bluuebunny/crossref_metadata_2025 huggingface dataset:
Long-term sickness absence among young and middle-aged workers in Norway: The impact of a population-level intervention
Authors: Hanvold Therese Nordberg , Kristensen Petter , Corbett Karina , Hasting Rachel Louise , Mehlum Ingrid Sivesind
Published: July 2020

Background The study objective was to evaluate the impact of a population-level intervention (the IA Agreement) on the one-year risk for long-term sickness absence spells (LSAS) among young and middle aged workers in Norway. Methods Using an observational design, we conducted a quasi-experimental study to analyse registry data on individual LSAS for all employed individuals in 2000 (n=298 690) and 2005 (n=352 618), born in Norway between 1976 and 1967. The intervention of interest was the tripartite agreement for a more inclusive working life (the IA Agreement). We estimated difference in pre-post differences (DID) in LSAS between individuals working in IA companies with the intervention and companies without, in 2000 and 2005. We used logistic regression models and present odds ratios (DID OR) with accompanying 95% CI. We stratified analyses by sex, industry and company size. Results . We found no significant change in the overall risk of long-term sickness absence spells after implementing the intervention among young and middle aged workers. Stratified by sex, the intervention resulted in a slight decrease in LSAS risk among female workers (DID OR 0.93 (0.91-0.96)) while the intervention showed no impact among male workers (DID OR 1.01 (0.97-1.06)). We found that companies signing the IA Agreement were large (≥50­ employees) and often within the manufacturing and health and social sectors. In large manufacturing companies, we found a reduction in LSAS, among workers both in companies with and without the intervention, resulting in no statistically significant impact of the IA intervention. In large health and social companies, we found an increase in LSAS among workers both in companies with and without the intervention. The increase was smaller among the workers in companies offering the IA intervention compared with workers in companies without, resulting in a positive impact of the IA intervention in the health and social industry. This impact was statistically significant only among female workers. Conclusions The results indicate that the impact of the IA Agreement on the risk of long-term sickness absence spells varies considerably depending on sex and industry. These findings suggest that reducing LSAS may warrant industry-specific interventions.
“They have been neglected for a long time”: a qualitative study on the role and recognition of Rural Health Motivators in the Shiselweni region, Eswatini
Authors: Walker Caroline , Burtscher Doris , Myeni John , Kerschberger Bernhard , Schausberger Bernadette , Rusch Barbara , Dlamini Nosipho , Whitehouse Katherine
Published: July 2020

Background: Community health workers (CHWs) are increasingly engaged to address human resource shortages and fill primary healthcare gaps. In Eswatini, a cadre of CHWs called Rural Health Motivators (RHM) was introduced in 1976 to respond to key public health challenges. However, the emergence of health needs, particularly HIV/TB, has been met with inadequate programme amendments; and the role of RHMs has become marginalised following the addition of other CHWs supported by non-governmental organisations. This study was implemented to understand the role of RHMs in decentralised HIV/TB activities. In this paper, we explore the findings in relation to the recognition of RHMs and the programme. Methods:This exploratory qualitative study utilised individual in-depth interviews, group and focus group discussions, participatory methods (utilising a game format) and observations. Participants were purposively selected and comprised RHM programme implementers, community stakeholders, and local and non-governmental personnel. Data collection took place between August and September 2019. Interviews were conducted in English or siSwati and transcribed. SiSwati interviews were translated directly into English. All interviews were audio recorded, manually coded and thematically analysed. Data was validated through methodical triangulation. Results: Suboptimal organisational structure and support, primarily insufficient training and supervision for activities were factors identified through interviews and observation activities. Significant confusion of the RHM role was observed, with community expectations beyond formally endorsed tasks. Community participants expressed dissatisfaction with receiving health information only, preferring physical assistance in the form of goods. Additionally, gender emerged as a significant influencing factor on the acceptability of health messages and the engagement of RHMs with community members. Expectations and structurally limiting factors shape the extent to which RHMs are recognised as integral to the health system, at all social and organisational levels. Conclusions: Findings highlight the lack of recognition of RHMs and the programme at both community and national level. This, along with historical neglect, has hindered the capacity of RHMs to successfully contribute to positive health outcomes for rural communities. Renewed attention and support mechanisms for this cadre are needed. Clarification of the RHM role in line with current health challenges and clearer role parameters is essential.
Incidence, risk factors and consequences of preterm birth – findings from a multi-centric observational study for 14 months in Nepal
Authors: Gurung Abhishek , Wrammert Johan , Sunny Avinash K , Gurung Rejina , Rana Netra , Basaula Yuba Nidhi , Paudel Prajwal , Pokhrel Amrit , Kc Ashish
Published: July 2020

