bluuebunny/crossref_metadata_2025 huggingface dataset:
Determinants of treatment outcomes of severe acute malnutrition among under-5 children in Yekatit 12 Hospital, Addis Ababa, Ethiopia: a retrospective cohort study
Authors: Kebede Mekonen Adimasu , Teshome Girum Sebsbie , Fenta Fkirtemariam Abebe , Getahun Melaku Bimerew
Published: May 2020

Background

Devastatingly, the number of children with SAM is still growing globally. Severe acute malnutrition is the third most common contributing factor to the deaths of under-5 children worldwide. According to the World Health Organization, severe acute malnutrition causes 1 million deaths annually via increased susceptibility to death from severe infection. Ethiopia is one of the countries with highest under-5 child mortality rate, with malnutrition underlying to 28% of all children deaths. In Ethiopia, some studies reported an alarming death and default rates which indicate the need for further study to assess contributing factors to the treatment outcomes of severe acute malnutrition. Therefore, the intention of this research is to determine the treatment outcomes of severe acute malnutrition and identify predictors of nutritional recovery.
Method:

A retrospective cohort study was conducted among 423 under-5 children with severe acute malnutrition. Logistic regression analysis was performed and an adjusted odd ratio with 95%CI was used to determine independent predictors.
Result

The overall recovery, death and default rates were 81.3%, 11.1% and 7.6% respectively. Age, vaccination status, HIV/AIDS, pneumonia, diarrhea and stunting were found to be significant independent predictors of treatment outcomes. The adjusted odd ratio (AOR) for nutritional recovery increased by 14.6% for every 1-month increase in child age (AOR = 1.146; 95%CI: 1.052–1.249). Regarding vaccination status, those under-5 children who were fully vaccinated for their age were about 4 time more likely to recover than their counterparts (AOR = 4.242; 95%CI: 1.566–11.491)
Conclusion

In conclusion, the overall nutritional recovery and default rate in this study were in the acceptable range of international standard even though the death rate was higher. Age and full vaccination were proven to increase nutritional recovery. Conversely, the presence of HIV/AIDS, pneumonia, diarrhea and stunting were proven to decrease nutritional recovery.
Study of The Influence of Chromium on A Cobalt Iron Alloy
Authors: mebrek smain , zergoug mourad , haine nacereddine
Published: May 2020

The present work comes within the framework of research of new materials, with improved properties, which could be an important key for innovative applications. For this purpose, two types of alloys, a binary (Fe, Co) and a ternary (Fe, Co, Cr), were first synthesized by mechanical grinding at high energy, varying the grinding time. In a second step, all the samples were subjected to various characterizations, a structural study (X-ray diffraction), a morphological study (scanning electron microscopy "SEM"), a magnetic characterization (the "VSM" vibrating sample magnetometer And finally, an electrical study (eddy currents). Numerous and valuable information was then deduced to know the variations in the average lens size, the internal micro deformation, the cell parameter, the saturation magnetization, the remnant field, the coercive field as well as the Z impedance, according to a only parameter, the grinding time.
The region ahead of the pancreas is a suitable place for performing endoscopic ultrasound-guided gastroenterostomy: from clinical data to swine trial
Authors: Hu Jinlong , Wang Guoxin , Gao Haixin , Sheng Shiyun , Sun Siyu
Published: May 2020

Background and Aims: Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is a minimally invasive treatment for gastric outlet obstruction that results in a low incidence of recurrence. This is the first study to investigate a suitable position for performing EUS-GE. Methods: We reviewed the clinical data from 20 upper gastrointestinal examinations and 20 computed tomography scans of the abdomen and hypothesized that the posterior wall of the stomach was a suitable place to perform EUS-GE. We verified this hypothesis by performing an animal study using 5 swine. Results: All retrievable anchor assisted EUS-GE were successfully performed at the intestinal region that was proximal to the head of the pancreas. The mean procedure time of EUS-GE was 28.4 ± 3.85 minutes (range of 22–32 minutes). There were no adverse events, such as bleeding. Necropsy of the animals showed that all of the stents were in the correct position. The mean distance between the site of gastroenterostomy and pylorus was 34.6 ± 3.58 cm (range of 30–38 cm). Conclusions: The intestinal region that was proximal to the head of the pancreas was a suitable place for performing endoscopic ultrasound-guided gastroenterostomy. The suitability of this location should be confirmed by further animal and clinical studies.
Potentially repurposable drugs for COVID-19 identified from SARS-CoV-2 Host Protein Interactome
Authors: Karunakaran Kalyani B. , Balakrishnan N. , Ganapathiraju Madhavi
Published: May 2020

We previously presented the protein-protein interaction network (‘HoP Interactome’) of 332 host proteins that were identified to interact with 27 nCoV19 viral proteins by Gordon et al. Here, we studied drugs targeting the proteins in this interactome to identify whether any of them may potentially be repurposable against SARS-CoV-2. We studied each of the drugs using the BaseSpace Correlation Engine and identified those that induce gene expression profiles negatively correlated with SARS/COVID-associated expression profile. This analysis resulted in 24 drugs whose differential gene expression (drug versus normal) had an anti-correlation with differential expression for SARS/COVID-19 (viral infection versus normal). These included drugs that were found to be effective against SARS-CoV-2 in cell-based assays, those that are being tested for their clinical activity against SARS-CoV-2 by others, those with proven activity against SARS-CoV/MERS-CoV, broad-spectrum antiviral drugs, and those identified/prioritized by other computational re-purposing studies. In summary, our integrated computational analysis of the HoP interactome in conjunction with drug-induced transcriptomic data resulted in drugs that may be repurposable for COVID-19.
Effects of prophylactic atropine in prevention of spinal anesthesia induced hypotension and bradycardia in geriatrics undergoing urological surgeries at a resource limited setting in Central Ethiopia, 2018; prospective cohort study.
Authors: Taye Moges Gelaw , Haddis Lidya , Abrar Meron , Aregawi Adugna , Melese Eyayalem
Published: May 2020

