bluuebunny/crossref_metadata_2025 huggingface dataset:
Association of physical fitness and motor ability at young age with locomotive syndrome risk in middle-aged and older men: J-Fit+ Study
Authors: Shen Shaoshuai , Suzuki Koya , Kohmura Yoshimitsu , Fuku Noriyuki , Someya Yuki , Naito Hisashi
Published: October 2020

Background: Physical fitness and motor ability are associated with the incidence of locomotive syndrome (LS) in older adults. The relationship between physical fitness and motor ability at a young age and LS risk in later life remains unclear. This study examined the association between physical fitness and motor ability among university students and their risk of LS in middle and old age.Methods: The participants were 231 male alumni aged 48–65 years from the Department of Physical Education of a university in Japan. Physical fitness and motor ability test results during their fourth year at the university were used. Physical fitness tests included the side-step test, vertical jump test, back muscle, grip strength, trunk lift, standing trunk flexion, and step-test. Motor ability was tested using the 50-m and 1,500-m run, running long jump, hand-ball throw, and pull-up test. LS risk was assessed using a seven-question standardized self-administered Loco-check questionnaire. Participants were divided into three groups (low, medium, and high) based on physical fitness and motor ability test results at young age, and LS risk was assessed at an older age across the three groups using Cox proportional hazards models.Results: From the 2017 follow-up survey, the median follow-up period was 37 years (interquartile range, 33–41), and LS risk was suspected for 31 (13.4%) participants. Better performance on the side-step test was associated with the reduced risk of LS (hazard ratio 0.32; 95% confidence interval, 0.101–0.983, P=0.047). Conclusions: Good agility (side-step test) at a young age may reduce the future risk of LS among middle-aged and older men.
Preoperative platelet count predicts posttransplant portal vein complications in orthotopic liver transplantation: a propensity score analysis
Authors: Li Qingshan , Wang Yue , Ma Tao , Ren Fenggang , Mu Fan , Wu Rongqian , Lv Yi , Wang Bo
Published: October 2020

Background: The role of platelets on the prognosis of patients with liver transplantation remains unclear. Thus, we aimed to evaluate the influence of preoperative platelet count on postoperative morbidity after liver transplantation.Methods: Clinical data of the patients who received liver transplantation from January 2015 to September 2018 were evaluated.Results: Of the 329 patients included, the average age was 46.71±0.55 years, and 243 were men (75.2%). The incidence of posttransplant portal vein complication was significantly higher in the high platelet count group (> 49.5×109/L; n=167) than in the low platelet count group (≤ 49.5×109/L, n=162, 12.6% vs. 1.9%). After multivariable regression analysis, high platelet count was independently associated with postoperative portal vein complication (odds ratio [OR]: 8.821, 95% confidence interval [CI]: 2.260 to 34.437). After the inverse probability of treatment weighting analysis, patients in the high platelet count group had significantly higher risk of portal vein complication (OR: 9.210, 95%CI: 1.907 to 44.498, p=0.006) and early allograft dysfunction (OR: 2.087, 95%CI: 1.131 to 3.853, p=0.019).Conclusions: Preoperative platelet count > 49.5×109/L was an independent risk factor for posttransplant portal vein complication and early allograft dysfunction. High preoperative platelet count could be an adverse prognostic predictor for liver transplantation recipients.
Individual Pain Sensitivity Is Associated With Resting-State Cortical Activities in Healthy Individuals but Not in Patients With Migraine: A Magnetoencephalography Study
Authors: Hsiao Fu-Jung , Chen Wei-Ta , Liu Hung-Yu , Wang Yen-Feng , Chen Shih-Pin , Lai Kuan-Lin , Pan Li-Ling Hope , Wang Shuu-Jiun
Published: October 2020

Background

Pain sensitivity may determine the risk, severity, prognosis, and efficacy of treatment of clinical pain. Magnetic resonance imaging studies have linked thermal pain sensitivity to changes in brain structure. However, the neural correlates of mechanical pain sensitivity remain to be clarified through investigation of direct neural activities on the resting-state cortical oscillation and synchrony.

Methods

We recorded the resting-state magnetoencephalographic (MEG) activities of 27 healthy individuals and 30 patients with episodic migraine (EM) and analyzed the source-based oscillatory powers and functional connectivity at 2 to 59 Hz in pain-related cortical regions, which are the bilateral anterior cingulate cortex (ACC), medial orbitofrontal (MOF) cortex, lateral orbitofrontal (LOF) cortex, insula cortex, primary somatosensory cortex (SI), primary motor cortex (MI), and posterior cingulate cortex (PCC). The mechanical punctate pain threshold (MPPT) was obtained at the supraorbital area (the first branch of the trigeminal nerve dermatome, V1) and the forearm (the first thoracic nerve dermatome, T1) and further correlated with MEG measures.

Results

The MPPT is inversely correlated with the resting-state relative powers of gamma oscillation in healthy individuals (all corrected P < 0.05). Specifically, inverse correlation was noted between the MPPT at V1 and gamma powers in the bilateral insula (r = −0.592 [left] and −0.529 [right]), PCC (r = −0.619 and −0.541) and MI (r = −0.497 and −0.549) and between the MPPT at T1 and powers in the left PCC ( r = −0.561) and bilateral MI ( r = −0.509 and −0.520). Furthermore, resting-state functional connectivity at the delta to beta bands, especially between frontal (MOF, ACC, LOF, and MI), parietal (PCC), and sensorimotor (bilateral SI and MI) regions, showed a positive correlation with the MPPT at V1 and T1 (all corrected P < 0.05). By contrast, in patients with EM, the MPPT was not associated with resting-state cortical activities.

