bluuebunny/crossref_metadata_2025 huggingface dataset:
Enhanced transferrin modified targeting delivery system via AFP promoter MR imaging reporter gene transfection
Authors: Zhou Jiaping , Zhou Qiaomei , Shu Gaofeng , Wang Xiaojie , Lu Yuanfei , Chen Haiyan , Hu Tingting , Cai Jinsong , Du Yongzhong , Yu Risheng
Published: March 2020

Background: Effective treatment and early diagnosis is essential for patients with hepatocellular carcinoma. Nowadays, there is an increasing interest in the utilization of AFP/Fth as an endogenous contrast agent for the early diagnosis of liver cancers. The transfection of AFP/Fth also leads to a considerable upregulation of transferrin receptors (TfR), which might be a potential target for an enhanced delivery of nanomedicines. However, there is no information regarding the utilization of overexpressed TfR for the treatment of liver cancers. Thus, the objective of our study was to investigate whether the transfection of AFP/Fth could be used for the early diagnosis, but also for an enhanced treatment of live cancers. Results: It was found that both of ferritin and TfR were upregulated after the transfection of AFP/Fth plasmid. The transfected cells showed a higher uptake of ferric ion than the un-transfected ones, resulting in a lower T2WI intensity. This result was due to the upregulation of ferritin in transfected cells, suggesting that transfection of AFP/Fth plasmid could be a potential strategy for early diagnosis of liver cancer. As compared with the un-transfected cells, the transfected cells showed a higher uptake of transferrin-modified liposomes, which was due to the specific interaction between transferrin with TfR overexpressed on the transfected cells. This is also the reason why the transferrin modified doxorubicin loaded liposomes (Tf-LP/DOX) showed better in vitro and in vivo anticancer ability than the LP/DOX. This results also suggested that transfection of AFP/Fth could result in an enhanced therapy of liver cancer. Conclusions: Transfection of AFP/Fth could be used for the early diagnosis, but also for an enhanced treatment of live cancers.
Is preoperative vestibular depth a factor affecting shrinkage of free gingival graft: A quasi-experimental study
Authors: Jalali Mahsa , Saeedi Moein , Mohammadi Mohammad , Ranjbar Hadi , Solghar Mohadeseh Arab
Published: March 2020

Background The purpose of the present study was to evaluate the effect of preoperative vestibular depth (VD) on FGG dimensional shrinkage.Methods This study was performed on 20 patients with insufficient attached gingiva width (AGW). Under local anesthesia, a partial thickness bed with submarginal incision was created. An FGG was prepared from the palate and sutured to the prepared bed. Clinical parameters including VD, probing depth (PD), keratinized gingiva width (KGW), AGW, vertical graft dimension (VGD), horizontal graft dimension (HGD) and graft area (GA) were evaluated preoperatively and 1, 3, and 6 months postoperatively. Because the distribution of data was normal, t-test and repeat measurement test were performed to analyze the data.Results Six months after FGG surgery, AGW and KGW raised to 6.15±1.01 mm and 7.55±1.1 mm, which were statistically significant (P <0.001). The shrinkage rate of HGD, VGD, and GA were 13%, 34%, 42% respectively after 6 months. The VD was increased 2.05 mm compared to baseline which was statistically significant (P <0.01). 6 months after surgery, KGW and AGW were 6.95±0.89 mm and 5.62±0.88 mm in patients with baseline VD <9mm, and 8.57±0.53 mm and 7.07±0.34 mm in patients with baseline VD ≥9 mm respectively. The difference of postoperative KGW and AGW between these two groups (based on baseline VD) was statistically significant. (P <0.01, P =0.001 respectively). The decrease in KGW and AGW in patients with VD <9 mm was 1.62 and 1.45 mm respectively after 6 months and this decrease was greater than patients with VD ≥9 mm.Conclusions It was concluded that the shrinkage of FGG was significantly greater in patients with less preoperative VD 6 months after surgery.Trial registration: This study was retrospectively registered by Iranian Registry of Clinical Trials (IRCT) with the number: IRCT20101204005305N18. Registered 22 September 2019. https://irct.ir/trial/41736
The Viewpoints of the Families of Patients with Bipolar I Disorder about the Nature of Disorder and treatment non-compliance: A Qualitative Study
Authors: Mousavi Nasim , norozpour marzieh , Taherifar Zahra , naserbakht Morteza , Shabani Amir
Published: March 2020

Background: Bipolar disorder is a common psychiatric disorder with a great psychological and social burden. Research indicates that therapeutic adherence in these patients is low. On the other hand, family knowledge about the disorder is one of the basic principles of treating this disorder. The purpose of the present study was to investigate the knowledge of family members of patients with bipolar I disorder and the reasons for treatment non-compliance in Iran.Methods: This study was conducted by qualitative content analysis method. In-depth interviews were categorized by open coded inductive method based on common meanings and continuous comparisons into subcategories and main subcategories.Results: The findings of this study indicated that the components of the viewpoints of the families of patients with bipolar I disorder, consisted of five themes: a) information about the disorder, b) information about the medications, c) information about the treatment and the role of the family in it, d) causes of patient’s medication non-compliance, and e) family guidelines for patient’s medication compliance.Conclusions: This study showed that family members did not have enough information about the nature of bipolar I disorder and related this to the lack of education. They did not know what causes the recurrence of the disorder and did not have sufficient knowledge about the prescribed drugs and treatment. Also, most families did not know the etiology of the disorder. Lack of knowledge among families can have a significant impact on relapse and therapeutic non-compliance of patients. It seems that these points need to be further emphasized in the education of families. The results of this study will be used to design guidelines and protocols for relapse prevention and family education and reduce the costs.
Association Between Genetic Polymorphisms and Steady-State Plasma Concentration of Warfarin Optical Isomers
Authors: Liu Yiwei , Chen Quanyao , Ming Wai-Kit , Wang Feiyu , Lin Rongfang , Lin Cuihong , Huang Pinfang
Published: March 2020