Background: Spinal anesthesia induced hypotension and bradycardia are common and hazardous in elderly patients. Many techniques are being tried to prevent and treat these problems even if there is a controversy. The effects of prophylactic atropine on prevention of spinal anesthesia induced hypotension and bradycardia in geriatrics for urologic surgeries are not well-established. Objective: To assess the effects of prophylactic atropine in prevention of spinal anesthesia induced hypotension and bradycardia in geriatrics undergoing urological surgeries at a resource limited setting in Central Ethiopia from December 1, 2017 to February 28, 2018 G.C. Methods: This is a prospective cohort study that recruits 76 patients who underwent elective urological surgeries. Independent t-test and Manny Whitney tests were used for numeric data while Chi-Square or Fisher exact test was used for categorical variables. P-values < 0.05 were considered as statistically significant. Results: There was no significant difference in baseline heart rate, mean arterial pressure, type & duration of surgery and total fluid administrations. There was a statistically significant difference in mean heart rate and mean arterial pressure at different times of measurement between the exposed and un-exposed groups. Total one hour vasopressor consumption was minimal in the exposed group (P = 0.038). Conclusion: Prophylactic atropine with in one minute of induction of spinal anesthesia in elderly patients undergoing urological surgery might reduce the incidence of hypotension and bradycardia.
Down-regulation of the Genome Uncoupled 4 Retards Starch Biosynthesis in Rice
Authors: Li Ruiqing , Jiang Meng , Zhang Huali
Published: May 2020

BackgroundStarch is the major storage carbohydrate in rice, with essential physical functions for plant growth. The starch biosynthesis in rice employs the cooperation of nucleus and plastid, which requires regulation of the signals from nucleus to plastid. However, the plastid-to-nucleus retrograde signals for starch biosynthesis is partly mediated by tetrapyrrole intermediates, i.e., heme, but the underlying mechanism is largely unknown. In previous studies, we revealed that the Genome Uncoupled 4 (OsGUN4) mutation in rice have been revealed to greatly affect tetrapyrrole intermediates but retain a high photosynthetic capacity. ResultsHere, we further found that down-regulation of OsGUN4 promoted to accumulate sucrose but reduce the total starch, attributing to abnormal performance of metabolisms and enzyme activities of starch biosynthesis in leaves of gun4epi. Besides, the exogenous sucrose led to induced starch synthesis but reduced sucrose contents in wild-type, while norflurazon(NF) treatments could eliminate or weaken these inductions. Nevertheless, no changes were detectedbetween check and sucrose treatments in the gun4epi,whereas NF treatment enhanced the trends of increased sucrose but reduced starch,suggesting the roles of OsGUN4 on balance of photosynthesis and starch biosynthesis. Dynamic activity changes of starch biosynthetic enzymes were in accordance with the contents of carbon metabolites. Moreover, RNA sequencing revealed that a great deal DEGs were associated with starch metabolic pathways, with 62 genes being up-regulated and 25 down-regulated in gun4epi. Many genes involved in starch biosynthesis performed down-regulated expression, including the transcription factor of bZIP58 and its target genes of OsBEIIb and OsSSI, which are vital for the formation of amylopectin and starch granules, while displayed up-regulatedexpression of OsSSIIIa and OsGBSSI that promotes the formation of amylose. ConclusionIn conclusion, these findings confirm that OsGUN4 play regulatory roles on biosynthetic genes and enzyme activity in starch biosynthesis.
The clinical implication of secondary pulmonary bacterial infection for the outcome of critically ill patients with Covid-19
Authors: Xiong Wei , Li Xiaojing , Wang Yahua , Zhan Zhihua , Xia Jiaan , Wu Chaomin , Han Fengfeng , Guo M.D. Xuejun , Xu Mei , Zhao Yunfeng
Published: May 2020

Background Covid-19 is an emerging and evolving infectious and communicable diseases which gravely endanger the lives of critically ill patients with it. It is crucial to determine the clinical implication of secondary pulmonary bacterial infection for the outcome of critically ill patients with severe Covid-19.Methods All critically ill patients with Covid-19(30 deceased and 35 discharged) between January 26, 2020 and March 15, 2020 in two ICUs of Jinyintan Hospital, Wuhan, China, were retrospectively reviewed, to investigate the clinical implication of secondary pulmonary bacterial infection in the prognosis of critically ill patients with severe Covid-19.Results The fatality rate between patients with positive and negative sputum bacterial culture is 75.0%vs 33.3% (P = 0.003). The ROC analyses demonstrate that NLR[0.921(0.858–0.984)P༜0.001], CRP[0.908(0.837–0.978)P༜0.001],neutrophil[0.832(0.728–0.937)P༜0.001],lymphocyte[0.858(0.755–0.960)P༜0.001],leucocyte[0.753(0.626–0.879)P༜0.001] and PCT [0.733(0.605–0.860)P = 0.001] have the discrimination power for the fatality. The Kaplan-Meier analyses show that the patients with negative sputum bacterial culture(P༜0.001) have higher cumulative overall survival rates, in comparison with the opposite. The positive sputum bacterial culture is positively correlated with leukocyte(r = 0.706), CRP(r = 0.733), NLR(r = 0.554) and PCT(r = 0.549)(all P༜0.001). A multivariate Cox regression analysis shows that sputum bacterial culture[15.36(4.291–54.980) P༜0.001], CRP[2.022(2.013–2.030) P༜0.001] and NLR[2.012(2.000-2.024) P = 0.045] are positively correlated with the fatality of the patients.Conclusions The critically ill patients with severe Covid-19 who are complicated with secondary pulmonary bacterial infection may have an unfavorable outcome, in comparison with those who are not. Secondary pulmonary bacterial infection is an independent factor for the fatality of critically patients with Covid-19.
Sleeping with Tuberculosis: Do over-crowded university hostels in Kenya increase TB transmission among youths - A pilot study
Authors: Teresia Maina , Annie Willets , Moses Ngari , Abdullahi Osman
Published: May 2020