Conclusions

Pain sensitivity in healthy individuals is associated with the resting-state gamma oscillation and functional connectivity in pain-related cortical regions. Further studies must be conducted in a large population to confirm whether resting-state cortical activities can be an objective measurement of pain sensitivity in individuals without clinical pain.
Different Impacts of the zero-markup drug policy on county general and traditional Chinese medicine hospitals: Evidence from Shandong province, China
Authors: Jiang Xiaofeng , He Ping , Zhu Dawei , Shi Xuefeng , Meng Qingyue
Published: October 2020

Background: As a key part of the new round of health reform, the zero-markup drug policy (ZMDP) removed the profit margins of drug sales at public health care facilities, and had some effects to the operation of these institutions. This study aims to assess whether the ZMDP has different impacts between county general and traditional Chinese medicine (TCM) hospitals.Methods: We obtained longitudinal data from all county general and TCM hospitals of Shandong province in 2007-2017. We used difference-in-difference (DID) method to identify the overall and dynamic effects of the ZMDP.Results: On average, after the implementation of the ZMDP, the share of revenue from medicine sales reduced by 16.47% and 10.42%, the revenue from medicine sales reduced by 24.04% and 11.58%, in county general and TCM hospitals, respectively. The gross revenue reduced by 5.07% in county general hospitals. The number of annual outpatient visits reduced by 11.22% in county TCM hospitals. Government subsidies increased by 199.22% and 89.3% in county general and TCM hospitals, respectively. The ZMDP reform was not significantly associated with the revenue and expenditure surplus, the number of annual outpatient visits and the number of annual inpatient visits in county general hospitals, the gross revenue, the revenue and expenditure surplus and the number of annual inpatient visits in county TCM hospitals. In terms of dynamic effects, the share of revenue from medicine sales, revenue from medicine sales, and gross revenue decreased by 20.20%, 32.58% and 6.08% respectively, and up to 28.53%, 63.89% and 17.94% after adoption, while government subsidies increased by around 170% to 200% in county general hospitals. The number of annual outpatient visits decreased by 9.70% and up to 18.84% in county TCM hospitals.Conclusion: The ZMDP achieved its some initial goals of removing the profits from western medicines in county hospitals’ revenue without disrupting the normal operation, and had different impacts between county general and TCM hospitals. Meanwhile, some unintended consequences were also recognized through the analysis, such as the decline of the utilization of the TCM.
Inconsistent reversal of HIV-1 latency ex vivo by antigens of HIV-1, CMV, and other infectious agents
Authors: Vollbrecht Thomas , Angerstein Aaron O. , Menke Bryson , Kumar Nikesh M. , Oliveira Michelli Faria , Richman Douglas D. , Guatelli John C
Published: October 2020

BackgroundA reservoir of replication-competent but latent virus is the main obstacle to a cure for HIV-1 infection. Much of this reservoir resides in memory CD4 T cells. We hypothesized that these cells can be reactivated with antigens from HIV-1 and other common pathogens to reverse latency. ResultsWe obtained mononuclear cells from the peripheral blood of antiretroviral-treated patients with suppressed viremia. We tested pools of peptides and proteins derived from HIV-1 and from other pathogens including CMV for their ability to reverse latency ex vivo by activation of memory responses. We assessed activation of the CD4 T cells by measuring the up-regulation of cell-surface CD69. We assessed HIV-1 expression using two assays: a real-time PCR assay for virion-associated viral RNA and a droplet digital PCR assay for cell-associated, multiply spliced viral mRNA. Reversal of latency occurred in a minority of cells from some participants, but no single antigen induced HIV-1 expression ex vivo consistently. When reversal of latency was induced by a specific peptide pool or protein, the extent was proportionally greater than that of T cell activation. ConclusionsIn this group of patients in whom antiretroviral therapy was started during chronic infection, the latent reservoir does not appear to consistently reside in CD4 T cells of a predominant antigen-specificity. Peptide-antigens reversed HIV-1 latency ex vivo with modest and variable activity. When latency was reversed by specific peptides or proteins, it was proportionally greater than the extent of T cell activation, suggesting partial enrichment of the latent reservoir in cells of specific antigen-reactivity.
Clinical Characteristics on Admission Predict In-Hospital Fatal Outcome in Patients Aged ≥75 Years with novel coronavirus disease (COVID-19) :A Retrospective Cohort Study
Authors: Yu Zhihua , Ke Yuhe , Xie Jiang , Yu Hao , Zhu Wei , He Liqun , Zheng Qiongli , Li Chuanwei , Lu Jingya , Li Songnan , Wen Songnan , Wei Sheng , Liu Nian , Wei Li , Bai Rong
Published: October 2020