Background We evaluated the effects of CYP2C19*2, CYP2C9*3, VKORC1 A1639G, CYP4F2, and MDR1 C3435T gene polymorphisms on the plasma concentrations of R- and S-warfarin enantiomers at the same dose.Methods The plasma concentrations of R- and S-warfarin were determined by ultra performance liquid chromatography/tandem mass spectrometry (UPLC-MS/MS) in 136 patients. The PCR-RFLP genotyping results were verified by pyrosequencing. The Hardy–Weinberg equilibrium of genotype frequencies was assessed using the Chi-square analysis. Relationships between genotype and plasma concentrations of the enantiomers were analyzed by Kruskal–Wallis test.Results There was no significant difference in the dosage between groups (P > 0.05). The CYP2C19*2, CYP2C9*3, CYP4F2, MDR1 C3435T, and VKORC1 A1639G mutation frequencies were 37.5%, 6.25%, 19.12%, 31.25%, and 3.31%, respectively. The plasma concentrations were non-normally distributed. The S-warfarin plasma concentration was significantly higher in CYP2C9*3 carriers than in non-carriers (P = 0.018) and in patients carrying the T allele of CYP4F2 than those carrying the C allele (P = 0.03). The VKORC1 A1639G polymorphism did not affect the steady-state plasma concentrations of R- and S-warfarin. The enantiomer ratio in homozygous patients (GG) was significantly lower than that in heterozygous patients (GA) and those lacking the mutation (AA) (P = 0.039). Enantiomer plasma levels were not significantly different between MDR1 C3435T and CYP2C19*2 (P > 0.052).Conclusions The CYP2C9*3 and CYP4F2 mutations are associated with increased plasma concentrations of S-warfarin. The VKORC1 A1639G polymorphism might affect the plasma ratio of R- and S-warfarin. Maintenance dose reduction during warfarin administration can be considered for patients with the CYP2C9*3 and CYP4F2 mutations.
High efficient extracellular production of recombinant Streptomyces PMF phospholipase D in Escherichia coli
Authors: Wang Jing , Xu Sheng , Pang Yang , Wang Xin , Chen Kequan , Ouyang Pingkai
Published: March 2020

Background Currently, Streptomyces is widely used in the preparation of phospholipase D (PLD) with high transphosphatidylation activity. However, the yield of PLD from Streptomyces was low and the culture period was long. Therefore, an efficient and cost-effective method is needed urgently.Results Firstly, PLDs from Streptomyces PMF and Streptomyces racemochromogenes were separately over-expressed in E. coli to compare their transphosphatidylation activity based on the synthesis of phosphatidylserine (PS), and PLDPMF was determined to have higher activity. To further improve PLDPMF synthesis, a secretory expression system suitable for PLDPMF was constructed and optimized with diﬀerent signal peptides. The highest secretory efficiency was observed when the PLDPMF gene was expressed together with its native signal peptide (Nat) and the signal peptide PelB from E. coli. For the application of recombinant PLD to PS synthesis, the PLD properties were characterized and 30.2 g/L of PS was produced after 24 h of bioconversion when 50 g/L phosphatidylcholine (PC) was added.Conclusions We succeeded in over-expressing PLD from Streptomyces PMF in E. coli with high transphosphatidylation activity and enhanced the yield by secretory expression. The secreted PLD was successfully used in the production of PS. Our work makes the large-scale production of PLD and PS feasible.
Roles and functions of exosomal miRNA in abdominal aortic aneurysm
Authors: Zhao YuBo , Wan Shuwei , Li Chuang , Guo Yaming , Cai Gaopo , Jiao Zhouyang , Hua Zhaohui , Xu Peng , Liu Shirui , Cao Hui , Li Zhen
Published: March 2020