Background: Preterm birth is a worldwide epidemic and a leading cause of neonatal mortality. In this study, we aimed to evaluate the incidence, risk factors and consequences of preterm birth in Nepal.Methods: This was an observational study conducted in 12 public hospitals of Nepal. All the babies born during the study period were included in the study. Babies born <37 weeks of gestation were classified as preterm births. For the association and outcomes for preterm birth, univariate followed by multiple regression analysis was conducted. Results: The incidence of preterm was found to be 93 per 1000 live births. Mothers aged less than 20 years (aOR 1.26 ;1.15-1.39) had a high risk for preterm birth. Similarly, education of the mother was a significant predictor for preterm birth: illiterate mothers (aOR 1.41; 1.22-1.64), literate mothers (aOR 1.21; 1.08-1.35) and mothers having basic level of education (aOR 1.17; 1.07-1.27). Socio-demographic factors such as smoking (aOR 1.13; 1.01-1.26), use of polluted fuel (aOR 1.26; 1.17-1.35) and sex of baby (aOR 1.18; 1.11-1.26); obstetric factors such as nulliparity (aOR 1.33; 1.20-1.48), multiple delivery (aOR 6.63; 5.16-8.52), severe anemia during pregnancy (aOR 3.27; 2.21-4.84), antenatal visit during second trimester (aOR 1.13; 1.05-1.22) and third trimester (aOR 1.24; 1.12-1.38), <4 antenatal visits during pregnancy (aOR 1.49; 1.38-1.61) were found to be significant risk factors of preterm birth. Preterm has a risk for pre-discharge mortality (10.60; 9.28-12.10). Conclusion: In this study, we found high incidence of preterm birth. Various socio-demographic, obstetric and neonatal risk factors were associated with preterm birth. Risk factor modifications and timely interventions will help in the reduction of preterm births and associated mortalities. Trial registration: ISRCTN30829654
Efficacy of Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in the Management of Malignant Ascites
Authors: Jiao Jie , Li Chengzhen , Yu Guanying , Zhang Lei , Shi Xiaoyan , Yan Jingdu , Zhang Houjun , Guo Peiming
Published: July 2020

Objective: The purpose of this study is to compare the difference of clinical efficacy between conventional intraperitoneal chemotherapy and HIPEC, so as to explore the clinical application value and advantages of HIPEC.Design: A retrospective analysis was conducted on 80 patients with malignant ascites admitted to our hospital from June 2017 to June 2019. The general clinical data and qualitative data of the treatment results of 80 patients with malignant ascites were processed by SPSS19.0 using χ2 test and quantitative data were processed by t test. P <0.05, statistical data can be considered statistically significant.Results: 1. There was no significant change in vital signs and temperature in the observation group during the treatment, and the difference was not statistically significant 2. The short-term total effective rate of patients in the observation group was 91.11%, and the short-term total effective rate of the patients in the control group was 40%.3. There was no significant difference in the incidence of adverse reactions between the two groups of patients.Conclusion: Intraperitoneal hyperthermic chemotherapy combined with intravenous chemotherapy can significantly control malignant ascites, and has small adverse reactions, which is worthy of clinical promotion and application.
Integrins Alpha-2 and Beta-1 expression increases through Multiple Generations of the EDW01 Patient-Derived Xenograft Model of Breast Cancer – Markers but not Drivers of Epithelial Mesenchymal Transition
Authors: Wafai Razan , Williams Elizabeth D. , de Souza Emma , Simpson Peter T. , Reed Amy E. McCart , Kutasovic Jamie R. , Waltham Mark , Snell Cameron E. , Blick Tony , Thompson Erik W. , Hugo Honor
Published: July 2020

Background: Breast cancers acquire aggressive capabilities via epithelial to mesenchymal transition (EMT), in which various integrins/integrin linked kinase signalling are upregulated. Methods: We investigated this in two patient-derived xenografts (PDXs) developed from breast-to-bone metastases, and it’s functional significance in a breast cancer cell line system. ED03 and EDW01 PDXs were grown subcutaneously in immunocompromised SCID mice through 11 passages and 7 passages, respectively. Tumour tissue was assessed using immunohistochemistry (IHC) for estrogen receptor (ER)-alpha, E-cadherin, vimentin, Twist1, beta-catenin, P120-RasGAP, CD44, CD24 and Ki67, and RT-qPCR of EMT-related factors (CDH1, VIM, CD44, CD24), integrins beta-1 (ITGB1), alpha-2 (ITGA2) and ILK. Integrin and ILK expression in epidermal growth factor (EGF) induced EMT of the PMC42-ET breast cancer cell line was assessed by RT-qPCR and Western blotting, as were the effects of their transient knockdown via small interfering RNA +/- EGF. Cell migration, changes in cell morphology and adhesion of siRNA-transfected PMC42-ET cells to various extracellular matrix (ECM) substrates was assessed.Results: The ED03 (ER+/PR-/HER2-/lobular) and EDW01 (ER+/PR-/HER2-/ductal) PDXs were both classified as molecular subtype luminal A. ED03 xenografts exhibited mutated E-cadherin with minimal expression, but remained vimentin-negative across all passages. In EDW01, the hypoxic indicator gene CAIX and Twist1 were co-ordinately upregulated at passage 4-5, corresponding with a decrease in E-cadherin. At passages 6-7, vimentin was upregulated along with ITGB1 and ITGA2, consistent with an increasing EMT. The ED03 PDX displayed minimal change over passages in mice, for all genes examined. ILK, ITGB1 and ITGA2 were also increased in the EGF-induced EMT of PMC42-ET cells (in which E-cadherin was downregulated) although siRNA against these targets revealed that this induction was not necessary for the observed EMT. However, their knockdown significantly reduced EMT-associated adhesion and Transwell migration.Conclusion: Our data suggest that despite an increase in integrins alpha-2 and beta-1 gene expression in the EMT exhibited by EDW01 PDX over multiple generations, this pathway may not necessarily drive the EMT process.
Temporal and Spatial Availability of Cereal Straw in Germany Case Study: Biomethane for the Transport Sector
Authors: Brosowski André , Bill Ralf , Thrän Daniela
Published: July 2020

