bluuebunny/crossref_metadata_2025 huggingface dataset:
Prognostic Significance of plasma albumin to fibrinogen ratio Associated Nomograms in Patients with breast invasive ductal carcinoma
Authors: Zheng Lihua , Liu Feng , Zhao Yaheng , Li Wei , Yang Yan , Zhang Hongsong , Liu Yunjiang
Published: August 2019

Background : In the context of breast invasive ductal carcinoma, this research aims to retrospectively evaluate by preoperative plasma albumin to fibrinogen ratio (AFR) and forecast oncological outcome and recurrence.
Methods : This reflective study included 230 patients who had surgical procedures at the Fourth Hospital of Hebei Medical University between January 2009 and April 2012 for the treatment of their non-metastatic breast invasive ductal carcinoma. We utilized an optimal value of preoperative plasma fibrinogen and albumin for the patient classification. Additionally, we used the Kaplan-Meier method to extensively evaluate progression-free and cancer-specific survival outcomes. The analysis of the linkages between the albumin to fibrinogen ratio and clinical outcomes was executed through the univariate and multivariate analyses. To construct nomograms and evaluate the survival outcomes, we used a variety of risk factors. We also verified the predictive accuracy through the Harrell's concordance index (C-index).
Results : The association of plasma AFR with diminished disease-free survival (DFS) and overall survival (OS) is statistically significant. An independent prognostic indicator is the plasma AFR, as reported by the multivariate analysis, for DFS (HR =1.346; 95% CI:1.107-1.636; p = 0.03) and overall survival (OS) (HR = 1.485; 95% CI: 1.106-1.993; p = 0.008). Two prediction model of OS and DFS based on the AFR was developed.
Conclusions : For patients with breast invasive ductal carcinoma, an independent prognostic factor for the outcomes of oncology patients is the elevated preoperative plasma AFR. For DFS and OS, the constructed nomogram demonstrated highly significant predictive accuracy.
Simplified Molecular Classification of Lung Adenocarcinomas Based on EGFR, KRAS, and TP53 Mutations
Authors: Ruiz-Cordero Roberto , Ma Junsheng , Khanna Abha , Lyons Genevieve Ray , Rinsurongkawong Waree , Bassett Roland , Guo Ming , Routbort Mark J , Zhang Jianjun , Skoulidis Ferdinandos , Heymach John Victor , Roarty Emily B , Tang Zhenya , Medeiros L. Jeffrey , Patel Keyur P , Luthra Rajyalakshmi , Roy-Chowdhuri Sinchita
Published: August 2019

Introduction: Gene expression profiling has consistently identified three molecular subtypes of lung adenocarcinoma that have prognostic implications. To facilitate stratification of patients with this disease into similar molecular subtypes, we developed and validated a simple, mutually exclusive classification.
Methods: Mutational status of EGFR, KRAS, and TP53 was used to define six mutually exclusive molecular subtypes. A development cohort of 283 cytology specimens of lung adenocarcinoma was used to evaluate the associations between the proposed classification and clinicopathologic variables including demographic characteristics, smoking history, fluorescence in situ hybridization and molecular results. For validation and prognostic assessment, 63 of the 283 cytology specimens with available survival data were combined with a separate cohort of 428 surgical pathology specimens of lung adenocarcinoma.
Results: The proposed classification yielded significant associations between these molecular subtypes and clinical and prognostic features. We found better overall survival in patients who underwent surgery and had tumors enriched for EGFR mutations. Worse overall survival was associated with older age, stage IV disease, and tumors with co- mutations in KRAS and TP53. Interestingly, neither chemotherapy nor radiation therapy showed benefit to overall survival.
Conclusions: The mutational status of EGFR, KRAS, and TP53 can be used to easily classify lung adenocarcinoma patients into six subtypes that show a relationship with prognosis, especially in patients who underwent surgery, and these subtypes are similar to classifications based on more complex genomic methods reported previously.
Association between PD-L1 expression and head and neck cancer prognosis: a meta-analysis
Authors: Shen Zhisen , Wu Linrong , Cai Xianlei , Ye Dong , Zhao Gangjun
Published: August 2019

Background: Programmed cell death ligand 1（PD-L1) plays an important role in tumor cell immune escape, and it has been extensively studied in head and neck cancer. However, its prognostic impact on patients with head and neck cancer remains controversial, so we sought to investigate this issue through a comprehensive meta-analysis. Methods: To assess the significance of PD-L1 on the survival of patients with head and neck cancer, we collected articles reported in PubMed, EMBASE, and Cochrane Library, until January 31, 2019. We also used the Newcastle Ottawa Scale (NOS) for literature quality evaluation. Results: The study included a total of 4551 patients affected by 6 different types of head and neck cancer reported in 26 articles. Our study found that the association between the expression of PD-L1 and the prognosis of head and neck tumors was highly heterogeneous (P < 0.00001, I2 = 80.0%); therefore, the random effects model was applied to combine the effect sizes. Based on the combined hazard ratios (HR)of 1.15 (95% CI: 0.88 to 1.50, P = 0.32), the expression of PD-L1 in head and neck tumors may not be a factor associated with poor prognosis. Conclusions: Our results suggest that PD-L1 expression cannot predict the overall survival of patients with oral, nasopharyngeal, or esophageal cancer. Through subgroup analysis, we found that the expression of PD-L1 may be a poor prognostic factor for some head and neck cancers.
Co-expression Network analysis of LncRNA associated with overexpression of DNMT1 in esophageal epithelial cells
Authors: Yin Dong , XU Yi , LI Xu-feng , CHEN Yan
Published: August 2019

