conclusion Inflammatory bowel disease, diabetes mellitus and neoadjuvant radiotherapy and chemotherapy in patients with colorectal cancer are the preoperative risk factors for HOS. Total colectomy and postoperative abdominal infection are the postoperative risk factors for HOS.
Accurate Determination of Genotypic Variance of Cell Wall Characteristics of a Populus trichocarpa Pedigree Using High-Throughput Pyrolysis-Molecular Beam Mass Spectrometry
Authors: Harman-Ware Anne Elizabeth , Macaya-Sanz David , Abeyratne Chanaka Roshan , Doeppke Crissa , Haiby Kathleen , Tuskan Gerald A. , Stanton Brian , DiFazio Stephen P. , Davis Mark F.
Published: January 2021

Background Pyrolysis-molecular beam mass spectrometry (py-MBMS) analysis of a pedigree of Populus trichocarpa was performed to study the phenotypic plasticity and heritability of lignin content and lignin monomer composition. Instrumental and microspatial environmental variability were observed in the spectral features and corrected to reveal underlying genetic variance of biomass composition.Results Lignin-derived ions (including m/z 124, 154, 168, 194, 210 and others) were highly impacted by microspatial environmental variation which demonstrates phenotypic plasticity of lignin composition in Populus trichocarpa biomass. Broad-sense heritability of lignin composition after correcting for microspatial and instrumental variation was determined to be H2 = 0.56 based on py-MBMS based on ions known to derive from lignin. Heritability of lignin monomeric syringyl/guaiacyl ratio (S/G) was H2 = 0.81. Broad-sense heritability was also high (up to H2 = 0.79) for ions derived from other components of the biomass including phenolics (e.g., salicylates) and C5 sugars (e.g., xylose). Lignin and phenolic ion abundances were primarily driven by maternal effects, and paternal effects were either similar or stronger for the most heritable carbohydrate-derived ions.Conclusions We have shown that many biopolymer-derived ions from py-MBMS show substantial phenotypic plasticity in response to microenvironmental variation in plantations. Nevertheless, broad-sense heritability for biomass composition can be quite high after correcting for spatial environmental variation. This work outlines the importance in accounting for instrumental and microspatial environmental variation in biomass composition data for applications in heritability measurements and genomic selection for breeding poplar for renewable fuels and materials.
Career aspirations among specialty residents in France: a cross-sectional gender-based comparison
Authors: Cathelain Alice , Jourdain Mercedes , Cordonnier Charlotte , Jonard Sophie Catteau , Sebbane Deborah , Copin Marie-Christine , Berlingo Laura , Rubod Chrystele , Garabedian Charles
Published: January 2021

Background: Most studies evaluating career aspirations among gender are performed in Anglo-Saxon countries. Two recent French studies looked at the career choice of residents in obstetrics & gynecology. It seemed useful to us to broaden this questioning to other specialties, by proposing a study to all residents in the same Faculty. The objective of our study was to describe residents’ career aspirations and possible barriers according to gender.Methods: Declarative cross-sectional survey, using questionnaires sent by email to the specialty residents of the Faculty of Medicine of Lille (France). An analysis by specialty group (i.e., medicine, surgery, obstetrics & gynecology, and anesthesia & resuscitation) and a comparison of the results according to gender were performed.Results: Of the 1,384 specialty residents currently in training, 462 answered the questionnaire (33.38%), among whom 289 women and 173 men (average age = 27.08 ± 0.091 years). Seventeen women (5.9%) were currently considering a university hospital career versus 37 men (21.4%) (p = 0.001).Gender analysis made it possible to identify obstacles to engaging in a university career: lacking a female model, more frequent doubting the ability to undertake this type of career among women (61.6%) than men (35.3%) (p < 0.001), and gender discrimination felt in the workplace for 51.6% of women (versus 7.5% of men, p < 0.001). Subgroup analysis showed specificities related to each specialty.Conclusions: Few residents plan to embark upon a university hospital career, let alone female residents. There are considerations specific to each specialty and marked gender differences regarding career aspirations. Many features have been identified as obstacles to access to university hospital positions for women. It is important to develop strategies to remove these barriers and enable women to pursue such university careers.Trial registration: Not applicable (no intervention)
Concentration Of Survivin In Children With Oligo- And Poly-Articular Juvenile Idiopathic Arthritis (JIA): Diagnostic And Prognostic Value – Single Center Study.
Authors: Lipinska Joanna , Kaszkowiak Marcin , Malachowska Beata , Swidrowska-Jaros Joanna , Smolewska Elzbieta
Published: January 2021

