bluuebunny/crossref_metadata_2025 huggingface dataset:
Shale Producers Adopt Geochemistry Fingerprinting to Quantify Cross-Well Production
Authors: Jacobs Trent
Published: November 2019

Obtain a sample of reservoir rock, heat it up, add pressure, and then take a real close look at the drop of oil that comes out to find its unique “fingerprint.”

At a high level, this is the emerging extraction and geochemistry process that more than two dozen tight-oil producers have recently adopted to solve one of the shale sector’s biggest mysteries: how does oil flow through the rock matrix and into a hydraulically fractured horizontal well?

In a stacked formation, that question branches off into a few more: how much do neighboring horizontal wells communicate, which zones are co-producing the most, and how do these factors change over time?

“The ground truth comes when you collect rock, and know exactly what depth that rock comes from, and then extract hydrocarbons from that rock to know the fingerprint of that depth,” said Faye Liu, the founder and chief executive of geochemistry startup RevoChem.

Founded last year, the Houston-based firm has so far identified a geochemical fingerprint in more than 5,000 reservoir rocks and produced oil samples from more than 300 wells in nine different shale plays in North America and the Vaca Muerta Shale in Argentina.

Every new sample sheds a bit more light on the complex flow patterns of unconventional reservoirs. Among RevoChem’s findings is that pad wells placed in different benches of a tight reservoir stand a high chance of experiencing some level of cross-well communication (Fig. 1).

“All of your oil is a mixture coming from multiple zones,” explained Liu who was formerly a geochemist with Conoco Phillips. She noted that despite how they appear in modeling software, the evidence from geochemical fingerprinting shows that hydraulic fractures often extend out of their target zone and into other oil-rich layers of rock. “Essentially, every operator is experiencing the same•process.”

A primary goal for adopters of the technology is to describe that vertical drainage in detail—and how the profile changes over time. “In a stacked development, every subsurface professional must be engaged with that understanding,” said Toby Deen, a senior engineer with private Permian oil and gas company Felix Energy, which started conducting time-lapse fingerprinting earlier this year.

In addition to vertical production allocation, operators are using geochemical fingerprinting to overcome the difficulty that other diagnostics have had in assessing the related parameter of fracture height. If wells are believed to have a fracture height somewhere in the range of 400–600 ft, then using wider distances between vertically separated wells to avoid interference is justified.

However, if the geochemistry shows that only 5–10% of the cross-well production is from the extreme tips of such a fracture network, then wider spacing may not be optimal (Fig. 2). What would make future spacing decisions easier is if an operator could prove that a majority of production is coming from an area just 200–300 ft away from the wellbore. “That means there is a lot of infill potential,” said Liu.
Analgosedation during flexible fiberoptic bronchoscopy: Comparing the clinical effectiveness and safety of remifentanil versus midazolam/propofol
Authors: Lee Hyun , Choe Yeong Hun , Park Seung Yong
Published: November 2019

Background: There are limited data regarding the efficacy and safety of remifentanil sedation for diagnostic bronchoscopy. The aim of this study was to evaluate the clinical efficacy and safety of remifentanil by comparing it with those of conventional drugs, midazolam and propofol.
Methods: A retrospective study of 186 patients who underwent diagnostic bronchoscopy at Chonbuk National University Hospital was performed. Patients were classified into the remifentanil group and midazolam/propofol group according to the drugs used during bronchoscopy.
Results: Of the 186 patients, 111 patients received remifentanil and 75 received midazolam/propofol during the bronchoscopy. The proportion of patients who required bronchoscopy for endobronchial inspection alone was significantly higher in the midazolam/propofol group than in the remifentanil group (93.3% vs. 71.2%; p < 0.001). In contrast, the proportion of patients who required more invasive procedures, such as bronchoscopic biopsy, bronchoalveolar lavage, or transbronchial lung biopsy, was significantly higher in the remifentanil group than in the midazolam/propofol group (27.8% vs. 6.7%; p < 0.001). The recovery time was significantly shorter in the remifentanil group than in the midazolam/propofol group (mean 6.4 min vs. 11.6 min, p < 0.001). There was no significant difference between the groups with regard to safety events including desaturation, hypotension, and arrhythmia.
Conclusions: Despite the higher proportion of patients who underwent more invasive procedures in the remifentanil group than in the midazolam/propofol group, there was no significant difference in safety events between the groups. Those in the remifentanil group also demonstrated a faster recovery time than those in the midazolam/propofol group.
“Being in good hands”: Next of kin’s perceptions of continuity of care in patients with heart failure
Authors: Östman Malin , Bäck-Pettersson Siv , Sandvik Ann-Helén , Sundler Annelie J
Published: November 2019