Background ： Novel coronavirus disease（COVID-19）has become a worldwide pandemic and precise fatality data by age group are needed urgently. This study to delineate the clinical characteristics and outcome of COVID-19 patients aged ≥75 years and identify the risk factors of in-hospital death. Methods ： A total of 141 consecutive patients aged ≥75 years who were admitted to the hospital between 12 th and 19 th February 2020. In-hospital death, clinical characteristics and laboratory findings on admission were obtained from medical records. The final follow-up observation was 31 st March 2020. Results ： The median age was 81 years (84 female, 59.6%). Thirty-eight (27%) patients were classified as severe or critical cases. 18 (12.8%) patients had died in hospital and the remaining 123 were discharged. Patients who died were more likely to present with fever (38.9% vs. 7.3%); low percutaneous oxygen saturation(SpO 2 ) (55.6% vs. 7.3%); reduced lymphocytes (72.2% vs. 35.8%) and platelets (27.8% vs. 4.1%); and increased D-dimer (94.4% vs. 42.3%), creatinine (50.0% vs. 22.0%), lactic dehydrogenase (LDH) (77.8% vs. 30.1%), high sensitivity troponin I (hs-TnI) (72.2% vs. 14.6%), and N-terminal pro-brain natriuretic peptide (NT-proBNP) (72.2% vs. 6.5%; all P<0.05) than patients who recovered. Male sex (odds ratio [OR]=13.1, 95% confidence interval[CI] 1.1 to 160.1, P=0.044), body temperature >37.3°C (OR=80.5, 95% CI 4.6 to 1407.6, P=0.003), SpO 2 ≤90% (OR=70.1, 95% CI 4.6 to 1060.4, P=0.002), and NT-proBNP>1800ng/L (OR=273.5, 95% CI 14.7 to 5104.8, P<0.0001) were independent risk factors of in-hospital death. Conclusions： In-hospital fatality among COVID-19 patients can be estimated by sex and on-admission measurements of body temperature, SpO 2 , and NT-proBNP. Key words ： Coronavirus disease; SARS-CoV-2; elderly; death; prediction
The use of ultrasound to locate a tethered surgical drain: a novel way to achieve fast removal
Authors: Li Hui , Du Yan , Wu Jia-bin , Wang Pan , Yang Jun , Hu Ping , Ai Tao
Published: October 2020

Background: It is rare that drains cannot be removed after surgery, however, this situation cannot be completely avoided, and is also hard to deal with. The main reason for a tethered drain is inadvertent suture fixation. At present, no effective way was published or widely accepted to locate the tethered drain. Methods: Three cases of orthopedic trauma patients experienced unsuccessful removal of the drain after surgery. The ultrasound was used to locate the sutured site of the drain. Based on the sliding sign and vanishing point which can be detected by the ultrasound, the sutured site of the drain can be clearly identified. Finally, the suture was loosened through a small incision, and the drain was completely removed. Results: The surgical procedure was very successful in all patients. The tethered drain was quickly and completely removed through a small incision with locating by ultrasound. Intravenous antibiotics were administered within 24 hours after surgery, and no wound or deep infections occurred.Conclusions: Ultrasound can be used to locate a tethered drain based on the sliding sign. This method can simplify the release procedure and achieve fast removal of the drain. Furthermore, it will help lower the risk of a retained drain and soft tissue complications.
Does prophylactic antibiotic administration for tooth extraction affect PT-INR in patients taking warfarin?
Authors: Iwata Eiji , Tachibana Akira , Kusumoto Junya , Takata Naoki , Hasegawa Takumi , Akashi Masaya
Published: October 2020

Background: Various antibiotics have been reported to interact with　warfarin. Reports to have investigated the effects of prophylactic antibiotic administration for tooth extraction in patients taking warfarin on the prothrombin time-international normalized ratio (PT-INR) are rare.Methods: A total of 110 patients receiving long-term stable warfarin therapy underwent tooth extraction without interruption of warfarin treatment. INR values were measured one month before the tooth extraction, the day of the extraction, and one week after the extraction. We investigated the changes of INR values between the day of extraction and one week after the extraction, as well as the various risk factors for increases in INR values.Results: Before and after tooth extraction, the number of patients taking cefcapene pivoxil, amoxicillin, and azithromycin was 57, 36, and 8, respectively. Nine patients were administered ampicillin before tooth extraction and received amoxicillin after their tooth extraction. One week after tooth extraction, the INR values increased beyond the therapeutic range in 3 out of 110 patients (2.7%). The INR values before tooth extraction in these three patients were close to 3.0. The INR value increased by more than twice as much in 1 of 110 patients (0.9%).Conclusion: Our results suggest that prophylactic antibiotic administration has little effect on their INR values when patients on stable warfarin therapy undergo tooth extraction. Surgeons have to take attention if the patients whose INR values are close to 3.0 before their extraction.
Size measurements of hepatocellular carcinoma: comparisons between contrast and two-dimensional ultrasound
Authors: Chen Fei , Wang Fei , Sun Si , Zhu Mei , Liu Zheng
Published: October 2020

