bluuebunny/crossref_metadata_2025 huggingface dataset:
Medical career expectations of academically talented high school students: A nationwide cross-sectional study in China
Authors: Wu Hongbin , Pei Leisi , Li Shan , Jiang Cheng
Published: April 2020

Background: Academically talented high school students (ATHSSs), an exceptional cohort, are not well studied for their career expectations, especially for those with medical career expectation (MCE). Nowadays, the public perception of the medical profession is changing in China. The purpose of this study was to answer questions about ‘is medicine attractive for ATHSSs and ‘what factors affect medical career expectations (MCE) for ATHSSs’ in China.Methods: A total of 16,479 representative ATHSSs in senior three completed a questionnaire and four different academic tests. Frequency statistics showed the proportion of ATHSSs with MCE. Unpaired t-tests were performed to find out the differences in demographics, family background, and academic performance between students with and without MCE. The logit models analysis were applied to explore the potential factors that affected the MCE of this exceptional group of students.Results: ATHSSs with MCE accounted for 20.6% (ranking 7/18) of the respondents. They were more likely to be female, came from relatively poorer families, lived in a rural area, and performed significantly worse in all academic tests except for mathematics, compared with those without MCE. In addition, the results revealed that gender (β=-0.436, p<0.01), region of hometown (β=-103, p<0.1), mother’s years of schooling (β=-0.019, p<0.05), and father’s occupational status (β=-0.005, p<0.01) contributed significantly to the MCE of academically talented students. Better performance in mathematics affected the MCE of ATHSSs taking the liberal arts and science tests differently. Conclusions: We found the medical career is becoming unattractive to academically talented students and the medical career may be losing their aura in China. Students who have medical career expectations are likely to be females and to have a weak family background.
Validation of a New Risk Score System for Non-variceal Upper Gastrointestinal Bleeding
Authors: Kim Min Seong , Moon Hee Seok , Kwon In Sun , Park Jae Ho , Kim Ju Seok , Kang Sun Hyung , Sung Jae Kyu , Lee Eaum Seok , Kim Seok Hyun , Lee Byung Seok , Jeong Hyun Yong
Published: April 2020

Background: Recently, a new international bleeding score was developed to predict 30-day hospital mortality in patients with upper gastrointestinal bleeding (UGIB). However, the efficacy of this newly developed scoring system has not been extensively investigated. We aimed to validate a new scoring system for predicting 30-day mortality in patients with non-variceal UGIB and determine whether a higher score is associated with re-bleeding, length of hospital stay, and endoscopic failure.Methods: A retrospective study was performed on 905 patients with acute non-variceal UGIB who were examined in our hospital between January 2013 and December 2017. Baseline characteristics, endoscopic findings, re-bleeding, admission, and mortality were reviewed. The 30-day mortality rate of the new international bleeding risk score was calculated using the receiver operating characteristic curves and compared to the pre-endoscopy Rockall score, AIMS65, Glasgow Blatchford score, and Progetto Nazionale Emorragia Digestiva score. To verify the variable for the 30-day mortality of the new scoring system, we performed multivariate logistic regression using our data and further analyzed the score items.Results: The new international bleeding scoring system showed higher receiver operating characteristic (ROC) curve values in predicting mortality (area under ROC curve 0.958; [95% confidence interval (CI)]), compared with such as AIMS65 (AUROC, 0.832; 95%CI, 0.806-0.856; P<0.001), PNED (AUROC, 0.865; 95%CI, 0.841-0.886; P<0.001), Pre-RS (AUROC, 0.802; 95%CI, 0.774-0.827; P<0.001), and GBS (AUROC, 0.765; 95%CI, 0.736-0.793; P <0.001). Multivariate analysis was performed using our data and showed that the 30-day mortality rate was related to multiple comorbidities, blood urea nitrogen, creatinine, albumin, syncope at first visit, and endoscopic failure within 24 hours during the first admission. In addition, in the high-score group, relatively long hospital stay, re-bleeding, and endoscopic failure were observed.Conclusion: The new international bleeding score could predict 30-day mortality better than the other scoring systems. High-risk patients can be screened using this new scoring system to predict 30-day mortality. The use of this scoring system seems to improve the outcomes of non-variceal UGIB patients through proper management and intervention.
Modified-ramped position: a New Position for Intubation of Obese Females. A Randomized Controlled Pilot Study
Authors: hasanin ahmed , Tarek Hager , Mostafa Maha MA , Arafa Amany , Safina Ahmed G , Elsherbiny Mona H , Hosny Osama , Gado Ahmed A , Almenesey Tarek , Hamden Ghada Adel , Mahmoud Mohamed , Amin Sarah
Published: April 2020