Background and objective: abdominal aortic aneurysms（AAAs）are the permanent dilatation of the abdominal aorta, ruptured AAA is a serious threat to the patient's life. It’s hardly known about exosomal miRNAs in AAA. The main purpose of this article is to screen miRNAs which differentially expressed in exosomes from normal people and patients with AAA, and to understand the mechanism of work.Material and methods: The plasma of healthy control group and patients with AAA were collected, and the RNAs from exosomes was isolated and sequenced. The mature miRNA sequence of miRBase 21 database was used to identify the known type and expression of miRNAs. DEGseq software was used to analyze the types of miRNAs with significant difference between the experimental group and the control group ( P ＜ 0.05, | log 2 (FoldChange) | ≥ 1 ). The targets of miRNAs were detected by miRTarBase, miRDB, TargetScan and miRWalk software. Targets were analyzed based on Kyoto encyclopedia of genes and genomes（ KEGG ）biological pathway and gene ontology（ GO ）functional enrichment analysis. Conclusion: miRNAs in exosomes regulate in the progress of AAA by activating PI3K-Akt/mTOR and MAPK pathway, and its mechanism needs more research. Background and objective: abdominal aortic aneurysms（AAAs）are the permanent dilatation of the abdominal aorta, ruptured AAA is a serious threat to the patient's life. It’s hardly known about exosomal miRNAs in AAA. The main purpose of this article is to screen miRNAs which differentially expressed in exosomes from normal people and patients with AAA, and to understand the mechanism of work. Material and methods: The plasma of healthy control group and patients with AAA were collected, and the RNAs from exosomes was isolated and sequenced. The mature miRNA sequence of miRBase 21 database was used to identify the known type and expression of miRNAs. DEGseq software was used to analyze the types of miRNAs with significant difference between the experimental group and the control group ( P ＜ 0.05, | log 2 (FoldChange) | ≥ 1 ). The targets of miRNAs were detected by miRTarBase, miRDB, TargetScan and miRWalk software. Targets were analyzed based on Kyoto encyclopedia of genes and genomes（ KEGG ）biological pathway and gene ontology（ GO ）functional enrichment analysis.Conclusion: miRNAs in exosomes regulate in the progress of AAA by activating PI3K-Akt/mTOR and MAPK pathway, and its mechanism needs more research.
Human and spatial-temporal clustering analysis of human brucellosis in mainland China from 2012 to 2016
Authors: Liang Peifeng , Zhao Yuan , Zhao Jianhua , Pan Dongfeng , Guo Zhongqin
Published: March 2020

Objective: The aim of the present study was to better understand the epidemiology of brucellosis in mainland China. We set out to investigate the human, temporal and spatial distribution and clustering characters of the disease.Methods: Human brucellosis data from mainland China between 2012 and 2016 were collected from the China Information System for Disease Control and Prevention. A geographic information system ArcGIS10.3 (ESRI, Redlands) and SaTScan software were used to identify potential changes in the spatial and temporal distribution of human brucellosis in mainland China during the study period.Results: A total of 244,348 cases of human brucellosis were reported during the study period. During 2012-2016, the average incidence of human brucellosis was higher in the 40-60 age group. The temporal clustering analysis showed that the high incidence of brucellosis occurring between march and July annually. The spatial clustering analysis of the incidence of human brucellosis showed that the location of brucellosis clustering in mainland China remained relatively fixed, mainly concentrated in most parts of northern China. The results of spatial-temporal clustering analysis showed that the primary cluster located in northeast of China, including Inner Mongolia, Heilongjiang, Jilin and Liaoning, and the high-risk time was from January 2012 to December 2013.Conclusion: Human brucellosis remains a widespread challenge, particularly in northern China. The clustering analysis highlights potential high-risk human, time and areas which may require special plans and resources for monitoring and controlling the disease.
Order-statistic filtering Fourier decomposition and its applications to rolling bearing fault diagnosis
Authors: Huang Siqi , Zheng Jinde , Pan Haiyang , Tong Jinyu
Published: March 2020

Inspired by the empirical wavelet transform (EWT) method, a new method for nonstationary signal analysis termed order-statistic filtering Fourier decomposition (OSFFD) is proposed in this paper. The OSFFD method uses order-statistic filtering and smoothing to preprocesses the Fourier spectrum of original signal, which improves the problem of sometimes unreasonable boundaries obtained by EWT directly segmenting the Fourier spectrum. Then, the mono-components with physical significance are obtained by adaptively reconstructing the coefficient of fast Fourier transform in each interval, which improves the problem of too many false components obtained by Fourier decomposition (FDM). The OSFFD method also is compared with the existing nonstationary signal decomposition methods including empirical mode decomposition（EMD）, EWT, FDM and variational mode decomposition（VMD） through analyzing simulation signals and the result indicates that OSFFD is less affected by noise and is much more accurate and reasonable in obtaining mono-components. After that, the OSFFD method is compared with the mentioned methods in diagnostic accuracy through analyzing the tested faulty bearing vibration signals and the effectiveness and superiority of OSFFD to the comparative methods in bearing fault identification are verified.
Anemia prevalence, severity and determinant factors among children aged 6-71 months in rural Hunan Province, China: a community-based cross-sectional study
Authors: Li Huixia , Xiao Juan , Liao Minghui , Huang Guangwen , Zheng Jianfei , Wang Hua , Huang Qun , Wang Aihua
Published: March 2020

Background

In recent ten years, with the rapid socioeconomic development and the extensive implementation of children nutrition improvement projects, the previous epidemiological data cannot reflect the actual level of anemia among children in China, especially in rural areas. Therefore, this study analyzed the prevalence, severity and associated determinant factors of anemia among children aged 6-71 months in rural Hunan Province.

Methods

A community-based cross-sectional study was conducted. Through multistage stratified cluster sampling, 5229 children aged 6 to 71 months and their caregivers were randomly selected from 72 villages across 24 towns in 12 counties from rural Hunan. The demographic characteristics of children and their caregivers, feeding practice, caregivers’ anemia-related feeding knowledge, and gestational conditions of mothers were acquired by using a unified questionnaire. Peripheral blood from the left-hand middle fingertip was sampled from each child, and hemoglobin concentration was measured using a HemoCue301 portable hemoglobin analyzer (Sweden). Associated determinant factors analyses involving overall anemia and anemic severity were conducted on multivariate logistic regression models.