Background: Ultrasound (US) imaging is known to underestimate tumor size in clinical. This study is aimed to compare the size measurements of hepatocellular carcinoma (HCC) in three US imaging modalities, i.e. two-dimensional (2D) imaging, the arterial phase (AP) and the late phase (LP) imaging of contrast-enhanced US (CEUS).Methods: Fifty-eight clinically proved HCC patients were included. The 2D and CEUS imaging were performed with Siemens S2000, Philips iu22 and BioSound Twice. 2.5 mL of SonoVue® was injected for every CEUS performance. Two physicians measured the maximal longitudinal and the transverse diameters of the tumors in 2D, the AP and the LP of CEUS from one image section. The three measurements were compared by paired t test.Results: The mean longitudinal diameter of HCC appeared to be maximal in the AP (4.73±2.04 cm) of CEUS and minimal in the LP (3.98±1.99 cm) of CEUS. The 2D diameter (4.26±2.07 cm) was in the middle between two CEUS measurements. There were significant differences between any two measurements.Conclusion: There is size difference between the three kinds of HCC measurement. It appeared to be maximal in the AP of CEUS and minimal in the LP. The 2D diameter was in the middle.
Assessment of isokinetic trunk muscle strength and its association with health-related quality of life in patients with degenerative spinal deformity
Authors: Yang Sen , Chen Can , Du Shiyu , Tang Yong , Li Kai , Yu Xueke , Tan Jiulin , Zhang Chengmin , Rong Zhigang , Xu Jianzhong , Wu Wenjie , Luo Fei
Published: October 2020

Background: A considerable portion of the elderly population are increasingly afflicted by degenerative spinal deformity (DSD), which seriously affects patient health-related quality of life (HRQoL). HRQoL index is used across many studies to show correlations between radio-graphical alignment, disability, and pain in patients with DSD. However, imaged structural deformity represents only one aspect for consideration, namely, the disability effect of DSD. We assessed the isokinetic strength of trunk muscle in patients with degenerative spinal deformity (DSD), and investigated its relationship with HRQoL.Methods: In total, 38 patients with DSD (DSD group) and 32 healthy individuals (control group) were recruited. Both groups were homogeneous for age, weight, height and body mass index (BMI). Assessments were performed using the isokinetic dynamometer IsoMed-2000; trunk extensor, flexor strength and flexion/extension (F/E) ratios were explored concentrically at speeds of 30°, 60° and 120° per second. The grip strength of both hands was measured using a hand-held dynamometer. Visual analogue scale (VAS) scores, the Oswestry Disability Index (ODI), a Roland-Morris disability questionnaire (RDQ), and a 36-item Short Form Health Survey (SF-36) evaluated patient HRQoL. Correlations between trunk strength and HRQoL were analyzed.Results: When compared with the control group, the DSD group showed lower trunk extensor strength at three velocity movements, and higher F/E ratios at 60° and 120°/s (p < 0.05). Both groups exhibited similar trunk flexor strength and grip strength (p > 0.05). In DSD group，trunk extensor strength at 60°/s was negatively associated with ODI and RDQ (p < 0.05). A negative relationship between trunk flexor strength at 120°/s and ODI was also recorded (p < 0.05). In addition, trunk extensor strength at 60°/s and trunk flexor strength at 120°/s were positively correlated with physical functioning and role-physical scores according to the SF-36 (p < 0.05). Conclusions: We identified isolated trunk extensor myopathy in DSD, which causes an imbalance in trunk muscle strength. Isokinetic trunk extensor strength at 60°/s and trunk flexor strength at 120°/s can predict disability, and decrease physical HRQoL in DSD patients.
Longitudinal change in arterial stiffness after delivery in women with preeclampsia and normotension: a prospective cohort study
Authors: KIM Sehun , LIM Hyun Ja , KIM Jeung-Ran , OH Kyung Joon , HONG Joon-Seok , Suh Jung-Won
Published: October 2020

Background: Preeclampsia is associated with increased arterial stiffness during pregnancy. However, data on the longitudinal change in arterial stiffness after delivery in women with preeclampsia are lacking. In this pilot study, we aimed to examine the longitudinal change in arterial stiffness using the cardio-ankle vascular index after delivery in women with preeclamptic and normotensive pregnancies. Methods: We enrolled pregnant women with preeclampsia (n=37) and normotension (n=36) who gave birth at Seoul National University Bundang Hospital between March 2013 and May 2016, and followed-up at day 1, 6 months, and 12 months after delivery. The longitudinal change in the cardio-ankle vascular index and other variables (blood pressure, lipid profiles, serum creatinine, and liver enzymes) were compared between the two groups using the mixed-effects model, and interactions among the main predictors were examined. Results: The longitudinal change in the cardio-ankle vascular index did not significantly differ between the two groups (β=0.11, 95% CI: -0.31–0.54, p=0.60). Predictors of the longitudinal change in the cardio-ankle vascular index includedage, time since delivery, body mass index, and diabetes mellitus. Women with preeclampsia showed significantly elevated blood pressure, lipid profiles, serum creatinine, and liver enzymes compared to women with normotension over the course of one year of follow-up. Conclusions: Preeclampsia is associated with unfavorable blood pressure and metabolic indices after delivery. However, we found no difference in the longitudinal change in arterial stiffness between women with preeclampsia and normotension over the course of one year after delivery. Trial registration: Retrospectively registered at ClinicalTrials.gov on October 29, 2019 (NCT04142268).
A systematic review assessing the under-representation of elderly adults in COVID-19 trials
Authors: Prendki Virginie , Tau Noam , Avni Tomer , Falcone Marco , Huttner Angela , Kaiser Laurent , Paul Mical , Leibovici-Weissmann Yaara , Yahav Dafna
Published: October 2020

