bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of oral care protocols practice by dentists in Rio de Janeiro towards HIV/AIDS individuals
Authors: Silva-Boghossian Carina Maciel , Boscardini Brenda Azzariti Berrondo , Pereira Claudia Maria , Moreira Edson Jorge Lima
Published: January 2020

Background The aim of this study was to evaluate the dentists’ knowledge and practice regarding HIV positive individuals’ oral care in Rio de Janeiro State. Methods Dentists from Rio de Janeiro State (n = 242) answered an electronic questionnaire on biosafety procedures, oral manifestations of AIDS, and knowledge of HIV infection. Collected information was stratified by gender, and data were analyzed using Chi-square and t tests. Results From the 14 oral manifestations investigated, oral candidiasis, necrotizing ulcerative gingivitis, and hairy leucoplakia were more associated with HIV, with no differences between the responses from men and women. Above 85% of the participants would be concerned about becoming infected with HIV after a needle/ sharp object injury and more than 80% of them were willing to be tested for HIV. However, significantly more women (98.8%), compared to men (91.3%), said they knew that HIV/ AIDS patients can contaminate dental care professionals, p = 0.007. There was a significant difference in the answers for the questions: “Are there special dental clinics for treatment of HIV/AIDS patients in Brazil?” (p = 0.044), and “Do the negative HIV tests surely indicate that the persons are free of viruses?” (p = 0.005). Significant differences between men and women were also observed regarding use of disposable mask (p = 0.01), and cap (p < 0.0001). Conclusion Most dentists who participated in the study presented a good knowledge on the care of HIV/ AIDS individuals, including biosafety protocols and in terms of the oral manifestations commonly associated to AIDS.
DNA barcode trnH-psbA is a promising candidate for efficient identification of forage legumes and grasses
Authors: Loera-Sánchez Miguel , Studer Bruno , Kölliker Roland
Published: January 2020

Objective
Grasslands are widespread ecosystems that fulfil many functions. Plant species richness (PSR) is known to have beneficial effects on such functions and monitoring PSR is crucial for tracking the effects of land use and agricultural management on these ecosystems. Unfortunately, traditional morphology-based methods are labor-intensive and cannot be adapted for high-throughput assessments.
DNA barcoding could aid increasing the throughput of PSR assessments in grasslands. In this proof-of-concept work, we aimed at determining which of three plant DNA barcodes ( rbcLa , matK and trnH-psbA ) best discriminates 16 key grass and legume species common in temperate sub-alpine grasslands.
Results
Barcode trnH-psbA had a 100% correct assignment rate (CAR) in the five analyzed legumes, followed by rbcLa (93.3%) and matK (55.6%). Barcode trnH-psbA had a 100% CAR in the grasses Cynosurus cristatus , Dactylis glomerata and Trisetum flavescens . However, the closely related Festuca, Lolium and Poa species were not always correctly identified, which led to an overall CAR in grasses of 66.7%, 50.0% and 46.4% for trnH-psbA , matK and rbcLa , respectively. Barcode trnH-psbA is thus the most promising candidate for PSR assessments in permanent grasslands and could greatly support plant biodiversity monitoring on a larger scale.
Synthesis and biological evaluation of 2-(4-methylsulfonyl phenyl) indole derivatives: Multi-target compounds with dual antimicrobial and anti-inflammatory activities
Authors: Shaker Ahmed , Abdelall Eman K. A. , Abdellatif Khaled R. A. , Abdel-Rahman Hamdy M.
Published: January 2020

Three series of 2-(4-methylsulfonylphenyl) indole derivatives have been designed and synthesized. The synthesized compounds were evaluated for their antimicrobial, COX inhibitory and anti-inflammatory activities. Compound 7g was identified to be the most potent antibacterial candidate against strains of MRSA , E. coli, K. pneumoniae, P. aeruginosa, and A. baumannii , respectively with safe therapeutic dose. Compounds 7a-k, 8a-c and 9a-c showed good anti-inflammatory activity with high selectivity toward COX-2 in comparison with reference drugs indomethacin and celecoxib. Compounds 9a-c were found to release moderate amounts of NO to decrease the side effects associated with selective COX-2 inhibitors. A molecular modeling study for compounds 7b, 7h, and 7i into COX-2 active site correlated with results of in vitro COX-2 inhibition assays.
Pelvic and Bladder Catecholamine-Producing Tumors A Review of the Literature
Authors: Petramala Luigi , Bisogni Valeria , Olmati Federica , Concistrè Antonio , Celi Monia , Saracino Vincenza , Iannucci Gino , Toma Giorgio De , Tarallo Maria Rita , Ciardi Antonio , Letizia Claudio
Published: January 2020