Screening and preliminary identification of DNMT1 high expression related LncRNA, which is involved in various inter-related signaling pathways, has revealed a theoretical basis for various types of disease mechanisms. LncRNA and mRNA differential expression profiles were identified on a microarray. The 10 LncRNAs with high levels of variation were identified by qRT-PCR. KEGG and GO analyses were used to dissect out differentially expressed mRNAs. Six signal pathways were selected based on the KEGG results of the LncRNA-mRNAs expression network analysis.We found a total of 6987 differentially expressed LncRNAs and 7421 differentially expressed mRNAs were obtained from the microarrays in experimental and control groups (P<0.05; Fold Change >2.0x). GO analysis KEGG pathway analysis showed high expression of DNMT1 in esophageal epithelial cells. Nine pathways involved mRNA up-regulation including natural killer cell mediated cytotoxicity and many other prominent biochemical pathways. Forty six pathways were associated with down regulated mRNAs and ribosomes involving multiple biological pathways. Co-expression network analysis showed that the 8 mRNA and 16 LncRNA were linked to the P53 signaling pathway. Interactions occurred between 22 LncRNA and 11 mRNA in the ErbB signaling pathway, between 19 LncRNA and 8 mRNA in epithelial cell signal transduction of Helicobacter pylori infection. Interactions were present in 19 LncRNAs and 5 mRNAs in the sphingolipid signaling pathway along with 21 with LncRNA and 12 with mRNAs in the PI3K-Akt signaling pathway. Cytotoxicity interactions occurred with 22 LncRNAs and 9 mRNAs in natural killer cells.
Pretreatment platelet/lymphocyte ratio (PLR) is a significant predictive marker for EGFR targeted therapy in patients with non-small-cell lung cancer
Authors: Liu Kejun , Zhang Weiwei , Tan Qinquan , Jiang Guanming , Jia Jun
Published: August 2019

Non-small-cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) gene mutation is benefited from targeted therapy. There is no other superior predictive factor for targeted therapy except EGFR in the clinical. In this study, we analyzed the effect of pretreatment platelet/lymphocyte ratio (PLR) in NSCLC patients. In the present study, a total of 96 patients with EGFR mutations were included in this study. All patients received EGFR targeted therapy, until disease progression, unacceptable toxicity or other factors. The following evaluation was conducted about 3 days before initial treatment: detailed clinical history, physical examination, radiographic results, pathological diagnosis and laboratory parameters including complete blood cell counts and albumin levels. We found that pretreatment PLR is significantly associated to the PFS of NSCLC patients with EGFR targeted therapy. Patients in the PLR ≥190 group had shorter PFS than those in the PLR <190 group (P= 0.009). Furthermore, the 1-year PFS rate in the PLR ≥190 group were inferior to the low value group (P= 0.016). Multivariate analysis confirmed the role of PLR on predicting the efficacy of targeted therapy for advanced NSCLC. In addition, we found that PLR was also an predictive biomarker for grade 3/4 adverse events of diarrhea. In conclusion, high pretreatment PLR was an independent indicator for predicting a poor PFS for NSCLC patients receiving EGFR-TKIs treatment. Further studies are needed to identify the impact of PLR on results of EGFR-TKIs treatment.
Experiences of Selected Students in the Scientific Olympiad for Medical Students – A Qualitative Study
Authors: Vahedi Leila , Ghorbanian Naser , Zabihi Atefeh , hazrati hakimeh
Published: August 2019

Objective: It is of great importance to identify the talent students in the Scientific Olympiad and pay attention to the upgrade of quality of these competitions. The aim of this study was to explain the Students' experiences about the Scientific Olympiad. This research was a phenomenological qualitative study. Data were collected based on questionnaires (27 students) and semi-structured interviews (13 students) who were selected in the Medical Students' Scientific Olympiad. The analyzing of information was performed using clayze method.
Results: Students' experiences were divided into two main themes, including motivating and restrictive factors. Scientific level, planning and implementation and welfare issues were obtained as the three main categories by analyzing data. The participants suggested four holding suggestions, side plans, facilities and the notification results. In conclusions, students' experiences stated that the Medical Students' Scientific Olympiad in Iran is still at an early stage that challenges further the knowledge level. Therefore, it is necessary to design questions with high taxonomy by trained academic facilities. Also, the attention to the side programs, welfare amenities and recreational programs as the motivating factors for participating in these competitions recommend.
Neurofeedback for tinnitus: Study protocol for a double-blind randomized controlled trial assessing the specificity of an alpha/delta neurofeedback training protocol in alleviating both the sound perception and the psychological distress, in a cohort of chronic tinnitus sufferers
Authors: Jensen Martin , Hüttenrauch Eva , Schmidt Jennifer , Andersson Gerhard , Chavanon Mira-Lynn , Weise Cornelia
Published: August 2019