Background

Understanding the magnitude of Tuberculosis (TB) transmission among the youth is a global priority as the disease burden shifts to this population. Learning institutions host overcrowded accommodation and classrooms, especially in resource limited contexts. Understanding the global threat of the youth as an infection pool on the wider population is highlighted in the global response to COVID 19. This pilot study aimed to test the feasibility of recruiting university students’ contacts and demonstrate transmission of TB in Pwani University, Kilifi County-Kenya.
Materials and Methods

A pilot study among Pwani University TB index cases receiving treatment at the Kilifi County Hospital was conducted. Index cases who consented provided information about their household and social contacts. Contacts were identified and screened using a World Health Organization (WHO) symptom-based questionnaire. Their sputum samples were analysed using GeneXpert. Multivariate log-binomial regression was used to determine demographic and clinical characteristics associated with TB infection among contacts with TB index patients.
Results

A total of 51 index cases were recruited, median (IQR) age of 21 (20–23) years and 31 (61%) were males. 156 contacts were screened, median (IQR) age of 23 (20–23) years, 80 (51%) were males and 76 (49%) were household contacts. Among the 156 TB contacts, 5 participants were confirmed positive for TB: prevalence of 3.2% (95% CI 1.0 to 7.3%). 8/156 (5.1%, (95% CI 2.2 to 10%) contacts, had clinical diagnosed TB despite having a negative GeneXpert result. In total 13/156 contacts had either confirmed or clinical diagnosed TB; 8.3% (95% CI 4.5 to 14%). Sharing a bed with an index case was the only factor significantly associated with TB infection among the five contacts with GeneXpert diagnosed TB.
Conclusion

Students sleeping in crowded hostels promote TB transmission within universities informing TB control interventions. Collaborating with existing national TB programme systems is a feasible approach to recruit people with active disease and their social contacts. Expansion of this approach to a larger population of students with TB infection may demonstrate the magnitude of TB transmission within universities, and the wider local communities.
Identification of Risk Factors for in-Hospital Death of COVID - 19 Pneumonia
Authors: Wang Zhigang , Wang Zhiqiang
Published: May 2020

Objective: To examine the clinical characteristics and identify independent risk factors for in-hospital mortality of 2019 novel coronavirus (COVID-19) pneumonia.Methods: A total of 156 patients diagnosed with COVID-19 pneumonia at the central Hospital of Wuhan from January 29, 2020, to March 20, 2020 were enrolled in this single-centered retrospective study. Their epidemiological parameters, clinical presentations, underlying diseases, laboratory test results and disease outcomes were collected and analyzed.Results: The median age of enrolled patients was 66. Underlying diseases were identified in 101 patients, with hypertension being the most common one, followed by cardiovascular disease and diabetes. The most common symptoms identified upon admission were fever, cough, dyspnea and fatigue. Compared to survival cases, patients who dead during hospitalization had higher plasma levels of D-dimer, creatinine, creatine kinase, lactate dehydrogenase, lactate and lower percentage of lymphocytes (LYM [%]), platelet count and albumin levels. Most enrolled patients received anti-biotics and anti-viral treatment. In addition, 60 patients received corticosteroid and 51 received intravenous immunoglobulin infusion. 44 patients received noninvasive ventilation, 19 received invasive ventilation. Respiratory failure was the most frequently observed complication (106 [67.9%]), followed by sepsis (103 [66.0%]), acute respiratory distress syndrome (ARDS) (67 [42.9%]) and septic shock (50 [32.1%]). Multivariable regression suggested that advanced age (OR [odds ratio]= 1.059, 95% CI [confidence interval]: 1.011-1.110, P= 0.016) and elevated lactate level upon admission (OR= 2.411, 95% CI: 1.177-4.941, P= 0.016) were independent risk factors for in-hospital mortality for COVID-19 infection. Meanwhile, increased LYM (%) at admission (OR= 0.798, 95% CI: 0.728-0.876, P< 0.001) indicated a better prognosis. Conclusions: In this study, we discovered that age, LYM (%) and lactate level upon admission were independent factors that could influence in-hospital mortality rate.
Work related injury and its disparity across selected occupations in Ethiopia: systematic review and meta-analysis
Authors: Gietaneh Wodaje , Simieneh Muluye Molla , Alene Muluneh , Asemie Moges Agazhe , Shitu Daniel
Published: May 2020

