bluuebunny/crossref_metadata_2025 huggingface dataset:
Long non-coding RNA H19 deficiency ameliorates bleomycin-induced pulmonary inflammation and fibrosis
Authors: WAN XIAOYU , TIAN XINBEI , DU JUN , LU YING , XIAO YONGTAO
Published: October 2020

Background: The poor understanding of pathogenesis in idiopathic pulmonary fibrosis (IPF) impaired development of effective therapeutic strategies. The aim of the current study is to investigate the roles of long non-coding RNA H19 (lncRNA H19) in the pulmonary inflammation and fibrosis of IPF. Methods: Bleomycin was used to induce pulmonary inflammation and fibrosis in mice. The mRNAs and proteins expression in lung tissues was determined by quantitative real-time polymerase chain reaction (qRT-PCR) and western blot. H19 knockout (H19-/-) mice were generated by CRISPR/Cas9.Results: The expression of H19 mRNA was up-regulated in fibrotic lungs patients with IPF as well as in lungs tissues that obtained from bleomycin-treated mice. H19-/- mice suppressed bleomycin-mediated pulmonary inflammation and inhibited the Il6/Stat3 signaling. H19 deficiency ameliorated bleomycin-induced pulmonary fibrosis and repressed the activation of TGF-β/Smad and S1pr2/Sphk2 in the lungs of bleomycin-treated mice. Conclusions: Our data suggests that H19 is a profibrotic lncRNA and a potential therapeutic target for pulmonary fibrosis.
Negative correlation between concentration of iron oxides and particulate matter in atmospheric dust: case study at industrial site during smoggy period
Authors: Petrovsky Eduard , Kapicka Ales , Grison Hana , Kotlik Bohumil , Miturova Hana
Published: October 2020

Background: Environmental magnetism, focusing on ferrimagnetic iron oxides, provides useful additional information on pollution of different environments. Magnetic methods have been applied to studies of atmospheric dust, namely PM10 (particulate matter smaller than 10 micrometers) in, e.g., industrial or urban areas. Until now, positive correlation was reported between concentration of iron oxides (expressed in terms of either magnetic susceptibility, saturation remanent or saturation induced magnetization) and concentration of PM10 or smaller. Purpose of this study was to verify the relationship between iron oxides and PM at monitoring site close to source of emissions rich in iron oxides during period of smoggy conditions. Results: We examined 24-hours PM10 and PM1 samples, collected during 10 days of smoggy winter period at a site close to steel plant, which represents a significant source of atmospheric emissions in industrial region of Northern Moravia (Czech Republic), known for generally high degree of air pollution. Magnetic hysteresis loops were measured in order to obtain parameters reflecting the concentration and grain-size distribution of iron oxides. Our data show unexpected negative correlation between saturation magnetization (concentration of ferrimagnetic iron oxides) and both PM1 and PM10 concentrations, to the best of our knowledge the trend not being reported yet.Conclusions: Our finding may seemingly disqualify magnetic methods as useful proxy in air pollution studies. However, we suggest that this is an exceptional case, specific to this region and monitoring site, as well as to synoptic conditions during the smoggy period. Although the significant dust emissions are presumably rich in iron oxides, the overall air quality at the monitoring site is determined by the general environment, controlled by many other sources of different character in the region, and by the specific climatic conditions. Thus, the nearby steel plant, presumably emitting dust rich in ferrimagnetic iron oxides, dominates the deposited dust at the nearby monitoring site only during very few days of suitable weather (namely wind speed and direction).
Optimal timing of ureteroscopic lithotripsy after the initial drainage treatment and risk factors for postoperative febrile urinary tract infection in patients with obstructive pyelonephritis: a retrospective study
Authors: Itami Yoshitaka , Miyake Makito , Owari Takuya , Iwamoto Takashi , Gotoh Daisuke , Momose Hitoshi , Fujimoto Kiyohide , Hirao Shuya
Published: October 2020

Background: A history of preoperative obstructive pyelonephritis has been reported as a risk factor for febrile urinary tract infection (fUTI) after ureteroscopic lithotripsy (URSL). But there is no clear evidence of risk factors for developing fUTI including the optimal timing of URSL after obstructive pyelonephritis treatment.

Methods: Of the 1361 patients, who underwent URSL at our hospital from January 2011 to December 2017, 239 patients had a history of pre-URSL obstructive pyelonephritis. The risk factors were analyzed by comparing the patients’ backgrounds with the presence or absence of fUTI after URSL. The factors examined were age, gender, body mass index, comorbidity, presence or absence of preoperative ureteral stent, stone position, stone laterality, stone size, Hounsfield unit (HU) value on computed tomography scan, history of sepsis during obstructive pyelonephritis, period from antipyresis to URSL, ureteral stenting period, operation time, and presence or absence of access sheath at URSL. In addition, the stone components and renal pelvic urinary culture bacterial species during pre-URSL pyelonephritis were also examined.

Results: Post-URSL fUTI developed in 32 of 239 patients (13.4%), and 11 of these 32 cases led to sepsis (34.4%). Univariate analysis showed that stone position, stone maximum HU value, presence of sepsis during obstructive pyelonephritis, period from antipyresis to URSL, pre-URSL ureteral stent placement, operation time were risk factors of fUTI. Stone components and urinary cultures during pyelonephritis were not associated with risk of fUTI. Multivariate analysis showed that renal stone position, pre-URSL ureteral stent placement > 21 days, and operation time > 75 minutes were independent risk factors of fUTI following the URSL.