Background: By 2030, the transport sector needs to achieve additional greenhouse gas savings of 67 million tonnes CO2-eq. and further progress requires swiftly implementable solutions. The fermentation of cereal straw is a promising option. Returning the digestate to the farmland can close agricultural cycles while simultaneously producing biomethane. The world's first large-scale, mono-digestion plant for straw is operational since 2014. The temporal and spatial biomass availability is a key issue when replicating this concept. No detailed calculations on this subject are available, and the strategic relevance of biomethane from straw in the transport sector cannot be sufficiently evaluated. Methods: To assess the balance of straw supply and use, a total of 30 data sets are combined, taking into account the cultivation of the five most important cereal types and the straw required for ten animal species, two special crops and twelve industrial uses. The data are managed at district level and presented for the years 2010 to 2018. In combination with high-resolution geodata, the results are linked to actual arable fields, and the availability of straw throughout the country is evaluated using a GIS. Results: During the analysis period, the mobilisable technical biomass potential for future biomethane production is between 13.9–21.5 Tg fm a-1; this is up to 62 % higher than the previously known level. The annual potential fluctuates considerably due to weather anomalies. The all-time maximum in 2014 and the minimum for the last 26 years in 2018 are separated by just four years and a difference of 7.6 Tg fm. However, large parts of the potential are concentrated only in a few regions and biomethane from straw could provide up to 145 PJ of a low-emission fuel. This would be associated with a greenhouse gas mitigation of roughly twelve million tonnes CO2-eq., which corresponds to around one-sixth of the climate target for the entire sector. Conclusion: Despite the strong fluctuations, the potential is sufficient to supply numerous plants and to produce relevant quantities of biomethane even in weak years. To unlock the potential, the outcomes should be discussed further with stakeholders in the identified priority regions.
Two Different Troponin Isoforms for Detecting Early Myocardial Injury after Curative Resection of Oesophageal Cancer
Authors: Gu Wei , Tang Wei , Zhang Zuojing , Xu Meiying , Wu Jingxiang
Published: July 2020

Background: The objective of this study was to explore the consistency and correlation of two troponin (cTn) subtypes, troponin I (cTnI) and high-sensitivity troponin T (hs-cTnT), which can be used to judge early myocardial injury after curative resection of oesophageal cancer.Methods: This study is a secondary analysis of data obtained from a previous randomized controlled trial on postoperative myocardial injury in 70 patients undergoing elective curative resection of oesophageal cancer who were randomly assigned to undergo aggressive body temperature management (nasopharyngeal temperature 36.61±0.18°C) or standard body temperature management (35.80±0.18°C, n = 35 in each arm). The serum cTnI and hs-cTnT levels were measured in each patient at the 4 time points: before the operation and 6 h~12 h, 24 h and 48 h after the operation. The diagnostic criteria of myocardial injury followed the third edition ESC/ACCF definition of myocardial infarction. The primary outcomes included the following: (1) the incidence of myocardial injury and the relationship between hs-cTnT and cTn and (2) the consistency and correlation of the two cTn subtypes.Results: A total of 280 pairs of cTn samples were tested. The incidence of postoperative day 2 myocardial injury was 8.6% (3/35) among patients receiving aggressive body temperature management and 31.4% (11/35) among patients receiving standard body temperature management (P<0.05). Among 3 patients who experienced myocardial injury in the aggressive body temperature management group, 2 met the diagnostic criteria for cTnI and hs-cTnT and only 1 met the diagnostic criteria for hs-cTnT. Among the 11 patients who experienced myocardial injury in the standard body temperature management group, 7 met the diagnostic criteria for cTnI and hs-cTnT and only 3 met the diagnostic criteria for hs-cTnT; only 1 met the diagnostic criteria for cTnI. The bias of cTnI and hs-cTnT was -8.82±31.91 ng/L. The consistency limit was -71.37~53.73 ng/L. The proportion within the scope of the consistency of its corresponding boundary was 98.57%. The correlation coefficient of cTnI and hs-cTnT was 0.845 (P<0.05).Conclusions: In the evaluation of postoperative myocardial injury in patients undergoing curative resection of oesophageal cancer, cTnI and hs-cTnT exhibit high consistency and a good correlation. The combination of cTnI and hs-cTnT can improve the detection rate of myocardial injury, thus providing a better reference than a single measure alone for reducing the risk of perioperative myocardial injury in patients.Trial registration: ChiCTR-INR-17011621. Registered June 10, 2017
Upregulation of long non-coding RNA LOC284454 may serve as a new serum biomarker for head and neck cancers
Authors: Fan Chunmei , Wang Jinpeng , Tang Yanyan , Zhang Shanshan , Xiong Fang , Guo Can , Zhou Yanhong , Li Zheng , Li Xiaoling , Li Yong , Li Guiyuan , Zeng Zhaoyang , Xiong Wei
Published: July 2020