Results

The overall anemia prevalence was 9.7% (506/5229), and the prevalence of mild, moderate and severe anemia was 6.7% (349/5229), 2.9% (151/5229) and 0.1% (6/5229), respectively. Children age groups of 6-11 months, 12-23 months and 36-47 months, exclusive breast-feeding within 6 months after birth, and maternal moderate/severe anemia were significantly associated with an increased risk of overall anemia in children. Children age groups of 6-11 months and 12-23 months, maternal moderate/severe anemia were significantly associated with an increased risk of mild anemia in children. Children age groups of 6-11 months, 12-23 months and 36-47 months, lower caregivers’ anemia-related feeding knowledge level, and maternal moderate/severe anemia were significantly associated with an increased risk of moderate/severe anemia in children. Children who underwent regular physical examination were less likely to have moderate/severe anemia. The common protective factor for overall, mild and moderate/severe anemia in children was high family income.

Conclusions

The anemia status of preschool children in rural Hunan Province was a mild public health problem and associated with children age group, feeding practice, regular physical examination, family income, caregivers’ anemia-related feeding knowledge level, and maternal moderate/severe anemia.
Association of p-phenylenediamine exposure with alterations of pulmonary function, pruritus and health-related quality of life in hair dye manufacturer workers: a cross-sectional study
Authors: zhang ming , Fan Lin , Zhang Meibian , Liu Baofeng , Zeng Qiang
Published: March 2020

Background p -Phenylenediamine (PPD) is a common component of hair dye, indicating the clinical characteristics of skin contact allergy and asthma with impaired pulmonary function. Howerver the adverse effects of PPD occupational exposure was rarely mentioned. The purpose of this study was to explore the PPD-induced pulmonary function, pruritus and health-related quality of life (HRQOL) of industrial workers of hair dye.
Methods We recruited 124 workers from a hair dye manufacturer exposed to PPD. Individual PPD exposure and pulmonary function of workers were measured. The quality of life and subjective pruritus of workers was also assessed by SF-36 and VAS of pruritus, respectively.
Results In the high PPD-exposed group, FVC% (percentage of forced vital capacity) was higher, while FEV1/FVC% (ratio percentage of forced expiratory volume) was lower than that in the low PPD-exposed group ( P <0.05). In terms of the HRQOL, the scores of mental health and vitality of the high PPD-exposed group were the lowest of all groups ( P <0.05), while the score of VAS was significantly higher than that of other two groups ( P <0.001). PPD levels were negatively correlated with vitality and mental health ( P <0.01). Higher PPD exposure level was correlated with a significantly higher VAS level (OR 9.394; 95%CI: 1.710, 51.622; P =0.010). The structural equation model provided a good fit to the data (χ2/df =1.607, GFI =0.901, AGFI =0.934, RMSEA =0.007, IFI =0.977, CFI =0.960, PGFI =0.615). And showed that PPD exposed level have positive effects on VAS level (β = 0.213, P <0.001). Then PPD exposed level partly via lack total score of SF-36 (β = -0.465, P =0.002); on negative effects on VAR level (β = -0.110, P <0.001).
Conclusion Occupational PPD exposure might be associated with pulmonary function impairment, poor HRQOL, and subjective pruritus of workers.
Scope of Natural Plant Extract to Deactivate COVID-19
Authors: Shahid Md Abdus , Chowdhury Mohammad Asaduzzaman , Kashem Mohammod Abul
Published: March 2020

The outbreak of coronavirus disease 2019 (COVID-19) has emerged as a severe threat for public health and economy throughout the world. The structure of corona virus is composed of RNA based proteins that contains amino (-NH2) and carboxyl (-COOH) groups. It includes nucleocapsid protein (N-protein), spike protein (S-protein), envelope and hemagglutinin-esterase dimer (HE). These proteins affect adversely on human gastrointestinal system, heart, kidney, liver, and central nervous system leading to several organ damages. This investigation reveals that the extracted components of natural plants, especially hydroxyl (-OH) groups react chemically to deactivate the active components of the virus by esterification process. As a case study, using one of the natural resources, as for example, licorice (Glycyrrhiza glabra) which has the components of glycyrrhizin, glycyrrhetic acid, liquiritin and isoliquiritin that can be used to neutralize the activeness of COVID-19 and it can be used as an antiviral drug. The extracted licorice is further processed with PVA solution to form antiviral nano-membrane for potential application as wound dressing materials, musk, gloves and against skin infection by electrospinning. The morphology of the membrane is characterized using scanning electron microscope (SEM). The research suggests that the other plants having deactivate components against virus can be applicable to resolve the human health crisis of the globe.
Clinical parameters predictive for sphincter-preserving surgery and prognostic outcome in patients with locally advanced low rectal cancer
Authors: Partl Richard , Magyar Marton , Hassler Eva , Langsenlehner Tanja , Kapp Karin Sigrid
Published: March 2020