Conclusions: F-UTI following the URSL could be avoided by ureteral stent placement period 21 days or less and operation time 75 minutes or less in patients with obstructive pyelonephritis.
BiCyCLE NMES - Neuromuscular Electrical Stimulation in The Perioperative Treatment of Sarcopenia and Myosteatosis in Advanced Rectal Cancer Patients: Design and Methodology of a Phase II Pilot Study
Authors: Pring Edward Tobias , Gould Laura Elizabeth , Malietzis George , Lung Phillip , Bharal Mina , Fadodun Tutuola , Bassett Paul , Naghibi Mani , Taylor Claire , Drami Ioanna , Chauhan Deeptika , Athanasiou Thanos , Street Tamsyn , Francis Nader K , Saxton John M , Jenkins John Taylor
Published: October 2020

Background Colorectal cancer is associated with secondary sarcopenia (muscle loss) and myosteatosis (fatty infiltration of muscle) and patients who exhibit these host characteristics have poorer outcomes following surgery. Furthermore, patients who undergo curative advanced rectal cancer surgery such as pelvic exenteration, are at risk of skeletal muscle loss due to immobility, malnutrition and a post-surgical catabolic state. Neuromuscular electrical stimulation (NMES) may be a feasible adjunctive treatment to help ameliorate these adverse side-effects. Hence, the purpose of this study is to investigate NMES as an adjunctive pre- and post-operative treatment for rectal cancer patients in the radical pelvic surgery setting and to provide early indicative evidence of efficacy in relation to key health outcomes. Method In a phase II, Double-blind, randomised controlled study, 58 patients will be recruited and randomised (1:1) to either a treatment (NMES plus standard care) or placebo (sham-NMES plus standard care) group. The intervention will begin two weeks pre-operatively and continue for eight weeks after exenterative surgery. The primary outcome will be change in mean skeletal muscle attenuation, a surrogate marker of myosteatosis. Sarcopenia, quality of life, inflammatory status and cancer specific outcomes will also be assessed. Discussion This pilot study will provide study important preliminary evidence of the potential for this adjunctive treatment. It will provide guidance on subsequent development of phase 3 studies on the clinical benefit of NMES for rectal cancer patients in the radical pelvic surgery setting. Trial Registration ClinicalTrials.gov Identifier: NCT04065984; Registered August 22, 2019; Recruiting.
Improving Diagnostic Ability And Confidence In Otoscopy Through A Supplementary Web Based Learning Platform: A Prospective Interventional Study
Authors: Azman Mawaddah , Rajasingam Devyadarsshni , Mokhtar Rahmi Hidayati Mohammad Mursal , Hamzah Amir Thaqiff , Iskandarrani Izzatul Ismah , Roslan Ainur Atikah , Besar Mohd Nasri Awang
Published: October 2020

Background Otoscopy is an important clinical skill to master in the undergraduate medical curriculum. This study investigated the effect of a supplementary web-based learning platform in improving diagnostic ability and confidence in otoscopy among final year medical undergraduates in Universiti Kebangsaan Malaysia Medical Centre (UKMMC).Methods A supplementary otoscopy training using a web-based learning platform was introduced to final year medical undergraduates who have completed a three-week posting in otorhinolaryngology. A total of 45 subjects who participated in the learning platform were included in this prospective interventional study. All of them answered questionnaires on level of confidence (LC) and completed online questions on diagnostic ability (DA) at three different timelines during the study: prior to intervention (T1), after intervention (T2) and 4 months following the intervention (T3).Results LC scores were significantly higher across the timelines measured: T1 vs T2 vs T3 respectively (p<0.05). DA scores were significantly higher across the timelines measured: T1 vs T2 vs T3 respectively (p<0.05). Both LC and DA scores showed sustained improvements at 4 months post intervention across both external auditory canal and tympanic membrane anatomical subsites. Conclusion Subjects’ level of confidence in performing otoscopy and diagnostic ability showed sustained improvements at 4 months with this intervention. We conclude that supplementary otoscopy training using a web based learning platform complements the teaching and learning of otoscopy among final year medical undergraduates.
Joint Optic Disc and Cup Segmentation Based on Densely Connected Depthwise Separable Convolution Deep Network
Authors: Liu Bingyan , Pan Daru , Song Hui
Published: October 2020

Background: Glaucoma is an eye disease that causes vision loss and even blindness. The cup to disc ratio (CDR) is an important indicator for glaucoma screening and diagnosis. Accurate segmentation for the optic disc and cup helps obtain CDR. Although many deep learning-based methods have been proposed to segment the disc and cup for fundus image, achieving highly accurate segmentation performance is still a great challenge due to the heavy overlap between the optic disc and cup. Methods: In this paper, we propose a two-stage method where the optic disc is firstly located and then the optic disc and cup are segmented jointly according to the interesting areas. Also, we consider the joint optic disc and cup segmentation task as a multi-category semantic segmentation task for which a deep learning-based model named DDSC-Net (densely connected depthwise separable convolution network) is proposed. Specifically, we employ depthwise separable convolutional layer and image pyramid input to form a deeper and wider network to improve segmentation performance. Finally, we evaluate our method on two publicly available datasets, Drishti-GS and REFUGE dataset. Results: The experiment results show that the proposed method outperforms state-of-the-art methods, such as pOSAL, GL-Net, M-Net and Stack-U-Net in terms of disc coefficients, with the scores of 0.9780 (optic disc) and 0.9123 (optic cup) on the DRISHTI-GS dataset, and the scores of 0.9601 (optic disc) and 0.8903 (optic cup) on the REFUGE dataset. Particularly, in the more challenging optic cup segmentation task, our method outperforms GL-Net by 0.7 % in terms of disc coefficients on the Drishti-GS dataset and outperforms pOSAL by 0.79 % on the REFUGE dataset, respectively. Conclusions: The promising segmentation performances reveal that our method has the potential in assisting the screening and diagnosis of glaucoma.
Dietary curcumin supplement promotes browning and energy expenditure in postnatal overfed rats
Authors: Zhu Xiaolei , Du Susu , Yan Qinhui , Min Cuiting , Zhou Nan , Zhou Wei , Li Xiaonan
Published: October 2020