AIM: The goal of the study was to assess the diagnostic and prognostic utility of survivin in patients with Juvenile Idiopathic Arthritis (JIA).METHODS: Seventy children with JIA – 59 newly diagnosed and 11 biologically treated (46 girls and 17 boys) aged 1.5-18 years and 29 healthy children as a control group, appropriately matched in terms of sex and age, were included into the study. The disease activity was established on the basis of JADAS-27 criteria. Concentration of survivin was assessed by an ELISA test in serum and also 18 matched synovial fluid samples collected from patients with JIA.RESULTS: Children with JIA were divided according to the subtype of the JIA. In 65.7% of patients oligoarthritis was diagnosed. The largest group comprised children of low disease activity (62.9%) according to JADAS-27. The serum concentration of survivin was significantly higher in children with JIA compared to the controls (p<0.001). Concentration of survivin was higher among patients positive for anti-cyclic citrullinated peptide autoantibodies (ACPA) (p=0.001). In all synovial fluid samples the concentration of survivin was higher than in matched serum (p=0.003). Serum survivin concentration was not significantly associated with radiological damage status or active synovitis assessed by joint ultrasonography. Survivin level was not significantly associated with disease duration time or treatment with TNF-α inhibitors in DMARD’s non-responders. CONCLUSIONS: Survivin should be considered as a biomarker of joint inflammation helpful in the diagnosis of oligo- and polyatricular JIA and probably not dependent of treatment with TNF-α inhibitors.
Short term outcomes of preterm infants following antenatal corticosteroid treatment for childbearing women at 34 (0/7) to 36 (6/7) weeks: do the advantages outweigh the disadvantages?
Authors: Hu Zhimei , Deng Xiaochun , Liu Honglin , Xie Lili , Liang Bingwei , Yang Jianhui , Lin Xuemei , Chen Peishan , Huang Yuejun
Published: January 2021

Background: The effects of maternal antenatal corticosteroid (ACS) treatment, for fetal maturation, on the short-term outcome of late preterm infants are unclear. Methods: This is a retrospective cohort study conducted in the Second Affiliated Hospital of Shantou University Medical College. Data of pregnant women who gave birth between 34 (0/7) to 36 (6/7) weeks gestation from January 2014 to June 2019 were collected. Nine short-term outcomes of preterm infants whose mother received ACS were compared to preterm infants whose mother did not receive ACS treatment.Results: In total, 1393 pregnant women (of whom 757 accepted ACS treatment before delivery) and 1472 preterm infants were eligible for analysis. Administration of ACS to pregnant women at high risk for giving birth between 34 (0/7) to 36 (6/7) weeks pregnancy, was related to shorter hospital stay and less cost of preterm infants(slope was -0.784, P=0.026 and slope was -933.173, P=0.001, respectively).Lack of maternal ACS treatment was an independent risk factor for neonatal respiratory distress syndrome (RR=0.548, 95%CI=0.332～0.906).Use of maternal ACS did not increase risk of neonatal pneumonia, neonatal hypoglycemia, neonatal sepsis, necrotizing enterocolitis of newborns, neonatal intracranial hemorrhage, and hypoxic-ischemic encephalopathy in preterm infants.Conclusions: Use of ACS for pregnant women at risk for giving birth between 34 (0/7) to 36 (6/7) weeks pregnancy hade more advantages than disadvantages of preterm infant short-term outcomes. Our study provides evidence-based medicine for clinicians to make ACS treatment choices for pregnant women with risk of giving birth between 34 (0/7) to 36(6/7) weeks gestation.
The application of 3D printing technology in the classification and preoperative planning of complex tibial plateau fractures
Authors: Chen Fuyang , Huang Chenyu , Ling Chen , Zhou Jinming , Wang Yufeng , Zhang Po , Jiang Xiao , Xu Xiaoming , Jian Jian , Wang Liming , Yao Qingqiang
Published: January 2021