Background : Endotracheal intubation requires optimum position of the head and neck. In obese females, the usual ramped position might not provide adequate intubating conditions. We hypothesized that a new position, termed modified-ramped position, during induction of anesthesia would facilitate endotracheal intubation through bringing the breasts away from the laryngoscope and would also improve the laryngeal visualizationMethods: Sixty obese female patients scheduled for general anesthesia were randomly assigned into either ramped or modified-ramped position during induction of anesthesia. In the ramped position (n=30), the patient head and shoulders were elevated to achieve alignment of the sternal notch and the external auditory meatus; while in the modified-ramped position (n=30), the patient shoulders were elevated using a special pillow, and the head was extended to the most possible range. Our primary outcome was the incidence of failed laryngoscopic insertion in the oral cavity (the need for patient repositioning). Other outcomes included time till vocal cord visualization, time till successful endotracheal intubation, difficulty of the mask ventilation, and Cormack-Lehane grade for laryngeal view.Results: Fourteen patients (47%) in ramped group required repositioning to facilitate introduction of the laryngoscope in the oral cavity in comparison to one patient (3%) in the modified-ramped position (p<0.001). Modified-ramped position showed lower incidence of difficult mask ventilation, shorter time for glottic visualization, and shorter time for endotracheal tube insertion compared to the ramped position. The Cormack-Lehane grade was better in the modified-ramped position. Conclusion: Modified-ramped position provided better intubating conditions, improved the laryngeal view, and eliminated the need for repositioning of obese female patients during insertion of the laryngoscope compared to ramped position.Clinical trial registration:Identifier: NCT03640442Registration URL: https://clinicaltrials.gov/ct2/show/NCT03640442?term=ahmed+hasanin&rank=4Date: August 2018
Model Construction of Medical Endoscope Service Evaluation System-Based on the Analysis of Delphi Method
Authors: Zheng Jun , Lou Ligang , Xie Ying , Chen Siyao , Li Jun , Wei Jingming , Feng Jingyi
Published: April 2020

Background: Medical endoscope is widely used in clinical practice for the purpose of diagnosis and treatment,occupying around 5% of the medical device market. Evaluating the true service level of medical endoscope is essential and necessary to improve overall performance of medical diagnosis and treatment, and to maintain competitiveness of endoscope manufacturers, however, such a tool is not available in the market. This study develops an Evaluation Index System (EIS) to assess service level of medical endoscope, and to provide suggestions for improving the service level through the Delphi method. Methods: Firstly, the possible factors influencing the service level were identified from literature review. In parallel, the Delphi expert method questionnaire was designed and 25 experts were invited to conduct three rounds of questionnaire, to evaluate and rate the possible factors. Finally, we determined the weights associated with the factors, using the analytic hierarchy process (AHP) and percentage method, and developed theservice level EIS. Results: The EIS consists of 3 first-level indicators, 24 second-level indicators and 68 third-level indicators. According to the weights computed using AHP, first-level indicators are ranked as post-sale (0.62), in-sale (0.25) and pre-sale (0.13). Through case verification, the medical endoscope brand Olympus had a total score of 4.17, Shanghai Aohua had a total score of 3.71, and Shanghai Chengyun had a total score of 3.28, which matches its market popularity and ranking in terms of market share. The results obtained from the EIS are consistent with the reality. Conclusions: The EIS established in this study is comprehensive, reliable and reasonable with strong practicality. The EIS can act as a tool for the endoscope users to evaluate potential products and make informed choices. It also provides a measurable basis for endoscope manufacturers and service providers to improve service quality.
Training effect on performance of mediolateral episiotomies for obstetricians and midwives
Authors: Zhao Baihui , Chen Yuan , Xi Fangfang , Dong Tian , Pu Yuqun , Wang Yali , Luo Qiong
Published: April 2020

Background: Simulation as an extensive used method for obstetric education is usually practiced for beginners, here we offered a course with simulated practice of performing a mediolateral episiotomy (MLE) for obstetricians and midwives in different seniority, and to evaluate the training effect on their knowledge and accuracy of cutting a MLE before and after the course.Methods: 82 participants were recruited at three different obstetric centers, included 35 obstetricians and 47 midwives. More than 5 years obstetric work in their careers were deemed to senior ones, and there were 29 junior and 53 senior ones. A 30 minutes training course were given to all participants by one senior obstetrician. Special paper pads simulating perineum at crowning were used to cut MLE before and after the course, and a questionnaire about their occupation characteristics was given before the course. Three parameters of the MLE were analyzed and compared. Results: On performing MLE, midwives had more training history and conducted cases than obstetricians (p < 0.01). After the course, the mean values of three parameters were significantly increased from 31.46 mm in length, 48 degrees in angle and 9.09 mm in distance to 34.29 mm, 50.622 degrees and 10.82 mm respectively. In subgroups, obstetricians had angle degrees increased significantly (p =0.022), while midwives had the length and distance increased significantly (p=0.001, p=0.004). Senior participants had the length and distance of incisions increased significantly (P=0.008, P=0.020), the accuracy of these two parameters also improved significantly (P=0.002, P=0.034). In subgroups of midwives and seniors, the accuracy of the length and distance also improved significantly after the course.Conclusions: Obstetricians need more professional training about midwifery including episiotomy. Simulated training of this mode is suitable for obstetric education like performing MLE. The absence of senior obstetricians and midwives should be avoided in such medical education.
Vertical pons hyperintensity and hot cross bun sign in cerebellar-type multiple system atrophy and spinocerebellar ataxia type 3
Authors: Sugiyama Atsuhiko , Yokota Hajime , Yamanaka Yoshitaka , Mukai Hiroki , Yamamoto Tatsuya , Hirano Shigeki , Koide Kyosuke , Ito Shoichi , Kuwabara Satoshi
Published: April 2020