Background
Heart failure (HF) is a chronic condition with a variety of diverse symptoms. Patients with HF are usually elderly with multimorbidity, which are both multifaceted and challenging. Being a next of kin to patients with HF is described as a complex task consisting of managing care and treatment, monitoring illness and being an emotional support, while also being able to navigate the healthcare system especially in long-term contact. However, few studies have investigated next of kin's perceptions of continuity of care in connection with HF. The present study aimed to describe continuity of care as perceived by the next of kin who care for patients with HF.
Methods
This study used a qualitative descriptive design. Semi-structured interviews were conducted with the next of kin (n=15) of patients with HF to obtain their perceptions of continuity of care. A phenomenographic analysis method was used to capture the participants' perceptions of the phenomenon.
Results
The analysis reveals that the next of kin perceive that support from healthcare professionals was strongly associated with experiences of continuity of care. Four categories reveal the next of kin's perceptions of continuity of care: Want to be involved without being in charge; A desire to be in control without acting as the driving force in the care situation; A need for sustainability without being overlooked; and Focusing on making life meaningful while being preoccupied with caregiving activities.
Conclusions
Next of kin perceive continuity of care, when they have access to care and treatment and when caregivers collaborate, regardless of healthcare is given by primary care, municipalities or specialist clinics. A sense of “being in good hands” sums up the need for continuous support, shared decision-making and seamless transitions between caregivers. It seems important that healthcare organisations safeguard effective and collaborative models. Moreover, professionals need to plan and perform healthcare in collaboration with patients and next of kin.
Keywords
Continuity of care, Heart failure, Next of kin, Phenomenography, Qualitative research
Competitive endogenous RNA (ceRNA) regulation network of lncRNAs, miRNAs, and mRNAs in Wilms tumour
Authors: tang fucai , Lu zechao , wang jiamin , Li zhibiao , Wu weijia , Duan Haifeng , He zhaohui
Published: November 2019

Background: Competitive endogenous RNAs (ceRNAs) have revealed a new mechanism of interaction between RNAs. However, an understanding of the ceRNA regulatory network in Wilms tumour (WT) remains limited.Methods: The expression profiles of mRNAs, miRNAs and lncRNAs in Wilms tumour samples and normal samples were obtained from the Therapeutically Applicable Research to Generate Effective Treatment (TARGET) database. The EdgeR package was employed to identify differentially expressed lncRNAs, miRNAs and mRNAs. Functional enrichment analyses via the ClusterProfile R package were performed, and the lncRNA–miRNA–mRNA interaction ceRNA network was established in Cytoscape. Subsequently, the correlation between the ceRNA network and overall survival was analysed.Results: A total of 2,037 lncRNAs, 154 miRNAs and 3,609 mRNAs were identified as differentially expressed RNAs in Wilms tumour. Of those, 205 lncRNAs, 26 miRNAs and 143 mRNAs were included in the ceRNA regulatory network. The results of Gene Ontology (GO) analysis revealed that the differentially expressed genes (DEGs) were mainly enriched in terms related to response to mechanical stimuli, transcription factor complexes, and transcription factor activity (related to RNA polymerase II proximal promoter sequence-specific DNA binding). The results of the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis showed that the DEGs were mainly enriched in pathways related to the cell cycle. The survival analysis results showed that 14 out of the 205 lncRNAs, 1 out of 26 miRNAs and 8 out of 143 mRNAs were associated with overall survival in Wilms tumour patients (P < 0.05).Conclusions: CeRNA networks play an important role in Wilms tumour. This finding might provide effective, novel insights for further understanding the mechanisms underlying Wilms tumour.
Diagnostic accuracy of multi-slice computed tomography in Children with Abernethy malformation
Authors: Guo Chen , Zhong Yumin , Wang Qian , Hu Liwei , Gu Xiaohong , Shao Hong , Wu Wei , Cao Jianfeng , Qiu Haisheng
Published: November 2019

Background ：Abernethy malformation is a rare congenital abnormality. Imaging examination is an important method for the diagnosis. The purpose of this study was to demonstrate manifestations of multi-slice computed tomography (MSCT) in Abernethy malformation and its diagnostic accuracy.