Background: Early postnatal overfeeding could result in metabolic imprinting that decreases energy expenditure following with white adipose tissue (WAT) gain throughout life. This research was to investigate whether curcumin (CUR) supplement could promote WAT browning and activate thermogenesis in postnatal overfed rats.Methods and results: This study adjusted the size of litters to three (small litters, SL) or ten (normal litters, NL) to mimic early postnatal overfeeding or normal feeding from postnatal day 3. From postnatal week 3 (weaning period), the SL rats were fed with a standard diet (SL) or a diet supplemented with 1% (SL1% CUR) or 2% (SL2% CUR) CUR for ten weeks. At postnatal week 13, SL rats with 1% or 2% CUR supplement had lower body weight and less WAT gain, had increased lean mass ratio, and their glucose tolerance and blood lipid levels had recovered to normal when compared to SL rats that did not receive the supplement. Moreover, increased respiratory exchange ratio (RER) and heat generation were consistent with expression levels of uncoupling protein 1 (UCP1) and other browning-related genes in the subcutaneous adipose tissue (SAT) of the SL2% CUR rats but not of the SL1% CUR rats. In addition, 2% CUR dietary supplement enhanced the serum norepinephrine (NE) levels in SL rats, with the upregulated mRNA levels of β3-adrenergic receptor (β3-AR) in SAT.Conclusion: Dietary CUR supplement attenuates body weight gain and metabolic disorders in SL, which might be induced by promoting browning of SAT and energy expenditure. Moreover, the benefits were more obvious in SL with 2% CUR supplement.
Effect of Massage Before or After Exercise on Delayed-onset Muscle Soreness in a Rat Model
Authors: Wei Qing-bo , Zhao Qian , Gu Jialing , Lin Jia , Zhu Yan , Song Ziqi , Li Fenglei
Published: October 2020

Background. Delayed-onset muscle soreness (DOMS), also known as tenderness of touch, refers to the pain caused by muscle mechanical stimulation, such as contraction and stretching. Chinese massage has been widely used in the treatment of sports fatigue and sports injury, but there is controversy in the efficacy. In this experiment, we established DOMS model in rats to observe the prevention and treatment effect of massage, to find the best time for intervention, and to provide scientific basis for the prevention and treatment of exercise fatigue.Methods. 130 male SD(sprague-dawley, SD) healthy rats were randomly divided into blank group, control group and massage group. Except for blank group, the other rats received DOMS model. Professionals applied kneading and twisting methods on both lower limbs of rats. The expression of IL-2, IL-6 and IL-8 in skeletal muscle of rats were determined by western blot, PCR and ELISA, and the content of serum creatine kinase was determined by ELISA. In addition, we measured the concentration of Ca2+, Ca2+-ATPase in mitochondria of skeletal muscle. The changes of skeletal muscle structure were observed by scanning electron microscopy.Result. After massage, the expression of IL-2, IL-6, IL-8 and CK decreased compared with control group (P < 0.01), the expression of IL-2, IL-6 and IL-8 in post massage group was lower than that in front massage group (P < 0.01), and the content of CK in front massage group was lower than that in post massage group(P < 0.01). The content of Ca2+ in front massage 24, 48 and 72h group was lower than that in post massage (P < 0.01), the concentration of Ca2+-ATPase in front massage 24h and 72h group was lower than that in post massage group (P < 0.05).Conclusion. Massage can prevent the injury of muscle and reduce the inflammatory reaction of muscle after exercise. It can also improve the activity of Ca2+-ATPase, enhance the transport of Ca2+ by mitochondria and protect the skeletal muscle.
Chronic Kidney Diseases Among Homeless and Slum Dwellers in Accra: A Survey Study
Authors: Bawah Ahmed Tijani , Edufia Foster , Yussif Fatima Nasara , Adu Anastasia , Seini Mohammed Mustapha , Yakubu Yakubu A , Ussher Francis Abeku
Published: October 2020

Objective: This study aimed at determining the prevalence of chronic kidney disease (CKD) among homeless people in Nima and Agbogbloshie, Accra, Ghana and to evaluate the association between socio‑demographic characteristics and CKD. Results: Participants with normal serum creatinine (SCr), made up of 232 males and 280 females totaling 512 took part in the study. Those with normal glomerular filtration rate (GFR) were 86% and 84.6% by means of the C-G and MDRD equations respectively. According to the C-G formula, kidney damage and mild to severe renal insufficiency was found in 13.2% of the participants and 4 participants (0.8%) had renal failure. On the other hand, 15.4% of the participants were found to have some kidney damage and mild to severe renal insufficiency according to the MDRD formula with no participant suffering from kidney failure. The prevalence of renal dysfunction among the homeless Ghanaians was significant especially among those with hypertension, diabetes and human immunodeficiency syndrome virus (HIV) infection. . Intensive social support aimed at preventing and managing kidney disease is crucial if we are to reduce the incidence of kidney related illnesses in homeless people.
Factors Influencing in Early Childbearing and Its Consequences on Nutritional Status of Bangladeshi Mothers: Nationally Representative Data
Authors: Sumon Khirujjaman , Sayem Md. Abu , Ma Abu Sayed Md Al , Bharati Premananda , Chakrabarty Suman , Taleb Md. Abu , Hossain Md. Golam
Published: October 2020