Background Coronavirus disease (COVID-19) has caused a pandemic threatening millions of people worldwide. Yet studies specifically assessing the geriatric population are scarce. We aimed to examine the participation of elderly patients in therapeutic or prophylactic trials on COVID-19.Methods In this review, randomized controlled trials (RCTs; n=12) comparing therapeutic or prophylactic interventions registered on preprint repositories and/or published since December 2019 were analyzed. We searched in PubMed, leading journals websites, and preprint repositories for RCTs and large observational studies. We aimed to describe the age of included patients, the presence of an upper age limit and of adjusted analyses on age, any exclusion criteria that could limit participation of elderly adults such as comorbidities, cognitive impairment, limitation of life expectancy; and the assessment of long-term outcomes such as the need of rehabilitation or institutionalization. Mean participant ages were reported and compared with observational studies. Results Twelve RCTs assessing drug therapy for COVID-19 were included. Mean age of patients included in RCTs was 56.3 years. An upper age limit was applied in three published trials (25%) and in 200/650 (31%) trials registered at clinicaltrials.gov. One trial reported a subgroup analysis in patients ≥65. Patients were excluded for liver-function abnormalities in eight trials, renal disease in six, cardiac disease or risk of torsade de pointes in five, and four for cognitive or mental criteria, which are frequent comorbidities in the oldest patients. Only three trials allowed a family member to provide consent. Patients enrolled in RCTs were on average 20 years younger than those included in large (n≥1000) observational studies. Seven studies had as their primary outcome a clinical endpoint, but none reported cognitive, functional or quality of life outcomes or need for rehabilitation or long-term care facility placement.Conclusions Elderly patients are clearly underrepresented in RCTs, although they comprise the population hardest hit by the COVID-19 pandemic. Long-term outcomes such as the need of rehabilitation or institutionalization were not reported. Future investigations should target specifically this vulnerable population.
Mutational profiles of marker genes of cervical carcinoma in Bangladeshi patients
Authors: Sharmin Shahana , Zohura Fatima Tuj , Islam Md. Sajedul , Shimonty Anika , Khan Md. Abdullah-Al-Kamran , Perveen Rehana , Sharmin Foujia , Ahsan Chowdhury Rafiqul , Islam Abul BMMK , Yasmin Mahmuda
Published: October 2020

Background: Cervical cancer is a gynecologic cancer type that develops in the cervix, accounting for 8% mortality of all female cancer patients. Infection with specific human papillomavirus (HPV) types is considered the most severe risk factor for cervical cancer. In the context of our socioeconomic conditions, an increasing burden of this disease and high mortality rate prevail in Bangladesh. Although several researches related to the epidemiology, HPV vaccination, and treatment modalities were conducted, researches on the mutation profiles of marker genes in cervical cancer in Bangladesh remain unexplored. Methods: In this study, five different genomic regions within the top three most frequently mutated genes (EGFR, KRAS and PIK3CA) in COSMIC database with a key role in the development of cervical cancers were selected to study the mutation frequency in Bangladeshi patients. In silico analysis was done in two steps: nucleotide sequence analysis and its corresponding amino acid analysis.Results: DNA from 46 cervical cancer tissue samples were extracted and amplified by PCR, using 1 set of primers designed for EGFR and 2 sets of primers designed for two different regions of both PIK3CA and KRAS gene. In total, 39 mutations were found in 26 patient samples. Eleven different mutations (23.91%), twenty-four different mutations (52.17%) and four mutations (8.7%) were found in amplified EGFR, PIK3CA and KRAS gene fragments, among which 1 (EGFR) was common in seven patient samples and 2 (PIKCA) were found in more than 1 patient. Our study shows that except for KRAS, the frequency of observed mutations in our patients is higher than those reported earlier in other parts of the world. Most of the exonic mutations were found only in the PIK3CA and EGFR genes.Conclusions: The study can be used as a basis to build a mutation database for cervical cancer in Bangladesh with the possibility of targetable oncogenic mutations. Further exploration needs to establish future diagnostics, personalized medicine decisions, and other pharmaceutical applications for specific cancer subtypes.
Correlating genomic copy number alterations with clinicopathologic findings in a case series of hepatocellular carcinoma
Authors: Peng Gang , Chai Hongyan , Ji Weizhen , Lu Yufei , Wu Shengming , Zhao Hongyu , Li Peining , Hu Qiping
Published: October 2020

Background: Oligonucleotide array comparative genomic hybridization (aCGH) analysis has been used for detecting somatic copy number alterations (CNAs) in various types of tumors. This study aimed to assess the clinical utility of aCGH for a case series of hepatocellular carcinoma (HCC) and to evaluate the correlation between CNAs and clinicopathologic findings.Methods: Survival outcomes from this case series were analyzed based on Barcelona-Clinic Liver Cancer Stage (BCLC), Edmondson-Steiner grade (E-S), and recurrence status. aCGH was performed on 75 HCC cases with paired DNA samples from tumor and adjacent nontumor tissues. Correlation of CNAs with clinicopathologic findings was analyzed by Wilcoxon rank test and clustering vs. K means.Results: The survival outcomes indicated that BCLC stages and recurrence status could be predictors and E-S grades could be a modifier for HCC. The most common CNAs involved gains of 1q and 8q and a loss of 16q (50%), losses of 4q and 17p and a gain of 5p (40%), and losses of 8p and 13q (30%). Analyses of genomic profiles and clusters identified that losses of 4q13.2q35.2 and 10q22.3q26.13 seen in cases of stage A, grade III and nonrecurrence were likely correlated with good survival, while loss of 1p36.31p22.1 and gains of 2q11.2q21.2 and 20p13p11.1 seen in cases of stage C, grade III and recurrence were possibly correlated with worst prognosis. Conclusions: These results indicated that aCGH analysis could be used to detect recurrent CNAs and involved key genes and pathways in patients with HCC. Further analysis on a large case series to validate the correlation of CNAs with clinicopathologic findings of HCC could provide information to interpret CNAs and predict prognosis.
Perception and belief in oral health among Karen ethnic group living along Thai-Myanmar border, Thailand
Authors: Thu Sai Wai Yan Myint , Ngeonwiwatkul Yaowaluk , Maneekan Pannamas , Phuanukoonnon Suparat
Published: October 2020