BackgroundGlobally, work related injury has been continued as a major public health problem. In Ethiopia there are few fragmented empirical studies particularly among workers of fast growing sectors and there is no a national representative study on work related injury. Therefore, this study aims to determine the magnitude of occupational injury and to identify its predictors among construction, textile and municipal solid waste management workers in Ethiopia.Objectiveto determine magnitude of Work related injury and its disparity across selected occupations in EthiopiaMethod:Both published and unpublished articles conducted in Ethiopia on work related injury were searched between the periods 12 October, 2019 to 15 December, 2019. Random effect model was employed to estimate the overall magnitude of occupational injury and its predictors.ResultsThe overall magnitude of work related injury was 39.35% (95% CI: 27.40, 51.30%). Subgroup analysis revealed that there was slight disparity across occupations and regions. Drinking alcohol, smoking cigarette, khat chewing habit, work related stress, level of education and utilization of PPE were significantly associated with work related injury.ConclusionThis study found that more than 1 in 3 workers had at least one occupational injury at work. There was slight disparity across occupations and regions. It is strongly recommend that health education programs about the risk of substance use on occupational injury and apply strict occupational safety practices regulations should be strengthened.
Analysis of renal function in a Health Examination Population in Chengdu (2012-2018)
Authors: Li Rui-Cen , Bao Ting , Yang Han-Wei , Xu Wang-Dong , Tang Huai-Rong
Published: May 2020

Background Dysfunction of kidney correlates with multiple renal diseases, for instance, chronic kidney disease. However, monitoring the changes of indexes related to renal function may help to early find the potential patients with renal diseases. Methods A cohort of 14,716 participants (8,148 males and 6,568 females) was recruited from the Health Examination Center at West China Hospital, Sichuan University, and was followed up since 2012 to 2018. Four indexes related to renal function, including creatinine (Cr), uric acid (UA), cystatin C (CysC) and urea nitrogen (UN) were selected to monitor the kidney function. Results Levels of CysC, Cr were reduced, and expression of UA was increased in all the participants since 2012 to 2018 overall. In addition, levels of CysC, UA, Cr and UN were higher in males than those in females, and expression of the four indexes was up-regulated in the elderly population compared with those in the younger population since 2012 to 2018 overall. Conclusions The findings suggested that some preventive action may be adopted early and more attention can focus on the health-examination population.
Gender differentials on productivity of rice farmers in south-western Nigeria: An Oaxaca-Blinder decomposition approach
Authors: Ojo Temitope Oluwaseun , Danso-Abbeam Gideon , Ogundeji Abiodun A
Published: May 2020

One of the critical constraints hindering the transformation of African agriculture in general, and Nigerian agriculture in particular, is gender disparities in productivity. This study, therefore, examines gender inequality in farm productivity and sources of the productivity differentials among rice farmers in Nigeria, using the Oaxaca-Blinder (OB) gender decomposition model. The results revealed an uneven situation between men and women, leading to a gender productivity gap of about 29% in favour of men. Thus, female-managed plots are 29% less productive than male-managed plots. The decomposition of the sources of gender productivity differences shows that marital status, education, farm size and access to market information are the significant determinants of the endowment factor that contribute to about 15% of the productivity gap. The study, therefore, concludes that gender productivity inequalities exist in the Nigerian agricultural sector, hence, paying attention to these productivity gaps and factors contributing to these gaps is crucial in formulating policy interventions oriented towards women empowerment.
An interaction effect analysis of thermodilution-guided hemodynamic optimization, patient condition, and mortality among successful cardiopulmonary resuscitation patients
Authors: Kovács Enikő , Gyarmathy V. Anna , Pilecky Dávid , Fekete-Győr Alexandra , Szakál-Tóth Zsófia , Gellér László , Hauser Balázs , Gál János , Merkely Béla , Zima Endre
Published: May 2020

Background

Post-cardiac arrest syndrome and target temperature management have an influence on hemodynamics in a complex way. Proper hemodynamic monitoring is necessary among post-cardiac arrest patients. The aim of our study was to investigate the effects of PiCCO™-guided hemodynamic management on short- and long-term mortality in post-resuscitation therapy and to disentangle the relationship between PiCCO™-application, the patients' condition, and mortality by assessing it as an interaction effect.
Methods

In this longitudinal analysis of 63 comatose patients after successful cardiopulmonary resuscitation cooled to 32–34˚C, 30 patients received no PiCCO™ monitor application and 33 received PiCCO™. Primary and secondary outcomes were 30-day and one-year mortality. Kaplan-Meyer curves and corresponding Log-rank tests were used to assess differences in mortality among PiCCO™ vs non-PiCCO™ patients. Interaction effects (patient`s condition vs. PiCCO™ application vs. mortality) were assessed by means of Chi-square tests and logistic regression models.
Results

30-day mortality was significantly, and one-year mortality was marginally higher among PiCCO™ patients. We found five interaction patterns between patients’ condition and being monitored with PiCCO™ with regard to mortality after 30 days, which distilled down to three interaction patterns by the end of the first year. More severe patient condition per se was not the cause of higher mortality rate in the PiCCO™ group. Moreover, patients in better health conditions (without ST-elevation myocardial infarction, without cardiogenic shock, without intra-aortic balloon pump device or without stroke in prior history) had worse outcomes in PiCCO™-guided therapy. Furthermore, catecholamine administration worsened both 30-day and one-year mortality among all patients.
Conclusions