Background The “hot cross bun” (HCB) sign, a cruciform hyperintensity in the pons on magnetic resonance imaging (MRI), has gradually been identified as a typical finding in multiple system atrophy, cerebellar-type (MSA-C). Few reports have evaluated the sensitivity of an HCB, including a cruciform hyperintensity and vertical line in the pons, which precedes a cruciform hyperintensity, in the early stages of MSA-C. Moreover, the difference in frequency and timing of appearance of an HCB between MSA-C and spinocerebellar ataxia type 3 (SCA3) has not been fully investigated.Methods This study investigated the time at which an HCB and orthostatic hypotension (OH) appeared in 41 patients with MSA-C, based on brain MRI and head-up tilt test. The MRI findings were compared with those of 26 patients with SCA3. The pontine signal findings on T2-weighted MRI were graded as 0 (no change), 1 (a vertical T2 high-intensity line), or 2 (a cruciform T2 high-intensity line), with grades 1 or 2 considered as an HCB. OH 30/15 was defined as a decrease in systolic blood pressure of > 30 mmHg or diastolic blood pressure of > 15 mmHg.Results Among the 24 patients with MSA-C within 2 years from the onset of motor symptoms, an HCB was detected in 91.7%, whereas OH 30/15 was present in 60.0%. Among the 36 patients with MSA-C within 3 years from the onset of motor symptoms, a grade 2 HCB was detected in 66.7% of those with MSA-C but in none of those with SCA-3.Conclusions HCB is a highly sensitive finding for MSA-C, even in the early stages of the disease. A grade 2 HCB in the early stage is an extremely specific finding for differentiating MSA-C from SCA-3.
Self-rated health inequalities in the intersection of gender, social class and regional development in Spain: exploring contributions of material and psychosocial factors
Authors: Barnils Núria Pedrós , Eurenius Eva , Gustafsson Per E
Published: April 2020

Background: Inequalities in health across social class, gender and regional context in Spain are well-known; however, there is a lack of research examining how these dimensions of inequality interact. This study explores self-rated health (SRH) inequalities across intersectional positions of gender, social class and region, and the contribution of material and psychosocial factors to these inequalities. Methods: Participants were drawn from the cross-sectional 2015 National Living Conditions Survey of Spanish residents aged 19-88 years (N=27,215; 77% response rate). Eight intersectional positions were formed by combining dichotomous variables of gender, social class and regional development. Poisson regression was used to estimate intersectional inequalities in SRH as prevalence ratios, and the contributions of material and psychosocial factors. Results: Results showed both cumulative and heterogeneous inequalities within and across intersectional positions. Inequalities in the intersection of social class and regional development were best explained by the joint contributions of material and psychosocial factors, while gender inequalities within non-manual social class were better explained by material factors alone. Conclusions: The results illustrate the complexity of interacting inequalities in health and their underpinnings in Spain. Local and national policies taking this complexity into account are needed to broadly improve equity in health in Spain.
Correlation of Binocular Refractive Errors and Calculation of Intraocular Lens Power for the Second Eye
Authors: Zhang Pengcheng , Yang Yuhuan , Yan Hong , Zhang Jie , Yan Weijia
Published: April 2020

Background: How to reduce the refractive error has always been a tricky problem. The aim of this study was to verify the correlation between binocular refractive errors (RE) after sequential cataract surgery and explore the individualized calculation method of intraocular lens (IOL) for the second eye.Methods: This is a prospective study. One hundred eighty-eight affected eyes of 94 age-related cataract patients with sequential cataract surgery from the Department of Ophthalmology, Tangdu Hospital, china, were recruited. Complete case data of 94 patients were included for correlation analysis of binocular RE. Thereafter, data of patients with RE values greater than 0.50 diopter (D) in the first eyes were extracted and divided randomly into two groups- Group A and B. As the adjustment group, in group A we modified the IOL power for the second eyes according to 50% of the RE of the first eye, and group B was the control group without modify. The mean absolute refractive error (MARE) values of the second eyes were evaluated one month after surgery.Results: The correlation coefficient of binocular RE after sequential cataract surgery was 0.760 (P < 0.001). After the IOL power of the second eyes were adjusted, the MARE of the second eyes was 0.57±0.41 D while MARE of the first eyes was 1.18±0.85 D, and the difference was statistically significant (P<0.001).Conclusions: Binocular REs were correlated positively after sequential cataract surgery. The RE of the second eye can be reduced by adjusting the IOL power based on 50% of the postoperative RE of the first eye.
Night sleep duration and risk of each lipid profile abnormality in a Chinese population: a prospective cohort study
Authors: Song Qiaofeng , Liu Xiaoxue , Zhou Wenhua , Wu Shouling , wang xizhu
Published: April 2020

Background To explore the associations between sleep duration and abnormalities in each serum lipid level in a Chinese population. Methods A prospective study was conducted with 34,260 participants from the general Chinese population. Sleep duration was categorized as ≤5, 6, 7, 8 or ≥9 h. Each lipid profile abnormality was defined according to the Chinese Guidelines for the Prevention and Treatment of Dyslipidemia in Adults(2016). The Cox proportional hazards model was used to assess these associations. Results Compared with a seven-hour sleep duration, longer sleep duration was significantly associated with low high-density lipoprotein cholesterol (HDL-C) levels (HR: 1.24; 95% CI: 1.12–1.38). In subgroup analyses, the positive association between long sleep duration and low HDL-C levels in men and in the different age groups were more pronounced than the association in women. No significant interactions were observed in the association between sleep duration and each abnormal serum lipid level by sex/age in the study population(p- interaction>0.05). Conclusions These findings suggest that longer sleep duration is associated with low HDL-C levels among the Chinese population.
Multiple functions of the scaffold protein Discs large 5 in the control of growth, cell polarity and cell adhesion in Drosophila melanogaster
Authors: Venugopal Parvathy , Veyssiere Hugo , Couderc Jean-Louis , Richard Graziella , Vachias Caroline , Mirouse Vincent
Published: April 2020