Background Tinnitus is a very common condition, which for some can have debilitating psychological consequences. Although some interventions are helpful in learning how to cope better with the tinnitus, at present there is no cure. Neurofeedback is an emerging treatment modality in tinnitus. Previous studies, utilizing an alpha/delta training protocol have shown promise. However, they were characterized by small sample sizes and lack of neurofeedback control conditions. Therefore, the aim of this study is to investigate, if an alpha/delta neurofeedback training protocol, compared to beta/theta neurofeedback or a diary control group, is effective in reducing, not only the tinnitus sound perception, but also the psychological symptoms associated with the condition. Methods The study is designed as a three-armed, single-blinded randomized controlled trial. Participants are randomly assigned to either an established neurofeedback protocol for tinnitus (alpha/delta training), another neurofeedback protocol as active comparator (beta/theta training) or diary control group. In the four-week intervention period, participants in both neurofeedback groups undergo ten sessions, whereas participants in the diary control group complete a diary bi-weekly. The primary outcomes are between group differences in tinnitus sound percept change, as measured with the Tinnitus Magnitude Index (TMI) and changes in tinnitus distress, measured with the Tinnitus Handicap Inventory (THI), four weeks post baseline. Secondary outcome measures include changes in tinnitus distress, sleep quality, depressive symptoms and whether neurofeedback leads to specific power changes in the trained frequency bands. Discussion This is the first double-blind, randomized controlled trial examining the efficacy of an alpha/delta neurofeedback training protocol in reducing the tinnitus sound percept and the distress associated with the condition. Compared to former studies, the present study is designed to assess both the specificity of an alpha/delta neurofeedback training protocol by including an active comparator, beta/theta neurofeedback training, and in addition to control for placebo effects by inclusion of a diary control group. We hope this study contributes not only to our understanding of the neurological underpinnings of tinnitus, but also to the potentiality of neurofeedback as a therapeutic agent.
Scaling Up Quality Improvement for Surgical Teams (QIST) - avoiding surgical site infection and anaemia at the time of surgery: protocol for a cluster randomised controlled trial
Authors: Scrimshire Ashley B , Booth Alison , Fairhurst Caroline , Tadd Win , Laverty Annie , Corbacho Belen , Torgerson David , McDaid Catriona , Reed Mike
Published: August 2019

Background:Measures shown to improve outcomes for patients often fail to be adopted into routine practice in the NHS. The Institute for Health Improvement Breakthrough Series Collaborative (BSC) model is designed to support implementation at scale. This trial aims to assess the effectiveness and cost-effectivenessof quality improvement collaboratives based on the BSC method for introducing service improvements at scale in the NHS.
Methods:Forty Trusts will be randomised (1:1) to introduce one of two protocols already shown to improve outcomes in patients undergoing elective total hip and knee replacement surgery.

The intervention is improvement collaboratives based on the BSC model, a learning system that brings together a large number of teams to seek improvement focused on a proven intervention. Collaboratives aim to deliver at scale, maximise local engagement and leadership and are designed to build capacity, enable learning and prepare for sustainability. Collaboratives involve learning sessions, action periods, and a summative congress.

Trusts will be supported to introduce either: decolonisation for MSSA to reduce post-operative infection (QIST:Infection), or an anaemia optimisation programme to reduce peri-operative blood transfusions (QIST:Anaemia). Trusts will continue with their usual practice for whichever protocol they are not introducing. Anonymised data related to both infection and anaemia outcomes for patients undergoing hip or knee arthroplasty at all sites will mean the two groups act as controls for each other.

The primary outcome for the QIST: Infection collaborative is deep MSSA surgical site infection within 90 days of surgery, and for the QIST: Anaemia collaborative is blood transfusion within 7 days of surgery. Patient-level secondary outcomes include length of hospital stay and re-admission, which will also inform the economic costings. Qualitative interviews will evaluate the support provided to teams.

Discussion: The scale of this trial brings considerable challenges and potential barriers to delivery. Anticipated challenges relate to recruiting and sustaining up to 40 organisations, each with their own culture and context. This complex project with multiple stakeholders across a large geography will be managed by experienced senior-level project leaders with a proven track record in advanced project management. The team will ensure effective project governance and communications.

Trial registration: ISRCTN, ISRCTN11085475. Pprospectively registered 15thFebruary 2018, https://www.isrctn.com/ISRCTN11085475?q=qist&filters=&sort=&offset=1&totalResults=1&page=1&pageSize=10&searchType=basic-search
Mass screening for hepatitis B and C in the Southern Upper Egypt
Authors: Soliman Gamal , Elzalabany Mahmoud S. , Hassanein Tarek , Miller F. DeWolfe
Published: August 2019

