bluuebunny/crossref_metadata_2025 huggingface dataset:
A Comprehensive Evaluation of Township Hospitals in the Severely Cold Areas of China
Authors: Wu Yue , Zhu Lei , Yu Tingting , Zhang Shanshan
Published: May 2021

Objective:

The aims of this study are to establish an evaluation system and find the existing problems in the architectural design of township hospitals in the severely cold regions of China.

Background:

Due to the geographical location and economic factors, development still has some key problems, such as inadequate construction, old facilities, and backward technology, which are more prominent in the severely cold regions.

Methods:

First, evaluation factors have been selected and determined by literature review and on-site investigation. Evaluation rules have been determined using fuzzy membership function. Then, the analytic hierarchy process is used to determine the weights of the evaluation factors at all levels. Finally, take a township hospital as an example to calculate the comprehensive evaluation results.

Results:

A comprehensive evaluation index system with 28 elements and 76 factors for the township hospitals in severely cold regions including the basic health service capacity, the emergency capacity, and the climate fitness.

Conclusions:

The establishment of the comprehensive evaluation system of township hospitals in severely cold areas in this study aims to find out the problems through the evaluation of the existing township hospitals in the severely cold areas and provide guidance for the transformation of existing township hospitals in the severely cold areas. By comparing the scheme evaluation for building hospitals, we shall look for the optimal solution to provide reference for future development in the construction of township hospitals.
Conditional and Overall Disease-Specific Survival in Patients With Paranasal Sinus and Nasal Cavity Cancer: Improved Outcomes in the Endoscopic Era
Authors: Sharma Rahul K. , Irace Alexandria L. , Schlosser Rodney J. , Overdevest Jonathan B. , Rowan Nicholas R. , Troob Scott H. , Gudis David A.
Published: May 2021

Background

The management of paranasal sinus and nasal cavity malignancies has evolved significantly with the development of advanced endoscopic techniques and improvements in adjuvant therapy. We sought to characterize both disease-specific survival (DSS) and 5-year conditional disease-specific survival (CDSS, the change in life expectancy with increasing survivorship) for sinus malignancies diagnosed before and after the year 2000.

Methods

Patients diagnosed with sinus and nasal cavity cancer between 1973-2015 were extracted from the Surveillance, Epidemiology, End Results (SEER) registry. Kaplan-Meier analysis for DSS was stratified by year of diagnosis before and after 2000. Cox-proportional hazards models of DSS controlling for stage, age, and year of diagnosis were generated. CDSS was calculated using Cox-regression models stratified by stage.

Results

We analyzed 10,535 patients. Diagnosis after the year 2000 was independently associated with improved DSS (HR:0.81, 95% CI: 0.75-0.87, P < .001) after controlling for age and stage. After stratifying by stage, diagnosis after year 2000 was associated with improved DSS for localized (HR:0.71, 0.59-0.86, P < .001) malignancies, regional (HR: 0.86, 0.78-0.94, P = .001) and distant malignancies (HR 0.74, 0.63-0.87, P < .001). CDSS improved with increasing survivorship for all stages of sinus and nasal cavity cancer, and those diagnosed after 2000 had improved CDSS compared to those diagnosed before 2000. Descriptively, the association of year of diagnosis with CDSS diminished with increasing survivorship for localized cancers, but was consistent for other stages.

Conclusion

For paranasal sinus and nasal cavity malignancies, year of diagnosis independently influences both DSS and CDSS. Improved survival is likely due to advances in both surgical and adjuvant treatments. To our knowledge, this study is the first to examine CDSS for these malignancies.
Allied Systems: Data governance challenges and the opioid crisis
Authors: McDermott Kevin
Published: May 2021

This teaching case based on real people and events describe a critical decision point during the nascent stage of entrepreneurial venture called Allied Systems Integration Solutions in May 2019. This data governance case explores the challenges with centralizing client data in an effort to help health practitioners cope with the opioid use crisis. Readers are asked to put themselves into the shoes of the protagonists who must make difficult operational decisions related to these data governance and behaviour management questions. This case is derived from participant observation of eight entrepreneurial mentoring sessions with the protagonist entrepreneurs. Detailed notes of participant observation sessions were maintained and qualitative data were analysed for the purpose of creating this business case. This case is intended for upper year undergraduate, or MBA courses. In particular, it should be used in curricula exploring the complexities of real-world data governance decisions, managing the trade-offs between operational efficiencies and data protection. This case would be most suited to courses in Management Information Systems, Database Management and Operations Management.
Evidence and rationale for a pragmatic approach to pre-operative isolation prior to elective urological surgery during the de-escalation phase of COVID-19
Authors: Smith Rhys O , Desai Roshni S , Jones Adam
Published: May 2021

Introduction:

In response to the COVID-19 pandemic elective operating decreased to meet critical care capacity demands at the Royal Berkshire Hospital. As this demand fell elective operating subsequently increased. This saw the introduction of the ‘Cold Pathway’ at the Royal Berkshire Hospital in line with Public Health England guidelines; the first urology patients being admitted on 14 May 2020. This requires patients to undergo a 14-day self-isolation period, which many find difficult, with a negative COVID-19 swab 48 h prior to their operation.

Aims:

This article examines whether any differences exist in patient outcomes related to COVID-19 since implementation of the Cold Pathway and the significance of this to the 14-day self-isolation rule.