Our analysis showed that there was a complex interaction relationship between PiCCO™-guided therapy, patients’ condition, and 30-day mortality for most conditions. Furthermore, in terms of one-year mortality, there was either no benefit whatsoever of PiCCO™ monitoring on survival or there was worse survival among patients who had no underlying conditions but received PiCCO™ (such as among patients who had no STEMI or had no stroke).
WITHDRAWN: Dynamic Analysis of Bevel Gear System in Main Retarder
Authors: Wang Xinbo , Zhu Xuebin , Song Xiaobo , Wang Di , Liu Qing , Cheng Kaihua
Published: May 2020

The main retarder of vehicle is gear rotor system, its vibration property is complex. The whole transfer matrix method is a new algorithm to study, relationship of the displacements and forces are established considering gyroscopic moment and coupling vibration. The meshing point between rotors is treated as coupling element, balance equations are estalished on deformation compatibility condition. The globe status vectors including forces and displacements of all shafts were integrated into a whole transfer matrix. So it can be programming and has high numerical stability and accuracy. The influence of the meshing effect on vibration of the system can be systematically studied. The status vectors such as displacements, deflection angles, torsion angles, shearing forces, bending moments and torques are no longer independent. The vibration property of the geared rotor system was calculated and analyzed. The numerical results revealed that many coupling critical rational speeds of the system are derived. vibration of main retarder can be improved.
The Influence of Ion Diffusion on Dielectric Properties of (Ba,Sr)TiO3-Based Composite Ceramics
Authors: Wang Wei , Xin Le , Ren Luchao , Shen Shiting , Jin Jingjing , Zhai Jiwei , Zhang Mingwei
Published: May 2020

The (Ba,Sr)TiO3-based composite ceramics, which exhibited different doping effect, were prepared via a solid-state sintering process. The doping and composite effects of different dielectrics on dielectric properties were studied. It has been found that dielectric properties were closely related to the variation of Tc caused by ion diffusion. The diffusion of dielectric phase ions into BST matrix was mainly responsible for degraded tunability and quality factors (Q). Ion diffusion has little effect on the dielectric properties of the system in which Tc moves to high temperature with the increase of dielectric content. All of these systems have a low degree of ion diffusion. Therefore, high tunability under low dielectric permittivity can be realized in these systems. The degradation of dielectric properties caused by ion diffusion can be effectively inhibited by selecting the dielectric material with special structure, and the composite ceramics with excellent comprehensive performance can be obtained. There existed percolation characteristic to deteriorate tunability at high dielectric content.
Interactions between anti-EGFR therapies and cytotoxic chemotherapy in oesophageal squamous cell carcinoma: Why clinical trials have failed and how they could succeed
Authors: Meemanage Madusha , Spender Lindsay C , Collinson Diane , Iannetta Joanna , Challapalli Pranavi , Turbitt Julie , Clark Caroline , Baxter Mark , Murray Graeme , Walsh Shaun , Miedzybrodzka Zofia , Petty Russell
Published: May 2020

BACKGROUND

Oesophageal squamous cell carcinoma (ESCC) has high mortality and poor prognosis. Advanced tumours are treated with fluoropyrimidine/platinum chemotherapy (PBC) followed by second-line irinotecan or taxane monotherapy, but resistance is common and new therapeutic approaches are needed. Approximately 20% of ESCC tumours carry copy number gain (CNG) of the epidermal growth factor receptor (EGFR) gene. Previous analysis of randomised clinical trials shows that anti-EGFR monotherapy benefits biomarker-selected patients with EGFR CNG and/or high expression by Immunohistochemistry (IHC). However, responses are often of short duration indicating that combining anti-EGFR therapy with other agents is required to optimise the benefit from anti-EGFR therapies even in biomarker selected patients. Randomised clinical trials have not shown benefit from the addition of anti-EGFR therapies to platinum fluoropyrimidine chemotherapy and uncertainty remains regarding the optimal cytotoxic chemotherapy partner for anti-EGFR therapies in ESCC.
METHODS

The effects of EGFR CNG on sensitivity to PBC in a cohort of gastroesophageal cancer patients (n = 302) was evaluated. Drug combination studies using the EGFR inhibitor gefitinib with cytotoxic chemotherapies, docetaxel, cisplatin, oxaliplatin and irinotecan, on cell proliferation and cell death of EGFR CNG ESCC cell lines were assessed.
RESULTS

EGFR CNG in gastroesophageal cancer patients was associated with better overall survival following platinum-based chemotherapy. Drug combination studies showed that co-administration of gefitinib and platinum-based cytotoxics was frequently antagonistic in cell-based assays in EGFR CNG ESCC, whereas the combination of gefitinib with docetaxel or irinotecan was more efficacious. Co-administration of gefitinib/docetaxel and sequential administration of docetaxel before gefitinib showed synergy, but docetaxel given after gefitinib was antagonistic.
CONCLUSIONS

Gefitinib/docetaxel co-administration demonstrated synergy and taxanes are likely to provide the most effective cytotoxic chemotherapy partner for anti-EGFR therapies in EGFR CNG-positive advanced ESCC. Combination of gefitinib and platinum-based cytotoxics was antagonistic suggesting anti-EGFR therapies might reduce anti-cancer effects of chemotherapy which could provide a key explanation for the lack of benefit for the addition of anti-EGFR therapies to PBC in randomised clinical trials. Our data suggest that the combination of docetaxel with anti-EGFR therapies, with careful consideration of dosing schedules, should be evaluated in advanced EGFR CNG-positive and/or IHC high EGFR expressing ESCC.
Medication Overuse Withdrawal in Children and Adolescents does not Always Improve Headache: A Cross-Sectional Study
Authors: Moavero Romina , Stornelli Maddalena , Papetti Laura , Ursitti Fabiana , Ferilli Michela Ada Noris , Balestri Martina , Sforza Giorgia , Tarantino Samuela , Vigevano Federico , Valeriani Massimiliano
Published: May 2020