Purpose. Starting from the description of two interesting cases, we wondered to review the literature on pelvic and bladder paragangliomas (PGLs) in order to illustrate clinical characteristics and current management, lightening the needed of a prompt diagnosis to avoid the onset of several complications. Although PGLs may arise at any site where physiologically chromaffin tissue exists, pelvic origins are not frequent (less than 2%), and the most common localization is the retroperitoneal space, whereas bladder PGLs account for less than 0.06% of all bladder neoplasms and less than 1% of all PGLs. Methods . We herein performed a brief review of the literature about pelvic PGLs in the PubMed library, conducted according to the PRISMA statement, including studies published from 1954 to 2019. We also discuss clinical presentation, morphologic appearance, and management of two cases of pelvic PGL, both of them characterized by an history of paroxysmal high blood pressure episodes uncontrolled by antihypertensive therapy associated with disabling symptoms, not clearly understood for many years. Results . Overall, we evaluated 108 case reports. The majority were females, presenting typical signs and symptoms, such as arterial hypertension (54.2%), hematuria (35.1%), and headache (33.6%). After treatment, the clinical and biochemical remission was evident in only 55% of analyzed cases. Conclusions . For their singular localization, pelvic and bladder PGLs often might be misdiagnosed. The significant delay in the proper treatment could be responsible for the relative low percentage of complete clinical and biochemical remission.
Up-regulating autophagy by targeting the mTOR-4EBP1 pathway: a possible mechanism for improving cardiac function in mice with experimental dilated cardiomyopathy
Authors: Jin Bo , Shi Haiming , Jun Zhu , Wu Bangwei , Geshang Quzhen
Published: January 2020

Background: Autophagy plays a crucial role in the pathological process of cardiovascular diseases. However, little is known about the pathological mechanism underlying autophagy regulation in dilated cardiomyopathy (DCM).Methods: We explored whether up-regulating autophagy could improve cardiac function in mice with experimental DCM through the mTOR-4EBP1 pathway. Animal model of DCM was established in BALB/c mice by immunization with porcine cardiac myosin. Both up- or down-regulation of autophagy were studied by administration of rapamycin or 3-MA in parallel. Morphology, Western blotting, and echocardiography were applied to confirm the pathological mechanisms.Results: Autophagy was activated and autophagosomes were significantly increased in the rapamycin group. The collagen volume fraction (CVF) was decreased in the rapamycin group compared with the DCM group (9.21 ± 0.82 % vs 14.38 ± 1.24 %, P<0.01). The expression of p-mTOR and p-4EBP1 were significantly decreased in rapamycin-induced autophagy activation, while the levels were increased by down-regulating autophagy with 3-MA. In the rapamycin group, the LVEF and FS were significantly increased compared with the DCM group (54.12 ± 6.48 % vs 45.29 ± 6.68 %, P<0.01; 26.89 ± 4.04 % vs 22.17 ± 2.82 %, P<0.05). As the inhibitor of autophagy, 3-MA aggravated the progress of maladaptive cardiac remodeling and declined cardiac function in DCM mice.Conclusions: The study indicated a possible mechanism for improving cardiac function in mice with experimental DCM by up-regulating autophagy via the mTOR-4EBP1 pathway, which could be a promising therapeutic strategy for DCM.
Prognostic Significance of the Preoperative Prognostic Nutritional Index in Epithelial Ovarian Cancer Patients: A Systematic Review and Meta-analysis of Cohort Studies
Authors: Gong Ting-Ting , Zhang Jia-Yu , Sun Hui , Wu Qi-Jun , Gao Song
Published: January 2020

BackgroundThe main aim of this study was to validate the potential association between the preoperative prognostic nutritional index (PNI) and survival of patients with ovarian cancer (OC).MethodsWe systematically searched multiple databases (PubMed, EMBASE, and Web of Science) for publications up to June 30, 2019, to identify observational studies evaluating the PNI in relation to survival. Two reviewers independently extracted data and assessed the quality of each study using the Newcastle-Ottawa Scale (NOS). Summary hazard ratios (HR) and 95% confidence intervals (CI) were calculated with the aid of a random-effects model. The potential for publication bias was explored using Funnel plots as well as Begg’s and Egger’s tests.ResultsAmong the 15,000 studies selected for selection, 5 retrospective cohort studies (4 from China and one from Japan) comprising 1964 OC patients met the inclusion criteria. All studies were graded as ‘low risk of bias’ according to NOS. A low preoperative PNI was associated with poor overall survival (HR = 1.69, 95% CI = 1.16–2.46; I2 = 83.8%) and progression-free survival (HR = 1.86, 95% CI = 1.39–2.51; I2 = 29.7%) of OC patients. No significant publication bias was detected.ConclusionsCollective data from the present systematic review and meta-analysis suggest that a low preoperative PNI is associated with poor survival in OC. Further prospective studies are required to confirm these findings.
Building a Sanitary Vulnerability Map from Open Source Data. Argentina, 2010-2018
Authors: Rosati Germán Federico , Olego Tomás Alberto , Brust Antonio Vazquez
Published: January 2020

Background: Designing public health policies to target the needs of specific places requires highly granular data. When geographic health statistics from official sources are absent or lacking in spatial detail, Sanitary Vulnerabilitymetrics derived from Census and other georeferenced public data can be used to identify areas in particular need of attention. With that aim, a Vulnerability Map was developed, identifying areas with a substantial deficit in its population health coverage. Methods: Census, official listings of public health facilities and crowdsourced georeferenced data are used. The Vulnerability Index is built using dimensionality reduction techniques such as Autoencoders and Non-parametric PCA. Main results: The high resolution map shows the geographical distribution of a Sanitary Vulnerability Index, produced using official and crowdsourced open data sources, overcoming the lack of official sources on health indicators at the local level. Conclusions: The Sanitary Vulnerability Map’s value as a tool for place specific policymaking was validated by using it to predict local health related metrics such as health coverage. Further lines of work contemplate using the Map to study the interaction between Sanitary Vulnerability and the prevalence of different diseases, and also applying its methodology in the context of other public services such as education, security, housing, etc.
Increased resistance of a methicillin-resistant Staphylococcus aureus Δagr mutant with modified control in fatty acid metabolism
Authors: Song Hun-Suk , Choi Tae-Rim , Han Yeong-Hoon , Park Ye-Lim , Park Jun Young , Yang Soo-Yeon , Bhatia Shashi Kant , Gurav Ranjit , Kim Yun-Gon , Kim Jae-Seok , Joo Hwang-Soo , Yang Yung-hun
Published: January 2020