Background: Identification of effective diagnostic and prognostic biomarkers of cancer is necessary for improving precision medicine. Long non-coding RNAs (lncRNAs) play an important regulatory role in tumor initiation and progression. The lncRNA LOC284454 is distinctly expressed in various head and neck cancers (HNCs), as demonstrated by our previous bioinformatics analysis. However, the expression levels and functions of LOC284454 in cancer are still unclear.Methods: We investigated the dysregulation of lncRNAs in HNCs using the GEO database and found that LOC284454 was highly expressed in HNCs. Serum samples from 212 patients with HNCs and 121 normal controls were included in this biomarker study. We measured the expression of LOC284454 in the sera of HNC patients and normal controls using RT-qPCR. Receiver operating characteristics (ROC) analysis is an important statistical method that is widely used in clinical diagnosis and disease screening. ROC was used to analyze the clinical value of LOC284454 in the early diagnosis of HNCs.Results: LOC284454 was significantly upregulated in the sera of patients with nasopharyngeal carcinoma, oral cancer, and thyroid cancer. LOC284454 upregulation had good clinical diagnostic value in these cancers, as evaluated by area under the ROC curve values of 0.931, 0.698, and 0.834, respectively.Conclusions:LOC284454 may be a valuable serum biomarker for HNCs facilitating the early diagnosis of malignant cancers. Further studies are needed to elucidate the mechanisms underlying the involvement of LOC284454 in HNCs. This study provides the first evidence that LOC284454 may be a serum biomarker for HNCs.
COX-2 gene rs689466 polymorphism is associated with increased risk of colorectal cancer among Caucasians: a meta-analysis
Authors: Zhang Yong-Chen , Zhao Hui , Chen Chen , Ali Mohammad Amzad
Published: July 2020

Background: Several studies have reported the Cyclooxygenase 2 (COX-2) rs689466 polymorphism as a susceptibility locus of colorectal cancer (CRC), but their findings are inconsistent. Thus, this meta-analysis was performed to more accurately identify the effects of this polymorphism on CRC risk.

Methods: Potential case-control studies on EMBASE, Google of Scholar, Web of Science, Cochrane Library, and PubMed were searched. The strength of association was quantified by pooled odds ratio and 95% confidence interval. Totally 16 articles involving 8,998 cases and 11,917 controls were included.

Results: None of the five tested genetic models revealed an association between rs689466 polymorphism and CRC risk. Stratified analysis by ethnicity uncovered a positive association between this polymorphism and higher CRC risk in Caucasians, but not in Asians. In addition, we found high expression of COX-2 was associated with better overall survival for all CRC patients.

Conclusion: To sum up, the COX-2 rs689466 polymorphism may be related with susceptibility to CRC in Caucasians. This finding should be verified by larger-size studies with different ethnic groups.
Sequential modelling of the Earth's core magnetic field
Authors: Ropp Guillaume , Lesur Vincent , Baerenzung Julien , Holschneider Matthias
Published: July 2020

We describe a new, original approach to the modelling of the Earth's magnetic field.

The overall objective of this study is to reliably render fast variations of the core field and its secular variation.

This method combines a sequential modelling approach, a Kalman filter, and a correlation based modelling step. All sources that most significantly contribute to the field measured at the surface of the Earth are modelled. Their separation is based on strong prior information on their spatial and temporal behaviours.

We obtain a time series of model distributions which display behaviours similar to those of recent models based on more classic approaches, particularly at large temporal and spatial scales. Interesting new features and periodicities are visible in our models at smaller time and spatial scales.

An important aspect of our method is to yield reliable error bars for all model parameters. These errors, however, are only as reliable as the description of the different sources and the prior information used are realistic.

Finally, we used a slightly different version of our method to produce candidate models for the IGRF-13.
Hemodynamic changes in superficial arteriovenous malformation surgery measured by intraoperative ICG fluorescence videoangiography with FLOW 800 software
Authors: Ye Xun , Wang Liang , Li Ming-tao , Chen Xiao-lin , Wang Hao , Ma Li , Wang Rong , Zhang Yan , Cao Yong , Zhao Yuan-li , Zhang Dong , Wang Shuo
Published: July 2020

Background: Arteriovenous malformation(AVM) have long-term “blood stealing” characteristics, which result in complicated hemodynamic features. To analyze the application of intraoperative indocyanine green angiography with FLOW 800 software in AVM surgeries.Methods: Data on 17 patients undergoing surgery with ICG fluorescence were collected. To analyze the hemodynamic features of AVM and the influence on the peripheral cortex of AVM resection, we assessed the following hemodynamic parameters: maximum intensity, slope of rise, time to half-maximal fluorescence, and transit time from arteries to veins.Results：In the 17 superficial AVMs studied, the time delay color mode of FLOW 800 software was superior to the traditional playback mode for identifying feeding arteries, draining veins, and their relation to normal cortical vessels.The maximum fluorescence intensity and slope of the ICG fluorescence curve of feeder arteries and draining veins were higher than those of normal peripheral vessels (P < 0.05). The transit times in AVMs were significantly shorter than those in normal peripheral vessels (P < 0.05).After AVM resection, cerebral flow increased in the cortex, and local cycle time become longer, although the differences were not significant (P > 0.05).Conclusions:Hemodynamic parameter analysis provided quality guidance for the resection of AVMs and could also be used in estimating changes in blood flow in the local cortex to identify abnormal hyperperfusion and residual nidus.
Next-Generation Sequencing Analysis of Endometrial Screening Liquid-Based Cytology Specimens A Comparative Study to Tissue Specimens
Authors: Akahane Toshiaki , Kitazono Ikumi , Yanazume Shintaro , Kamio Masaki , Togami Shinichi , Sakamoto Ippei , Nohara Sachio , Yokoyama Seiya , Kobayashi Hiroaki , Hiraki Tsubasa , Suzuki Shinsuke , Ueno Shinichi , Tanimoto Akihide
Published: July 2020