Background. MOH can be diagnosed in subjects with headache occurring 15 days/month in association with a regular medication overuse, but its existence is not universally accepted. ICHD-3 redefined criteria for MOH, removing the criterion associating drug suspension with headache course. Aim of our study was to compare the rate of patients diagnosed with medication overuse headache (MOH) according to ICHD-2 and ICHD-3 criteria, to verify the degree of concordance. Secondary aim was to verify if drug withdrawal was really associated with pain relief.Methods. In this cross-sectional study, we retrospectively analyzed a sample of 400 patients followed for primary chronic headache at the Headache Center of Bambino Gesù Children’s Hospital. We then selected those presenting with a history of medication overuse, and we applied both ICHD-2 and ICHD-3 criteria to verify in which patients the criteria would identify a clinical diagnosis of MOH.Results. We identified 42 subjects (10.5%) with MOH; 23 of them (55%) presented a relief of headache withdrawing drug overuse. Regarding the applicability of the ICHD-2 criteria, 43% of patients (18/42) fulfilled all criteria, while all ICHD-3 diagnostic criteria were satisfied in 76% of patients (32/42). Eighteen patients (43%) satisfied both ICHD-2 and ICHD-3 criteria, while 10 patients (24%) did not satisfy either diagnostic criteria.Conclusions. Our study suggests that in children and adolescents withdrawing medication overuse is not always associated with a clinical benefit. Therefore, though allowing a MOH diagnosis in a higher rate of patients as compared to ICHD-2, the application of ICHD-3 criteria does not guarantee a true a causal relationship between medication overuse and headache worsening.
Cancer-driven IgG promotes the development of castration-resistant Prostate Cancer though the SOX2-CIgG pathway
Authors: Qin Caipeng , Sheng Zhengzuo , Huang Xinmei , Tang Jingshu , Liu Yang , Xu Tao , Qiu Xiaoyan
Published: May 2020

Background: Although Androgen deprivation therapy (ADT) is the initial treatment strategy for prostate cancer, recurrent castration-resistant prostate cancer (CRPC) eventually ensues. In this study, cancer-derived immunoglobulin G(CIgG) was found to be induced after ADT, identifying CIgG as a potential CRPC driver gene.Methods: The expression of CIgG and its clinical significance in prostate cancer tissue was analyzed by TCGA database and immunohistochemistry. Subsequently, the sequence features of prostate cell line (LNcap, DU145, PC3) VHDJH rearrangements were analyzed via comparison with the best matching functional germline IgVH, IgDH and IgJH genes. We also assessed the effect of CIgG on the migratory, invasive and proliferative abilities of prostate cancer cells in vitro and vivo. Cells with high CIgG expression (CIgGhigh) and low CIgG expression (CIgG-/low) from the PC3 cell line were sorted by FACS using a CIgG monoclonal antibody named RP215, then, suspended microsphere, colony formation and drug-resistant assays were performed. A NOD/SCID mouse tumor xenograft model was developed for the study of the tumorigenic effects of the different cell populations. The AR-SOX2-CIgG signaling pathway was validated by immunohistochemistry, immunofluorescence, qRT-PCR, Western blot, luciferase and ChIP assays and bioinformatics analyses. Finally, we investigated the effect of RP215 inhibition on the progression of prostate cancer in vivo using a Babl/c nude mouse xenograft model.Results: We demonstrated that CIgG was induced by androgen deprivation therapy (ADT) and upregulated by SOX2 [SRY (sex determining region Y)-box 2] in prostate cancer, which may promote the development of CRPC. In addition, our findings underscore a novel role of CIgG signaling in the maintenance of stemness and the progression of cancer through MARK/ERK and AKT in prostate cancer.Conclusion: Our data suggests that CIgG could be a driver of CRPC development, and that targeting the SOX2-CIgG axis may therefore inhibit CRPC development after ADT.
Geohazards Affecting Cultural Heritage Monuments. A Complex Case Study From Romania
Authors: Ilies Dorina Camelia , Caciora Tudor , Herman Grigore Vasile , Ilies Alexandru , Ropa Madalina , Baias Stefan
Published: May 2020

The impact that geohazards have on cultural heritage requires continuous research in order to assess risks, prevention and conservation. This study has as the main research object, a uniquen monument in terms of its connection with the risk phenomena. It is about a wooden church historical monument from the village of Corbești, Romania, which was destroyed at the beginning of the tenth decade of the last century by a meteorological hazard, later reconstructed on a new site (in Oradea Municipality), and currently there is a risk of being affected by a geological hazard. The study focused on three main directions of research, namely: reconstructing the film of events, analyzing current risks and finding viable methods for future conservation and promotion. The methodology is based on extensive field research and the use of digital technologies. The results obtained confirmed the church's tendency to be affected by the emergence of a new risk phenomenon - landslides. In order to conserve and rebuild in case of need, the monument was digitized and a three-dimensional model of high accuracy was developed. This approach has the advantage of being low-cost, fast, non-invasive and providing large volumes of valuable information in the process of cultural heritage conservation.
The Global State and Development Trends of Research in Periprosthetic Joint Infection: A Bibliometric and Visualized Study
Authors: Zhang Haitao , Fan Yinuo , Xin Pengfei , Cao Houran , Feng Wenjun , Li Jie , Deng peng , Zeng Jianchun , Zeng Yirong
Published: May 2020