Background: Utilization of oral health services has been low among rural populations in Thailand, especially for minority ethnicity populations living along the borders. The aim of this study was to increase understanding of the determinants of the underutilization of oral health services among these populations.Methods: A qualitative study using in-depth interview and semi-structured interview was conducted among participants of Karen ethnicity living in Mae Tan Sub-district, Thasongyang District, Tak Province, Thailand. The interviews focused on exploring the participants’ perceptions of oral health problems, oral health and hygiene, and oral health-seeking behaviors. The verbatim-transcribed interviews were analyzed using thematic analysis.Results: A total of 101 participants (50 adults and 51 children) with a Karen ethnic background took part in the interviews. Most participants could not identify oral health problems and did not perceive dental disease as a problem unless there was severe pain that could not be relieved by painkillers. The Karen ethnic community worked as subsistence farmers, and their busy daily activities consisted of farming, going to the forest to hunt and gather, performing housework, and taking care of their children. Dental health was given a lower priority compared with general health. The perceived value of primary teeth was low, which was identified as an underlying factor resulting in delayed oral health care seeking among this population. The participants had relied on self-care throughout their lifetimes, using either traditional medicines or modern painkillers to relieve toothaches. Fear of dental procedures among children was also described as a barrier to seeking dental health care.Conclusions: This study found that the lifestyle and traditions of Karen people living in this area influence their oral health care and hygiene activities as well as their health-seeking behaviors. Further research should emphasize how to improve oral health promotion by providing necessary services and health education appropriately to Karen ethnic populations living along the Thai-Myanmar border.
Molar Incisor Hypomineralization, prevalence, pattern and distribution in Sudanese children
Authors: Abdalla Hanna Elhassan , Abuaffan Amal Hussein , Kemoli Arthur Musakulu
Published: October 2020

Background: Molar incisor hypomineralization (MIH) has serious impact on oral health-related quality of life for a child, due to its effects on tooth structure, aesthetics and behavior of the child. The current study was designed to determine the prevalence, pattern and distribution of MIH in school children in Sudan.Methods: This was a descriptive cross-sectional study involving 568 children, aged 8-11 years from schools in Khartoum State. Following collecting their socio-demographic data, the children were examined for hypomineralization on the 12 MIH indexed teeth, and assessed on the MIH pattern and distribution. The data collected were analyzed to obtain descriptive statistics, and the results related to the socio-demographic and other dental-related factors of the children using chi-square test and Spearman Rank Correlation, with the significant level set at P<0.05.Results: The prevalence of MIH in the study population was 20.1%. The majority of cases had both permanent first molars (PFMs) and permanent incisors affected (12.5%). However, in 7.6% of the cases, only molars were affected. Even though more maxillary teeth were affected when compared to the mandibular teeth, there is no statistical significant difference between the occurrence of hypomineralization on mandibular and maxillary molars (P=0.22). Maxillary incisors were significantly more affected by MIH when related to the mandibular ones (P=0.00). Demarcated opacities were the commonest pattern of MIH defects (69.9%) in the experimental group.Conclusion: The prevalence of MIH in Sudanese children was 20.1%. In both dental arches, the permanent molars and incisors were frequently affected, with the demarcated opacity type of MIH being the most common form of defect. Further studies are recommended to better understand the possible etiologies of MIH in Sudanese children.
Trend and treatment outcomes of latent tuberculosis infection among migrant persons in Japan: retrospective analysis of Japan Tuberculosis Surveillance data
Authors: Kawatsu Lisa , Uchimura Kazuhiro , Ohkado Akihiro
Published: October 2020