Background: Early marriage and early pregnancy is a social as well as medical problem in developing countries, which may have an impact on health and nutritional status of teenage mothers. Therefore, the objective of this study was to determine the influencing factors of early childbearing (ECB) and its consequences on nutritional status of Bangladeshi mothers. Methods: Data was extracted from the last survey of Bangladesh Demographic and Health Survey (BDHS-2014). Women who delivered their first baby before their age 20 years are considered as ECB mothers. Nutritional status was measured by body mass index (BMI) which was categorized as (i) under nutrition (BMI<18.5 kg/m2), (ii) normal (18.5≤BMI<25 kg/m2) and (iii) over nutrition BMI≥25 kg/m2). Chi-square test and both univariable and multivariable logistic regressions, and z-proportional test were used in this study. Results: This study revealed that the prevalence of ECB among currently non-pregnant mothers in Bangladesh was 83% (urban: 77% and rural: 85.8%). A multivariable binary logistic regression model provided the following six risk factors of ECB: (i) living location (division), (ii) respondents’ education, (iii) husbands’ education, (iv) household wealth quintiles, (v) respondents’ age at first marriage, and (vi) number of family members. Still 17.6% mothers were undernourished in Bangladesh; among them 18.5% and 13.4% were ECB and non- ECB mothers respectively, while 25.5% mothers were over nourished. Univariable model demonstrated that ECB mothers had a greater risk to be undernourished than non-ECB mothers [COR=1.26, 95% CI: 1.11-1.43; p<0.01]. Conclusions: In this study, some modifiable factors were found as predictors of ECB in Bangladesh. ECB mothers were more prone to become under-nourished. These findings can be considered to reduce the number of ECB mothers in Bangladesh consequently to improve their nutritional status.
Climate change has increased genotype-environment interactions in wheat breeding
Authors: Xiong Wei , Reynolds Matthew , Crossa Jose , Payne Thomas , Schulthess Urs , Sonder Kai , Addimando Nicoletta , Singh Ravi , Ammar Karim , Gerard Bruno
Published: October 2020

The International Maize and Wheat Improvement Center (CIMMYT) develops and distributes annually elite wheat lines as international trials worldwide to assess their performance in different environments and utilization by partners for use in breeding or release as varieties. However, as elsewhere, the collaborator test sites where trials are evaluated have experienced climate change, with implications for how adapted wheat genotypes are bred. Using a standard quantitative genetic model and archived datasets for four global spring wheat trials, we show that the genotype-environment-interaction (GEI) has increased by up to 500% over recent decades. Notably crossover has increased over time, a critical indicator of changes in the ranking of cultivar performance in different environments. Climatic factors explain over 70% of the year-to-year variability in GEI and crossover interactions for yield. Examining yield responses of all genotypes in all trial environments from 1985 to 2017 reveals that climate change has increased GEI by ~ 49% and ranking change by ~38%. Genetic improvement of wheat targeted to high-yielding environments has exacerbated this increase, but the performance of new wheat germplasm developed to withstand heat and drought stress is more adapted and stable, offsetting the increase in ranking changes due to the warmer climate.
Prophylactic Gastrostomy in Locally Advanced Head and Neck Cancer: Results of A National Survey Among Radiation Oncologists
Authors: Dragan Tatiana , Duprez Fréderic , Gossum André Van , Gulyban Akos , Beauvois Sylvie , Digonnet Antoine , Lalami Yassine , Gestel Dirk Van
Published: October 2020

Background: Nutritional complications in patients with locally advanced head and neck cancer (LA-HNC) treated by concurrent chemoradiotherapy (CCRT) often lead to placement of a prophylactic gastrostomy (PG) tube, while indication lacks harmonization. Our aim was to explore the current PG tube utilization among Belgian radiation oncology centers.Methods: A survey was distributed to all 24 Belgian Radiation oncology departments, with questions about the number of patient treated per year, whether the PG indication is discussed at the multidisciplinary board, placement technique, time of starting nutrition and removal, its impact on swallowing function and importance of clinical factors. For the latter Relative Importance and Discordance Indexes were calculated to describe the ranking and agreement.Results: All 24 center submitted the questionnaire. Twenty three treat more than 20 head and neck (HNC) patients per year, while four (1 in 21-50; 3 in 51-100) are not discussing the gastrostomy tube indication at the multidisciplinary board. For the latter, endoscopic placement (68%) is the dominant technique, followed by the radiologic (16%) and laparoscopic (16%) methods. Seventy-five percent start the enteral nutrition when clinically indicated, 17% immediately and 8% from the start of radiotherapy. Majority of specialists (19/24) keep the gastrostomy tube until the patient assume an adequate oral feeding. Fifteen centres are considering PG decrease swallowing function. Regarding factors and their importance in the decision for the PG, foreseen irradiated volume reached highest importance, followed by ‘anatomical site’, ‘patients’ choice’ and ‘postoperative versus definitive’ and ‘local expertise’, with decreasing importance respectively. Disagreement indexes showed moderate variation.Conclusions: The use of a PG tube for LAHNC patients treated by CCRT shows disparity at national level. Prospective studies are needed to ensure proper indication of this supportive measure.
A Bronchoscopic Steam Thermal Ablation (BTVA) Case Report in A 85-Year-Old Male Clinically Compromised
Authors: Marchese Roberto , Scaduto Federica , Nigro Chiara Lo
Published: October 2020