Background : Scaffold proteins support a variety of key processes during animal development. Mutant mouse for the MAGUK protein Discs large 5 (Dlg5) presents a general growth impairment and moderate morphogenetic defects. Results: Here, we generated null mutants for Drosophila Dlg5 and show that it owns similar functions in growth and epithelial architecture. Dlg5 is required for growth at a cell autonomous level in several tissues and at the organism level, affecting cell size and proliferation. Our results are consistent with Dlg5 modulating hippo pathway in the wing disc, including the impact on cell size, a defect that is reproduced by the loss of yorkie. However, other observations indicate that Dlg5 regulates growth by at least another way that may involve Myc protein but nor PI3K neither TOR pathways. Moreover, epithelia cells mutant for Dlg5 also show a reduction of apical domain determinants, though not sufficient to induce a complete loss of cell polarity. Dlg5 is also essential, in the same cells, for the presence at Adherens junctions of N-Cadherin, but not E-Cadherin. Genetic analyses indicate that junction and polarity defects are independent. Conclusions : Together our data show that Dlg5 own several conserved functions that are independent of each other in regulating growth, cell polarity and cell adhesion. Moreover, they reveal a differential regulation of E-cadherin and N-cadherin apical localization.
Radiographic severity index in COVID-19 pneumonia: relationship to age and sex in 783 Italian patients
Authors: Borghesi Andrea , Zigliani Angelo , Masciullo Roberto , Golemi Salvatore , Maculotti Patrizia , Farina Davide , Maroldi Roberto
Published: April 2020

Purpose: To improve the risk stratification of patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), an experimental chest X-ray (CXR) scoring system for quantifying lung abnormalities was introduced in our Diagnostic Imaging Department. The purpose of this study was to retrospectively evaluate correlations between the CXR score and the age or sex of Italian patients infected with SARS-CoV-2. Material and Methods: Between March 4, 2020 and March 18, 2020, all CXR reports containing the new scoring system were retrieved. Only hospitalized patients with SARS-CoV-2 infection were enrolled. For each patient, age, sex, and the CXR report containing the highest score were considered for the analysis. Patients were also divided into seven groups according to age. Non-parametric statistical tests were used to examine the relationship between the severity of lung disease and the age or sex.Results: 783 Italian patients (532 males and 251 females) with SARS-CoV-2 infection were enrolled. The CXR score was significantly higher in males than in females only in groups aged 50 to 79 years. A significant correlation was observed between the CXR score and age in both males and females. Males aged 50 years or older and females aged 80 years or older with coronavirus disease 2019 showed the highest CXR score (median ≥ 8).Conclusions: Males aged 50 years or older and females aged 80 years or older showed the highest risk of developing severe lung disease. Our results may help to identify the highest-risk patients and those who require specific treatment strategies.
Integrative analysis of circRNAs, miRNAs and mRNAs profiles reveal that ceRNAs networks in chicken intramuscular and abdominal adipogenesis
Authors: Zhang Meng , Han Yu , Zhai Yanhui , Ma Xiangfei , An Xinglan , Zhang Sheng , Li Ziyi
Published: April 2020

BackgroundTissue-specific fat deposition is regulated by a series of complex regulation mechanisms. Epigenetic regulations, such as circular RNAs (circRNAs), have been proved to be the crucial regulator of diseases, development, metabolism and adipogenesis. To investigate the functional roles of circRNAs in adipogenesis and tissue-specific fat deposition, we comprehensively analyzed the Ribo-Zero RNA-Seq and miRNAs data during chicken abdominal and intramuscular adipogenic differentiation. Results Here, we first reported circRNAs and miRNAs profiles during chicken adipogenic differentiation in adipocytes-derived from various adipose tissues. Large amounts of downregulated miRNAs might promote adipogenesis through activating their target genes which were related to fatty metabolism and adipogenic differentiation. Furthermore, we identified several candidate circRNAs by the correlation analysis between the expression levels of circRNAs and adipogenic genes, tissues as well as the dynamic expression patterns of circRNAs during adipogenic differentiation. Moreover, we constructed competing endogenous RNA (ceRNAs) networks during chicken intramuscular and abdominal adipogenesis through combining with miRNAs and mRNAs data. Several candidate circRNAs might affect adipogenesis by regulating miRNAs through PPAR and fatty acid metabolism related pathways, such as circLCLAT1, circFNDC3AL, circCLEC19A and circARMH1.ConclusionOver all, our result indicated that some tissue- or cell-specific circRNAs and miRNAs may have notable effects on chicken adipogenesis and tissue-specific fat deposition.
Investigation of Pindan Soil Modified with Polymer Stablisers for Road Pavement
Authors: PARK HYUN KYU , Lee Hyuk , Vimonsatit Vanissorn
Published: April 2020