Background Although controversial, there are data suggesting that clinical parameters can predict the probability of sphincter preserving procedures in rectal cancer. The purpose of this study was to investigate the association between clinical parameters and the sphincter-preserving surgery rate in patients who had undergone neoadjuvant combination therapy for advanced low rectal cancer. Methods In this single center study, the charts of 540 patients with locally advanced rectal cancer who had been treated with induction chemotherapy-and/or neoadjuvant concomitant radiochemotherapy (nRCT) over an 11-year period were reviewed in order to identify patients with rectal cancer ≤6 cm from the anal verge, who had received the prescribed nRCT only. Univariate and multivariate analyses were used to identify pretreatment patient- and tumor associated parameters correlating with sphincter preservation. Survival rates were calculated using Kaplan-Meier analyses. Results 280 of the 540 patients met the selection criteria. Of the 280 patients included in the study, 158 (56.4%) underwent sphincter-preserving surgery. 164 of 280 patients (58.6%) had a downsizing of the primary tumor (ypT < cT) and 39 (23.8%) of these showed a complete histopathological response (ypT0 ypN0). In univariate analysis, age prior to treatment, Karnofsky performance status, clinical T-size, relative lymphocyte value, CRP value, and interval between nRCT and surgery, were significantly associated with sphincter-preserving surgery. In multivariate analysis, age (hazard ratio (HR)=1.05, CI95%: 1.02-1.09, p=0.003), relative lymphocyte value (HR=0.94, CI95%: 0.89-0.99, p=0.029), and interval between nRCT and surgery (HR=2.39, CI95%: 1.17-4.88, p=0.016) remained as independent predictive parameters. A significant longer disease-free (p =0.009) and overall survival (p =0.004) were observed in the sphincter-preserving surgery group. Conclusions The findings of our study in a consistently treated cohort of 280 patients with advanced low rectal cancer suggest that clinical parameters have a role in predicting sphincter-preserving surgery.
Positional repeatability and variation in internal and external markers during volumetric-modulated arc therapy under end-exhalation breath-hold conditions for pancreatic cancer patients
Authors: Sasaki Makoto , Nakamura Mitsuhiro , Ono Tomohiro , Ashida Ryo , Yoshimura Michio , Nakata Manabu , Mizowaki Takashi , Sugimoto Naozo
Published: March 2020

Background: To assess the positional repeatability of internal and external markers among multiple breath-hold (BH) sessions and assess the positional variation of these markers within BH sessions for volumetric-modulated arc therapy (VMAT) for pancreatic cancer patients. Methods: A total of 13 consecutive pancreatic cancer patients with an internal marker were enrolled. Single full-arc coplanar VMAT was delivered under end-exhalation (EE) BH conditions, while monitoring the internal marker with kilovoltage (kV) X-ray fluoroscopy. Positional repeatability of internal and external markers was indicated by the difference between the reference marker position and the marker position at the beginning of each BH session, and positional variation was indicated by the maximum displacement of the marker during each BH session. Results: The overall positional repeatability was 0.6 ± 1.5 mm in the X-axis for the centroid of the internal marker (CoIM), -0.1 ± 2.2 mm in the Y-axis for the CoIM, and 0.8 ± 2.2 mm for the external marker. An internal marker position > 2 mm from the reference position in the Y-axis was observed in 19.1% of all BH sessions, despite the external marker position being ≤ 2 mm from the reference position. Meanwhile, the proportion of sessions with positional variation ≤ 2 mm was 93.2% and 98.7% for the CoIM and external marker, respectively. Conclusions: External marker motion can be used as a surrogate for pancreatic tumor motion during BH-VMAT; however, an optimal internal margin is required to ensure positional repeatability.
Comparison of the Gut Microbiota Disturbance in Rat Models of Irritable Bowel Syndrome Induced by Maternal Separation and Multiple Early-life Adversity
Authors: Wu Enqi , Jingzhu Song , Lingpeng Pei , Yaqin Ling
Published: March 2020

Background: The aims of this study was to identify the effect of modeling procedures on bacterial communities and investigate whether different modeling procedures lead to consistent patterns of gut microbiota compositions. Methods: Two IBS rat models (MS alone and multiple-early-adversity modeling) were established and the gut microbiotas were analyzed using 16S-rRNA-based high-throughput sequencing methods. Results: Rats from both models exhibited visceral hypersensitivity and the two model groups exhibited differences in the extent of visceral sensitivity and fecal water content. The microbial community structure of the two models exhibited significant differences compared to the controls, while the two model groups also exhibited significant differences between them. Furthermore, microbial community functional predictions suggested that the two models exhibited different abundances of metabolisms and pathways. Several common and distinct characteristic differences were also observed between the two model groups. Alloprevotella were more abundant in both model groups, while Butyricicoccus, Turicibacter, Ruminococcus, and Clostridium_sensu_stricto along with the family it belongs to were less abundant relative to controls. In addition, the abundance of Clostridium_IV, Corynebacterium, Rothia, Elusimicrobium, Romboutsia, Allobaculum, Parasutterella and their related taxa were specifically associated with MS group, whereas Butyricimonas and Vampirovibrio along with its related taxa were specifically associated with MAM group. Among those, Butyricimonas, Butyricicoccus and Corynebacterium were found partially mediates early adversity exposure-induced visceral hypersensitivity. Conclusions: our results highlight the importance in evaluating gut microbiota characteristics in IBS research while also systematically considering potential modeling procedural differences. The microbial compositional/functional differences identified in this study were suggestive to further investigation of mechanism of early adversity induced IBS.
Economic impact of aggression in closed long-stay psychiatric wards
Authors: Bles Nienke J. de , Hazewinkel Andreia W.P. , Bogers Jan P.A.M. , Mouton Constant , Hout Wilbert B. van den , Hemert Albert M. van , Ottenheim Nathaly Rius , Giltay Erik
Published: March 2020