Methods ：Fourteen children with Abernethy malformation were admitted to our center in China between July 2011 and January 2018. All 14 patients (eight males and six females) received MSCT and digital subtraction angiography (DSA) while eight patients also received ultrasound. The patients’ age ranged from 1 to 14 (median age 8 years old). The clinical records of the patients were retrospectively reviewed. MSCT raw data were transferred to an Advantage Windows 4.2 or 4.6 workstation (General Electric Medical Systems, Waukesha, WI). We compared the findings of MSCT with DSA and surgical results in order to ascertain diagnostic accuracy.

Results ：Three cases had type Ib Abernethy malformation and eleven cases had type II. Two cases of type II Abernethy malformation were misdiagnosed as type Ib using MSCT. Comparing the findings of MSCT with DSA and surgical results, the accuracy of MSCT was 85.7% (12/14), in which 100.0% (3/3) were type Ib and 81.8% (9/11) were type II. Clinical information included congenital heart disease, pulmonary hypertension, diffuse pulmonary arteriovenous fistula, abnormal liver function, hepatic nodules, elevated blood ammonia, and hepatic encephalopathy. Eleven cases were treated after diagnosis. One patient with Abernethy malformation type Ib(1/3) underwent liver transplantation. Seven patients with Abernethy malformation type II (7/11) were treated by shunt occlusion, received laparoscopy, or were treated with open surgical ligation. Another three patients (3/11) with Abernethy malformation type II were treated by interventional portocaval shunt occlusion under DSA.

Conclusion ：MSCT attains excellent capability in diagnosing type II Abernethy malformation and further shows the location of the portacaval shunt. DSA can help when it is hard to determine diagnosis between Abernethy type Ib and II using MSCT.

Key words: Abernethy malformation; Angiography; Tomography
Improving management of glycaemic control in people with T2DM in Primary Care: estimation of the impact on the clinical complications and associated costs
Authors: Mata-Cases Manel , Mahon James , Mauricio Didac , Franch-Nadal Josep , Real Jordi , Hex Nick
Published: November 2019

Aim To estimate the potential benefits in terms of avoided complications and cost reduction if the Spanish health system would encourage the intensification of treatment for better glycaemic control in adults with Type 2 diabetes from the current HbA1c target used in clinical practice of 68 mmol/mol to a target of 53 mmol/mol. Methods The IQVIA Core Diabetes Model (version 9.0) was used to model the impact of these changes in respect of micro- and macrovascular complications and the associated costs. The modelling was based on data derived from the SIDIAP-Q population database from Catalonia, taking a random cohort of 10,000 people with type 2 diabetes and dividing it into sub-groups based on their basal HbA1c. Results The CDM modelling showed that the average cost reduction per person varies depending on basal HbA1c. The model estimates that after 25 years, people with a basal HbA1c between 48 and 58 mmol/mol and >75 mmol/mol show an average cost reduction of €6,027 and €11,966, respectively. Applying the per-person cost reduction to the cohorts of the prevalent population in Spain (1,910,374) the overall estimated cost reduction was €14.7 billion over 25 years. The improvements in outcomes resulted in an estimated reduction of more than 1.2 million complications cumulatively over 25 years, of which more than 550,000 relate to diabetic foot and more than 170,000 related to renal disease. Conclusion Over a 25 year period, Spain could considerably reduce costs and avoid major complications if, on a population level, more ambitious glycaemic control, according to Spanish or EU guidelines, could be achieved among people with type 2 diabetes by reducing the HbA1c threshold for treatment intensification. Although there is a slower trajectory for benefits in earlier years, there is a much more rapid benefit gain between years 5 and 15.
Iodine concentration and content measured by dual-source computed tomography are correlated to thyroid hormone levels in euthyroid patients
Authors: Li ZhengTeng , Zhai Rui , Liu HongMei , Pan Dongmei
Published: November 2019