Background : It is well documented that Egypt has the highest prevalence of hepatitis C virus (HCV) in the world. The recent development of fast acting, highly effective direct acting antiviral drugs (DAAs), has opened the possibility of treating and curing HCV infection in the Egyptian population on large scale.
Methods : A screening demonstration project was implemented in southern Egypt in and around the city of Luxor. Free screening and if indicated, treatment, was offered to those 16 years or older for anti-HCV antibody (anti-HCV) and hepatitis B virus surface antigen (HBsAg) using third generation enzyme immunoassays (Enzygnost® Anti-HCV and HbsAg). Statistical methods included estimation of odds ratios (OR) and 95% confidence intervals (95% CI).
Results: There was a large turnout of 67,042 persons who were screened in a 12-month period starting in June 2106. 31,965 males (47.7%) and 35,077 females (52.3%) were screened with a mean age of 43.6±14.3 years. 9,701 patients (14.5%) were positive for anti-HCV and 2,950 (4.4%) for HBsAg. Prevalence of anti-HCV was significantly higher in males than females (19.67% vs.9.73% OR=2.27; CI 2.2 to 2.4; p<0.001) and the same for HBsAg (6.2% vs. 2.8% OR=2.3; CI 2.2 to 2.5; p<0.001). The prevalence of anti-HCV was significantly associated with age (p<0.001), ranging from between 1-4% in individuals below the age of 40 years, then increased steadily to 42% at age 60 followed by a precipitous decline in age specific prevalence.
Conclusions: The results showed unanticipated patterns of anti-HCV and HBsAg by age and gender in contrast to previous reports on this unique HCV epidemic in Egypt. Moreover, the results provide essential information for effective planning, design, and evaluation for future Egyptian national mass screen and treatment programs.
Revealing QTLs Associated with Fatty Acid Composition and Compactness on an Integrated Linkage Map Of Oil Palm Interspecific Backcross 2 (BC2)
Authors: Yaakub Zulkifli , Kamaruddin Katialisa , Singh Rajinder , Mustafa Suzana , Marjuni Marhalil , Ting Ngoot-Chin , Amiruddin Mohd Din , Leslie Low Eng-Ti , Cheng-Li Ooi Leslie , Sritha Kandha , Nookiah Rajanaidu , Jansen Johannes , Abdullah Meilina Ong
Published: August 2019

Background
Molecular breeding has opened new avenues for crop improvement with the potential for faster progress. As oil palm is the major producer of vegetable oil in the world, its improvement, such as developing compact planting materials and improving its oil’s fatty acid composition, is important.

Results
This study sought to identify the QTLs associated with fatty acid composition and vegetative traits for compactness in the crop. It integrated two separate interspecific backcross two (BC2) mapping populations to improve the genetic resolution and evaluate the consistency of the QTLs identified. A total of 1,963 markers (1,814 SNPs and 149 SSRs) spanning a total map length of 1793 cM was integrated into a consensus map. The QTL analysis observed 19 and 10 significant genomic loci associated with FAC and compactness, respectively.

Conclusions
A few genomic regions were revealed to be major loci influencing FAC and compactness. It is hoped that the QTLs identified will be useful tools for marker-assisted selection, accelerate the process of identifying desirable genotypes for breeding.
Investigation of Recombinant Tissue Plasminogen Activator Complications in Treatment of patients with ischemic stroke visiting Vali-e-Asr hospital in Birjand, 2016-2017
Authors: Riasi Hamid Reza , Zarei Elham , Salehi Forod , Sayehmiri Fatemeh
Published: August 2019

Background: Current treatment options for the sake of treating acute ischemic stroke include recombinant tissue plasminogen activator or dual anti platelet therapies. This study aims to evaluate the complications of recombinant tissue plasminogen activator in treatment of patients with ischemic stroke who were admitted in Vali-e-Asr hospital in Birjand, 2016-2017. Method: This descriptive analytic study was performed on patients with acute ischemic stroke who were admitted in neurology ward of Vali-e-Asr hospital in Birjand from 2016 to 2017. A total of 127 patients participated in this study. The data about complications of treatment were collected by questionnaires and entered into SPSS 21. Then, data were analyzed by Chi-square or Fisher exact test at a significant level of p≤ 0.5. Results: A total of 127 subjects received treatment for ischemic stroke. Thirty-one (24.4%) patients have been treated with recombinant tissue plasminogen activator and ninety-six (75.6%) have been treated conventionally with dual antiplatelet. These two groups were matched in terms of age and sex. The history of hypertension in the recombinant tissue plasminogen activator group and the conventional treatments were 32.3% and 67.7%, respectively (p=0.03). 99% of patients in the antiplatelet treatment group (N=96) and 96.8% of patients in the recombinant tissue plasminogen activator group (N=31) have been discharged and one death was occurred in each group (p=0.4). Regarding the incidence of recombinant tissue plasminogen activator complications, IVH was reported in two patients (6.5%, p = 0.06) Conclusion: The incidence of mortality was the same in two groups. Also, complications were only reported in two patients in the recombinant tissue plasminogen activator group (both intraventricular hemorrhage) and the difference was not statistically significant. Researchers recommend that more clinical trials must be conducted. If it is approved, the findings of the current studies will be widely taken into consideration for acute stroke treatment.
Reinterpretation, reclassification, and its downstream effects: Challenges for clinical laboratory geneticists
Authors: Mecky Julia el , Johansson Lennart , Plantinga Mirjam , Fenwick Angela , Lucassen Anneke , Dijkhuizen Trijnie , Hout Annemieke van der , Lyle Kate , Langen Irene van
Published: August 2019