Methicillin-resistant Staphylococcus aureus (MRSA) strains are distinct from general Staphylococcus strains with respect to the composition of the membrane, ability to form a thicker biofilm, and, importantly, ability to modify the target of antibiotics to evade their activity. The agr gene is an accessory global regulator of gram-positive bacteria that governs virulence or resistant mechanisms and is therefore an important target for the control of resistant strains. However, the mechanism by which agr impacts factors affecting resistance to β-lactam antibiotics remains unclear. In the present study, we found an Δagr mutant strain with higher resistance to high concentrations of b-lactam antibiotics such as oxacillin and ampicillin. To determine the influence of variation in the microenvironment of cells between the parental and mutant strains, fatty acid analysis of the supernatant, total lipids, and phospholipid fatty acids were compared. The Δagr mutant strain tended to produce fewer fatty acids and retained lower amounts of C16, C18 fatty acids in the supernatant. Phospholipid analysis showed a dramatic increase in the hydrophobic longer-chain fatty acids in the membranes. To target these differences in fatty acid distribution and membrane composition, we applied several surfactants and found that sorbitan trioleate (Span85) had a synergistic effect with oxacillin by decreasing biofilm formation and growth. These findings indicate that agr suppression allows for MRSA to antagonize antibiotics via several changes, including constant expression of mecA, fatty acid metabolism and distribution, and biofilm thickening, resulting in a strain with higher resistance to β-lactam antibiotics.
Analysis Surgical Outcomes of Ruptured Anterior Communicating Artery Aneurysm: Lateral Supraorbital Versus Pterional Approach.
Authors: Yu Kaijie , Cai Yurong , Zhang Jianmin , Zhou Gezhi , Yuan Jianlie
Published: January 2020

Objective To compare lateral supraorbital approach with pterional approach to determine the most effective routine to clip anterior communicating artery aneurysm.Method A total of 85 patients with anterior communicating artery aneurysm underwent surgical clipping, 34 through the lateral supraorbital approach and 51 through the pterional approach from June 2016 to June 2018 in the department of neurosurgery,Jinhua central hospital. We retrospectively analyzed the demographic and clinical variables including age, sex and Hunt-Hess grade. Accordingly, operative data, clinical outcome and postoperative complications were analyzed. The mRS at discharge and 6 months later were evaluated.Outcome All aneurysms were completely clipped. There was no significant difference in intraoperative aneurysm rupture rate and intensive care time between the two groups (P>0.05). Compared with the pterional approach, the operation time of the lateral approach was shorter, the amount of bleeding was less, and the bone flap was small, and there was a statistical difference (P<0.05). There was no statistically significant difference in complications between the two groups (P <0.05). There was no significant difference in mRS between the two groups at different time points (P>0.05). There was no significant difference in hospital stay between the two groups (P>0.05).Conclusion According to our results, we recommend the lateral supraorbital approach for ACoAA and A1/A2 to neurosurgeons who have gained sufficient experience due to its advantages over the pterional approach.
GC×GC-HRMS nontarget fingerprinting of organic micropollutants in urban freshwater sediments
Authors: Lübeck Josephine Susanne , Alexandrino Guilherme Lionello , Christensen Jan H
Published: January 2020

Background: Sediments are sinks for organic micropollutants, which are traditionally analysed by gas chromatography-mass spectrometry (GC-MS). Although GC-MS and GC-MS/MS (tandem MS) are preferred for target screening, they provide only limited chromatographic resolution for nontarget screening. In this study, a comprehensive two-dimensional GC-high-resolution MS method (GC×GC-HRMS) was developed for nontarget screening and source identification of organic micropollutants in sediments from an urban channel and adjacent lake in Copenhagen, Denmark. The GC×GC-HRMS data were processed by pixel-based chemometric analysis using baseline subtraction, alignment, normalisation, and scaling before principal component analysis (PCA) of the pre-processed GC×GC-HRMS base peak ion chromatograms (BPCs). The analysis was performed to identify organic micropollutants of high abundance and relevance in the urban sediments and to identify pollution sources. Tentative identifications were based on match factors and retention indices and tagged according to the level of identification confidence. Results: The channel contained both significantly higher concentrations of micropollutants and a higher diversity of compounds compared to the lake. The PCA models were able to isolate distinct sources of chemicals such as a natural input (viz. a high relative abundance of mono-, di- and sesquiterpenes) and a weathered oil fingerprint (viz. alkanes, naphthenes and alkylated polycyclic aromatic hydrocarbons). A dilution effect of the weathered oil fingerprint was observed in lake samples that were close to the channel. Several benzothiazole-like structures were identified in lake samples close to a high-traffic road which could indicate a significant input from asphalt or tire wear particles. In total, 104 compounds and compound groups were identified. Conclusions: Several chemical fingerprints of different sources were described in urban freshwater sediments in Copenhagen using a pixel-based chemometric approach of GC×GC-HRMS BPCs. Various micropollutants of anthropogenic origin were identified. Tailored pre-processing and careful interpretation of the identification results is inevitable and still requires further research for an automated workflow.
Characteristics and source tracing of organic carbon in intertidal sediments of wetland in Yangtze Estuary, China
Authors: Yu Haiyan , Li Weiwei , Han Changxu , Fang Han , Shu Xingquan , Liu Yongfeng , Pan Yuwei , Ma Limin
Published: January 2020