Background : Aggressive behaviour (i.e. verbal, physical towards objects, self, or others) is highly prevalent in long-term psychiatric inpatient care. We aimed to estimate the overall incidence of aggression, the time staff took to handle aggression incidents, and the weighted average financial costs thereof. Methods : A random sampling procedure was conducted at three long-term psychiatric inpatient care facilities, covering all weekdays and work shifts (day, evening, and night). Psychiatric nurses were asked to recall all incidents of their shift. For the time spent on each type of incident, members of staff were monitored in real-time for a period of one week. Estimated costs were calculated by the time spent multiplied by hourly wages in addition to any material-related costs. Results : The incidence rates were 90 incidents per patient year: 63 for verbal aggression, 8 for physical aggression towards objects, 7 for self-harm, and 12 for physical aggression towards others. The average time spent per incident was 125 minutes but differed for each type of incident. Almost 80% of this time was consumed by nursing staff. The average cost per aggression incident was €78; extrapolated per patient year, the total costs were approximately €7000. Conclusions : The current study found a high rate of aggression incidents in closed long-stay psychiatric wards, particularly when accounting for verbal aggression. Reports of aggression on these types of wards are scarce. Nevertheless, aggression seems to have a severe impact on invested time and related costs, which suggests a need for aggression-prevention and de-escalating programs.
Thinning enhances ecosystem multifunctionality via increase of functional diversity in a Pinus yunnanensis natural secondary forest
Authors: Huang Xiaobo , Li Shuaifeng , Su Jianrong
Published: March 2020

Background: The impacts of thinning on ecosystem multifunctionality (EMF) remain largely unexplored. In this study, we analyzed nine variables related to four ecosystem functions (nutrient cycling, soil carbon stocks, decomposition, and wood production) under five thinning intensities. We included a control group to evaluate the shift in EMF of a Pinus yunnanensis natural secondary forest. We also assessed the relationship between above- and belowground biodiversity and EMF under these different thinning intensities. Additionally, we evaluated the effects of biotic and abiotic factors on EMF with the structural equation model (SEM). Results: We found that EMF tended to increase with thinning intensity, and that thinning significantly improved EMF except the low intensity of thinning. Individual ecosystem functions (EFs) all had a significant positive correlation with thinning intensity. Different EFs showed different patterns with the increase of thinning intensity: the nutrient cycling and the soil carbon stock of thinning three times and five times were significantly greater than other thinning intensities and control group; decomposition correlated directly to the increase of thinning intensity; the wood production of the fourth thinning was greatest. Thinning intensity had a significant positive correlation with functional diversity and soil moisture. Both functional diversity and soil moisture had a significant positive correlation with EMF, but soil fungal operational taxonomic units (OTUs) had a significant negative correlation with EMF. Based on SEM, we found that thinning improved EMF mainly by increasing functional diversity. Conclusion: Our study both demonstrates that thinning is a good management technique from an EMF perspective, and provides an input to improve management of a P. yunnanensis natural secondary forest.
The competition and survival of stump sprouts of Quercus spp. in a regenerated stand during the 19 years after a forest fire in the Republic of Korea
Authors: KIM Jeonghwan , Lim Joo-Hoon , Shin Moonhyun , Han Seung Hyun , Kang Wonseok
Published: March 2020

Background : Forest fire is a natural phenomenon that is very important to afforestation in the secondary succession process. Approximately 349.7 M ha yr -1 of forest had been lost due to forest fire in the world. In Republic of Korea, the forest fires occur at a rate of approximately 400 events yr -1 , and burned areas are mainly located on the eastern coast. In the eastern coastal region, pine forest is widely distributed, and pine forest is changed to oak forest through stump sprout regeneration following forest fires. However, there is a lack of research on oak competition during regeneration in burned areas. Therefore, this research was conducted to evaluate the effects of species composition and the survival ratio of Quercus serrata , Quercus variabilis , and Quercus mongolica in burned areas. The investigation plots were set to investigate tree growth, survival, and composition in Goseong-gun, Republic of Korea. Results : The mean tree heights of Q. serrata and Q. variabilis were approximately 9.8 m and 9.1 m, respectively, which were higher than the approximately 5.8 m heights of Q. mongolica stands 18 years after a forest fire, and the trend for tree diameter at breast height was the same for all three species. In the early stage of regeneration, the survival probability of the Q. serrata sprouts rapidly decreased at a rate 1.7-2.0 times higher than that of other oak species in the Q. serrata -dominant stands. The median survival time of Q. variabilis sprouts in the Q. variabilis -dominant stands was approximately 10.1 years, which was similar to Q. serrata -dominant stands. However, the dominant stand of Q. mongolica was different from that of other dominant stands due to different topography and soil environments located in the ridge and the upper part of the mountain. Conclusion : Dominant species decision seems to be determined by the survival and occurrence of sprouts during the early stage in postfire regenerated oak forests. Therefore, it would be more desirable to coppice sprout for dominant species productivity and rapid dominance after a forest fire.
Feasibility of a noninvasive operability assessment in chronic thromboembolic pulmonary hypertension under real-world practice.
Authors: Chaverri adriana Rodriguez , Ostolaza Yolanda Revilla , Lopez-Gude Maria Jesus , Velazquez María Teresa , Antonio Ines Ponz de , Charterina Sergio Alonso , Gonzalez-Trevilla Agustin Albarran , Nuñez Marta Perez , Vela Jose Luis Perez , Ruiz Rafael Morales , Jimenez Juan F. Delgado , Ynsaurriaga Fernando Arribas , Cortina Jose Maria , Subias Pilar Escribano
Published: March 2020