Background: Liquid-based cytology (LBC) is now a widely used method for cytologic screening and cancer diagnosis. Since the cells are fixed with alcohol-based fixatives, and the specimens are stored in a liquid condition, LBC specimens are suitable for genetic analyses. Methods: Here, we established a small cancer gene panel, including 60 genes and 17 microsatellite markers for next-generation sequencing, and applied to residual LBC specimens obtained by endometrial cancer screening to compare with corresponding formalin-fixed paraffin-embedded (FFPE) tissues. Results: A total of 49 FFPE and LBC specimens (n=24) were analyzed, revealing characteristic mutations for endometrial cancer, including PTEN, CTNNB1, PIK3CA, and PIK3R1 mutations. Eight cases had higher scores for both tumor mutation burden (TMB) and microsatellite instability (MSI), which agree with defective mismatch repair (MMR) protein expression. Paired endometrial LBC, and biopsied and/or resected FFPE tissues from 7 cases, presented almost identical mutations, TMB, and MSI profiles in all cases. Conclusion: These findings demonstrate that our ad hoc cancer gene panel enabled the detection of therapeutically actionable gene mutations in endometrial LBC and FFPE specimens. Endometrial cancer LBC specimens offer an alternative and affordable source of molecular testing materials.
General and Tuberculosis-Specific Service Readiness in two states in Nigeria
Authors: Oluwasanu Mojisola , Hassan Abiodun , Adebayo Ayodeji , Ogbuji Queen Chidinma , Adeniyi Bamidele Olaiya , Adewole David , Ladipo Oladapo Alabi , Ajuwon Grace , Ajuwon Ademola
Published: July 2020

Background: Tuberculosis is the world’s deadliest infectious disease and a leading cause of death in Nigeria. The availability of a functional healthcare system is critical for effective TB service delivery and attainment of national and global targets. This study was designed to assess readiness for TB service delivery in Oyo and Anambra states of Nigeria. Methods: This was a facility-based study with a mixed-methods convergent parallel design. A multi-stage sampling technique was used to select 42 primary, secondary, and tertiary healthcare facilities in two TB high burden states. Data were collected using key informant interviews, a semi-structured instrument adapted from the WHO Service Availability and Readiness Assessment tool and facility observation using a checklist. Quantitative data were analysed using descriptive and inferential statistics while qualitative data were transcribed and analysed thematically. Data from both sources were integrated to generate conclusions.Results: The domain score for basic amenities in both states is 48.8%; 47.0% in Anambra and 50.8% in Oyo state with 95% confidence interval [-15.29, 7.56]. In Oyo, only half of the facilities (50%) have access to constant power supply compared to 72.7% in Anambra state. The overall general service readiness index for both states is 69.2% with Oyo state having a higher value (73.3%) compared to Anambra with 65.4% (p=0.56). The domain score for availability of staff and TB guidelines is 57.1% for both states with 95% confidence interval [-13.8, 14.4]. Indicators of this domain with very low values were staff training for the management of HIV and TB co-infection and training on MDR -TB. Almost half (47.6%) experienced a stock out of TB drugs in the 3 months preceding the study. The overall tuberculosis-specific service readiness index for both states is 75%; this was higher in Oyo (76.5%) than Anambra state (73.6%) (p=0.14). Qualitative data revealed areas of deficiencies for TB service delivery such as inadequate infrastructure, poor staffing, and gaps with continuing education on TB management.Conclusions: The weak health system remains a challenge and there must be concerted actions and funding by the government and donors to improve the TB healthcare systems.
Comparison of Bailout and Planned Rotational Atherectomy for Severe Coronary Calcified Lesions
Authors: CAO Cheng-fu , MA Yu-liang , LI Qi , LIU Jian , ZHAO Hong , LU Ming-yu , wang weimin
Published: July 2020

Background: To compare outcomes of bailout and planned rotational atherectomy (RA) in the treatment of severe calcified coronary lesions.Methods: Data of patients treated with RA from 2017 to 2018 at a single-center registry were retrospectively analyzed. All patients were divided into planned RA and bailout RA groups, data between two groups were compared.Results: A total of 190 patients were included in this study, 138 patients received planned RA and 52 patients received bailout RA. Baseline clinical characteristics had no significant differences between groups. The number of implanted stents and total stents length were similar. But the number of balloon (1.6±0.8 vs. 2.7±1.3, P<0.001), procedure time (83.5±26.2 vs. 100.8±36.4min, P=0.007), fluoroscopy volume (941±482 vs. 1227±872mGy, P=0.012] and contrast amount （237±62 vs. 275±90ml, P=0.003）were all lower in planned RA group. Planned RA had a higher procedural success rate (99.3% vs. 92.3%, P=0.007) and a lower complication incidence (4.3% vs. 17.3%, P=0.009). But the primary outcomes at 3 years (9.2% and 16.6%, log rank p=0.24) had no difference between groups.Conclusions: For severe coronary artery calcification, although planned RA did not improved the long term prognosis compared with bailout RA, but it can improve the immediate procedural success rate, reduce the incidence of complications, the procedure time and the volume of contrast.
Associations of childhood exposure to malaria with cognition and behaviour outcomes: a systematic review protocol
Authors: SSEMATA ANDREW SENTOOGO , NAKITENDE JACQUELLINE ANN , KIZITO SIMON , WHIPPLE ELIZABETH C , BANGIRANA PAUL , NAKASUJJA NOELINE , JOHN CHANDY C , McHENRY MEGAN SONG
Published: July 2020