Methods:

Urology patients electively operated on between 23 March 2020–3 July 2020 were included. A combination of electronic records and telephone consultations were used to obtain data regarding a pre-selected set of questions.

Results:

One hundred and ninety-six patients were included. Seventy-eight patients were admitted prior to the introduction of the Cold Pathway and 118 after this point. Of patients analysed prior to the implementation of the Cold Pathway, one required ongoing hospital treatment as a result of potentially obtaining COVID-19 from in-patient admission. Of the 78 patients, 14 isolated prior to their procedure. Post-implementation, 118 patients were examined. Despite claiming to have complied with self-isolation instructions at admission, 45 patients admitted retrospectively to not complying at all or only partially. One patient developed COVID-19 3 weeks post-operatively.

Discussion:

We have shown no difference in outcomes, in relation to COVID-19, when comparing those admitted pre- and post-Cold Pathway implementation. Many patients describe difficulty in following this isolation period. In conjunction with falling national and local levels of COVID-19 positive cases, we have therefore adopted a more pragmatic approach to patient isolation with the ability to perform operations based on clinical need and individual patient circumstances.

Level of evidence:

This is a cohort study of patients undergoing elective urological surgery at the Royal Berkshire Hospital.
The Relationship Between Carbon Disclosure Project Scores and Global 500 Companies: A Perspective From National Culture
Authors: Oktay Sadiye , Bozkurt Serdar , Yazıcı Kübra
Published: May 2021

This research aims to examine the relationship between voluntary carbon disclosures and national cultures of Global 500 companies that direct the world economy. The research is essential in terms of showing the results of the Paris agreement, which is considered to have an impact on climate change, one of the most outstanding variables affecting sustainability, in the national context. Our study is one of the few on the sustainability theories (stakeholder, legitimacy, signaling, and system) and the relationship between carbon disclosures and the context of national culture both. As a consequence of this research, the relationships between Carbon Disclosure Project (CDP) data and the national culture to which Global 500 companies belong were determined. In this context, CDP climate scores also differ in five dimensions (uncertainty avoidance, individualism, power distance, long-term orientation, indulgence) other than Hofstede’s masculinity dimension. CDP’s water security values differ only in the social aspect to avoid uncertainty. Also, we find that the Paris agreement makes a difference in carbon disclosures.
Longer Screws Can Reduce the Stress on the Upper Instrumented Vertebra With Long Spinal Fusion Surgery: A Finite Element Analysis Study
Authors: Oe Shin , Narita Kengo , Hasegawa Kazuhiro , Natarajan Raghu N. , Yamato Yu , Hasegawa Tomohiko , Yoshida Go , Banno Tomohiro , Arima Hideyuki , Mihara Yuki , Ushirozako Hiroki , Ide Koichiro , Yamada Tomohiro , Watanabe Yuh , Matsuyama Yukihiro
Published: May 2021

Study Design:

A finite element analysis study.

Objective:

Of proximal junctional failure, upper instrumented vertebra (UIV) fracture can causes severe spinal cord injury. Previously, we reported that higher occupancy rate of pedicle screw (ORPS) at UIV prevented UIV fracture in adult spinal deformity surgery; we had not yet tested this finding using a biomechanical study. The purpose of present study was to measure the differences in loads on the UIV according to the length of PS and ORPS.

Methods:

We designed an FE model of a lumbar spine (L1-S1) using FE software. The PS was set from L2 to S1 and connected the rod. The FE model simulated flexion (8 Nm) to investigate the loads at UIV (L2) according to the length of the PS. There were 5 screw lengths examined: 40 (ORPS 36.4%), 45 (48.5%), 50 (66.7%), 55 (81.8%), and 60 mm (93.9%).

Results:

Stress with bending motion was likely to occur at the upper front edge of the vertebral body, the pedicles, and the screw insertion point. The maximum equivalent stress according to screw lengths of 40, 45, 50, 55, and 60 mm were 45.6, 37.2, 21.6, 13.3, and 14.8 MPa, respectively. The longer screw, the less stress was applied to UIV. No remarkable change was observed between the screw lengths of 55 and 60 mm.

Conclusions:

Increasing ORPS to 81.8% or more reduced the load on the UIV. To prevent UIV fracture, the PS length in the UIV should be more than ORPS 81.8%.
Student Learning in Online College Programs
Authors: Cellini Stephanie Riegg , Grueso Hernando
Published: May 2021

We draw on administrative data from the country of Colombia to assess differences in student learning in online and traditional on-campus college programs. The Colombian context is uniquely suited to study this topic, as students take a compulsory exit examination at the end of their studies. We can therefore directly compare the performance on the exit exam for students in online and on-campus programs both across and within institutions, degrees, and majors. Using inverse probability weighting methods based on a rich set of background characteristics coupled with institution–degree–major fixed effects, our results suggest that bachelor’s degree students in online programs perform worse on nearly all test score measures (including math, reading, writing, and English) relative to their counterparts in on-campus programs. Results for shorter technical certificates are more mixed. While online students perform significantly worse than on-campus students on exit exams in private institutions, they perform better in SENA—the main public vocational institution in the country.
Formative Education Online: Teaching the Whole Person During the Global COVID-19 Pandemic
Authors: Kim Deoksoon , Wortham Stanton , Borowiec Katrina , Yatsu Drina Kei , Ha Samantha , Carroll Stephanie , Wang Lizhou , Kim Julie
Published: May 2021