Background – The development of an optimized assessment of operability in patients with chronic thromboembolic pulmonary hypertension (CTEPH) is crucial. This study aimed to evaluate the feasibility of a noninvasive operability assessment of CTEPH based on multidetector computed tomographic angiography (MCTA). Methods –176 patients with CTEPH were evaluated from January 2016 to April 2018. Throughout the first phase, operability was assessed with MCTA and pulmonary angiography (PA): initial surgical decision was made based on MCTA with further analysis of PA to evaluate which cases initial decision was not modified by PA. During the second phase, PA was limited to patients judged inoperable based on MCTA or in those whose assessment was not possible. Results – Patients deemed operable (50%) based on MCTAalong the first phase, had been adequately classified, as PA did not modify the initial decision in all but one patient. Comparable results were obtained throughout the implementation phase, in which decision of operability was based on MCTA in 49% of the patients. Regarding operated patients, decision of operability had been based solely on MCTA in 94% of those with level I disease regarding intraoperative CTEPH classification; in 75% with level II disease and 54% with level III. This approach enabled shorter time periods to complete surgical assessment and the avoidance of PA-related morbidity. Baseline parameters, postoperative measures and survival rates at 1 year after surgerywere comparable in both phases. Conclusions - Noninvasive operability assessment is feasible in a subset of CTEPH patients and optimizessurgical candidacy evaluation.
Sanfu herbal patch applied at acupoints in patients with bronchial asthma: study protocol for a randomized controlled trial
Authors: Xiaoyan Xie , Xu Danghan , Zhuang Lixing , Liu Hui , Tan Sui , Lu Yanqing , Su Meiyi , Chen Jie , Pan Haihua , Lu Lu , Xu Yiming , Liao Muxi , Xu Zhanqiong , He Jun
Published: March 2020

Background Bronchial asthma (BA) is one of the most common inflammatory airway disorders. As one of the main non-drug therapies, the Sanfu herbal patch (SHP) has been widely used to treat BA, although the evidence and mechanism are inconclusive. The objective of this pilot trial is to clarify the clinical efficacy and safety of the SHP in the treatment of BA in the chronic persistent or clinical remission stage and to provide high-quality data for further research.Methods: We propose a multicenter, double-blinded, parallel, randomized, placebo-controlled clinical trial involving 4 study hospitals in China. A total of 72 eligible participants will be randomized into an SHP group and a placebo group. They will receive SHP for 3 treatment sessions(TSs). The primary outcome will be changes in forced expiratory volume in one second after 3 TSs. Secondary outcomes will include: (1) the Asthma Quality of Life Questionnaire, Asthma Control Test, and Asthma Long-term Follow-up Scale; (2) levels of Metallothionein-2 and Transgelin-2 in blood and urine; and (3) levels of IL-5, IL-13, IL-23, IL-25, and thymic stromal lymphopoietin in blood. Analysis of the data will be performed at baseline, at the end of the 2nd and 3rd TSs and at 24-week follow-up. The safety of the SHP will be evaluated at each TS.Discussion: The aim of this trial is to determine whether SHP is more effective than placebo in the treatment of patients with BA, and whether SHP works by reducing airway inflammation and reversing bronchoconstriction.Trial registration: Chinese Clinical Trial Registry(http://www.chictr.org.cn), ChiCTR1900024616. Registered on 19 July 2019.
STUDY PROTOCOL Glioma patients in outpatient care - Optimization of psychosocial care in neuro-oncological patients (GLIOPT): study protocol of a multicenter cluster randomized controlled trial
Authors: Renovanz Mirjam , Hippler Melina , Voss Martin , Wehinger Jens , Keßler Almuth F. , Gempt Jens , Nadji-Ohl Minou , Lucas Carolin Weiß , Rapp Marion , Misch Martin , Coburger Jan , Mehlitz Marcus , Meixensberger Jürgen , Keric Naureen , Tabatabai Ghazaleh , Blettner Maria , Schranz Melanie , Singer Susanne
Published: March 2020

Background: Patients with high-grade gliomas (HGG) often suffer from high distress and require psychosocial support. However, due to neurological and neurocognitive deficits, adequate assessment of distress and support needs remains a challenging unmet clinical need. The objective of the present study is to investigate whether a systematic implementation of signaling questions into the routine outpatient consultation will be helpful to bridge this gap.Methods and design : This is a multicenter cluster randomized study with two arms. Randomization is done on a cluster level with 13 hospitals providing regular neuro-oncological outpatient services conducted by neurologists and/or neurosurgeons. The intervention will include an assessment of psychosocial distress of patients in doctor-patient-conversationcompared to assessment of psychosocial distress via questionnaire (control, standard of care). In total, 616 HGG patients will be enrolled. The outcome will be the number of HGG patients with increased psychosocial distress who receive professional support from psychosocial services. Secondary endpoints are inter alia number of patients reporting psychosocial distress and unmet needs detected correctly by the respective method; quality of life; psychological well-being and burden of the patients before and after doctor-patient consultation as well as the length of the doctor-patient-consultation. Discussion: Patients with HGG are confronted with an oncological diagnosis and at the same time with high symptom burden. This often leads to distress, which is not always adequately recognized and treated. So far, only a limited number of adequate instruments are available to assess HGG patient's distress. Yet, an adequate care and support network might facilitate the course of the disease and tumor therapies for patients. Our hypothesis is that an assessment conducted directly by attending doctors and in which the doctors talk to patients with HGG will be more effective than an assessment via a questionnaire, leading to better identifying patients in need for support. This may lead to an improvement of health care in these patients. Further, this method might be implemented also in other brain tumor patients (e.g. patients with brain metastases).Trial registration: Register: German Clinical Trials Register, registration number: DRKS00018079 Registration date: 3 rd September 2019, URL: http://www.drks.de/DRKS00018079
Comparison of fetal and plasma fibronectin concentrations in diagnosis of Preterm: delivery A cross sectional, descriptive-analytical study
Authors: moradi zahra , Meshkibaf mohamadHassan , Jafarzadeh Saeedeh , Dehghan Azizallah , Moradi parvin , Keshavarzi Ameneh
Published: March 2020