Background: Bronchoscopic lung volume reduction (BLVR) techniques improve lung function and increase exercise tolerance in patients with chronic obstructive pulmonary disease (COPD) and BLVR treatment is included in the Global Initiative for Chronic Obstructive Lung Disease (GOLD) treatment guidelines for these patients. BTVA (Intervapor Uptake Medical, Tustin, CA, USA) represents a recent therapy of this group that allows to treat sublobar areas and for this reason is used clinically compromised patients, like in this case report.Case presentation: In this paper we describe a case report of an 85-year-old male with severe respiratory failure and a diagnosis of emphysema presented with dyspnea and clinical worsening, despite the best medical therapy practiced. For comorbidity and pathology’s features he was excluded from surgical treatment options, like lung volume reduction surgical (LVRS) and from positioning of endobronchial valves (EBV) for the presence of collateral ventilation and he was addressed to BTVA. The procedure was successful for this patient.Conclusions: This case supports recent suggestions that BTVA can be a good alternative treatment for patients properly selected.
Effect of Anticoagulant/Antiplatelet Therapy on the Development and Progression of Diabetic Retinopathy
Authors: Jeng Chi-Juei , Hsieh Yi-Ting , Lin Cheng-Li , Wang I-Jong
Published: October 2020

Background:We investigated whether antiplatelet/anticoagulant (APAC) therapy can protect patients with type 2 diabetes mellitus (T2DM) from the development or progression of diabetic retinopathy (DR).Methods:This is a prospective cohort study using Longitudinal Health Insurance Database in Taiwan. A total of 73964 type 2 diabetic patients ≥ 20 years old were included. The cumulative incidence of nonproliferative DR (NPDR) was estimated and plotted for APAC users and nonusers using Kaplan–Meier curves, and the difference was assessed using the log-rank test. Incidence of NPDR, proliferative diabetic retinopathy (PDR), and diabetic macular edema (DME) were calculated by dividing the number of NPDR, PDR, and DME events by the total person-years for each group. A Cox proportional hazards model was used to assess the effect as hazard ratios (HRs) and corresponding 95% confidence intervals (CIs), with APAC use considered as a time-dependent covariate. Factors significant in the univariate model were adjusted in a multivariable model, namely, age; sex; comorbidities of hypertension, dyslipidemia, diabetic nephropathy, diabetic neuropathy, heart disease, cardiovascular disease, and peripheral arteriolar disease; and medications such as statins and fibrates. Results:Compared with nonusers, APAC users also had a lower cumulative incidence of NPDR (P < 0.001), overall incidence of NPDR (10.7 per 1000 person-years), and risk of developing NPDR (adjusted HR = 0.78, 95% CI = 0.73–0.83). However, no significant differences were observed between APAC users and nonusers in the risks of PDR or DME.Conclusion:APAC medicationshave a protective effect against NPDR but not against PDR or DME.
Evaluation of Changes in the Ganglionic Cell Inner Plexiform Layer and Macular Retinal Nerve Fibre Layer in Patients Receiving Hydroxychloroquine
Authors: Saad Mouna Al , Shehadeh Amin , Ameerh Mohammed A. Abu , Meqbil Jehad , Qablawi Mohammad , AlRyalat Saif Al Deen , Elubous Khaled
Published: October 2020

Backgrounds: To evaluate changes in the thickness of ganglionic cell-inner plexiform layer and macular retinal nerve fiber layer using ocular coherence tomographyin patients exposed to hydroxychloroquine .Methods: This was a retrospective, cross-sectional study of patients on hydroxychloroquine therapy. Ocular coherence tomography images showing of ganglionic cell-inner plexiform cell layer and macular retinal nerve fiber layer thickness were obtained and compared to those of the control groups. The relationship between the thickness of of ganglionic cell-inner plexiform and macular retinal nerve fibre layer and the duration and cumulative dose of hydroxychloroquine was evaluated.Results: In all, 219 patients were included in this study; the mean age was 43.38 (±17.39) years. The study group comprised 100 (20 male and 80 female) patients, with a mean age of 45.28 (± 12.24) years; the control group had 119 patients (44 males and 75 females), with a mean age of 41.79 (± 20.67) years, with no significant difference in age between the groups (p = 0.123). There was a significant difference in mean of ganglionic cell-inner plexiform thickness between the study and control groups (85.6+/- 8 μm ) vs. (88.6+/-6 μm ) (p = 0.006), with a mean difference of 0.31 (95% confidence interval). The average RNFL thickness was similar in the study and control groups, 28.8±2.5 μm (range: 23 – 38) and 29.2±2.8 μm (range: 22 – 35) respectively, (p = 0.389). There was no significant correlation between of ganglionic cell-inner plexiform and macular retinal nerve fibre layer with daily dose (p = 0.229) or cumulative dose of hydroxychloroquine (p = 0.678). Conclusion : The average thickness of ganglionic cell -inner plexiform cell layer was significantly lower in those taking hydroxychloroquine than in controls. Thinning of this layer could be an early indicator of retinal toxicity before the appearance of clinical retinopathy. However, thickness of the macular retinal nerve fibre laye showed no decrease in hydroxychloroquine users and did not correlate with the duration or cumulative doses of hydroxychloroquine. Therefore, macular retinal nerve fibre layer thickness is not a useful biomarker for the early detection of hydroxychloroquine retinal toxicity.
Quantitative Analysis of Colistin-Resistant Escherichia Coli in Retail Meat from Local Vietnamese Markets
Authors: Nguyen Thang Nam , Khong Diep Thi , Le Ha Viet , Tran Hoa Thi , Phan Quang Ngoc , Le Huong Thi Thu , Kawahara Ryuji , Yamamoto Yoshimasa
Published: October 2020