Background: Periprosthetic Joint Infection (PJI) remains a great challenge for joint orthopedic surgeons. The purpose of this study is to identify promising research directions by comprehensively analyze the global status and development trend of research in PJI based on bibliometrics and visual analysis.Methods: Overall the literature about PJI from 1994 to 2020 was searched from Web of Science Core Collection (WOSCC). The extracted data (author, journal, institution, country or region, research orientation, support fund, Cited situation) were analyzed by bibliometrics. VOSviewer was used for bibliographic coupling, co-citation, co-authorship, co-occurrence analysis. According to the results of visual analysis, this paper explores the global status and hot prediction direction of PJI.Results: A total of 2,283 eligible publications were retrieved. In terms of the trend of previous years, an increasing number of PJI publications will be published. Among the countries in the world, the United States has the largest contribution to the field of PJI. Although “Journal of Arthroplasty” has published the largest number of articles, the most influential journal is "Clinical Orthopaedics and Related Research”. Thomas Jefferson University has the largest number of publications of any organization. The study of PJI can be divided into four clusters: "Study on diagnosis", "Related risk factors", "Study on treatment", and "Study on anti-biofilm in vitro". The diagnosis and risk factors of PJI is considered to be a hot direction in the future direction.Conclusions: In recent years, the literature related to PJI has presented a continuous growth trend. The United States is the largest contributor to this field. More attention should be paid to the diagnostic and risk factors of PJI, which may be the future hot spots in this field.
In Vitro Activity of Methylene Blue on Mycobacterium Tuberculosis Complex Isolates
Authors: GAZEL Deniz
Published: May 2020

Background: Methylene blue (MB) is used for bacterial staining, and as an antidote drug. We aimed to investigate the antimicrobial effects of MB against Mycobacterium tuberculosis complex clinical isolates. Methods: Seventeen stored Mycobacterium tuberculosis complex isolates were inoculated into Mycobacteria Growth Indicator Tubes (MGIT) and incubated in Automated Mycobacterial Detection System (AMDS). MGIT tubes containing MB blue at concentrations of 0.2, 2, 20, 1000 µg ml-1 and control were prepared. Antibiograms were performed using AMDS. Results: Six isolates were susceptible to MB at all concentrations and five were susceptible to only 1000 µg ml-1 MB. Three isolates were susceptible to 1000 and 20 µg ml-1 MB. Susceptibility rate was found 94% when the critical concentration was accepted 400 GU (1/100 of control). Conclusions: MB may become an alternative anti-tuberculosis agent especially in the topical form of this drug due to their well-known side effects and dosing regimens.
CT Protocols for Attenuation Correction and Segmentation in 99mTc-MAA SPECT/CT for 90Y Radioembolization Treatment Planning – a Simulation Study
Authors: Lu Zhonglin , Mok Greta S. P.
Published: May 2020

Background Conventional 99mTc-macroaggregated albumin (99mTc-MAA) planar scintigraphy overestimates lung shunt fraction (LSF) as compared to SPECT/CT in 90Y radioembolization treatment planning. However, the respiratory motion artifact due to the temporal mismatch between static SPECT and helical CT (HCT) may compromise the SPECT quantitation accuracy by incorrect attenuation correction (AC) and volume-of-interest segmentation. The goal of this study is to systematically assess different AC and segmentation protocols for LSF, tumor-to-normal liver (TNR), organ absorbed dose and injected activity (IA) estimation in 99mTc-MAA SPECT/CT.Methods The 4D XCAT phantom was used to simulate 10 patient anatomies with 99mTc-MAA distribution based on the clinical data, each with LSF of 5%, 10%, 15% and 20%, axial respiratory motion of 2 cm, different TNR and tumor size. An analytical projector for low energy high resolution parallel-hole collimator was used to simulate realistic noisy planar acquisitions, and 128 projections over 360o for SPECT, both modeling attenuation, scatter and geometric collimator-detector-response. Five attenuation maps, i.e., (i) HCT at end-inspiration (HCT-IN), (ii) HCT at mid-respiration (HCT-MID), (iii) HCT at end-expiration (HCT-EX), (iv) cine averaged CT (CACT) and (v) interpolated average CT (IACT) were applied for SPECT AC and segmentation in LSF, dosimetric and IA evaluation. Mid-respiratory phases were also extracted from CACT/IACT for VOI segmentation while CACT/IACT were used for AC, i.e., hybrid CT protocols.Results For LSF estimation, SPECT/CACT has the least absolute errors. Planar significantly overestimates LSF and lung absorbed dose compared to SPECT especially for LSF of 5%. SPECT-based is better than CT-based segmentation in TNR estimation. There is no statistically significant difference for different CT protocols for TNR, normal liver and tumor absorbed dose estimation. Hybrid CTs and HCT-MID performed the best for IA especially for higher LSF.Conclusions 99mTc-MAA SPECT/CT with an appropriate choice of CT protocol for AC and segmentation is superior to planar in LSF and lung absorbed dose estimation. The 4D CT protocols are recommended for AC and segmentation to alleviate respiratory artifacts and improve quantitation accuracy in 90Y radioembolization treatment planning. HCT-EX would also be a recommended choice if 4D CT is not available.
Integrating Quantitative and Qualitative Approaches to Explore Absenteeism Attributed to Air Pollution and its Attributed Direct and Indirect Costs Among Private Sector Companies in Ulaanbaatar, Mongolia
Authors: Ganbat Mandukhai , Erdenebileg Nasantogtokh , Batbold Chuluunbileg , Nergui Saruul , Anderson Ron , Heikens Alex , Sarantuya Moiltmaa , Wigfall Clarence , Warburton David
Published: May 2020