Background Preterm delivery is amongst the main reasons for child mortality. Therefore, its prediction can reduce a large number of its complications. The present study aimed to compare fetal and plasma fibronectin concentrations in diagnosis of preterm delivery. Methods Serum samples were obtained from 105 women at 24-36 weeks of gestation. However, only 40 women gave permission for taking vaginal samples. Fibronectin concentration was measured using ELISA technique. Then, plasma and fetal fibronectin levels were compared in term and preterm deliveries. Results Out of the 105 participants, 28 experienced preterm delivery (26.7%). The mean gestational age at the time of sampling was 28.11 + 2.98 weeks. The mean plasma fibronectin level was 6226.43+7174.97 ng/ml among the mothers with term infants and 7724.01 + 1143.82 ng/ml among those with preterm infants. Although the mean plasma fibronectin level was higher in preterm delivery, the difference was not statistically significant (p=0.667). The mean fetal fibronectin level was 156.61 + 126.42 ng/ml among the mothers with term infants and 127.71 + 43.14 ng/ml among those with preterm infants, but the difference was not statistically significant (p=0.241). The cut-off point of plasma fibronectin level was 1750 ng/ml with the sensitivity of 80.25% and specificity of 85.17%. Additionally, the cut-off point of fetal fibronectin level was 158.98 ng/ml with the sensitivity of 94.62% and specificity of 22.08%. Conclusion Plasma fibronectin testing had lower sensitivity and higher specificity compared to fetal fibronectin testing. This implies that plasma testing has lower false positive cases and can identify a larger number of true positive cases of preterm delivery.
Misfortune never comes singly - the first case of COVID-19 with rupture of thoracic aortic aneurysm
Authors: Zhao Kun , Cao Zhang , Zhu Changju , Zhang Yi , Chen Feifan
Published: March 2020

Background: SARS-CoV-2 is a newly discovered virus, leading COVID-19 a global threaten nowadays. Case Presentation: The first case of a patient with a thoracic aortic aneurysm (TAA) that became infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was reported here. The patient died suddenly from a ruptured aorta 19 h after hospital admission. Conclusion: COVID-19 patients with TAA should attract the highest vigilance as COVID-19 might expedite the process of TAA rupture through cytokine storm syndrome, leading to rapid death with little or no warning signs.
Clinical characteristics of Coronavirus Disease 2019 outside Wuhan and development of early risk stratification tool
Authors: Hong Yucai , Huang Jianping , Chen Dong , Ye Yinghai , Su Feifei , Dai Jianyi , Shi Jichan , Shao Chaochao , Zhang Zhongheng
Published: March 2020

Importance: Clinical characteristics of coronavirus disease 2019 (COVID-19) outside Wuhan are not well described, and there is no risk stratification tool for the prediction of COVID-19 outcome.Objective: To describe the clinical characteristics of COVID-19 outside Wuhan and to develop a risk stratification tool for early risk stratification.Design, Setting, and Participants: Single center, retrospective observational study conducted at Wenzhou, Zhejiang province (January 2020-February 2020) that included 140 patients with confirmed COVID-19. Clinical characteristics were described. A multivariate regression model was built to predict the risk of length of stay in hospital > 20 days (ProLOS). The last patient visit was on February 23, 2020.Interventions: NoneMain Outcomes and Measures: The primary outcome was ProLOS. Other outcomes included conversion to negative nucleic acid test, date of hospital discharge, vital status at discharge.Results: A total of 140 patients were included during the study period. Lower lymphocyte count (1.0 [0.7, 1.3] vs. 1.3 [0.9, 1.72] × 109/𝐿; p = 0.008), lower ionized sodium (136 [134.6, 137.83] vs. 138 [135.28, 140.03] mmol/L; p < 0.001) and higher PaCO2 (40.82 ± 3.96 vs. 38.48 ± 5.48 mmHg; p = 0.007) were associated with higher risk of ProLOS. The median time from hospital admission to the first negative nucleic acid test was 13 days (7.25 to 17 days). There were 4 (3%) critically and 5 (4%) severely ill patients. A multivariate model included predictors of age, time from contact to confirmation, DBP, lymphocyte count, AST, ionized sodium, PaCO2 showed good calibration and discrimination with an AUC of 81.6% (95% CI: 74.4% to 88.8%).Conclusions and Relevance: The study described clinical characteristics of COVID-19 outside Wuhan. The major difference of COVID-19 in other cities included low comorbidity burden, low prevalence of severe or critical cases and low mortality rate. The risk stratification tool can be used for medical decision making and resource allocation.Authors Yucai Hong and Jianping Huang contributed equally to this work and are co-first authors.