Road failures are often caused by structural weaknesses, and particularly unsealed roads are vulnerable to water as water easily flows into road structures. Moisture susceptibility of materials is an important aspect when pavements are designed as moisture can weaken bonds between aggregates. Pindan soil is a red soil, known as a soft and moisture sensitive soil. Polymer stabilisers have been proved that they can improve soil mechanical properties by providing an internal waterproofing. Studies of the polymer-Pindan soil stabilisation have been focused on engineering performances, but literature shows little information on the fundamental information of Pindan soil. This project focuses on fundamental information of Pindan soil and its improved performances using polymer stabilisers. Plastic index, specific gravity and particle size distribution were tested to obtain the basic properties. Compaction, Unconfined Compressive Strength and California Bearing Ratio tests were performed to determine the mechanical properties. The chemical property was examined using X-ray diffraction. Furthermore, the waterproof effect of the polymers on the stabilised Pindan soil was investigated from capillary rise tests. In addition, the mechanical properties of individual soil grains were investigated using nanoindentation tests. The materials used for this investigation primarily consisted of Pindan soil collected in Broome, Western Australia, and three polymer products manufactured in Australia. Based on the results, it is evident that the failure behaviour, strain and strength as well as the basic properties of the soils are affected and changed by the Polymer stabilisers. The type of polymer influenced the optimum moisture contents and strengths rather than the amount of polymer. Similarly, Nanoindentation technology provided various information such as elastic modulus, hardness, packing density, stiffness, cohesion and fracture toughness of soils at nano-scales. Polymers can reduce water ingress and minimise moisture in the pavement structures. Thus, the structures can maintain its strength and prevent deformation, which will increase the lifetime of unsealed pavements.
Milan criteria in the MELD era – Is it justifiable to extend the limits for orthotopic liver Transplantation?
Authors: Morgül Mehmet Haluk , Felgendreff Philipp , Kienlein Andreas , Gauger Ulrich , Semmling Katrin Semmling , Hau Hans-Michael , Tautenhahn Hans-Michael , Bartels Michael
Published: April 2020

BackgroundThe Milan criteria (MC) are widely used for the indication of liver transplantation (LTx) in hepatocellular carcinoma (HCC). Good long-term results have also been reported following LTx for patients exceeding the MC. In this article, we compare the overall and recurrence-free survival of our patients fulfilling and exceeding the MC according to the posttransplant histopathological results.Patients and MethodsData from 120 patients with HCC (22 females and 98 males) were analyzed. The median patient age was 61 years (Q1, Q3: 54.7, 65.4), and the median MELD score was 11 (Q1, Q3: 8, 15). The median follow-up period was 53 months (Q1, Q3: 16.6, 78). Patients were categorized into established criteria (MC, up-to-seven (UTS), Asan criteria, AFP score), and the outcome of the individual groups was compared.ResultsSeventy-four of 120 patients fulfilled the MC, 86 patients met the UTS criteria, 85 patients fulfilled the Asan criteria, and 79 patients had an AFP score less than or equal to 2. The 1- and 5-year survival rates of all patients were 76.7% and 55.6%, respectively. In total, 14.2% of all patients (5.4% of patients who met the MC, 7% of patients who met the UTS criteria, 5.9% of patients who met the Asan criteria, and 6.3% of patients who had an AFP score less than 2) experienced recurrence.ConclusionsThe outcomes of the patients were comparable to those reported in the current literature. In our population, similar recurrence and survival rates of the patients were noted for patients fulfilling the UTS criteria irrespective of fulfilling or exceeding the MC. Consequently, we consider using UTS criteria as the extended criterion for LTx indication.
Local Tirofiban Infusion for Remnant Stenosis in Large Vessel Occlusion: Tirofiban ASSIST study
Authors: Kim Yong-Won , Sohn Sung-Il , Yoo Joonsang , Hong Jeong-Ho , Kim Chang-Hyun , Kang Dong-Hun , Kim Yong-Sun , Lee Seong-Joon , Hong Ji Man , Choi Jin Wook , Hwang Yang-Ha , Lee Jin Soo
Published: April 2020

Background
Compared to embolic occlusions, intracranial atherosclerotic stenosis (ICAS)-related large vessel occlusions (LVOs) often require rescue treatment following mechanical thrombectomy (MT). Herein, we hypothesized that local tirofiban infusion can be effective and safe for remnant stenosis in LVO during endovascular treatment, and can improve clinical outcomes.
Methods
This observational multicenter registry study (January 2011 to February 2016) included patients with ICAS who underwent endovascular treatment for LVO within 24 hours after stroke onset. An underlying fixed focal stenosis at the occlusion site observed on a cerebral angiography during and after MT was retrospectively determined as a surrogate marker of ICAS. Procedural and clinical outcomes were compared between the tirofiban and non-tirofiban groups.
Results
Patients were older (median, 71 years vs. 63 years, p = 0.015) and the onset to puncture time was longer (median, 395 min vs. 275 min, p = 0.036) in the tirofiban group than in the non-tirofiban group. Final reperfusion success (modified Treatment In Cerebral Ischemic 2b–3) was more frequent (86.4% vs. 42.4%, p = 0.016) and post-procedure parenchymal hematoma type 2 and/or thick subarachnoid hemorrhages were less frequent (5.1% vs. 15.3%, p = 0.068) in the tirofiban group. The frequency of favorable outcomes 3 months after endovascular revascularization therapy (modified Rankin Scale 0–2) was significantly higher in the tirofiban group (52.5% vs. 32.2%, p = 0.025) and tirofiban administration was an independent predictor of favorable outcomes (odds ratio, 4.013; 95% confidence interval, 1.300–12.386; p = 0.016).
Conclusions
Local tirofiban infusion may be an effective and safe adjuvant treatment option for patients with ICAS-LVO.
A tentacle for every occasion: comparing the hunting tentacles and sweeper tentacles, used for territorial competition, in the coral Galaxea fascicularis
Authors: Yosef Oshra , Popovits Yotam , Malik Assaf , Ofek-Lalzer Maya , Mass Tali , Sher Daniel
Published: April 2020