The COVID-19 pandemic, an unprecedented public health emergency, challenged higher education and threatened students’ well-being in several ways. With the abrupt shift to online learning, were instructors able to maintain a focus on educating whole students, in addition to teaching subject matter? We answer this question by investigating “formative education,” an approach to teaching and learning that emphasizes holistic development, exploring formative education online during the pandemic. This qualitative study investigates the strategies of 37 college faculty who provided successful formative education online. A cross-subject analysis of data from faculty interviews and supplemental materials (course artifacts, course evaluations, student interviews) uncovered three teaching approaches that faculty used to achieve formative education online: empathic (centering students’ emotions), reflective (facilitating deep inquiry), and adaptive (having flexibility in meeting students’ needs). These approaches could help instructors design online education that engages the whole person.
Carotid approach to anterior circulation thromboembolectomy in an adult with failing fontan physiology: a case report
Authors: Eden Caroline , Clifford Hugo , Wang Arthur , Mohammed Asif , Yim Peter
Published: May 2021

Background

Anesthetic management of an adult with failing Fontan physiology is complicated given inherent anatomical and physiological alterations. Neurosurgical interventions including thromboembolectomy may be particularly challenging given importance of blood pressure control and cerebral perfusion.

Case Presentation

We describe a 29 year old patient born with double outlet right ventricle (DORV) with mitral valve atresia who after multi-staged surgeries earlier in life, presented with failing Fontan physiology. She was admitted to the hospital almost 29 years after her initial surgeries to undergo workup for a dual heart and liver transplant in the context of a failing Fontan with elevated end diastolic pressures, NYHA III heart failure symptoms, and liver cirrhosis from congestive hepatopathy. During the workup in the context of holding anticoagulation for invasive procedures, she developed a middle cerebral artery (MCA) stroke requiring a thromboembolectomy via left carotid artery approach.

Discussion and Conclusions

This case posed many challenges to the anesthesiologist including airway control, hemodynamic and cardiopulmonary monitoring, evaluation of perfusion, vascular access, and management of anticoagulation in an adult patient in heart and liver failure with Fontan physiology undergoing thromboembolectomy for MCA embolic stroke.
Accelerating diagnosis of Parkinson’s disease through risk prediction
Authors: Yuan William , Beaulieu-Jones Brett , Krolewski Richard , Palmer Nathan , Veyrat-Follet Christine , Frau Francesca , Cohen Caroline , Bozzi Sylvie , Cogswell Meaghan , Kumar Dinesh , Coulouvrat Catherine , Leroy Bruno , Fischer Tanya Z. , Sardi S. Pablo , Chandross Karen J. , Rubin Lee L. , Wills Anne-Marie , Kohane Isaac , Lipnick Scott L.
Published: May 2021

Background

Characterization of prediagnostic Parkinson’s Disease (PD) and early prediction of subsequent development are critical for preventive interventions, risk stratification and understanding of disease pathology. This study aims to characterize the role of the prediagnostic period in PD and, using selected features from this period as novel interception points, construct a prediction model to accelerate the diagnosis in a real-world setting.

Methods

We constructed two sets of machine learning models: a retrospective approach highlighting exposures up to 5 years prior to PD diagnosis, and an alternative model that prospectively predicted future PD diagnosis from all individuals at their first diagnosis of a gait or tremor disorder, these being features that appeared to represent the initiation of a differential diagnostic window.

Results

We found many novel features captured by the retrospective models; however, the high accuracy was primarily driven from surrogate diagnoses for PD, such as gait and tremor disorders, suggesting the presence of a distinctive differential diagnostic period when the clinician already suspected PD. The model utilizing a gait/tremor diagnosis as the interception point, achieved a validation AUC of 0.874 with potential time compression to a future PD diagnosis of more than 300 days. Comparisons of predictive diagnoses between the prospective and prediagnostic cohorts suggest the presence of distinctive trajectories of PD progression based on comorbidity profiles.

Conclusions

Overall, our machine learning approach allows for both guiding clinical decisions such as the initiation of neuroprotective interventions and importantly, the possibility of earlier diagnosis for clinical trials for disease modifying therapies.
The small-molecule protein ligand interface stabiliser E7820 induces differential cell line specific responses of integrin α2 expression
Authors: Hülskamp Michael David , Kronenberg Daniel , Stange Richard
Published: May 2021

Background

The mechanism of small-molecule stabilised protein-protein interactions is of growing interest in the pharmacological discovery process. A plethora of different substances including the aromatic sulphonamide E7820 have been identified to act by such a mechanism. The process of E7820 induced CAPERα degradation and the resultant transcriptional down regulation of integrin α2 expression has previously been described for a variety of different cell lines and been made responsible for E7820’s antiangiogenic activity. Currently the application of E7820 in the treatment of various malignancies including pancreas carcinoma and breast cancer is being investigated in pre-clinical and clinical trials. It has been shown, that integrin α2 deficiency has beneficial effects on bone homeostasis in mice. To transfer E7820 treatment to bone-related pathologies, as non-healing fractures, osteoporosis and bone cancer might therefore be beneficial. However, at present no data is available on the effect of E7820 on osseous cells or skeletal malignancies.