Objective: The spread of drug-resistant bacteria via food has contributed to the dissemination of resistant bacteria among humans. However, the status of food contamination with resistant bacteria, particularly the level of resistant bacteria in food, have not yet been well elucidated.Results: In this study, the abundance of colistin-resistant Escherichia coli in meat samples was quantified to understand the origin of the contamination of meat available in local Vietnamese markets. Fifteen samples each of chicken and pork meat purchased from local Vietnamese markets were assessed for the presence of colistin-resistant E. coli with the mobile colistin resistance gene mcr. The results showed that 40% (6/15) and 66% (10/15) of the pork and chicken meat samples, respectively, were contaminated with colistin-resistant E. coli. The median levels of colistin-resistant E. coli in the contaminated pork and chicken samples were 1.8 × 104 and 4.2 × 103 CFU/g, respectively. The results of phylogenetic analysis of isolates from a chicken meat sample showed that the contaminated colistin-resistant E. coli were a mix of multiple phylogenetical clones of bacteria that may have multiplied during sale. This is the first study to quantify the abundance of colistin-resistant E. coli in meat samples.
Research, Development, and Evaluation of Application Effect of the in-out Storage Management System for Department Consumables
Authors: Luo Jiang , Zhao Fengying , Wang Yan , Zhang Yongze , Yan XiaoFang , Huang XiaoTing
Published: October 2020

Background: This study aimed to explore the research and development (R&D) and application of the in–out storage management system for departments to perform efficient, scientific, and information-based consumable management.Method: The expert and R&D teams of consumable management were set up, and the information-based in–out storage management system for consumables was designed and developed. Further, the system was tested, adjusted, and used. The system was operated on a personal computer. It was divided into three modules: public consumables, bed consumables, and quality control management, including the functions of in–out storage, early warning, query, and statistics of consumables. Economic indicators, work efficiency of consumable management, nurse burnout, consumable warehouse management, and satisfaction of the staff before and after the application of the management system were compared.Results: After 2 years of application of the management system, the daily price of department consumables per bed decreased from 53.43 ± 10.27 yuan to 31.98 ± 7.36 yuan, a decrease of 40.15%, saving the management cost of the department. The time spent on consumable management daily was shortened from 119.5 (106.75–123.5) min to 20 (17.25–24.25) min. The monitoring and control of the department consumables revealed that the matching between collection and use reached 95%–105%. The scores of emotional fatigue and job indifference of nurses decreased from 22.90 ± 1.65 and 8.75 ± 1.25 to 17.20 ± 2.04 and 6.00 ± 1.30, respectively. The number of monthly applications for consumable collection decreased by 75%, and the satisfaction of the warehouse keeper and collection staff increased from 76.62% and 80.78% to 98.8% and 98.5%, respectively. All the differences were statistically significant (P < 0.05).Conclusion: The in–out storage management system effectively improved the quality and efficiency of the consumable management of the department and promoted its scientific and standardized operation gradually.
Priority Setting in The Brazilian Emergency Medical Service: A Multi-Criteria Decision Analysis (MCDA)
Authors: Frazão Talita Dias Chagas , Santos Ana FA , Camilo Deyse GG , Junior João FC , Souza Ricardo Pires
Published: October 2020

Background: Multicriteria Decision Analysis is a tool capable of supporting decisions with multiple criteria. Notwithstanding its con rmed value in the health area; so far, no studies have been found to help prioritize victims in the Emergency Medical Service, EMS. Since decision making within EMS involves multiple criteria, it is essential to nd techniques and tools that encompass such elements, as to reduce errors. As to address this gap, the current research developed a multicriteria decision model to help prioritizing victims in the Brazilian EMS, which are still managed as a manual task. Methods: To reach such endeavour, it was formed an expert panel and a discussion group, tasked to de ne the limits of the problem, and to identify the evaluation criteria for choosing a victim, amongst four alternatives derived from clinical and traumatic diseases scenarios of absolute priority in emergency situations occurrences. For prioritization, an additive mathematical method was utilized, aggregating criteria in a exible and interactive version - FiTradeoff. Results: The present work contributed to victims' prioritization by using the multicriteria decision support methodology which led to the identi cation of twenty- ve evaluation criteria to guide the decision. It was noted that the protocols to guide regulating physicians do not consider all the criteria for prioritizing victims in an environment of resource scarcity. In the prioritization simulation composed of four demanding victims and only one available ambulance, the proposed model supported the decision by suggesting the prioritization of Victim 2. Conclusions: From the identi ed improvement points, the developed decision model was able to improve the regulatory action of medical professionals. The elicitation procedure enabled the identi cation of criteria that, albeit well known, were not formalized by the current guidance protocols, which could contribute to contradictions and conicts across the decision chain. Last, but not least, the proposed model could support decision making under the guarantee of a rational and transparent decision-making process that could be applied in other EMS.
Clinical Risk Score for Central Precocious Puberty Among Girls with Precocious Pubertal Development: A Cross Sectional Study
Authors: You Jingyu , Cheng Xianying , Li Xiaojing , Li Mingqin , Yao Li , Luo Feihong , Cheng Ruoqian , Xi Li , Ye Jiangfeng
Published: October 2020