Background: Malaria is one of the major contributing risk factors for poor development of children living in low- and middle- income countries (LMICs). However, little is known about the specific domains of cognition and behaviour that are impacted by malaria, the extent of these deficits, and the different types of the malaria spectrum that are associated with these deficits. The objective of this systematic review is to determine the association of the different type of malaria infection on cognition and behavioural outcomes among children living in LMICs. Methods and analysis: We will systematically search online bibliographic databases including MEDLINE (via PubMed), CINAHL (via EBSCO), PsycINFO (via EBSCO), Embase and The Cochrane Central Register of Controlled Trials (CENTRAL) as well as Google Scholar and bibliographies of pertinent articles. We will include studies with a comparison group (e.g., clinical trials, cohort, observational, cross-sectional case–control and controlled before and after or interrupted–time–series studies) involving children under 18 years of age living in LMICs, as determined by World Bank Criteria, with either an active malaria infection or history of malaria. Included articles must also measure cognitive and/or behaviour outcomes determined by standardized psychological assessments (questionnaire-based scales and or neurocognitive assessments). Studies will be excluded if they are not in English, lack a control group, take place in a high-income country, or if a standardized instrument was not used. Two reviewers will independently review all articles to determine if they meet eligibility criteria. Any conflicts will be resolved after discussion with a third reviewer. When a list of included articles is finalized, two reviewers will extract data to populate and then cross check within an electronic table. Risk of bias and the strength of evidence and recommendations will be assessed independently using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria, and a final score will be given upon consensus. For sufficiently homogeneous data on measured outcomes in multiple studies, we will investigate the possibility of pooling data to perform a meta-analysis. Discussion: This systematic review will evaluate the evidence of the association of malaria on the cognitive and behavioural outcomes. Findings from this planned review will generate insight on the domains affected by the different forms malaria infection and may inform subsequent malaria interventions and future research in paediatric care.Systematic review registration: This systematic review has been registered under the International Prospective Register of Systematic Reviews (PROSPERO; registration number: CRD42020154777)
IFI6 is an effective therapeutic target in esophageal squamous cell carcinoma via the modulation of oxidative stress
Authors: Liu Zhenchuan , Gu Shaorui , Lu Tiancheng , Wu Kaiqin , Li Lei , Dong Chenglai , zhou yongxin
Published: July 2020

Background: Esophageal squamous cell carcinoma (ESCC) is one of the most lethal forms of adult cancer with poor prognosis. Substantial evidence indicates that reactive oxygen species (ROS) are important modulators of aggressive cancer behavior. However, the mechanism by which ESCC cells integrate redox signals to modulate carcinoma progression remains elusive. Methods: The expression of interferon alpha inducible protein 6 (IFI6) in clinical ESCC tissues and cell lines was detected by RT-PCR and Western blotting. The correlation between IFI6 expression levels and aggressive ESCC disease stage was examined by immunohistochemistry. Bioinformatic analysis was conducted to explore the potential function of IFI6 in ESCC. ESCC cell lines stably depleted of IFI6 and ectopically expressing IFI6 were established using lentiviruses expressing shRNAs and an IFI6 expression plasmid, respectively. The effects of IFI6 on ESCC cells were determined by cell-based analyses, including EdU assay, apoptotic assay, cellular and mitochondria-specific ROS detection, seahorse extracellular flux, and mitochondrial calcium flux assays. Blue native-polyacrylamide gel electrophoresis was used to determine mitochondrial supercomplex assembly. Transcriptional activation of NADPH oxidase 4 (NOX4) via ATF3 was confirmed by dual luciferase assay. In vivo tumor growth was determined in mouse xenograft models. Results: We find that the expression of IFI6, an IFN-stimulated gene localized in the inner mitochondrial membrane, is markedly elevated in ESCC patients and a panel of ESCC cell lines. High IFI6 expression correlates with aggressive disease phenotype and poor prognosis in ESCC patients. IFI6 depletion suppresses proliferation and induces apoptosis by increasing ROS accumulation. Mechanistically, IFI6 ablation induces mitochondrial calcium overload by activating mitochondrial Ca 2+ uniporter and subsequently ROS production. Following IFI6 ablation, mitochondrial ROS accumulation is also induced by mitochondrial supercomplex assembly suppression and oxidative phosphorylation dysfunction, while IFI6 overexpression produces the opposite effects. Furthermore, energy starvation induced by IFI6 inhibition drives endoplasmic reticulum stress through disrupting endoplasmic reticulum calcium uptake, which upregulates NOX4-derived ROS production in an ATF3-dependent manner. Finally, the results in xenograft models of ESCC further corroborate the in vitro findings. Conclusion: Our study unveils a novel redox homeostasis signaling pathway that regulates ESCC pathobiology and identifies IFI6 as a potential druggable target in ESCC.
'We always support each other – no matter what': a qualitative analysis of work-related psychosocial demands, stressors and resources in general practice teams
Authors: Tsarouha Elena , Preiser Christine , Weltermann Birgitta , Junne Florian , Seifried-Dübon Tanja , Stuber Felicitas , Hartmann Sigrid , Wittich Andrea , Rieger Monika A , Rind Esther , Consortium IMPROVEjob-
Published: July 2020