Methods

Pre-osteoblastic (MC3T3 and Saos-2) cells and endothelial (eEnd2 cells and HUVECs) cells, each of human and murine origin respectively, were investigated. Vitality assay with different concentrations of E7820 were performed. All consecutive experiments were done at a final concentration of 50 ng/ml E7820. The expression and production of integrin α2 and CAPERα were investigated by quantitative real-time PCR and western blotting. Expression of CAPERα splice forms was differentiated by semi-quantitiative reverse transcriptase PCR.

Results

Here we present the first data showing that E7820 can increase integrin α2 expression in the pre-osteoblast MC3T3 cell line whilst also reproducing canonical E7820 activity in HUVECs. We show that the aberrant activity of E7820 in MC3T3 cells is likely due to differential activity of CAPERα at the integrin α2 promoter, rather than due to differential CAPERα degradation or differential expression of CAPERα spliceforms.

Conclusion

The results presented here indicate that E7820 may not be suitable to treat certain malignancies of musculoskeletal origin, due to the increase in integrin α2 expression it may induce. Further investigation of the differential functioning of CAPERα and the integrin α2 promoter in cells of various origin would however be necessary to more clearly differentiate between cell lines that will positively respond to E7820 from those that will not.
Endodontic length measurements using 3D Endo, cone-beam computed tomography, and electronic apex locator
Authors: Van Pham Khoa
Published: May 2021

Background

The objective of this study is to investigate the accuracy of the 3D Endo software, cone-beam computed tomography (CBCT) software, and the electronic apex locator (EAL) in endodontic length determination.

Methods

302 root canals in 111 human extracted molars were chosen. Access cavity was performed, and root canal lengths were measured with a digital caliper for actual length (AL) and EAL for electronic length. Teeth were then scanned using CBCT device at voxel size of 0.10 mm. It measured root canal lengths using the CBCT (Romexis Viewer), 3D Endo for proposed length (3D-PL) and correct length (3D-CL). Mean differences between the four methods with the AL were calculated and compared. Fisher’s exact test, paired t-test, Bland-Altman plot were used to test the differences among the experimental modalities in working length determination at the significance of 0.05.

Results

The accuracy in the range of ± 0.5 mm of the EAL ProPex II was highest among the experimental modalities, however this method disagreed with the actual length.

Conclusions

The correct working length after adjustment from the semi-automatically length by the 3D Endo software and Romexis Viewer measurements agreed with the AL.
Current use of the pelvic organ prolapse quantification system in clinical practice among Korean obstetrician-gynecologists
Authors: Kim Soo Rim , Suh Dong Hoon , Jeon Myung Jae
Published: May 2021

Background

To assess current use of the Pelvic Organ Prolapse Quantification (POP-Q) system in clinical practice among Korean obstetrician-gynecologists.

Methods

A web-based questionnaire was sent to 780 Korean Society of Obstetrics and Gynecology members. The items evaluated in the questionnaire were demographic characteristics and current use of the POP-Q system in the evaluation of pelvic organ prolapse (POP) and surgical decision-making. Differences between POP-Q users and nonusers were analyzed by using the two-sample t-test and chi-squared test.

Results

One hundred twenty-six members (16%) responded to the survey. Of the respondents, 48% reported using the POP-Q system in the evaluation of POP. Members who were female, urogynecologists, or performed a high volume of prolapse surgery were more likely to use the POP-Q system (p < 0.05). All but one of the POP-Q users reported using the specific criteria to determine whether each compartmental prolapse should be corrected during prolapse surgery. Most respondents used stage 2 or the hymen as a threshold for prolapse to be corrected for all compartments.

Conclusions

Less than half of Korean obstetrician-gynecologists use the POP-Q system in the evaluation of POP. Almost all of POP-Q users make a surgical decision based on the results of the POP-Q examination.
Prediction of hospital bed capacity during the COVID− 19 pandemic
Authors: Deschepper Mieke , Eeckloo Kristof , Malfait Simon , Benoit Dominique , Callens Steven , Vansteelandt Stijn
Published: May 2021

Background

Prediction of the necessary capacity of beds by ward type (e.g. ICU) is essential for planning purposes during epidemics, such as the COVID− 19 pandemic. The COVID− 19 taskforce within the Ghent University hospital made use of ten-day forecasts on the required number of beds for COVID− 19 patients across different wards.

Methods

The planning tool combined a Poisson model for the number of newly admitted patients on each day with a multistate model for the transitions of admitted patients to the different wards, discharge or death. These models were used to simulate the required capacity of beds by ward type over the next 10 days, along with worst-case and best-case bounds.

Results

Overall, the models resulted in good predictions of the required number of beds across different hospital wards. Short-term predictions were especially accurate as these are less sensitive to sudden changes in number of beds on a given ward (e.g. due to referrals). Code snippets and details on the set-up are provided to guide the reader to apply the planning tool on one’s own hospital data.

Conclusions

We were able to achieve a fast setup of a planning tool useful within the COVID− 19 pandemic, with a fair prediction on the needed capacity by ward type. This methodology can also be applied for other epidemics.
Fostering innovative behavior in health organizations: a PLS-SEM analysis of Norwegian hospital employees
Authors: Mutonyi Barbara Rebecca , Slåtten Terje , Lien Gudbrand
Published: May 2021

Background

Health organization research is experiencing a strong refocus on employees’ individual innovative behavior (IIB), revealing that many of the influential factors at work remain uncertain. Hence, this study empirically examines fostering of hospital employees’ IIB by focusing on direct and indirect relationships of organizational culture (here labeledinternal market-oriented culture, IMOC), psychological capital (PsyCap), and organizational commitment (OC).