Background. In recent years, the amount of genomic data produced in clinical genetics services has increased significantly due to the advent of next-generation sequencing. This influx of genomic information leads to continuous changes in knowledge on how genetic variants relate to hereditary disease. These changes can have important consequences for patients who have had genetic testing in the past, as new information may affect their clinical management. When and how patients should be recontacted after new genetic information becomes available has been investigated extensively. However, the issue of how to handle the changing nature of genetic information is significantly underexplored in a laboratory setting, despite it being the first stage at which changes in genetic data are identified and managed. Methods. The authors organized a 7-day online focus group discussion in which all Dutch molecular genetics diagnostic laboratories were represented. Results. Laboratories in our study reinterpret genetic variants reactively, e.g. at the request of a clinician or following identification of a previously classified variant in a new patient. Participants currently deemed active, periodic reinterpretation to be unfeasible and opinions differed on whether it is desirable, particularly in regard to patient autonomy and the main responsibilities of the laboratory. The efficacy of reinterpretation was questioned in the presence of other strategies, such as reanalysis and resequencing of DNA. Despite absence of formal policy regarding when to issue a new report for clinicians due to reclassified genetic data, participants indicated similar practice across all laboratories. However, practice differed significantly between laboratory geneticists regarding the reporting of VUS reclassifications. Conclusion. Based on the results, the authors formulated five challenges needing to be addressed in future laboratory guidelines: 1. Should active reinterpretation of variants be conducted by the laboratory as a routine practice? 2. How does reinterpretation initiated by the laboratory relate to patient expectations and consent? 3. When should reinterpreted data be considered clinically significant and communicated from laboratory to clinician? 4. Should reinterpretation, reanalysis or a new test be conducted? 5. How are reclassifications perceived and how might this affect laboratory practice?
Incidence of hypoxemia in a post-anaesthesia care unit and relevant risk factors: a retrospective study of 14604 patients with general anaesthesia
Authors: Tang Shuai , Zhang Liangyan , Han Wei , Xue Yang , Tian Yi , Zhang Xiuhua , Huang Yuguang
Published: August 2019

Background This article is aim to investigate the incidence and risk factors for postoperative hypoxemia in a post-anaesthesia care unit (PACU). Methods The retrospective cohort assessed 14604 postoperative patients who were admitted to PACU between January 2015 and December 2015. A pulse oximeter was used to monitor and record pulse oxygen saturation (SpO2) every 5 minutes. Clinical data were collected for all these patients, and the incidence of and risk factors for postoperative hypoxemia were analysed. Results The total incidence of hypoxemia was 21.83% (SpO2 ≤ 95%) and 2.79% (SpO2 ≤ 90%). Multiple regression analysis indicated that the risk factors were age ≥50-year old, body mass index (BMI) ≥25kg/m2, American Society of Anaesthesiologists (ASA) II and III, limb surgery, and thoracic surgery. Conclusions Therefore, hypoxemia was common in postoperative patients in the PACU. Age, BMI, ASA classification, and surgical site are associated with postoperative hypoxemia. More attention should be paid to these patients to prevent hypoxemia in the PACU.
PROtective Ventilation with a low versus high Inspiratory Oxygen fraction(PROVIO) and its effects on postoperative pulmonary complications:protocol for a randomized controlled trial
Authors: Li Xue-Fei , Jiang Dan , Jiang Yu-Lian , Yu Hong , Jiang Jia-Li , He Lei-Lei , Yang Xiao-Yun , Yu Hai
Published: August 2019

Background: Postoperative pulmonary complications (PPCs) is the most common perioperative complication following surgical site infection (SSI), which prolongs the hospital stay and increases health care cost. Lung-protective ventilation strategy is considered better practice in abdominal surgery to prevent PPCs. However, the role of inspiratory oxygen fraction (FiO₂) in the strategy remains disputable. Previous trials have focused on reducing SSI by increasing inhaled oxygen concentration but higher FiO₂ (80%) was found to be associated with a greater incidence of atelectasis and mortality in recent researches. The trial aims at evaluating the effect of different FiO₂ added to lung-protective ventilation strategy on the incidence of PPCs during general anesthesia for abdominal surgery.
Methods: PROtective Ventilation with a low versus high Inspiratory Oxygen fraction trial（PROVIO）is a single-center, prospective, randomized, controlled trial planning to recruit 252 patients undergoing abdominal surgery lasting for at least 2 hours. The patients will be randomly assigned to (1) a low FiO₂ (30% FiO₂) group and (2) a high FiO₂ (80% FiO₂) group in lung-protective ventilation strategy. The primary outcome of the study is the occurrence of PPCs within the postoperative 7 days. Secondary outcomes include the severity grade of PPCs, the occurrence of postoperative extrapulmonary complications and all-cause mortality within the postoperative 7 and 30 days.
Discussion: PROVIO trial assesses the effect of low versus high FiO₂ added to lung-protective ventilation strategy on PPCs for abdominal surgery patients and the results will provide practical approaches to intraoperative oxygen management.
Trial registration number: Registered at www.ChiCTR.org.cn on 13 February 2018 with identifier no. ChiCTR18 00014901. Keywords: Postoperative pulmonary complications, Lung-protective ventilation, Fraction of inspired oxygen, Abdominal surgery.
The prevalence of HIV among MSM in China: a large-scale systematic analysis
Authors: Dong Mengjie , Peng Bin , Liu Zhen-Feng , Ye Qian-ni , Liu Hao , Lu Xi-Li , Zhang Bo , Chen Jia-Jia
Published: August 2019