Background: Wetland ecosystem is characterized by water-land interaction and plays an important role in regional energy and material circulation. In the context of global climate change, the study of wetland carbon storage and carbon cycle has become a focus of academic attention. The characteristics of organic carbon in sediments and its source is a key problem in the study of carbon cycle in wetlands. Results: In this study, the characteristics of total organic carbon (TOC), total nitrogen (TN) accumulation, and stable carbon isotope (δ13C) in the vegetation and soil were investigated for the three dominant salt marsh vegetation Phragmites australis (PA), Spartina alterniflora (SA), Scirpus mariqueter (SM) of the coastal wetlands of Chongming Dongtan in the Yangtze River Estuary. The results showed that the mean value of TOC and TN concentrations in the surface sediments of wetland were 1.39 ± 0.34% and 0.091± 0.024%, respectively. The carbon stable isotope (δ13C) mean value of sediment was -24.17±1.51‰. The TOC of the sediment in the three saltmarsh plant communities was in the order of SA (1.76 ± 0.38%) > PA (1.45 ± 0.37%) > SM (0.96 ± 0.44%). The simulation results of the three end-member mixing equations showed that the organic carbon in sediments was mainly derived from suspended particles (42.44 ± 20.89%) and vegetation (34.50 ± 25.23%). The contribution rate of microalgae is lower (23.06 ± 4.62%). Conclusion: The organic carbon in sediments of wetland in Yangtze Estuary are the result of mixed input of terrestrial organic carbon and marine organic carbon. Organic carbon in sediments was mainly derived from suspended particles and vegetations. The results provide preliminary knowledge of the distribution and sources of sedimentary organic carbon for better understanding the sediment transport and deposition in this region.
Efficacy and safety of YinQiSanHuang-antiviral decoction on chronic hepatitis B: study protocol for a randomized, placebo-controlled, double-blinded trial
Authors: wu qing-juan , Lv Wen-Liang , Li Juan-Mei , Zhang Ting-Ting , Zhou Wen-hui , Zhang Qiang , Wang Jiu-Chong , Wang Qing-Nan , Zhang Ruo-Xuan , Zhao Xin , Chen Si-Tong , Liu Shuang , Li Gao-Hui , Cao Zheng-Min , Xu Lei , Chen Jing
Published: January 2020

Background: Chronic hepatitis B (CHB) is a global public health problem. Antiviral therapy is the primary treatment. Studies have shown that combined therapy of traditional Chinese medicine (TCM) and conventional antiviral drugs has better clinical efficacy than conventional antiviral for treatment of CHB. YinQiSanHuang-antiviral decoction (YQSH) is a TCM compound preparation used for over thirty years, and has shown its effect on anti-hepatitis B virus and slowing progression of hepatitis B-related liver diseases in a small-scale clinical observation. Until now there is no convincing evidence demonstrating the clinical effectiveness of YQSH in anti-liver cirrhosis and anti-liver cancer. To evaluate the efficacy and safety of YQSH and its preventive effect on hepatitis B cirrhosis, a rigorously designed randomized, double-blind, placebo-controlled clinical trial is needed. Methods: This is a multicenter, randomized, placebo-controlled, double-blinded trial, 5 hospitals involved in. Totally 802 patients are randomly allocated to two groups: the YQSH group (n=401) or the placebo group (n=401). The YQSH group receives YQSH with Entecavir, the placebo group receives granule of placebo with Entecavir. Patients receive treatment for 52 weeks, and then are followed up for 52±2 weeks. The primary outcome measure is the annual incidence of cirrhosis. The secondary outcome measures are HBV-DNA negative rate, HBsAg negative rate, HBeAg seroconversion rate, liver function (Alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamyl transferase (GGT), alkaline phosphatase (ALP), serum albumin (ALB) and total bilirubin (TBIL)), spleen thickness, evaluation scores of patients’ clinical symptoms and safety assessment. Outcomes will be assessed at baseline and after treatment. Discussion: Combination therapy could become a trendy of treatment of CHB, this trial expecting to provide credible clinical evidence for the future combination of TCM and conventional antiviral drugs for the treatment of CHB. Trial registration: ChiCTR1900021521, this protocol was registered in the Chinese Clinical Trial Registry (URL: http://www.chictr.org.cn) on February 25th, 2019. Keywords: chronic hepatitis B, cirrhosis, traditional Chinese medicine, clinical trial, efficacy
Effect of community active case-finding strategies for detection of tuberculosis in Cambodia: study protocol for a pragmatic cluster randomized controlled trial
Authors: Teo Alvin Kuo Jing , Prem Kiesha , Evdokimov Konstantin , Ork Chetra , Eng Sothearith , Tuot Sovannary , Chry Monyrath , Mao Tan Eang , Hsu Li Yang , Yi Siyan
Published: January 2020