Background: Screening for latent tuberculosis infection (LTBI) among migrant population has become a critical issue for many low tuberculosis (TB) burden countries. Evidence regarding effectiveness of LTBI programs are limited, however, partly because of paucity of national data on treatment outcomes for LTBI. In Japan, notification of LTBI is mandatory, and its treatment outcome is reported as part of Japan’s national TB surveillance system. We thus conducted a detailed analysis of LTBI among foreign-born persons, to update the epidemiological trend of newly notified LTBI between 2007 and 2018, and to examine the treatment regimen and outcome of those notified in 2016 and 2017, focusing specifically on the potential risk factors for lost to follow-up.Methods: We extracted and analyzed the data of newly notified LTBI patients from the Japan Tuberculosis Surveillance System to examine the overall trend of notification and by age groups and modes of detection between 2007 and 2018, and the cohort data for treatment regimen and outcomes of foreign-born persons notified with LTBI in 2016 and 2017. Trends and proportions were summarized descriptively, and logistic regression analysis was conducted to identify potential risk factors for lost to follow-up. Comparisons were made with the Japan-born patients where appropriate.Results: Both the number and proportion of LTBI among foreign-born persons have been constantly increasing, reaching 963 cases in 2018. Analysis of cohort data indicated that the proportion of those on shorter regimen was higher among the foreign- than Japan-born patients (5.5% vs. 1.8%, p<0.001). The proportion of those who have been lost to follow-up and transferred outside of Japan combined was higher among the foreign- than Japan-born patients (12.0% vs, 8.2%, p<0.001). Risk factors for lost to follow-up were being employed on a temporal basis, and job status unknown (adjusted odds ratios 3.11 and 4.09, 95% confidence intervals 1.34-7.26 and 1.60-10.48, respectively).Conclusions: Migrant population face greater risk of interrupting LTBI treatment, and interventions to improve adherence are a critical component of programmatic management of LTBI. Further studies are needed to explore the cultural and socioeconomic situation in which foreign-born persons undergo LTBI treatment in Japan.
Live birth rate and neonatal outcomes of different quantities and qualities of frozen transferred blastocyst in patients requiring whole embryo freezing stratified by age
Authors: Chen Shiping , Du Hongzi , Liu Jianqiao , Liu Haiying , Li Lei , He Yuxia
Published: October 2020

Background: Multiple pregnancies are associated with significant complications and health risks for both mothers and infants. Single blastocyst transfer (SBT) is a logical and effective measure to reduce the incidence of multiple pregnancy with assisted reproductive technology (ART). Whether it is suitable for everyone undergoing SBT was inconclusive, in view of the consideration of embryo quality and patients’ age. Therefore, this study aimed to explore live birth rate (LBR) and neonatal outcomes of different quantities and qualities of blastocysts in patients stratified by age, using a cutoff of 35 years, who required whole embryo freezing and underwent a subsequent frozen thawed transfer (FET) cycle.Methods: A total of 3,362 patients were divided into five groups: group A (n=1569) received a single good-quality blastocyst, group B (n=1113) received two good-quality blastocysts, group C (n=313) received one good- and one average-quality blastocyst, group D (n=222) received two average-quality blastocysts, and group E (n=145) received one average-quality blastocyst.Results: For patients who received good-quality blastocysts, irrespective of age, the LBR of double blastocyst transfer (DBT) was about 50–65% and the multiple pregnancy rate (MPR) was 40–60%; however, the LBR of SBT was 40–55%, and the MPR was 3.5–6.3%. For patients who only had average-quality blastocysts, the MPR of double average-quality blastocyst transfer was as high as 30–50%. Moreover, about 70–90% of preterm births resulted from multiple pregnancies, and about 85–95% of low birth weight babies come from multiple pregnancies. The neonatal outcomes (gestational age, birth weight, and birth height) of DBT were significantly lower than those of SBT regardless of age, and this statistical difference disappeared if the patients were subgrouped by singleton or twin. There is no significant difference in neonatal outcomes between single good-quality blastocyst and single average-quality blastocyst transfer.Conclusions: SBT is a preferable option for patients regardless of age when good-quality blastocysts are available. For patients who only had average-quality blastocysts, they should be informed that DBT was associated with higher multiple pregnancy and adverse neonatal outcomes when compared with SBT regardless of age, suggesting that the practice of SBT is also feasible for these patients.
Identification of intestinal flora-related key genes and therapeutic drugs in colorectal cancer
Authors: Zhang Jiayu , Zhang Huaiyu , Li Faping , Song Zheyu , Li Yezhou , Zhao Tiancheng
Published: October 2020

Background: Colorectal cancer (CRC) is a multifactorial tumor and a leading cause of cancer-specific deaths worldwide. Recent research has shown that the alteration of intestinal flora contributes to the development of CRC. However, the molecular mechanism by which intestinal flora influences the pathogenesis of CRC remains unclear. This study aims to explore the key genes underlying the effect of intestinal flora on CRC and therapeutic drugs for CRC.Methods: Intestinal flora-related genes were determined using text mining. Based on The Cancer Genome Atlas database, differentially expressed genes (DEGs) between CRC and normal samples were identified with the limma package of the R software. Then, the intersection of the two gene sets was selected for enrichment analyses using the tool Database for Annotation, Visualization and Integrated Discovery. Protein interaction network analysis was performed for identifying the key genes using STRING and Cytoscape. The correlation of the key genes with overall survival of CRC patients was analyzed. Finally, the key genes were queried against the Drug-Gene Interaction database to find drug candidates for treating CRC.Results: 518 genes associated with intestinal flora were determined by text mining. Based on The Cancer Genome Atlas database, we identified 48 DEGs associated with intestinal flora, including 25 up-regulated and 23 down-regulated DEGs in CRC. The enrichment analyses indicated that the selected genes were mainly involved in cell-cell signaling, immune response, cytokine-cytokine receptor interaction, and JAK-STAT signaling pathway. The protein-protein interaction network was constructed with 13 nodes and 35 edges. Moreover, 8 genes in the significant cluster were considered as the key genes and chemokine (C-X-C motif) ligand 8 (CXCL8) correlated positively with the overall survival of CRC patients. Finally, a total of 24 drugs were predicted as possible drugs for CRC treatment using the Drug-Gene Interaction database.Conclusions: These findings of this study may provide new insights into CRC pathogenesis and treatments. The prediction of drug-gene interaction is of great practical significance for exploring new drugs or novel targets for existing drugs.
Metabolic Syndrome Components and Acute Pancreatitis: A Case-Control Study in China
Authors: Shen zhemin , Wang Xueqiao , Zhen Zili , Wang Yao , Sun Peilong
Published: October 2020