Background The gold standard for the diagnosis of central precocious puberty (CPP) is gonadotropin-releasing hormone (GnRH) or GnRH analogs (GnRHa) stimulation test. But the stimulation test is time-consuming and costly. Our objective was to develop a risk score model with readily available features.Methods A cross sectional study based on the electronic medical record system including 627 girls with precocious puberty were conducted in the Children’s Hospital, Fudan University, Shanghai, China from January 2010 to August 2016. Patients were randomly split into the training (n=314) and validation (n=313) sample. In the training sample, variables associated with CPP (P<0.2) in univariate analyses were introduced in a multivariable logistic regression model and selected using a forward stepwise analysis. A risk score model was built with the scaled coefficients of the model and tested in the validation sample.Results CPP was diagnosed in 54.8% (172/314) and 55.0% (172/313) of patients in the training and validation sample respectively. The CPP risk score model included variables of age at onset of puberty, basal luteinizing hormone (LH) concentration, largest ovarian volume, and uterine volume. The C-index was 0.85 (95% CI: 0.81-0.89) for the training sample and 0.86 (95% CI: 0.82-0.90) for the validation sample. Two cut-off points were selected to delimitate a low- (<10 points), median- (10-19 points), and high-risk (≥ 20 points) group. Conclusions A risk score model developed among girls with precocious pubertal development had moderate discrimination to stratify CPP risk, which could help make decisions on the need for GnRH (GnRHa) stimulation test.
Gram-negative Versus Gram-positive in Primary Pyogenic Spondylitis and Analysis of Risk Factors for Relapse
Authors: Dai Guohua , Li Shu Zhong , Yin Chuqiang , Sun Yuanliang , Wang Qizun , Hou Jianwen , Luan Liangrui , Wang Zhongying , Wang Zhichao , Wang Ting
Published: October 2020

Purpose：In the present study, we aimed to compare and analyze the clinical features, diagnosis, treatment and prognosis of primary pyogenic spondylitis caused by Gram-positive and Gram-negative bacteria.Methods: A retrospective analysis consisting of 76 cases of primary pyogenic spondylitis with complete clinical information was carried out from January 2013 to January 2020 in our hospital. The patients were divided into two groups according to Gram staining: Gram-negative group (n=33) and Gram-positive group (n=43). The clinical characteristics, diagnosis, treatment and prognosis of the two groups were compared and analyzed.Results: Staphylococcus aureus accounted for the highest proportion of the Gram-positive group, while Escherichia coli accounted for the highest proportion of the Gram-negative group. Before treatment, there were no significant differences in terms of age, gender, affected segment, spinal abscess, diabetes mellitus, course of disease, admission erythrocyte sedimentation rate (ESR), admission C-reactive protein (CRP), and admission white blood cell (WBC) count between the two groups (P>0.05). After treatment, there were no statistically significant differences in discharge ESR, discharge CRP, ESR decline rate, CRP decline rate, surgery, recurrence, follow-up time, hospital stay, and body temperature ≥38℃ between the two groups (P>0.05). The body temperature of the Gram-negative group was higher compared with the Gram-positive group, and the number of patients with urinary tract infection in the Gram-negative group was significantly greater compared with the Gram-positive group (P<0.05). Antibiotic treatment time <6 weeks was an independent risk factor for recurrent infection.Conclusions: The body temperature of the Gram-negative group was higher compared with the Gram-positive group, and there were significantly more cases with urinary tract infection in the Gram-negative group compared with the Gram-positive group (P<0.05). Antibiotic treatment time <6 weeks was an independent risk factor for recurrent infection.
The Optimal Administration Time of Butorphanol in Suppressing Sufentanil-induced Cough: A Single-Center Randomized Double-Blind Trial
Authors: Song Yuejiao , Xu Zhihong , Chen Zhenyi , Liao Qingwu
Published: October 2020

Backgroud: To evaluate the optimal administration time of butorphanol in suppressing sufentanil-induced cough(SIC) during the induction of general anesthesia.Methods:180 patients were randomly divided into 4 equally sized groups: at 5min, 2min and 0min before anesthesia induction, all patients were sequentially injected the drug labeled A/B/C (butorphanol 1mg or normal saline), GI received intravenously drug A/B/C (All were normal saline),GII received intravenously drug A/B/C (A was butorphanol, B and C were saline), GIII received intravenously drug A/B/C (B is butorphanol, A and C were saline), GIV received intravenously drug A/B/C (C is butorphanol，A and B were saline). ALL Patients were then administrated with sufentanil 0.4 µg/kg in 5s after drug C. The incidence and severity of SIC was recorded within 2 minutes after sufentanil injection. MAP, HR, and SpO2 were recorded at T0 (before the administration of any drug),Ta, Tb, Tc (before the injection of drug A/B/C), T1( 2minutes after sufentanil injection) and T2 (1 minutes after endotracheal intubation). Results: The incidences of cough in GII, GIII, and IV were lower than that in GI (0.09, 0.01, and 0 vs 42.2%, P<0.01), while there were no significant differences between GII, GIII, and GIV. The HR of all 4 groups at T2 were significantly higher than their levels at any other time (P<0.05,T2 vs other time), but there’s no significant difference among 4 groups at T2. The MBP of all 4 groups at Ta and Tb were significantly lower than their levels at any other time (P<0.05, Ta and Tb vs other time), but there’s no significant difference among 4 groups at Ta and Tb. At Ta, the SpO2 of GII was significantly lower than GI, GIII and GIV (P<0.05); at Tb, the SpO2 of GII was significantly lower than GI (P<0.05) and GIV (P<0.01); at Tc, the SpO2 of GIII were significantly lower than GIV (P<0.05).Conclusion: Intravenous butorphanol 1 mg could effectively suppress SIC before sufentanil injection. Without waiting time before administering the sufentanil may be feasible in clinical practice, it has the same suppressive effection and has no influence on BP, HR, SpO2 and the total amount of sufentanil. Trial registration: Chinese Clinical Trial Registry with registration number ChiCTR1900024394. Registered 9 July 2019.
Holistically assessing and improving the sustainability of aquaculture development in China
Authors: Dong Shuanglin , Dong Yun-wei , Verreth Johan , Olsen Yngvar , Liu Wen-jing , Fang Qi-zhi , Cao Ling , Zhou Yan-gen , Li Li , Li Jing-yu , Mu Yong-tong , Sorgeloos Patrick
Published: October 2020