Background:Coral reefs are among the most diverse, complex and densely populated marine ecosystems. To survive, morphologically simple and sessile cnidarians have developed mechanisms to catch prey, deter predators and compete with adjacent corals for space, yet the mechanisms underlying these functions are largely unknown. Here, we characterize the histology, toxic activity and gene expression patterns in two different types of tentacles from the scleractinian coral Galaxea fascilcularis – catch tentacles (CTs), used to catch prey and deter predators, and sweeper tentacles (STs), specialized tentacles used for territorial aggression. Results:STs exhibit more mucocytes and higher expression of mucin genes than CTs, and lack the ectodermal cilia used to deliver food to the mouth and remove debris. STs and CTs also express different sensory g-protein coupled receptors, suggesting they may employ different sensory pathways. Each tentacle type has a different complement of stinging cells (nematocytes), and the expression in the two tentacles of genes encoding structural nematocyte proteins suggests the stinging cells develop within the tentacles. CTs have higher neurotoxic and hemolytic activities, consistent with a role in prey capture, whereas the STs have higher phospholipase A2 activity, which we speculate may have a role in inducing tissue damage during territorial aggression. The toxin genes expressed in each tentacle are also different. Conclusions:These results show that the same organism utilizes two distinct tentacle types, each equipped with a different venom apparatus and toxin composition, for prey capture and defense and for territorial aggression.
Precarious working conditions and psychosocial work stress act as a risk factor for symptoms of postpartum depression during maternity leave: results from a longitudinal cohort study
Authors: Karl Marlene , Schaber Ronja , Kress Victoria , Kopp Marie , Martini Julia , Weidner Kerstin , Garthus-Niegel Susan
Published: April 2020

Introduction: Most Western women work during their reproductive years, but past research has often neglected the influence of work-related factors on postpartum health. Especially postpartum depression (PPD) puts an enormous psychological burden on mothers. Therefore, this study aims to investigate the prospective impact of precarious working conditions and psychosocial work stress (such as work-privacy conflict and effort-reward imbalance at the job) during pregnancy on symptoms of maternal PPD. Methods: In the prospective-longitudinal cohort study DREAM (DResdner Studie zu Elternschaft, Arbeit und Mentaler Gesundheit), N = 587 employed women were questioned about their work during pregnancy and mental health 8 weeks after delivery. Results: Multiple regression analyses revealed that work-privacy conflict, low reward at work, and precarious working conditions significantly predicted symptoms of PPD, even when controlling for lifetime depression, anxiety, education, parity, and age. Conclusion: Our results indicate that psychosocial work stress and precarious working conditions have important implications for maternal peripartum mental health and might act as prospective risk factors for PPD even during the period of maternal leave. Hence, preventative measures targeting work life need to be investigated in more detail.
The diagnostic value of quantitative analysis of ASL, DSC-MRI and DKI in the Grading of Cerebral Gliomas: A Meta-Analysis
Authors: Jixin Luan , Wu Mingzhen , Wang Xiaohui , Qiao Lishan , Guo Guifang , Zhang Chuanchen
Published: April 2020

Objective
To perform quantitative analysis on the efficacy of using relative cerebral blood flow (rCBF) in arterial spin labeling (ASL), relative cerebral blood volume (rCBV) in dynamic magnetic sensitivity contrast-enhanced magnetic resonance imaging(DSC-MRI), and mean kurtosis (MK) in diffusion kurtosis imaging (DKI) to grade cerebral gliomas.
Methods
Literature regarding ASL, DSC-MRI, or DKI in cerebral glioma grading in both English and Chinese were searched from PubMed, Embase, Web of Science, CBM, China National Knowledge Infrastructure (CNKI), and Wanfang Database as of April 2019. A Meta-Analysis was performed to evaluate the efficacy of ASL, DSC-MRI, and DKI in the grading of cerebral glioma.
Result
A total of 54 articles (11 in Chinese and 43 in English) were included. Three quantitative parameters in the grading of cerebral glioma, rCBF in ASL, rCBV in DSC-MRI,and MK in DKI had an overall sensitivity of 0.88[95%CI(0.83,0.92)], 92[95%CI(0.83,0.96)],0.88[95%CI(0.82,0.92)], and an overall specificity of 0.91[95%CI(0.84,0.94)],0.81[95%CI(0.73,0.88)], 0.86[95%CI(0.78,0.91)] respectively. The overall area under the ROC curve were 0.95[95%CI(0.93,0.97)], 0.91[95%CI(0.89,0.94)], 0.93[95%CI(0.91,0.95)] respectively.
Conclusion
Quantitative parameters rCBF, rCBV and MK have high diagnostic efficacy for preoperative grading of cerebral gliomas.
Giving syphilis and gonorrhea to friends: Using in-person friendship networks to find additional cases of gonorrhea and syphilis
Authors: Rosenbaum Janet E. , Jennings Jacky , Ellen Jonathan , Borkovic Laurel , Scott Jo-Ann , Wylie Charleen , Rompalo Anne
Published: April 2020