Background Work-related stress has been associated with poor psychological and physical outcomes. A better understanding of work-related psychosocial demands, risks and resources can therefore contribute to the prevention of work-related stress. Compared to the general population, medical staff have reported a higher prevalence of chronic stress. Using general practices as an example for small enterprises, this study aims to gain a deeper understanding of work-related psychosocial demands, stressors and resources in the primary care setting. Methods We applied an ethnographic design, comprising a combination of participating observations, individual interviews with physicians (N = 6) and focus group discussion with practice assistants and administrative staff (N = 19) in five general practices in Germany. Access to the practice teams was established via a university general practice network. A grounded theory approach was applied to analyze all data. Results Our results identified specific psychosocial demands, stressors and resources exemplified mainly along two typical tasks in GP practices: the issuing of medical prescriptions and blood sampling. Main psychosocial risks included factors related to work content and tasks (e.g. incompleteness of task), organization of work (e.g. frequent interruptions), and the working environment (e.g. noise). Work-related resources comprised staff’s influence on aspects related to work organization (e.g. scope for action) and social support (e.g. positively perceived teamwork). These factors did not occur in isolation but were closely interrelated with each other.Conclusion Although work processes in general practices are complex and required to comply with legal regulations, the specific organization of work processes is the responsibility of the general practitioner. Therefore, there are opportunities for practice owners and practice teams to establish working procedures in ways that reduce psychosocial risks and strengthen work-related resources.
Identifying Integration and Differentiation in a Hospital’s Logistical System: A social network analysis of a case study
Authors: Ham Annelies van der , Merode Frits Van , Ruwaard Dirk , Raak Arno Van
Published: July 2020

Background
Integration, the coordination and alignment of tasks, has been promoted widely in order to improve the performance of hospitals. Both organization theory and social network analysis offer perspectives on integration. This exploratory study research aims to understand how a hospital’s logistical system works, and in particular to what extent there is integration and differentiation. More specifically, it first describes how a hospital organizes logistical processes; second, it identifies the agents and the interactions for organizing logistical processes, and, third, it establishes the extent to which tasks are segmented into subsystems, which is referred to as differentiation, and whether these tasks are coordinated and aligned, thus achieving integration.

Methods
The study is based on case study research carried out in a hospital in the Netherlands. All logistical tasks that are executed for surgery patients were studied. Using a mixed method, data were collected from the Hospital Information System (HIS), documentation, observations and interviews. These data were used to perform a social network analysis and calculate the network metrics of the hospital network.

Results
This paper shows that 23 tasks are executed by 635 different agents who interact through 31,499 interaction links. The social network of the hospital demonstrates both integration and differentiation. The network appears to function differently from what is assumed in literature, as the network does not reflect the formal organizational structure of the hospital, and tasks are mainly executed across functional silos. Nurses and physicians perform integrative tasks and two agents who mainly coordinate the tasks in the network, have no hierarchical position towards other agents. The HIS does not seem to fulfill the interactional needs of agents.

Conclusions
This exploratory study reveals the network structure of a hospital. The cross-functional collaboration, the integration found, and position of managers, coordinators, nurses and doctors suggests a possible gap between organizational perspectives on hospitals and reality. This research sets a basis for further research that should focus on the relation between network structure and performance, on how integration is achieved and in what way organization theory concepts and social network analysis could be used in conjunction with one another.
Global targetome analysis reveals critical role of miR-29a in pancreatic stellate cell mediated regulation of PDAC tumor microenvironment
Authors: Dey Shatovisha , Liu Sheng , Factora Tricia D , Taleb Solaema , Riverahernandez Primavera , Udari Lata , Zhong Xiaoling , Wan Jun , Kota Janaiah
Published: July 2020