Methods

The study focused on a sample of 1008 hospital employees, using a partial least squares–structural equation modeling method to analyze and test the relationships hypothesized in this study. A multigroup comparison was performed to test the heterogeneity of personal characteristics. The indirect relationships of PsyCap were tested using mediator analyses.

Results

Our results reveal that IMOC has a positive and significant correlation to employees’ PsyCap and IIB. PsyCap is directly related to IIB and indirectly related to IMOC and IIB. Furthermore, the study found that IIB is related to OC.

Conclusions

This study extends the current debate on how IIB is fostered at work by examining PsyCap and IMOC as antecedents of IIB. The study has added to the IIB research area by examining the role of IIB on OC. The study is among the first attempts in its category to contribute to health organizations and managers by empirically examining the role of IMOC on employees’ PsyCap and IIB—and, in turn, their OC.
Evaluation of a serum-based antigen test for tuberculosis in HIV-exposed infants: a diagnostic accuracy study
Authors: Mao Liyan , LaCourse Sylvia M. , Kim Soyeon , Liu Chang , Ning Bo , Bao Duran , Fan Jia , Lyon Christopher J. , Sun Ziyong , Nachman Sharon , Mitchell Charles D. , Hu Tony Y.
Published: May 2021

Background

Non-sputum methods are urgently needed to improve tuberculosis diagnosis and treatment monitoring in children. This study evaluated the ability of a serum assay quantifying a species-specific peptide of the Mycobacterium tuberculosis CFP-10 virulence factor via nanotechnology and matrix-assisted laser desorption ionization time-of-flight mass spectrometry to diagnose tuberculosis in HIV-infected and HIV-uninfected infants.

Methods

Serum CFP-10 peptide signal was blinded evaluated in cryopreserved sera of 519 BCG-immunized, HIV-exposed infants (284 HIV-infected, 235 HIV-uninfected) from a multi-center randomized placebo-controlled isoniazid prophylaxis trial conducted in southern Africa between 2004 and 2008, who were followed up to 192 weeks for Mtb infection and TB. Children were classified as confirmed, unconfirmed, or unlikely tuberculosis cases using 2015 NIH diagnostic criteria for pediatric TB.

Results

In HIV-infected infants, CFP-10 signal had 100% sensitivity for confirmed TB (5/5, 95% CI, 47.8–100) and 83.7% sensitivity for unconfirmed TB (36/43, 95% CI 69.3–93.2), with 93.1% specificity (203/218, 95% CI 88.9–96.1). In HIV-uninfected infants, CFP-10 signal detected the single confirmed TB case and 75.0% of unconfirmed TB cases (15/20; 95% CI 50.9–91.3), with 96.2% specificity (177/184, 95% CI, 92.3–98.5). Serum CFP-10 achieved 77% diagnostic sensitivity for confirmed and unconfirmed TB (13/17, 95% CI, 50–93%) at ≤ 24 weeks pre-diagnosis, and both CFP-10-positivity and concentration declined following anti-TB therapy initiation.

Conclusions

Serum CFP-10 signal exhibited high diagnostic sensitivity and specificity for tuberculosis in HIV-infected and HIV-uninfected infants and potential utility for early TB detection and monitoring of anti-TB treatment responses.
Signature RNAS and related regulatory roles in type 1 diabetes mellitus based on competing endogenous RNA regulatory network analysis
Authors: Shi Qinghong , Yao Hanxin
Published: May 2021

Background

Our study aimed to investigate signature RNAs and their potential roles in type 1 diabetes mellitus (T1DM) using a competing endogenous RNA regulatory network analysis.

Methods

Expression profiles of GSE55100, deposited from peripheral blood mononuclear cells of 12 T1DM patients and 10 normal controls, were downloaded from the Gene Expression Omnibus to uncover differentially expressed long non-coding RNAs (lncRNAs), mRNAs, and microRNAs (miRNAs). The ceRNA regulatory network was constructed, then functional and pathway enrichment analysis was conducted. AT1DM-related ceRNA regulatory network was established based on the Human microRNA Disease Database to carry out pathway enrichment analysis. Meanwhile, the T1DM-related pathways were retrieved from the Comparative Toxicogenomics Database (CTD).

Results

In total, 847 mRNAs, 41 lncRNAs, and 38 miRNAs were significantly differentially expressed. The ceRNA regulatory network consisted of 12 lncRNAs, 10 miRNAs, and 24 mRNAs. Two miRNAs (hsa-miR-181a and hsa-miR-1275) were screened as T1DM-related miRNAs to build the T1DM-related ceRNA regulatory network, in which genes were considerably enriched in seven pathways. Moreover, three overlapping pathways, including the phosphatidylinositol signaling system (involving PIP4K2A, INPP4A, PIP4K2C, and CALM1); dopaminergic synapse (involving CALM1 and PPP2R5C); and the insulin signaling pathway (involving CBLB and CALM1) were revealed by comparing with T1DM-related pathways in the CTD, which involved four lncRNAs (LINC01278, TRG-AS1, MIAT, and GAS5-AS1).