Background Ulaanbaatar, Mongolia, the coldest national capital city, has the highest winter seasonal mean concentrations of PM2.5 and PM10. During January, the coldest month, peak pollution levels are > 8 times higher than the World Health Organization (WHO) guideline values are reached, on average, 15.7 times. Over 80% of this seasonal air pollution is due to domestic heating with coal stoves in large ger residential communities that surround much of the city. This report presents an analysis of the direct and indirect costs of wintertime seasonal air pollution due to the absenteeism of private-sector employees.Methods Questionnaire data were obtained for 1330 employees working for private sector companies over six economic sectors. To assess employee’s direct and indirect costs, healthcare-related costs such as cost per hospitalization, medication, and outpatient visits were calculated using the Cost-of-Illness approach. Non-healthcare costs, such as transportation and food, were also estimated in the study. Individual Indirect costs were calculated with the Human Capital Approach, which estimates the hours of work lost by the person due to disease and then multiplies total lost hours by the hourly wage.Results Approximately 60% of employee absences occurred during the coldest and hence most air polluted time of 4 months of the year from November to February. Female employees were proportionately more likely to be absent than their male counterparts. Individual direct healthcare costs attributed to air pollution related-sickness absences totaled 1,005,000₮ ($361.50) per year due to being absent from work an average of 3 days three times during the winter in Ulaanbaatar. The median cost of lost wages for 3 days’ absence is 120,000₮ ($43.20).Conclusions We conclude that wintertime pollution has a major impact on absenteeism rates among private-sector employees, and therefore, we postulate that this must be a significant driver of opportunity costs, affecting not only corporate bottom lines but also employees.
Global COVID-19 spread: socioeconomic determinants and lessons for future pandemics
Authors: Ngepah Nicholas
Published: May 2020

This paper examines some factors that can complement public health systems in managing the spread of the COVID-19 with implications for preparedness towards possible future pandemics. It adapts and applies two suitable econometric models in the theoretical framework of social determinants of health. The one models are the Poisson’s Pseudo Maximum Likelihood (PPML) and the quantile estimator, applied to panel data for 195 countries over days of infection from first recorded case. The COVID-19-related data is from our world in data, and the socioeconomic variables are from the World Bank’s World Development indicators. The results suggest that enhancing capacity for early testing complemented by reduction of international exposure; improved management of population dynamics; ensuring better sanitation and hygiene practices and reducing alcohol use are key to addressing the rapid spread of the COVID-19, and readiness for future pandemics of similar a kind.
An increased pretreatment neutrophil-to-lymphocyte ratio predicts severe novel coronavirus-infected pneumonia
Authors: Wang Xiaoyue , Jiang Desheng , Huang Huang , Chen Xiaofeng , Zhou Chunlei , Jiao Dongsheng , Fan Ping , Cui Qian , Liao Hui , Shi Binbin
Published: May 2020

Objective The aim of this study was to identify early warning signs for severe novel coronavirus-infected pneumonia (COVID-19).Methods We retrospectively analyzed the clinical data of 90 patients with COVID-19 at the Guanggu District of Hubei Women and Children Medical and Healthcare Center comprising 60 mild cases and 30 severe cases. The demographic data, underlying diseases, clinical manifestations and laboratory blood test results were compared between the two groups. Logistic regression analysis was performed to identify the independent risk factors that predicted severe COVID-19. The receiver-operating characteristic (ROC) curve of independent risk factors was calculated, and the area under the curve (AUC) was used to evaluate the efficiency of the prediction of severe COVID-19.Results The patients with mild and severe COVID-19 showed significant differences in terms of cancer incidence, age, pretreatment neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP) and the serum albumin (ALB) level (P<0.05). The severity of COVID-19 was correlated positively with the comorbidity of cancer, age, NLR, and CRP but was negatively correlated with the ALB level (P<0.05). Multivariate logistic regression analysis showed that the NLR and ALB level were independent risk factors for severe COVID-19 (OR=1.319, 95% CI: 1.043-1.669, P=0.021; OR=0.739, 95% CI: 0.616-0.886, P=0.001), with AUCs of 0.851 and 0.128, respectively. An NLR of 4.939 corresponded to the maximum joint sensitivity and specificity according to the ROC curve (0.700 and 0.917, respectively).Conclusion An increased NLR can serve as an early warning sign of severe COVID-19.
A Simple Botanical Key to Several Forage and Weedy Grass Seedlings For Use in a Student Laboratory Exercise
Authors: George J. R. , Pepper G. E.
Published: May 2020

A dichotomous key using vegetative characteristics permits identification of grasses before emergence of inflorescences. Nine forage species and seven weedy grasses commonly found in the northern U. S. are described. Simplicity in design and terminology makes this key useful either as a laboratory exercise in crop science classes or by individuals wishing to evaluate a new forage seeding. Isolated plants can also be identified, or established stands can be evaluated before flowering. The use of potted specimens from the greenhouse and seedlings grown in the laboratory sandbench increases the effectiveness of this botanical key as an instructional tool.