Background: Syphilis and gonorrhea reached an all-time high in 2018, including in populations that stigmatize same-sex sexual contact. The resurgence of syphilis and gonorrhea requires innovative methods of sexual contact tracing that encourage disclosure of same-sex contacts. Over 75% of Grindr users report seeking “friendship,” so this study asked people diagnosed with syphilis and gonorrhea to identify their friends.Methods: Patients at the two Baltimore STI clinics and the Baltimore City Health Department were asked 12 questions to elicit members of their friendship networks before eliciting sexual networks. The study included 353 index cases and 172 contacts, yielding a friendship network of 331 non-isolates (n=331) and sexual-only network of 140 non-isolates. The data were plotted and analyzed using exponential family random graph analysis.Results: Eliciting respondents’ in-person social contacts yielded 12 syphilis cases and 6 gonorrhea cases in addition to the 16 syphilis cases and 4 gonorrhea cases that would have been found with sexual contacts alone. Syphilis is clustered within sexual (odds ratio=2.2, 95% confidence interval (1.36, 3.66)) and social contacts (OR=1.31, 95% CI (1.02, 1.68)). Gonorrhea is clustered within reported social (OR=1.56, 95% CI (1.22, 2.00)) but not sexual contacts (OR=0.98, 95% CI (0.62, 1.53)). Conclusions: Eliciting the friendship networks of people diagnosed with syphilis and gonorrhea may find members of their sexual networks, drug use networks, or people of similar STI risk. Friendship networks include more diagnosed cases of syphilis and gonorrhea than sexual networks alone, especially among populations with many non-disclosing MSM and WSW.
Relatively semi-conservative replication and a folded slippage model for simple sequence repeats
Authors: Tan Zhongyang , Zhang Hongxi , Li Douyue , Zhao Xiangyan , Pan Saichao , Wu Xiaolong , Peng Shan , Huang Hanrou , Shi Ruixue
Published: April 2020

BackgroundSimple sequence repeats (SSRs) are found ubiquitously in almost all genome, and their formation mechanism is ambiguous yet.ResultsHere, the SSRs were analyzed in 55 randomly selected segments of genomes from a fairly wide range of species, with introducing more open standard for extensively mining repeats. A high percentage of repeats were discovered in these segments, which is inconsistent with the current theory suggested that repeats tend to disappear over long-term evolution. Therefore, a mechanism is most probably responsible for continually producing repeats during replication to balance continuous repeat disappearance, which may makes the replicating process relatively semi-conservative. To improve the current straight-line slippage model, we proposed a folded slippage model involving the geometric space of nucleotides and hydrogen bond stability to explain the high-percent SSR occurrence, which can describe SSR expansion and contraction more reasonably. And analysis of external forces in the folding template strands suggested that the microsatellites tend to expand than contract.ConclusionOur research may provide implements for contributions of microsatellites to genome evolution and complement semi-conservative replication.
Using Kano diagrams to display the most cited article types, affiliated countries, authors and MeSH terms on spinal surgery in recent 12 years
Authors: Chou Po-Hsin , Yeh Yu-Tsen , Kan Wei-Chih , Wei Chien Tsai , Kuo Shu-Chun
Published: April 2020

Background: Citation analysis has been increasingly applied to assess the quantity and quality of scientific research in various fields worldwide. However, these analyses on spinal surgery do not provide visualization of results. This study aims (1) to evaluate the worldwide research citations and publications on spinal surgery and (2) to provide visual representations using Kano diagrams onto the research analysis for spinal surgeons and researchers.Methods: Article abstracts published between 2007 and 2018 were downloaded from PubMed Central(PMC) in 5 journals, including Spine, European Spine Journal, The Spine Journal, Journal of Neurosurgery: Spine, and Journal of Spinal Disorders and Techniques. The article types, affiliated countries, authors, and Medical subject headings (MeSH terms) were analyzed by the number of article citations using x-index. Choropleth maps and Kano diagrams were applied to present these results. The trends of MeSH terms over the years were plotted and analyzed.Results: A total of 18,808 publications were extracted from the PMC database, and 17,245 were affiliated to countries/areas. The 12-year impact factor for the five spine journals is 5.758. We observed that (1) The largest number of articles on spinal surgery was from North America(6417, 37.21%). Spine earns the highest x-index(=82.96). Comparative Study has the highest x-index(=66.74) among all article types. (2) The United States performed exceptionally in x-indexes (=56.86 and 44.5) on both analyses done on the total 18,808 and the top 100 most cited articles, respectively. The most influential author whose x-index reaches 15.11 was Simon Dagenais from the US. (3) The most cited MeSH term with an x-index of 23.05 was surgery based on the top 100 most cited articles. The most cited article (PMID=18164449) was written by Dagenais and his colleagues in 2008. The most productive author was Michael G Fehlings, whose x-index and the author's impact factor are 13.57(=√(13.16*14)) and 9.86(=331.57/33.64), respectively.Conclusions: There was a rapidly increasing scientific productivity in the field of spinal surgery in the past 12 years. The US has extraordinary contributions to the publications. Furthermore, China and Japan have increasing numbers of publications on spinal surgery. This study with Kano diagrams provides an insight into the research for spinal surgeons and researchers.
Maximum entropy method-based forest fire prediction mapping of Sikkim Himalaya.
Authors: Banerjee Polash
Published: April 2020

The recent episodes of forest fire in Brazil and Australia of 2019 are tragic reminders of the hazards of the forest fire. Globally incidents of forest fire events are in the rise due to human encroachment into wilderness and climate change. Sikkim with a forest cover of more than 47%, suffers seasonal instances of frequent forest fire during the dry winter months. To address this issue, a GIS-aided and MaxEnt machine learning-based forest fire prediction map has been prepared using forest fire inventory database and maps of environmental features. The study indicates that amongst the environmental features, population density and proximity to roads are the major determinants of the forest fire. This indicates the role of human activities on the incidences of a forest fire. Model validation criteria like ROC curve, correlation coefficient and Cohen’s Kappa show a good predictive capability (AUC = 0.95, COR = 0.77, κ = 0.77). The outcomes of this study in the form of a forest fire prediction map can aid the stakeholders of the forest in taking informed mitigation measures.
Overexpression of TPT1-AS1 and SAMMSON and down expression of LINC00961 associated with Advanced Grades of Gastric Cancer
Authors: Amini Mohammad Amin , Karimi Jamshid , Khodadadi Iraj , Tavilani Heidar , Talebi Seyed Saman , Afshar Behrouz
Published: April 2020