Background: Cambodia has made notable progress in the fight against tuberculosis (TB). However, these gains are impeded by a significant proportion of undiagnosed cases. To effectively reach people with TB, active case finding (ACF) strategies have been adopted by countries affected by the epidemic, including Cambodia, alongside passive case finding (PCF). Despite increased efforts to improve case detection, approximately 40% of TB cases in Cambodia remained undiagnosed in 2017. In Cambodia, several community-based TB ACF modalities have been implemented, but their effectiveness has yet to be systematically assessed. Methods: This pragmatic cluster randomized controlled trial will be conducted between December 2019 and June 2021. We will randomize eight operational districts (cluster) in 7 provinces (Kampong Cham, Kampong Thom, Prey Veng, Thbong Khmum, Kampong Chhnang, Kandal, and Kampong Speu) to either the control group (PCF) or the intervention groups (ACF using a seed-and-recruit model, ACF targeting household and neighborhood contacts, and ACF targeting persons aged ≥55 using mobile screening units). The primary endpoints will be TB case notification rates, additionality, and cumulative yield of TB cases. The secondary endpoints include treatment outcomes, the number needed to screen to find one TB case, and cost-effectiveness outcome measures. We will analyze the primary and secondary endpoints by intention-to-treat. We will compare cluster and individual-level characteristics using student’s t-test and hierarchical or mixed-effect models to estimate the ratio of these means. Incremental cost-effectiveness ratio per disability-adjusted life year averted will also be considered as a benchmark to determine if the interventions are cost-effective. Discussion: This study will build an evidence base to inform future scale-up, implementation, and sustainability of ACF strategies in Cambodia and other similar settings. Implementation of this study will also complement TB control strategies in Cambodia by conducting ACF in operational districts without active interventions to find TB cases currently. Those who are ill and might have TB will be promptly screened, diagnosed, and linked to care. Early diagnosis and treatment initiation will also benefit their community by interrupting transmission and prevent further infections. The experience gained from this project will inform future attempts in conducting pragmatic trials in low-resource settings. Trial registration: This trial is registered at ClinicalTrials.gov, NCT04094350. Registered 18 September 2019.
The combination of cold exposure training and a breathing exercise attenuates the inflammatory response in humans
Authors: Zwaag Jelle , Naaktgeboren Rick , Herwaarden Antonius E. van , Pickkers Peter , Kox Matthijs
Published: January 2020

Background - We previously showed that a training intervention encompassing two breathing exercises and exposure to cold enables for voluntary activation of the sympathetic nervous system, reflected by profoundly increased plasma adrenaline levels, and subsequent attenuation of the endotoxin-induced inflammatory response. Herein, we determined the contribution of the different elements of the training, assessed if the training duration is of importance, and whether it can be provided by an independent trainer instead of the well-known individual who devised it. Methods – Forty healthy male volunteers were randomized to either a short or extensive training in both breathing exercises (i.e. cyclic hyperventilation with or without prolonged breath retention) by either the creator of the intervention or an independent trainer. In a subsequent study, 48 healthy male volunteers were randomized to cold exposure training, training in the established optimal breathing exercise, a combination of both, or no training. All 48 subjects were subsequently intravenously challenged with 2 ng/kg lipopolysaccharide to induce endotoxaemia. Results - Both breathing exercises were equally effective in enhancing plasma adrenaline concentrations and this response was also independent from the length of the training or the individual who provided it. Cold exposure training alone did not result in relevant modulation of the endotoxin-induced cytokine response, although flu-like symptoms were markedly reduced compared with the untrained group. Whereas subjects who received training in the breathing exercise alone displayed attenuated plasma levels of pro-inflammatory cytokines IL-6, IL-8, IP-10, MCP-1, MIP-1α, and MIP-1β (-34%, -14%, -48%, -37%, and -28%, respectively) during endotoxemia, combined training resulted in enhanced concentrations of anti-inflammatory IL-10 (+44%) and reduced concentrations of TNF-α, IL-6, IL-8, IP-10, MCP-1, MIP-1α, and MIP-1β (-32%, -35%, -30%, -48%, -29%, -35%, -30%, respectively) compared with untrained individuals. Conclusions - The combination of cold exposure training and a hyperventilation breathing exercise attenuates the in vivo inflammatory response most potently. Our study demonstrates that the immunomodulatory effects of the intervention can be reproduced in a standardized manner, thereby paving the way for clinical trials. Trial registration - Both studies described in this manuscript are registered at www.clinicaltrials.gov (breathing exercises study: NCT02417155; experimental human endotoxaemia study: NCT03240497).
Wound hematoma after anterior cervical spine surgery: A retrospective study of risk factors analysis
Authors: Zhou Kai , He Zhongyuan , Tang Ke , Quan Zhengxue
Published: January 2020

Background: The postoperative wound hematoma after anterior cervical spinal surgery is a very critical complication. We aim to explore the risk factors independently associated with postoperative wound hematoma in patients who have undergone anterior cervical spine surgery. Methods: Clinical data of patients with cervical spondylosis or cervical disc herniation who underwent anterior cervical spine surgery by the senior author from January 2011 to December 2017 were evaluated. A multivariate logistic regression was conducted to compare the hematoma group and the non-hematoma group in order to find out which factors that were independently associated with hematoma formation. Mann-Whitney U test was conducted to compare the Neck disability Index score in two groups. Results: A total of 678 patients met the criteria who underwent anterior cervical spine surgery. 13 patients were identified as wound hematoma who have undergone hematoma evacuation, in which hemorrhage sites were found. Multivariate logistic regression identified that history of hypertension (p=0.039 OR=4.42 95%CI 1.08-18.07) and therapeutic heparin use (p=0.020 OR=4.58 95%CI 1.27-16.59) were independent risk factors of hematoma formation. The t-test shows no significant differences between the hematoma group and no hematoma group in APTT and PT levels (p>0.05). Mann-Whitney U test indicates that there was no difference in NDI scores between the two groups(p>0.05). Conclusion: History of hypertension and therapeutic heparin use are risk factors for hematoma formation. Meticulous hemostasis, moderate muscle subtraction, and perioperative airway management are critical in avoiding hematoma development. Hematoma evacuation as quickly as possible is necessary. Key word: wound hematoma, logistic models, risk factors, hypertension, heparin use, hemostasis.
Reverse reaming distraction for acetabular reconstruction of chronic pelvic discontinuity
Authors: Sun Jing-yang , Ni Ming , Ma Hai-yang , Du Yin-qiao , Shen Jun-min , Chen Ji-ying , Zhou Yong-gang , Zhang Guo-qiang
Published: January 2020