Conclusion

The identified signature RNAs may serve as important regulators in the pathogenesis of T1DM.
SCUBE3 serves as an independent poor prognostic factor in breast cancer
Authors: Huo Qin , He Xi , Li Zhenwei , Yang Fan , He Shengnan , Shao Ling , Hu Ye , Chen Siqi , Xie Ni
Published: May 2021

Background

Accumulating evidences indicate that the signal peptide-CUB-EGF-like domain-containing protein 3 (SCUBE3) plays a key role in the development and progression of many human cancers. However, the underlying mechanism and prognosis value of SCUBE3 in breast cancer are still unclear.

Methods

The clinical data of 137 patients with breast cancer who underwent surgical resection in Taizhou Hospital of Zhejiang Province were retrospectively analyzed. We first conducted a comprehensive study on the expression pattern of SCUBE3 using the Tumor Immune Estimation Resource (TIMER) and UALCAN databases. In addition, the expression of SCUBE3 in breast tumor tissues was confirmed by immunohistochemistry. The protein–protein interaction analysis and functional enrichment analysis of SCUBE3 were analyzed using the STRING and Enrichr databases. Moreover, tissue microarray (TMA) was used to analyze the relationship between SCUBE3 expression levels and clinical-pathological parameters, such as histological type, grade, the status of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor (HER2). We further supplemented and identified the above results using the UALCAN and bc-GenExMiner v4.4 databases from TCGA data. The correlation between the expression of SCUBE3 and survival was calculated by multivariate Cox regression analysis to investigate whether SCUBE3 expression may be an independent prognostic factor of breast cancer.

Results

We found that the expression level of SCUBE3 was significantly upregulated in breast cancer tissue compared with adjacent normal tissues. The results showed that the distribution of breast cancer patients in the high expression group and the low expression group was significantly different in ER, PR, HER2, E-cadherin, and survival state (p < 0.05), but there was no significant difference in histologic grade, histologic type, tumor size, lymph node metastasis, TMN stage, subtypes, or recurrence (p > 0.05). In addition, the high expression of SCUBE3 was associated with relatively poor prognosis of ER- (p = 0.012), PR- (p = 0.029), HER2 + (p = 0.007). The multivariate Cox regression analysis showed that the hazard ratio (HR) was 2.80 (95% CI 1.20–6.51, p = 0.0168) in individuals with high SCUBE3 expression, and HR was increased by 1.86 (95% CI 1.06–3.25, p = 0.0300) for per 1-point increase of SCUBE3 expression.

Conclusions

These findings demonstrate that the high expression of SCUBE3 indicates poor prognosis in breast cancer. SCUBE3 expression may serve as a potential diagnostic indicator of breast cancer.
Application of an ultrasound semi-quantitative assessment in the degradation of silk fibroin scaffolds in vivo
Authors: Cai Lihui , Gao Nan , Sun TingYu , Bi Ke , Chen Xin , Zhao Xia
Published: May 2021

Background

Research on the degradation of silk fibroin (SF) scaffolds in vivo lacks uniform and effective standards and experimental evaluation methods. This study aims to evaluate the application of ultrasound in assessing the degradation of SF scaffolds.

Methods

Two groups of three-dimensional regenerated SF scaffolds (3D RSFs) were implanted subcutaneously into the backs of Sprague-Dawley rats. B-mode ultrasound and hematoxylin and eosin (HE) staining were performed on days 3, 7, 14, 28, 56, 84, 112, 140, and 196. The cross-sectional areas for two groups of 3D RSFs that were obtained using these methods were semi-quantitatively analyzed and compared to evaluate the biodegradation of the implanted RSFs.

Results

The 3D RSFs in the SF-A group were wholly degraded at the 28th week after implantation. In contrast, the 3D RSFs in the SF-B group were completely degraded at the 16th week. Ultrasonic examination showed that the echoes of 3D RSFs in both groups gradually decreased with the increase of the implantation time. In the early stages of degradation, the echoes of the samples were higher than the echo of the muscle. In the middle of degeneration, the echoes were equal to the echo of the muscle. In the later stage, the echoes of the samples were lower than that of the muscle. The above changes in the SF-B group were earlier than those in the SF-A group. Semi-quantitative analysis of the cross-sectional areas detected using B-mode ultrasound revealed that the degradations of the two 3D RSF groups were significantly different. The degradation rate of the SF-B group was found to be higher than that of the SF-A group. This was consistent with the semi-quantitative detection results for HE staining. Regression analysis showed that the results of the B-mode ultrasound and HE staining were correlated in both groups, indicating that B-mode ultrasound is a reliable method to evaluate the SF scaffold degradation in vivo.

Conclusions

This study suggests that B-mode ultrasound can clearly display the implanted SF scaffolds non-invasively and monitor the degradation of the different SF scaffolds after implantation in living organisms in real-time.
Infection, dissemination, and transmission efficiencies of Zika virus in Aedes aegypti after serial passage in mosquito or mammalian cell lines or alternating passage in both cell types
Authors: Talavera-Aguilar Lourdes G. , Murrieta Reyes A. , Kiem Sungmin , Cetina-Trejo Rosa C. , Baak-Baak Carlos M. , Ebel Gregory D. , Blitvich Bradley J. , Machain-Williams Carlos
Published: May 2021

Background

Zika virus (ZIKV) is an arthropod-borne virus (arbovirus) with an urban transmission cycle that primarily involves humans and Aedes aegypti. Evidence suggests that the evolution of some arboviruses is constrained by their dependency on alternating between disparate (vertebrate and invertebrate) hosts. The goals of this study are to compare the genetic changes that occur in ZIKV after serial passaging in mosquito or vertebrate cell lines or alternate passaging in both cell types and to compare the replication, dissemination, and transmission efficiencies of the cell culture-derived viruses in Ae. aegypti.