Background Pancreatic ductal adenocarcinoma (PDAC) is one of the most aggressive forms of malignancies with a nearly equal incidence and mortality rates in patients. Pancreatic stellate cells (PSCs) are critical players in PDAC microenvironment to promote the aggressiveness and pathogenesis of the disease. Dysregulation of microRNAs (miRNAs) have been shown to play a significant role in progression of PDAC. Earlier, we observed a PSC-specific downregulation of miR-29a in PDAC pancreas, however, the mechanism of action of the molecule in PSCs is still to be elucidated. The current study aims to clarify the regulation of miR-29a in PSCs and identifies functionally important downstream targets that contribute to tumorigenic activities during PDAC progression. Methods In this study, using RNAseq approach, we performed transcriptome analysis of paired miR-29a overexpressing hPSC cells and controls. Enrichment analysis was performed with the identified differentially expressed genes (DEGs). miR-29a targets in the dataset were identified, which were utilized to create network interactions. Western blots were performed with the top candidate miR-29a targets in hPSC cells transfected with miR-29a mimic or scramble control. Results RNAseq analysis identified 202 differentially expressed genes, which included 19 downregulated direct miR-29a targets. Translational repression of eight key pro-tumorigenic and -fibrotic targets namely IGF-1, COL5A3, CLDN1, E2F7, MYBL2, ITGA6 and ADAMTS2 by miR-29a was observed in PSCs. Using pathway analysis, we find that miR-29a modulates effectors of IGF-1-p53 signaling in PSCs that may hinder carcinogenesis. We further observe a regulatory role of the molecule in pathways associated with PDAC ECM remodeling and tumor-stromal crosstalk, such as INS/IGF-1, RAS/MAPK, laminin interactions and collagen biosynthesis. Conclusions Together, our study presents a comprehensive understanding of miR-29a regulation of PSCs, and identifies essential pathways associated with PSC-mediated PDAC pathogenesis. The findings suggest an anti-tumorigenic role of miR-29a in the context of PSC-tumor cell crosstalk and advocates for the potential of the molecule in PDAC targeted therapies.
Implementation of the TaperGuard™ endotracheal tube in an unselected surgical population to reduce postoperative pneumonia
Authors: Martini Ross P , Yanez N David , Treggiari Miriam , Tekkali Praveen , Soelberg Cobin , Aziz Michael F
Published: July 2020

Background : Endotracheal tube (ETT) designs to decrease the risk of ventilator associated pneumonia (VAP) include supraglottic suctioning, and/or modifications of the cuff shape. The TaperGuard™ ETT has a tapered, polyvinylchloride cuff designed to reduce microaspiration around channels that form with a standard barrel-shaped cuff.

We compared risk of postoperative pneumonia using the TaperGuard™ ETT and the standard ETT in surgical patients requiring general anesthesia with endotracheal intubation.

Methods : We used an interrupted time-series design to compare endotracheal intubation using the TaperGuard™ ETT (intervention cohort), and a historic cohort using the standard ETT (baseline cohort), among surgical patients requiring hospital admission. We compared the incidence of postoperative pneumonia in the intervention and baseline cohorts. Data were collected from the electronic health record and linked to patient-level data from National Surgical Quality Improvement Project. Additionally, we performed secondary analyses in a subgroup of patients at high risk of postoperative pneumonia.

Results : 15,388 subjects were included; 6,351 in the intervention cohort and 9,037 in the baseline cohort. There was no significant difference in the incidence of postoperative pneumonia between the intervention cohort (1.62%) and the baseline cohort (1.79%). The unadjusted odds ratio (OR) of postoperative pneumonia was 0.90 (95% CI: 0.70, 1.16; p=0.423) and the OR adjusted for patient characteristics and potential confounders was 0.90 (95% CI: 0.69, 1.19; p=0.469), comparing the intervention and baseline cohorts. There was no a priori selected subgroup of patients for whom the use of the TaperGuard™ ETT was associated with decreased odds of postoperative pneumonia relative to the standard ETT. Hospital mortality was higher in the intervention cohort (1.5%) compared with the baseline cohort (1.0%; OR 1.46, 95% CI: 1.09, 1.95; p=0.010).

Conclusions : The broad implementation of the use of the TaperGuard™ ETT for intubation of surgical patients was not associated with a reduction in the risk of postoperative pneumonia. In the setting of a low underlying postoperative pneumonia risk and the use of recommended preventative VAP bundles, further risk reduction may not be achievable by simply modifying the ETT cuff design in unselected or high-risk populations undergoing inpatient surgery.

ClinicalTrials.gov ID NCT02450929
Rural-urban differences in the mental health of perinatal women: a UK-based cross-sectional study
Authors: Ginja Samuel , Jackson Katherine , Newham James J , Henderson Emily J , Smart Debbie , Lingam Raghu
Published: July 2020

Background: International data suggest that living in a rural area is associated with an increased risk of perinatal mental illness. This study tested the association between rurality and risk for two mental illnesses prevalent in perinatal women - depression and anxiety.Methods: Using a cross-sectional design, antenatal and postnatal women were approached by healthcare professionals and through other networks in a county in Northern England (UK). After providing informed consent, women completed a questionnaire where they indicated their postcode (used to determine rural-urban status) and completed three outcome measures: the Edinburgh Postnatal Depression Scale (EPDS), the Whooley (depression measure), and the Generalised Anxiety Disorder 2-item (GAD-2). Logistic regression models were developed, both unadjusted and adjusted for potential confounders, including socioeconomic status, social support and perinatal stage.Results: 295 participants provided valid data. Women in rural areas (n=130) were mostly comparable to their urban counterparts (n=165). Risk for depression and/or anxiety was found to be higher in the rural group across all models: unadjusted OR 1.67 95% CI 1.03 to 2.72, p=.038. This difference though indicative did not reach statistical significance after adjusting for socioeconomic status and perinatal stage (OR 1.57 (0.40), 95% CI 0.95 to 2.58, p=.078), and for social support (OR 1.65 (0.46), 95% CI 0.96 to 2.84, p=.070).Conclusions: Data suggested that women in rural areas were at higher risk of depression and anxiety than their urban counterparts. Further work should be undertaken to corroborate these findings and investigate the underlying factors. This will help inform future interventions and the allocation of perinatal services to where they are most needed.