Introduction The acetabular distraction technique demonstrates encouraging radiographic and clinical outcomes in treating chronic pelvic discontinuity. The aim of this study is to describe a modified distraction technique and to show our results. Methods This study identified 12 cases of chronic pelvic discontinuity undergoing primary or revision total hip arthroplasty (THA) with the technique of reverse reaming distraction between July 2015 and November 2018. All 12 patients had a minimum followup of 12 months. Radiographs were reviewed to inspect for component loosening. Clinical assessment included the Harris hip score (HHS) and an ambulatory scoring system. Results At the time of final follow-up, no patient was revised. One patient had up to 1 cm migration of the cup in a horizontal or vertical direction and more than 20° change in the abduction angle but was asymptomatic. In the remaining 11 patients, no migration of the component was detected. Both the HHS and ambulatory score showed improvement in all patients. There were no perioperative complications. No postoperative dislocation occured. Conclusions Reverse reaming distraction is a feasible technique in treatment of chronic pelvic discontinuity. Sometimes it can work with the aid of augment or cup-cage construct. When both the superior and inferior portions of the pelvis achieve osteointegration into the porous metal cup, a long-term durability can be expected.
Association between neoangiogenesis after first and second indirect bypass in moyamoya disease
Authors: Ge Peicong , Zhang Qian , Ye Xun , Liu Xingju , Deng Xiaofeng , Wang Jia , Wang Rong , Zhang Yan , Zhang Dong , Zhao Jizong
Published: January 2020

Background The research on neoangiogenesis after indirect bypass for moyamoya disease (MMD) evaluated by using digital subtraction angiography (DSA) is limited. Our study objective was to investigate association between neoangiogenesis after first indirect bypass and second indirect bypass in MMD.Methods All consecutive inpatients with MMD who received indirect bypass at Beijing Tiantan Hospital, Capital Medical University from January 2011 through December 2017 were screened. Bilateral neoangiogenesis was evaluated on lateral views and anteroposterior views by using DSA .Results Twenty-two patients (44 hemispheres) were included in this study. After a median 7.5 months DSA follow-up, On lateral views, 9 (40.9%) hemispheres had grade A, 8 (36.4%) hemispheres had grade B, and 5 (22.7%) hemispheres had grade C after the first procedures; 11 (50.0%) hemispheres had grade A, 7 (31.8%) hemispheres had grade B, and 4 (18.2%) hemispheres had grade C after the second surgery. On anteroposterior views of ECA, 2 (9.1%) hemispheres had level 0, 3 (13.6%) had level 1, 6 (27.3%) had level 2, and 11 (50.0%) had level 3 after the first procedures; 2 (9.1%) hemispheres had level 0, 2 (9.1%) had level 1, 6 (27.3%) had level 2, and 12 (54.6%) had level 3 after second operation. Neovascularization after second operation was strongly associated with the neovascularization after first operation on lateral views (r s =0.770; p=0.000) and the anteroposterior views (r s =0.548; p=0.008).Conclusion Neovascularization after second indirect bypass was strongly associated with neovascularization of first indirect bypass.
The TAND checklist: a useful screening tool in children with tuberous sclerosis and neurofibromatosis type 1
Authors: Cervi Francesca , Saletti Veronica , Turner Katherine , Peron Angela , Bulgheroni Sara , Taddei Matilde , Briola Francesca La , Canevini Maria Paola , Vignoli Aglaia
Published: January 2020