Background：The prevalence of HIV among men who have sex with men (MSM) has become a significant public health challenge. The aim was to comprehensively estimate the national prevalence of HIV among MSM and its time trends through a large-scale systematic analysis.
Methods：Systematic search of Cochrane Library, PubMed, EMBASE, CNKI, VIP, and Wanfang Data databases without language restriction for studies on the prevalence of HIV among MSM published before Dec.31, 2018. Studies were eligible for inclusion if they were published in the peer-reviewed literature and used validated assessment methods to assess the prevalence of HIV among MSM. Estimates were pooled using random-effects analysis.
Results：Data were extracted from 355 cross-sectional studies (571,328 individuals) covered 59 cities from 30 provinces and municipalities of China. The overall national prevalence of HIV among MSM from 2001 to 2015 was estimated to be 5.7% (95% CI: 5.4–6.1%), with high between-study heterogeneity (I2 = 98.0%, P < 0.001). Our study showed an increased tendency in the HIV prevalence as time progressed by meta-regression analysis (I2= 95.9%, P<0.0001). HIV prevalence was the highest in those aged 50 years and older with HIV prevalence of 19.3% (95%CI: 13.1-27.4%, N=13). HIV was more prevalent in the illiterate population (16.8%), than in those who had received an education. Although the internet was a major venue for Chinese MSM seeking male sex partners (35.6%, 95%CI: 32.3%-39.9%, N=101), seeking MSM in bathhouses/saunas had the highest associated prevalence of HIV (13.4%, 95%CI: 10.3%-17.1%, N=22). The HIV prevalence among MSM varied by location: compared with other regions in China, HIV was highly prevalent among MSM in the southwest (10.7%, 95%CI: 9.3%-12.2%, N=91). Compared to participants who sometimes or always used condoms, participants who had never used a condom in the past 6 months had a higher risk of HIV infection, with odds ratios of 0.1 (95%CI: 0.08-0.14).
Conclusions：Our analysis provided reliable estimates of China’s HIV burden among MSM, which appears to present an increasing national public health challenge. Effective government responses are needed to address this challenge and include the implementation of HIV prevention.
Using a Hepatitis B surveillance system evaluation in Fujian, Hainan, and Gansu Provinces to improve data quality and assess program effectiveness, China, 2015
Authors: Zheng Hui , Millman Alexander J. , Rainey Jeanette J. , Wang Fuzhen , Zhang Rui , Chen Hong , Yin Zundong , Wang Huaqing , zhang Guomin
Published: August 2019

Background: Monitoring hepatitis B surveillance data is important for evaluating progress towards global hepatitis B elimination goals. Accurate classification of acute and chronic hepatitis infections is essential for assessing program effectiveness.
Methods: We evaluated hepatitis B case-reporting at six hospitals in Fujian, Hainan and Gansu provinces in 2015 to assess the accuracy of case classification. We linked National Notifiable Disease Reporting System (NNDRS) HBV case-reports with hospital information systems and extracted information on age, gender, admission ward and viral hepatitis diagnosis from medical records. To assess accuracy, we compared NNDRS reported case-classifications with the national HBV case definitions. Multivariable logistic regression was used to identify factors associated with misclassification.
Results: Of the 1,420 HBV cases reported to NNDRS, 23 (6.5%) of the 352 acute reports and 648 (60.7%) of the 1,068 chronic reports were correctly classified. Of the remaining, 318 (22.4%) were misclassified and 431 (30.4%) could not be classified due to the lack of supporting information. Based on the multivariable analysis, HBV cases reported from Hainan (aOR=1.8; 95% CI: 1.3-2.4) and Gansu (aOR=12.7; 95% CI: 7.7-20.1) along with reports from grade 2 hospitals (aOR=1.6; 95% CI:1.2-2.2) and those from non-HBV related departments (aOR=5.3; 95% CI: 4.1-7.0) were independently associated with being ‘misclassified’ in NNDRS.
Conclusions: We identified discrepancies in the accuracy of HBV case-reporting in the project hospitals. Onsite training on the use of anti-HBc IgM testing as well as on HBV case definitions and reporting procedures are needed to accurately assess program effectiveness and ensure case-patients are referred to appropriate treatment and care. Routine surveillance evaluations such as this can be useful for improving data quality and monitoring program effectiveness.
Benchmarking Variant Identification Tools for Plant Diversity Discovery
Authors: Wu Xing , Heffelfinger Christopher , Zhao Hongyu , Dellaporta Stephen L.
Published: August 2019

Background The ability to accurately and comprehensively identify genomic variations is critical for plant studies utilizing high-throughput sequencing. Most bioinformatics tools for processing next-generation sequencing data were originally developed and tested in human studies, raising questions as to their efficacy for plant research. A detailed evaluation of the entire variant calling pipeline, including alignment, variant calling, variant filtering, and imputation was performed on different programs using both simulated and real plant genomic datasets. Results A comparison of SOAP2, Bowtie2, and BWA-MEM found that BWA-MEM was consistently able to align the most reads with high accuracy, whereas Bowtie2 had the highest overall accuracy. Comparative results of GATK HaplotypCaller versus SAMtools mpileup indicated that the choice of variant caller affected precision and recall differentially depending on the levels of diversity, sequence coverage and genome complexity. A cross-reference experiment of S. lycopersicum and S. pennellii reference genomes revealed the inadequacy of single reference genome for variant discovery that includes distantly-related plant individuals. Machine-learning-based variant filtering strategy outperformed the traditional hard-cutoff strategy resulting in higher number of true positive variants and fewer false positive variants. A 2-step imputation method, which utilized a set of high-confidence SNPs as the reference panel, showed up to 60% higher accuracy than direct LD-based imputation. Conclusions Programs in the variant discovery pipeline have different performance on plant genomic dataset. Choice of the programs is subjected to the goal of the study and available resources. This study serves as an important guiding information for plant biologists utilizing next-generation sequencing data for diversity characterization and crop improvement.
Transcriptome changes reveal the genetic mechanisms of the reproductive plasticity of workers in lower termites
Authors: Ye Chenxu , Rasheed Humaira , Ran Yuehua , Yang Xiaojuan , Xing Lianxi , Su Xiaohong
Published: August 2019