Background: Tibial plateau fracture is one of the common intra-articular fractures in clinic. And its accurate classification and treatment is a difficult problem for orthopedic surgeons. Our research aims to investigate the application value of 3D printing in the classification and preoperative planning of complex tibial plateau fractures.Methods: 28 cases of complex tibial plateau fractures diagnosed and treated in our hospital from January, 2017 to January, 2019.01 were analyzed. Preoperative spiral CT scan was performed and then DICOM data were input into the computer. We use Mimics to process data. And 3D printing technology was applied to print the 3D model of fracture (1:1). Combined with the 3D printed model, the tibial plateau fractures were subdivided into seven types according to the geometric plane of the tibial plateau. The surgical approach was determined on the 3D printed model. And then simulated operations such as accurate reduction of fracture and selection of plate placement were performed.Results: The reconstructed 3D model of tibial plateau fracture can accurately reflect the direction of fracture components displacement and the degree of plateau collapse. Also, it can help with the preoperative reconstructive plan for the tibial plateau fracture. The intraoperative fracture details were basically the same as the 3D printed model. And The fracture surface of the tibial plateau of all 28 patients was well improved in terms of restoring the anatomical structure.Conclusion: 3D printing technology can be used to guide the classification and preoperative planning of complex tibial plateau fractures.
The influence of gingival phenotype on the morphology of the maxillary central papilla
Authors: Belák Šimon , Žižka Radovan , Starosta Martin , Zapletalová Jana , Šedý Jiří , Štefanatný Michal
Published: January 2021

Background Preservation of the interdental papilla is an essential part of the functional and esthetic rehabilitation of dental treatment. It has been described that thicker gingival tissues are more resistant to recession. The main objective of this investigation was to analyze whether a thin gingival phenotype represents a potential risk indicator affecting interdental papilla fill, height, or width in an esthetic region between maxillary central incisors. The secondary goals were: 1) to analyze parameters describing the papilla – fill, height, width, and effect of papilla base width on the vertical papillary dimension; 2) to determine correlation between different non-invasive measurements of gingival thickness; 3) to compare both sexes. Methods A total of 54 periodontally healthy students (20–30 years old) were included in the study. Gingival thickness was measured using Pirop Ultrasonic Biometer. Gingival phenotype was also assessed by gingival probe transparency. Papilla height and width were measured, and the degree of papilla recession was classified. Results No significant relationship between papilla fill, height, width and gingival probe transparency or gingival thickness was found. Gingival thickness and gingival probe transparency showed a significant relationship (P < 0.001). There was a significant relationship between papilla height and papilla fill (P = 0.028). A papilla which filled the interdental space completely seemed to be shorter. A strong positive correlation between papilla height and papilla width was found (P <0.0001). The papilla between maxillary central incisors was significantly higher in males (P = 0.01). Conclusion The appearance of the interdental papilla may be influenced by various factors. Within the limitations of this study, the results showed that the thin gingival phenotype alone is no potential risk indicator affecting interdental papilla fill, height, or width. It seems that there may be some effect of papilla base width on its vertical dimension. Gingival probe transparency is a simple reliable method of assessment of gingival thickness with a threshold value of 1-mm gingival thickness between the thick and thin phenotypes.