Background: Tuberous Sclerosis Complex (TSC) and Neurofibromatosis type 1 (NF1) are neurocutaneous disorders commonly characterized by neuropsychiatric comorbidities. The TAND (Tuberous Sclerosis Associated Neuropsychiatric Disorders) Checklist is currently used to quickly screen for behavioural, psychiatric, intellectual, academic, neuropsychological and psychosocial manifestations in patients with TSC. We administered the authorized Italian version of the TAND Checklist to 42 TSC patients and to 42 age- and sex-matched NF1 patients, for a total of 84 individuals, aged 4-20 years. Aims of this study: - to test the overall usability of the TAND Checklist in NF1, -to compare the results between children and adolescents with TSC and NF1 and –to assess whether neuropsychiatric manifestations change in relation to the severity of their phenotype. Results: TSC cohort: 35.6% had Intellectual Disability (ID), 11.9% Specific Learning Disorders (SLD), 50.0% Attention Deficit Hyperactivity Disorder (ADHD) and 16.6% anxious/mood disorder. 33.3% had formal diagnosis of Autistic Spectrum Disorder (ASD). Paying attention and concentrating (61.9%), impulsivity (54.8%), temper tantrums (54.8%), anxiety (45.2%), overactivity/hyperactivity (40.5%), aggressive outburst (40.5%), absent or delayed onset of language (40.5%), repetitive behaviors (35.7%), academic difficulties (> 40%), deficits in attention (61.9%) and executive skills (50.0%) were the most commonly reported problems. NF1 cohort: 9.5% had ID, 21.4% SLD, 46.6% ADHD, and 33.3% anxious/mood disorder. No one had a diagnosis of ASD. Commonly reported issues were paying attention and concentrating (59.5%), impulsivity (52.4%), anxiety (50.0%), overactivity/hyperactivity (38.1%), temper tantrums (38.1%), academic difficulties (> 40%), deficits in attention (59.5%), and executive skills (38.1%). Neuropsychiatric features in TSC vs NF1: Aggressive outburst and ASD features were reported significantly more frequently in TSC than in NF1. Conclusion: The TAND Checklist used for TSC is acceptable and feasible to complete in a clinical setting, and is able to detect the complexity of neuropsychiatric involvement in NF1 as well. NF1 is mainly characterized by an ADHD profile, anxiety problems and SLD, while ASD features are strongly associated with TSC. In conclusion, the TAND-Checklist is a useful and reliable screening tool, in both TSC and NF1.
Antimicrobial Susceptibility Profile of Extended Spectrum Beta- lactamases Producing Enterobacteriaceae isolated from clinical samples refereed to the National Bacteriology and Mycology Reference Laboratory, Ethiopia
Authors: Negeri Abebe Aseffa , Seyoum Eyasu Tigabu , Taklu Dejenie Shiferaw , Tsige Estifanos , Assefa Dawit , Ayenew Zeleke , Abdeta Abera , Beyene Degefu , Ebrahim Semira , Addis Tesfa , Mekonnen Yonas , Yitagesu Yohannis , Seyoum Elias , Adamu Etsehiwot , Fentaw Surafel
Published: January 2020

Background Extended-spectrum beta-lactamases (ESBL) producing Enterobacteriaceae are prevalent worldwide and they are unique challenges for treatment and control of bacterial infectious diseases. ESBL genes not only confer resistance to oximino-cephalosporins and aztreonum but also, they are multidrug-resistant to other commonly available antimicrobial agents used in clinical practice.Objective To determine the prevalence and antimicrobial susceptibility profile of ESBL producing Enterobacteriaceae isolated from clinical samples referred to the national clinical bacteriology and mycology reference laboratory.Materials and Methods A cross-sectional study was conducted on Enterobacteriaceae culture- positive clinical samples that were referred to the national bacteriology and mycology reference laboratory from August 2018 to July 2019. Bacterial isolation was performed according to the inoculation and incubation conditions of each clinical specimen and identifications of the isolates were performed using standardized biochemical tests for gram-negative bacteria. Antimicrobial susceptibility profiles of these cultures were determined using the disk diffusion method on Muller Hinton agar according to the recommendation by Clinical and Laboratory Standard Institute (CLSI). ESBL production was detected using CLSI Screening and confirmation test. A double-disk synergy test was used for confirmation.Results Out of 371 culture positive for Enterobacteriaceae , 240 (64.7%) were positive for ESBL production, and the most prevalent species were Klebsiella sp 131(54.6%) followed by E. coli 79 (32.9%). Of 131 ESBL positive Klebsiella spp, 95 (72.5%) were obtained from blood samples and among 79 E. coli isolates, 51 (64.6%) of the strains were isolated from urine samples. All ESBL positive isolates were resistant to ampicillin and all generation of cephalosporins. In addition, 100% of them were multidrug resistant. There were also high proportions of resistant ESBL positive isolates to other classes of antimicrobial agents. Less resistance rates were documented for carbapenems drugs and amikacin from the class of aminoglycosides.Conclusion ESBL producing Enterobacteriaceae we reported in this study was not only highly prevalent but also they are multidrug resistant to most clinically available antimicrobial agents including carbapenems. Therefore, public awareness and regular monitoring
Dissection of the mutation accumulation process during bacterial range expansions
Authors: Bosshard Lars , Peischl Stephan , Ackermann Martin , Excoffier Laurent
Published: January 2020

Background Recent experimental work has shown that the evolutionary dynamics of bacteria expanding across space can differ dramatically from what we expect under well-mixed conditions. During spatial expansion, deleterious mutations can accumulate due to inefficient selection on the expansion front, potentially interfering with and modifying adaptive evolutionary processes.Results We used whole genome sequencing to follow the genomic evolution of 10 mutator Escherichia coli lines during 39 days (∼1650 generations) of a spatial expansion, which allowed us to gain a temporal perspective on the interaction of adaptive and non-adaptive evolutionary processes during range expansions. We used elastic net regression to infer the positive or negative effects of mutations on colony growth. Even though the colony size, measured after three day of growth, decreased at the end of the experiment in all 10 lines, and mutations accumulated at a nearly constant rate over the whole experiment. We find evidence that beneficial mutations accumulate primarily at an early stage of the experiment, leading to a non-linear change of colony size over time. Indeed, colony size remains almost constant at the beginning of the experiment and then decreases after ∼12 days of evolution. We also find that beneficial mutations are enriched in flagella genes, genes encoding transport proteins, and genes coding for the membrane structure, whereas deleterious mutations show no enrichment for any biological process.Conclusions Our experiment shows that beneficial mutations target specific biological functions mostly involved in inter or extra membrane processes, whereas deleterious mutations are randomly distributed over the whole gnome. It thus appears that the interaction between genetic drift and the availability or depletion of beneficial mutations determines the change in fitness of bacterial populations during range expansion.
The effects of intermittent fasting on liver physiology and metabolism in mice
Authors: Ma Jianbo , Cheng Yan , Su Qiang , Ai Wen , Gong Ling , Wang Yueying , Li Linhao , Ma Zhongren , Pan Qiuwei , Qiao Zilin , Chen Kan
Published: January 2020