Methods

An isolate of ZIKV originally acquired from a febrile patient in Yucatan, Mexico, was serially passaged six times in African green monkey kidney (Vero) cells or Aedes albopictus (C6/36) cells or both cell types by alternating passage. A colony of Ae. aegypti from Yucatan was established, and mosquitoes were challenged with the cell-adapted viruses. Midguts, Malpighian tubules, ovaries, salivary glands, wings/legs and saliva were collected at various times after challenge and tested for evidence of virus infection.

Results

Genome sequencing revealed the presence of two non-synonymous substitutions in the premembrane and NS1 regions of the mosquito cell-adapted virus and two non-synonymous substitutions in the capsid and NS2A regions of both the vertebrate cell-adapted and alternate-passaged viruses. Additional genetic changes were identified by intrahost variant frequency analysis. Virus maintained by continuous C6/36 cell passage was significantly more infectious in Ae. aegypti than viruses maintained by alternating passage and consecutive Vero cell passage.

Conclusions

Mosquito cell-adapted ZIKV displayed greater in vivo fitness in Ae. aegypti compared to the other viruses, indicating that obligate cycling between disparate hosts carries a fitness cost. These data increase our understanding of the factors that drive ZIKV adaptation and evolution and underscore the important need to consider the in vivo passage histories of flaviviruses to be evaluated in vector competence studies.

Graphical abstract
The prevalence of the iutA and ibeA genes in Escherichia coli isolates from severe and non-severe patients with bacteremic acute biliary tract infection is significantly different
Authors: Ikeda Mahoko , Kobayashi Tatsuya , Fujimoto Fumie , Okada Yuta , Higurashi Yoshimi , Tatsuno Keita , Okugawa Shu , Moriya Kyoji
Published: May 2021

Background

Although Escherichia coli is the most frequently isolated microorganism in acute biliary tract infections with bacteremia, data regarding its virulence are limited.

Results

Information on cases of bacteremia in acute biliary tract infection in a retrospective study was collected from 2013 to 2015 at a tertiary care hospital in Japan. Factors related to the severity of infection were investigated, including patient background, phylogenetic typing, and virulence factors of E. coli, such as adhesion, invasion, toxins, and iron acquisition.

In total, 72 E. coli strains were identified in 71 cases, most of which primarily belonged to the B2 phylogroup (68.1%). The presence of the iutA gene (77.3% in the non-severe group, 46.4% in the severe group, P = 0.011) and the ibeA gene (9.1% in the non-severe group, and 35.7% in the severe group, P = 0.012) was significantly associated with the severity of infection. Among the patient characteristics, diabetes mellitus with organ involvement and alkaline phosphatase were different in the severe and non-severe groups.

Conclusions

We showed that bacteremic E. coli strains from acute biliary tract infections belonged to the virulent (B2) phylogroup. The prevalence of the iutA and ibeA genes between the two groups of bacteremia severity was significantly different.
Research on Whole-Process Tensile Behavior of Headed Studs in Steel–Concrete Composite Structures
Authors: Zhuang Liang-Dong , Chen Hong-Bing , Ma Yuan , Ding Ran
Published: May 2021

The headed studs have been widely applied in steel–concrete composite structures as shear connectors. However, the tensile performance of headed studs is also key to the structural performance in many cases such as the semi-rigid composite joints including steel beam–concrete wall joint and steel column–base joint. Therefore, this study presents experimental and analytical study on the whole-process tensile behavior of headed studs. Tests on a total of 33 pullout specimens are first conducted. The tensile capacity and load–deformation behavior of the anchorage concrete, which dominates the structural performance of headed studs, are thoroughly analyzed. In addition, test data in the literature are collected for quantitatively evaluating the influence of embedment depth, bearing area, boundary conditions, and concrete strength on the tensile behavior of the anchorage concrete. On the basis of the influence evaluation, an analytical model represented by a piecewise function is proposed to describe the whole-process load–deformation behavior of the anchorage concrete and validated through the comparison between the predicted curves and all collected experimental results. Then the proposed model is applied to simulate the rotational behavior of the typical semi-rigid joint anchored by headed studs, which takes the contribution of the anchorage concrete into consideration, and is verified by experimental results. The research findings indicate that tensile behavior of anchorage concrete is crucial to the structural performance of semi-rigid joints, even for headed studs with large embedment depth and bearing area.
Lymphatic filariasis elimination endgame in an urban Indian setting: the roles of surveillance and residual microfilaremia after mass drug administration
Authors: Modi Anjali , Vaishnav Keshav G. , Kothiya Kailash , Alexander Neal
Published: May 2021

Background

To secure the gains of lymphatic filariasis (LF) elimination programs, attention is needed to the ‘residual microfilaremia phase’, in which high-risk populations may be crucial. The present study documents the impact of mass drug administration (MDA) in the urban Indian setting of Surat City, with high rates of in-migration.

Methods

Epidemiological assessment included National Filaria Control Program (NFCP) and World Health Organization recommended routine and pre-MDA microfilaremia surveys respectively. Routine filaria surveys were conducted around the year in approximately 2000–4000 people per month, while pre-MDA surveys were carried out annually among approximately 4000 people from four fixed and four random sites. In 2016, Transmission Assessment Survey (TAS) was done in primary school children. The outcomes were microfilaremia (Mf) and antigen prevalence; more specifically, microfilaremia according to place of birth, in pre-MDA and routine night blood smears (NBS) collected from 2008 to 2015. Prevalence ratios and confidence intervals were calculated.