Background: The reproductive plasticity of termite workers provides colonies with tremendous flexibility to respond to environmental changes, which is the basis for evolutionary and ecological success. Although it is known that all colony members share the same genetic background and that differences in castes are caused by differences in gene expression, the pattern of the specific expression of genes involved in the differentiation of workers into reproductives remains unclear. In this study, the isolated workers of Reticulitermes labralis developed into reproductives, and then comparative transcriptomes were used for the first time to reveal the molecular mechanisms underlying the reproductive plasticity of workers.
Results: We identified 38,070 differentially expressed genes and found a pattern of gene expression involved in the differentiation of the workers into reproductives. 12,543 genes were specifically upregulated in the isolated workers. Twenty-five signal transduction pathways classified into environmental information processing were related to the differentiation of workers into reproductives. Ras functions as a signalling switch regulates the reproductive plasticity of workers.The catalase gene which is related to longevity was up-regulated in reproductives.
Conclusion: We demonstrate that workers leaving the natal colony can induce the expression of stage-specific genes in the workers, which leads to the differentiation of workers into reproductives and suggests that the signal transduction along the Ras-MAPK pathway crucially controls the reproductive plasticity of the workers. This study also provides an important model for revealing the molecular mechanism of longevity changes.
Investigation of the kieserite–szomolnokite solid-solution series, (Mg,Fe)SO4·H2O, with relevance to Mars: Crystal chemistry, FTIR, and Raman spectroscopy under ambient and martian temperature conditions
Authors: Talla Dominik , Wildner Manfred
Published: August 2019

The investigation of hydrous sulfate deposits and sulfate-cemented soils on the surface of Mars is one of the important topics in the recent scientific endeavor to retrieve detailed knowledge about the planetary water budget and surface weathering processes on our neighbor planet. Orbital visible/near-IR spectra of the surface of Mars indicate kieserite, MgSO4·H2O, as a dominant sulfate species at lower latitudes. However, given the Fe-rich composition of the martian surface, it is very probable that its actual composition lies at an intermediate value along the solid-solution series between the kieserite and szomolnokite (FeSO4·H2O) end-members. Despite the known existence of significant lattice parameter changes and spectral band position shifts between the two pure end-members, no detailed crystal chemical and spectroscopic investigation along the entire kieserite–szomolnokite solid solution range has been done yet.

The present work proves for the first time the existence of a continuous kieserite–szomolnokite solid-solution series and provides detailed insight into the changes in lattice parameters, structural details, and positions of prominent bands in FTIR (5200–400 cm–1) and Raman (4000–100 cm–1) spectra in synthetic samples as the Fe/Mg ratio progresses, at both ambient as well as Mars-relevant lower temperatures. Additionally, an UV-Vis-NIR (29 000–3500 cm–1) crystal field spectrum of szomolnokite is presented to elucidate the influence of Fe2+-related bands on the overtone- and combination mode region.

The kieserite–szomolnokite solid-solution series established in this work shows Vegard-type behavior, i.e., lattice parameters as well as spectral band positions change along linear trends. The detailed knowledge of these trends enables semi-quantitative estimations of the Fe/Mg ratio that can be applied to interpret martian monohydrated sulfates in data from remote sensing missions on a global scale as well as from in situ rover measurements. Given the knowledge of the surface temperature during spectral measurements, the established temperature behavior allows quantitative conclusions concerning the Fe/Mg ratio. Our understanding of the kieserite–szomolnokite solid-solution series will be well applicable to the Mars 2020 and ExoMars 2020 rover missions that will focus on near IR (0.9 to 3.5 μm) and, for the first time on Mars, Raman spectroscopy.
Change of crackling noise in granite by thermal damage: Monitoring nuclear waste deposits
Authors: Xie Kainan , Jiang Xiang , Jiang Deyi , Xiao Yang , Chen Shiwan , Dahmen Karin A. , Vives Eduard , Planes Antoni , Salje Ekhard K.H.
Published: August 2019

High-sensitivity detection of acoustic emission from granite under uniaxial stress, together with advanced statistical analysis, shows changing collapse mechanisms when a sample is pre-heated. Massive microstructural changes occur at temperatures >500 °C while low-temperature (<<500 °C) treatment leads to scale invariant crackling noise with a mixed fix-point behavior. After treatment at higher temperatures, the collapse occurs via acoustic signals that show energy distributions with systematic deviations from the Gutenberg-Richter law while the Omori's and Båth's laws are not influenced by the thermal treatment. The granite samples stem from the site in the Beishan mountains where a new burial site for nuclear waste will be constructed. According to the 13th Five-Year Plan of the P.R. China, Chinese nuclear power installed capacity will reach 58 million kilowatts in 2020 and produce about 3200 tons of high-level nuclear waste every year. Monitoring the stability of the host rock at high temperatures becomes hence a key issue. Our analysis can serve as a blueprint for a protocol for continuous monitoring of the burial site.
Listeria sp., en cantinas de almacenamiento de leche cruda de vaca en Tunja – Boyacá
Authors: Urbano-Cáceres Eliana , Aguilera-Becerra Astrid , Jaimes-Bernal Claudia , Pulido-Medellín Martín
Published: August 2019