Background: Intermittent fasting, as an emerging diet concept, has been widely practiced in the global population. A broad spectrum of health benefits has been reported in animal models and in humans for intermittent fasting. However, the underlying mechanisms remain largely elusive. In this study, we aimed to explore the effects and potential mode-of-action of intermittent fasting in mouse models, with focus on the liver.Methods: C57BL/6 mice were divided into five groups of 8-14 each, including 30-days ad libitum group, 30-days intermittent fasting group, 60-days ad libitum group, 60-days intermittent fasting group and refeeding group (30-days intermittent fasting followed by 30-days ad libitum). The food intake, body weight, liver weight and the blood biochemical parameters were detected. Targeted metabolic profiling of liver was performed.Results: We found that daily 12-hour intermittent fasting for one or two months significantly reduced the cumulative food intake, compared with the mice fed ad libitum. Fasting resulted in significantly reduced liver weight, with minimal effect on body weight. This effect on the liver by one month fasting could not be reversed by following one-month ad libitum feeding. Among the measured blood biochemical parameters, glucose level was decreased, while alkaline phosphatase was increased in the fasting mice. Surprisingly, targeted metabolic profiling revealed the global elevation of metabolites in the livers of fasting mice. These metabolic molecules include ATP, NADP, NADPH and succinate that are essentially involved in the citric acid cycle and oxidative phosphorylation. Conclusion: Daily 12-hour intermittent fasting for one to two months significantly reduced liver weight in mice, which is associated with enhanced liver metabolism.
Sedentary behavior, physical activity and renal function in middle-aged and older adults: isotemporal substitution modelling
Authors: Kosaki Keisei , Tanahashi Koichiro , Matsui Masahiro , Akazawa Nobuhiko , Osuka Yosuke , Tanaka Kiyoji , Dunstan David W. , Owen Neville , Shibata Ai , Oka Koichiro , Maeda Seiji
Published: January 2020

Background: Both physical inactivity and sedentary behavior (too much sitting) can contribute to renal dysfunction. However, the potential benefits of behavior change (e.g., replacing sedentary behavior with physical activity) on renal function are not fully understood. We used isotemporal substitution to model potential impacts on renal function of replacing time from one behavior to another in middle-aged and older adults.
Methods: For 174 Japanese adults (aged 50 – 83 years; 76 % women), the time spent in sedentary behavior, light-intensity physical activity (LPA), and moderate to vigorous-intensity physical activity (MVPA) were assessed using uniaxial accelerometers. Renal function was evaluated by the estimated glomerular filtration rate (eGFR) from serum creatinine and cystatin C levels.
Results: In univariate analyses, eGFR was significantly, albeit weakly, correlated with time spent in sedentary behavior ( r s = – 0.229), LPA ( r s = 0.265) and with MVPA ( r s = 0.353). In the isotemporal substitution models, replacement of 30 min/day of sedentary behavior with equivalent LPA time was not significantly associated with eGFR ( β = 2.25, p = 0.111); however, replacement with the same amount of MVPA was beneficially associated with eGFR ( β = 5.51, p < 0.05).
Conclusions: These cross-sectional findings suggest that both sedentary behavior (detrimentally) and physical activity (beneficially) may be contributors to maintaining renal function and that replacing sedentary behavior with MVPA may benefit renal health in middle-aged and older adults.
Identification of key genes of papillary thyroid carcinoma by integrated bioinformatics analysis
Authors: Xue Gang , Lin Xu , Wu Jingfang , Pei Da , Wang Dong-Mei , Zhang Jing , Zhang Wen-Jing
Published: January 2020

Background:Papillary thyroid carcinoma (PTC) is one of the fastest-growing malignant tumor types of thyroid cancer. Therefore, identifying the interaction of genes in PTC is crucial for elucidating its pathogenesis and finding more specific molecular biomarkers. Methods:In this study, 4 pairs of PTC tissues and adjacent tissues were sequenced using RNA-Seq, and 3745 differentially expressed genes (DEGs) were screened. The results of GO and KEGG enrichment analysis indicate that the vast majority of DEGs may play a positive role in the development of cancer. Then, the significant modules were analysed using Cytoscape software in the protein-protein interaction (PPI) network. Survival analysis, TNM analysis, and immune infiltration analysis of key genes are all analyzed. And the expression of ADORA1, APOE and LPAR5 genes was verified by qPCR in papillary thyroid carcinoma compared to their matching adjacent tissues.Results: A total of 25 genes were identified as hub genes with nodes greater than 10. The expression of 25 key genes in PTC were verified by the GEPIA database, and the overall survival and disease free survival analyses of these key genes were conducted with Kaplan–Meier plots. We found that only three genes were confirmed with our validation and were statistically significant in PTC, namely ADORA1, APOE, and LPAR5. Further analysis found that the mRNA levels and methylation degree of these three genes are significantly correlated with the TNM staging of PTC, and these three genes are related to PTC immune infiltration. Verification of the expression of these three genes by RT-qPCR further confirmed the reliability of our results. Conclusion: Our study identified three genes that may play key regulatory roles in the development, metastasis, and immune infiltration of papillary thyroid carcinoma.Key words :RNA-Seq, papillary thyroid carcinoma, key gene, bioinformatics