Background: Acute pancreatitis (AP) is a common inflammatory disorder of the pancreas. Recent evidence has shown that metabolic syndrome is positively correlated with the severity of AP. However, only a few studies have revealed the relationship between metabolic syndrome and the occurrence of AP. We therefore elucidated the association between the components of metabolic syndrome and the occurrence of AP. Methods: A hospital-based case-control study was conducted. A total of 705 patients admitted to our hospital from January 2016 to December 2018 were included in the study. Subjects were divided into case and control groups according to their diagnosis: (1) According to the revised Atlanta classification from 2012, patients diagnosed with AP were enrolled in the case group. (2) Patients without a history of AP or any disease related to metabolic syndrome were allocated into the control group. Controls were matched to cases individually by sex and age (control/case ratio=1). Results: The incidence rate of metabolic syndrome in AP patients was 30.9%, which was more frequent than that in controls (13.2%) (OR=2.837; 95% CI 1.873-4.298, p<0.001). In the multivariate regression analysis, a history of smoking or alcohol consumption and biliary stones were significantly associated with AP (OR=2.441; 95% CI 1.865-5.172, p<0.001; OR=1.777; 95% CI 1.060-2.977, p=0.029; OR=28.995; 95% CI 13.253-63.435, p<0.001). In addition, the occurrence of AP was significantly associated with total cholesterol (TC) (OR=1.992; 95% CI 1.246-3.183, p=0.004), triglyceride (TG) (OR=2.134; 95% CI 1.403-3.245, p<0.001), hyperglycaemia (OR=2.261; 95% CI 1.367-3.742, p=0.001), and low values of apolipoprotein A (Apo A) (OR=0.270; 95% CI 0.163-0.447, p<0.001). Conclusions: Metabolic syndrome and its components were associated with AP occurrence.
Nanomicelles potentiate histone deacetylase inhibitor efficacy in vitro.
Authors: Pisano Simone , Wang Xiong , Parra Jezabel Garcia , Gazze Andrea , Edwards Kadie , Feltracco Veronica , Hu Yanzhen , He Le , Gonzalez Deyarina , Francis Lewis , Conlan Robert Steven , Li Chao
Published: October 2020

Background. Amphiphilic block copolymers used as nanomicelle drug carriers can effectively overcome poor drug solubility and specificity issues. Hence, these platforms have a broad applicability in cancer treatment. In this study, Pluronic F127 was used to fabricate nanomicelles containing the histone deacetylase inhibitor SAHA, which has an epigenetic-driven anti-cancer effect in several tumor types. SAHA loaded nanomicelles were prepared using a thin-film drying method and characterized for size, surface charge, drug content and drug release properties. Loaded particles were tested for in vitro activity and their effect on cell-cycle and markers of cancer progression. Results. Following detailed particle characterization, cell proliferation experiments demonstrated that SAHA loaded nanomicelles more effectively inhibited the growth of HeLa and MCF-7 cell lines compared with free drug formulations. The 30nm SAHA containing nanoparticles were able to release up to 100% of the encapsulated drug over a 72h time window. Moreover, gene and protein expression analyses suggested that their cytoreductive effect was achieved through the regulation of p21 and p53 expression. SAHA was also shown to upregulate E-cadherin expression, potentially influencing tumor migration.Conclusions. This study highlights the opportunity to exploit pluronic-based nanomicelles for the delivery of compounds that regulate epigenetic processes, thus inhibiting cancer development and progression.
Parents' and medical staff's experience of adolescents with suicide-related behaviors admitted to a general hospital in China: qualitative study
Authors: Fu Xi , Yang Jiaxin , Liao Xiaoli , Shen Yidong , Ou Jianjun , Li Yamin , Chen Runsen
Published: October 2020

Background: Currently, there is increasing awareness of suicide-related behaviors. Mental health services are a key location for assisting people with suicide-related behaviors. However, few studies focused on the evaluation and experience of the mental health care system from families and the medical staff’s perspective in China. The study aims to explore parents' and the front-line medical staff's experience of an adolescent with suicide-related behaviors admitted to the psychiatry department of a general hospital in China.Design: Qualitative study was employed in the study. Participants were recruited from a general hospital in China characterized by high levels in the Chinese mental health system.Methods: Semi-structured in-depth interviews were conducted exploring their experience and perceptions when an adolescent was admitted to the hospital. The theme analysis method is used for data analysis.Results: Participants expressed dissatisfaction in the psychiatric department. Other barriers in their work were identified, such as the shortage of staff and difficulties in caring or communicating with patients. Besides, the imperfect treatment system also contributes to the low satisfaction of patients and their families. Two themes and six subthemes were identified: 1) staff perceives difficult to engage SRBs patients (feelings of helplessness, the need for compassion, challenges of professional self-efficacy, the recommendations to the health care service); 2) parents not satisfied with the existing hospital services (doubt the hospitalization treatment and the advice to the health care service).Conclusion: This study found that insufficient staffing and lacking of systematic professional treatment models are the major challenges. We suggest increasing the input of mental health resources to expand and train the mental health service team and establish a complete set of a treatment model for SRBs.