Results

A total of 25 480 pre-MDA and 306 198 routine NBS were examined during the study. In 2008, the Mf prevalence in the routine survey was 63/18 814 (0.33%), declining to 23/39 717 (0.06%) in 2016. Pre-MDA surveys showed a similar decrease from 47/4184 (1.1%) in 2008 to 12/4042 (0.3%) in 2015. In those born outside Surat, microfilaremia decreased below transmission thresholds, but remained more than treble that of the remainder of the population, in both the pre-MDA surveys [prevalence ratio: 3.17, 95% confidence interval (CI): 1.15–8.72], and the routine surveys (3.31, 95% CI: 1.47–7.48). Though the TAS results indicated that MDA endpoints had been reached, sub-group analysis identified that 90% of antigenemic children were from families of high-risk groups.

Conclusions

Extensive long-term epidemiological monitoring suggests that all the urban population, including high-risk groups, have benefitted from the ELF program. To prevent re-establishment of infection in large urban areas with unsanitary conditions conducive to filarial vector breeding, there is need to identify residual microfilaremia by customized surveys in addition to pre-MDA monitoring and TAS. The present findings can be used to develop strategies to prioritize screening, surveillance and plan treatment of high-risk groups after achieving MDA endpoints.
Tocilizumab treatment for COVID-19 patients: a systematic review and meta-analysis
Authors: Wei Qiu , Lin Hua , Wei Rong-Guo , Chen Nian , He Fan , Zou Dong-Hua , Wei Jin-Ru
Published: May 2021

Background

Coronavirus disease 2019 (COVID-19) has killed over 2.5 million people worldwide, but effective care and therapy have yet to be discovered. We conducted this analysis to better understand tocilizumab treatment for COVID-19 patients.

Main text

We searched major databases for manuscripts reporting the effects of tocilizumab on COVID-19 patients. A total of 25 publications were analyzed with Revman 5.3 and R for the meta-analysis. Significant better clinical outcomes were found in the tocilizumab treatment group when compared to the standard care group [odds ratio (OR) = 0.70, 95% confidential interval (C): 0.54–0.90, P = 0.007]. Tocilizumab treatment showed a stronger correlation with good prognosis among COVID-19 patients that needed mechanical ventilation (OR = 0.59, 95% CI, 0.37–0.93, P = 0.02). Among stratified analyses, reduction of overall mortality correlates with tocilizumab treatment in patients less than 65 years old (OR = 0.68, 95% CI: 0.60–0.77, P < 0.00001), and with intensive care unit patients (OR = 0.62, 95% CI: 0.55–0.70, P < 0.00001). Pooled estimates of hazard ratio showed that tocilizumab treatment predicts better overall survival in COVID-19 patients (HR = 0.45, 95% CI: 0.24–0.84, P = 0.01), especially in severe cases (HR = 0.58, 95% CI 0.49–0.68, P < 0.00001).

Conclusions

Our study shows that tocilizumab treatment is associated with a lower risk of mortality and mechanical ventilation requirement among COVID-19 patients. Tocilizumab may have substantial effectiveness in reducing mortality among COVID-19 patients, especially among critical cases. This systematic review provides an up-to-date evidence of potential therapeutic role of tocilizumab in COVID-19 management.

Graphical abstract
Association of self-perceived income status with psychological distress and subjective well-being: a cross-sectional study among older adults in India
Authors: Muhammad T. , Srivastava Shobhit , Sekher T. V.
Published: May 2021

Background

As the older population aged 65 and over worldwide, is estimated to increase from 9% in 2019 to 16% in 2050, rapid aging will transform the aspects such as economic security, employment status, and family structure. The effects of lower levels of perceived income and poor socioeconomic status on the mental health of older adults appear to be large and enduring. Therefore, the present study contributes to the literature on understanding the association of socioeconomic conditions and self-perceived income status in particular, with self-assessed mental health outcomes (psychological distress and subjective well-being) among older adults in India.

Methods

Data for the present study was derived from the Building Knowledge Base on Population Ageing (BKPAI) in India. Bivariate and binary logistic regression analyses were conducted to understand the relationship between socioeconomic status and outcome variables.

Results

About 43% of older adults had no income whereas 7% had income but perceived as not sufficient to fulfil their basic needs. Nearly, 9% of older adults were retired from regular employment. Almost 70% older adults had received no pension and nearly 18% of older adults had no asset ownership. It is revealed that older adults with income that is partially sufficient to fulfil their basic needs were 2.23 times [OR: 2.23, CI: 1.75–2.84] and 1.96 times [OR: 1.96, CI: 1.55–2.47] significantly more likely to suffer from psychological distress and low subjective well-being than those who had income which was sufficient to fulfil their basic needs.

Conclusions

By focusing on four target areas such as the income support, education, family oriented initiatives and local or regional policies, the current framework for assessing the mental health among older adults in India can be modified. A move towards a guaranteed pension for eligible older individuals by which they do not have to remain as a financial burden on their children, may reduce their self-perceived economic distress and result in higher levels of wellbeing in older ages. Also, strategies to address socioeconomic disadvantages and gender differentials related to mental health status among older population are urgently needed.