Aquaculture is the fastest growing food production industry in terms of annual growth rate and has become an important contributor in supplying essential macro-and micro-nutrients for the global population. However, there is a great deal of uncertainty in its further development due to the high and increasing pressure of environmental challenges and of resource constraints. To achieve overall sustainable development of the aquaculture sector in China, the dominant producer of farmed seafood in the world, the priority is to clarify the sustainability of major aquaculture production systems (APSs) and to seek a holistic approach to improve their sustainability. Here the sustainability of ten major types of APSs in China, was evaluated comparatively by three objective and subjective methods involving eleven social, economic, environmental, and resource criteria. Accordingly, ecological intensification of aquaculture systems (ELIAS), integrating anthropogenic inputs with aquaculture ecosystem services, is proposed to improve the sustainability of these APSs. ELIAS that should be widely adopted by the multiple stakeholders provides a feasible solution to realize the goals of increasing aquaculture outputs with less negative environmental influence while saving energy at the same time.
Site-specific Metastases of Gallbladder Adenocarcinoma and Their Prognostic value for Survival: A SEER-based Study
Authors: Yang Yingnan , Tu Zhuolong , Ye Chentao , Cai Huajie , Yang Shouzhang , Chen Xuehai , Tu Jinfu
Published: October 2020

Background: Gallbladder cancer is a rare but highly malignant cancer, which often progresses to a metastatic stage when diagnosed because of its asymptomatic manifestation. In this study, we intended to analyze the prognostic value of metastatic gallbladder adenocarcinoma (GBA) with site-specific metastases.Methods: Using the Surveillance, Epidemiology, and End Results (SEER) database, GBA patients diagnosed with metastases between 2010 and 2016 were selected to identify the prognosis according to the isolated metastatic sites, including liver, lung, bone, brain and distant lymph nodes (DL). Kaplan-Meier methods were used for survival comparisons and multivariable Cox regression models were constructed to find out independent factors that associated with survival.Results: Data from 1526 eligible patients were extracted from the SEER database. Among the patients, 788 (51.6%) had isolated liver metastases, 80 (5.2%) had isolated distant nodal involvement, 45 (2.9%) had isolated lung metastases, 21 (1.4%) had isolated bone metastases, 2 (0.1%) had isolated brain metastases and 590 (38.7%) had multiple metastases. No significant survival difference was shown between patients with single or multisite metastases (P>0.05). Patients with isolated lung or DL metastases had significant better survival outcomes than those with isolated bone metastases (P<0.05). Multivariate analysis showed that performing surgery at primary site, receiving chemotherapy were associated with better OS and CSS for patients with isolated liver or DL metastases.Conclusions: The study showed that different metastatic sites affect survival outcomes in metastatic GBA patients. Highly selected subset of patients with liver or DL metastases might benefit from surgery at primary site.
Combined Oropharyngeal/Nasal Swab is Equivalent to Nasopharyngeal Sampling for SARS-CoV-2 Diagnostic PCR
Authors: Desmet Tania , De Paepe Peter , Boelens Jerina , Coorevits Liselotte , Elizaveta Padalko , Vandendriessche Stien , Leroux-Roels Isabel , Aerssens Annelies , Callens Steven , Braeckel Eva Van , Malfait Thomas , Vermassen Frank , Verhasselt Bruno
Published: October 2020

Background: Early 2020, the COVID-19 epidemic became a public health emergency of international concern. To address this pandemic broad testing with an easy, comfortable and reliable testing method is of utmost concern. Nasopharyngeal (NP) swab sampling is the reference method though hampered by international supply shortages. A new oropharyngeal/nasal (OP/N) sampling method was investigated using the more readily available throat swab.Methods: In this prospective observational study 36 COVID-19 patients were tested with both a NP and combined OP/N swab for SARS-CoV-2 RNA by PCR. In hospitalized suspect patients, who tested negative on both swabs, extensive retesting was performed. The sensitivity of NP versus combined OP/N swab sampling on admission and the correlation between viral RNA loads recovered was investigated.Results: 35 patients were diagnosed with SARS-CoV-2 by means of either NP or OP/N sampling. The paired swabs were both positive in 31 patients. The one patient who tested negative on both NP and OP/N swab on admission, was ultimately diagnosed on bronchoalveolar lavage fluid. A strong correlation was found between the viral RNA loads of the paired swabs (r = 0.76; P < 0.05). The sensitivity of NP and OP/N analysis in hospitalized patients (n = 28) was 89.3% and 92.7% respectively.Conclusions: This study demonstrates equivalence of NP and OP/N sampling for detection of SARS-CoV-2 by means of rRT-PCR. Sensitivity of both NP and OP/N sampling is very high in hospitalized patients.