Objetivo. Determinar la relación entre el tipo de detergente, el tiempo de uso de la cantina y el tipo de agua utilizada para lavado de las cantinas y la presencia de Listeria sp. en muestras recolectadas a partir de cantinas de almacenamiento de leche cruda de vaca, en fincas del municipio de Tunja-Boyacá-Colombia. Materiales y métodos. Se recolectaron 293 muestras mediante muestreo no probabilístico a conveniencia, en un periodo de nueve meses. El aislamiento de Listeria se realizó por métodos microbiológicos y la identificación de especies utilizando pruebas bioquímicas. Se aplicó un cuestionario para evaluar los factores asociados (tipo de detergente, tipo de agua y tiempo de uso de las cantinas). Resultados. La prevalencia de L. monocytogenes fue de 2.7% (n=8). No se encontró asociación estadísticamente significativa entre las variables relacionadas con la limpieza de las cantinas y la presencia de L. monocytogenes. Conclusiones. Se demostró la existencia de L.  monocytogenes en leche cruda, siendo la prevalencia encontrada inferior a las reportadas en estudios nacionales e internacionales. Se evidencia la circulación de especies de Listeria sp en la cadena productiva láctea del departamento de Boyacá. Por otra parte, es el primer panorama de L. monocytogenes y L. ivanovii mostrando la necesidad de la implementación de medidas de control en la industria láctea.
Metodos ultrassonográficos para la evaluación de testículos en gatos
Authors: Botelho Brito Marina , Maronezi Marjury Cristina , Uscategui Ricardo A R , Avante Michelle L , Simões Ana R , Monteiro Frederico O B , Feliciano Marcus A R
Published: August 2019

Los testículos son los principales órganos sexuales de los machos y su función es producir espermatozoides y hormonas sexuales. Los trastornos de estos órganos son comunes en gatos domésticos. La ultrasonografía convencional, combinada con el análisis hemodinámico en tiempo real por Doppler y ultrasonido contrastado son herramientas diagnósticas importantes para la evaluación de enfermedades testiculares en gatos. Además, La elastografía-ARFI es un método ecográfico actual que evalúa la elasticidad tisular por medio del elastograma y de la velocidad de propagación de las ondas de cizallamiento. El estudio ecográfico de los testículos es un procedimiento de diagnóstico por imágenes común.
Nursing Unit Communication During a US Public Health Emergency: Natural Experiment
Authors: Benham-Hutchins Marge , Carley Kathleen M , Brewer Barbara B , Effken Judith A , Reminga Jeffrey
Published: August 2019

Background

In the second half of 2014, the first case of Ebola virus disease (EVD) was diagnosed in the United States. During this time period, we were collecting data for the Measuring Network Stability and Fit (NetFIT) longitudinal study, which used social network analysis (SNA) to study relationships between nursing staff communication patterns and patient outcomes. One of the data collection sites was a few blocks away from where the initial EVD diagnosis was made. The EVD public health emergency during the NetFIT data collection time period resulted in the occurrence of a natural experiment.

Objective

The objectives of the NetFIT study were to examine the structure of nursing unit decision-making and information-sharing networks, identify a parsimonious set of network metrics that can be used to measure the longitudinal stability of these networks, examine the relationship between the contextual features of a unit and network metrics, and identify relationships between key network measures and nursing-sensitive patient-safety and quality outcomes. This paper reports on unit communication and outcome changes that occurred during the EVD natural disaster time period on the 10 hospital units that had data collected before, during, and after the crisis period.

Methods

For the NetFIT study, data were collected from nursing staff working on 25 patient care units, in three hospitals, and at four data collection points over a 7-month period: Baseline, Month 1, Month 4, and Month 7. Data collection was staggered by hospital and unit. To evaluate the influence of this public health emergency on nursing unit outcomes and communication characteristics, this paper focuses on a subsample of 10 units from two hospitals where data were collected before, during, and after the EVD crisis period. No data were collected from Hospital B during the crisis period. Network data from individual staff were aggregated to the nursing unit level to create 24-hour networks and three unit-level safety outcome measures—fall rate, medication errors, and hospital-acquired pressure ulcers—were collected.

Results

This analysis includes 40 data collection points and 608 staff members who completed questionnaires. Participants (N=608) included registered nurses (431, 70.9%), licensed vocational nurses (3, 0.5%), patient care technicians (133, 21.9%), unit clerks (28, 4.6%), and monitor watchers (13, 2.1%). Changes in SNA metrics associated with communication (ie, average distance, diffusion, and density) were noted in units that had changes in patient safety outcome measures.

Conclusions

Units in the hospital site in the same city as the EVD case exhibited multiple changes in patient outcomes, network communication metrics, and response rates. Future research using SNA to examine the influence of public health emergencies on hospital communication networks and relationships to patient outcomes is warranted.