Background

One of the deadliest cancers in the world is gastric cancer. Long non-coding RNAs play prominent roles in cancer. LINC00961, TPT1-AS1, and SAMMSON have recently been discovered, which significantly contribute in various cancers and can affect the tumor size, grade of tumors and the metastasis condition. The aim of this study was to determine LINC00961, SAMMSON and TPT1-AS1 expression in gastric cancer tissues in comparison with healthy adjacent tissues.
Methods

The number of cancerous tissues and control groups was calculated to be at 40 (n = 40) and were analyzed by Quantitative real-time polymerase chain reaction.
Results

We found that overexpression of TPT1-AS1 and SAMMSON, and downexpression of LINC00961 in cancerous tissues in comparison with healthy adjacent tissues. A positive association between TPT1-AS1 and SAMMSON expression and tumor grade was observed. The level of mRNA folding change increased in cancer group compared to control group and *P < 0.05 is considered for mRNA folding change.
Conclusion

Finally, we found that overexpression of TPT1-AS1 and SAMMSON, and downexpression of LINC00961 were observed significantly in gastric cancer tissues in comparison with adjacent non-cancerous tissues. These lncRNAs were suggested as potential tumor markers for the diagnosis and treatment of gastric cancer.
Incidence and prevalence of systemic lupus erythematosus among Korean women in childbearing years: a nationwide population-based study
Authors: Chung Min Kyung , Park Jin Su , Lim Hyun Sun , Lee Chan Hee , Lee Jisoo
Published: April 2020

Background

Most women with systemic lupus erythematosus (SLE) are diagnosed with the disease in their reproductive years, but the incidence and prevalence of SLE among women of childbearing age have not been studied. The objective of this study was to estimate the incidence and prevalence of SLE among the Korean women of childbearing age.
Methods

Women aged 20 to 44 years with SLE were identified from National Health Insurance Service – National Health Information Database (2009–2016), which contain health information of approximately 97% of the Korean population. SLE was defined by International Classification of Diseases, 10th revision code, M32. Incidence and prevalence were calculated per 100,000 person-years and stratified by year and age.
Results

A total of 12,756 women with SLE were identified. The incidence of SLE from 2011 to 2016 among women in childbearing years was 8.18/100,000 person-years (95% CI 7.94–8.43), with the highest incidence in 2016 (8.56/100,000 person-years, 95% CI 7.95–9.17) and the lowest incidence in 2012 (7.85/100,000 person-years, 95% CI 7.28–8.42). The prevalence of SLE from 2009 to 2016 among women in childbearing years was 77.07/100,000 person-years (95% CI 75.76–78.39), with the highest prevalence in 2014 (79.47/100,000 person-years, 95% CI 77.64–81.30) and the lowest in 2010 (74.19/100,000 person-years, 95% CI 72.45–75.93). The peak age for SLE incidence was between 25–39 years, and lower incidence was seen in the early (20–24 years) and late (40–44 years) childbearing age periods. There was an increasing trend in prevalence according to age in women of childbearing age, with the highest prevalence occurring in the 40–44 age group.
Conclusions

The risk and burden of SLE are high among women during their childbearing years. This calls for special attention to this particular population group when allocating health resources.
Radiotherapy combined with gefitinib for patients with locally advanced non-small cell lung cancer who are unfit for surgery or concurrent chemoradiotherapy: A phase Ⅱ clinical trial
Authors: Fu Zhixue , Liang Jun , Xu Yang , Wang Wenqing , Lei Deng , Tao Zhang , Bi Nan , Wang Xiaozhen , Chen Dongfu , Zhou Zongmei , Wang Luhua
Published: April 2020

Background: The objectives of this study were to determine the objective effective response rate, survival, and safety of radiotherapy combined with gefitinib in patients with locally advanced non-small cell lung cancer (NSCLC) who were unfit for surgery or concurrent chemoradiotherapy.Methods: The patients with the locally advanced NSCLC who were unfit to receive surgery or concurrent chemoradiotherapy, received thoracic intensity-modulated radiotherapy (IMRT) combined with gefitinib 250 mg daily.Results: Twenty-nine patients were enrolled between July 2014 and March 2017. Of the 29 patients, 21 (72.4%) experienced a partial response, 6 (20.7%) had stable disease, and 2 (6.9%) experienced progression of disease. The objective response rate was 72.4%, and the disease control rate was 93.1%. The median follow-up time was 51 months. The disease progression showed in 26 (89.7%) patients, including local progression in 20 (69.0%) and distant metastasis in 16 (55.2%). The median survival time (MST) and progression-free survival time (PFS) were 26 and 11 months, respectively. The 3-, 4-, 5-year survival rates were 37.6%, 29%, and 29%, respectively. The PFS rates were 17.2%, 9.2%, and 9.2%. Two patients developed grade 3 acute adverse events, and two patients developed grade 2 acute irradiation pneumonitis.Conclusions: For patients with locally advanced NSCLC who are not eligible for surgery or concurrent chemoradiotherapy, IMRT combined with gefitinib can improve the objective effective rate and is generally well-tolerated.