Background: The aim of this study was to investigate the correlation of the dual energy CT measured iodine concentration and total iodine content with blood measured thyroid parameters. Methods: 43 patients with normal thyroid function at our hospital from August 2017 to October 2019 were included in this retrospective study. Dual energy CT was used to scan the neck of thyroid patients. The mean iodine concentration and thyroid tissue volume were measured to calculate the total iodine content of the thyroid. Relevant tests of triiodothyronine (FT3), total triiodothyronine (TT3), total thyroxine (TT4), free thyroxine (FT4), and thyroid hormone (TSH) were conducted. The correlation of the thyroid mean iodine concentration and total iodine content with blood-measured thyroid function was analysed. Result: The total iodine content in the thyroid was positively correlated with FT3 but negatively correlated with TSH. The mean iodine concentration of the thyroid was positively correlated with both FT3 and TT3. Conclusion: The thyroid iodine content measured by dual energy CT can be used to determine the human iodine nutritional status and evaluate thyroid function, which will facilitate the diagnosis and treatment of thyroid diseases.
Layer-specific speckle tracking analysis of left ventricular systolic function and synchrony in maintenance hemodialysis patients
Authors: Liu Chang , Yan Zining , Fan Li , Huang Jun , Shen Dan , Song Xiangting
Published: November 2019

Background: This study investigated the value of layer-specific strain analysis by twodimensional speckle tracking echocardiography (2D-STE) for evaluating left ventricular (LV) systolic function and synchrony in maintenance hemodialysis (MHD) patients. Methods: A total of 34 MHD patients and 35 healthy controls were enrolled in this study. Dynamic images were collected at the LV apical long-axis, the four- and twochamber, and the LV short-axis views at the basal, middle, apical segments. The layerspecific speckle tracking (LST) was used to analyze the longitudinal strain (LS) and circumferential strain (CS) of LV sub-endocardium, mid-myocardium, subepicardium, global longitudinal strain (GLS), global circumferential strain (GCS), the LV 17 segment time to peak LS (TTP), the peak strain dispersion (PSD). The differences in these parameters were compared between control and MHD, and the correlation between PSD and each LS parameter was examined. The receiver operator characteristic curve was used to evaluate the efficacy of three myocardial layer LS and CS in the assessment of LV systolic dysfunction in MHD. Results: MHD had comparable left ventricular ejection fraction (LVEF), but significantly smaller GLS, GCS, and three-layer LS and CS compared to the control. The three layer LS of the basal segment, middle segment, and apex segment was significantly reduced in the MHD compared to the normal, while the three myocardial layer CS of the basal segment, middle segment, and apex segment was significantly reduced in the MHD compared to the normal, except for the sub-endocardium of middle and apex segment. MHD had significantly higher TTP of LV 17 segments and PSD compared to controls, and had delayed peak time in most segments. In addition, PSD of MHD was positively correlated with subendocardial and mid-myocardial LS and GLS, but not with subepicardial LS. The area under the curves (AUCs) of sub-endocardial, mid-myocardial, and sub-epicardial LS in MHD were 0.894, 0.852, and 0.870, respectively; the AUCs of sub-epicardial, midmyocardial, and sub-endocardial CS were 0.852, 0.837, and 0.669, respectively. Conclusion: LST may detect the early changes of all three-layer LS and CS and PSD in MHD, and is a valuable tool to diagnose LV systolic dysfunction in MHD.
NaCl-responsive ROS scavenging and energy supply in alkaligrass callus revealed from proteomic analysis
Authors: Zhang Yongxue , Zhang Yue , Yu Juanjuan , Zhang Heng , Wang Liyue , Wang Sining , Guo Siyi , Miao Yuchen , Chen Sixue , Li Ying , Dai Shaojun
Published: November 2019

Background: Salinity has obvious effects on plant growth and crop productivity. The salinity-responsive mechanisms have been well-studied in differentiated organs (e.g., leaves, roots and stems), but not in unorganized cells such as callus. High-throughput quantitative proteomics approaches have been used to investigate callus development, somatic embryogenesis, organogenesis, and stress response in numbers of plant species. However, they have not been applied to callus from monocotyledonous halophyte alkaligrass (Puccinellia tenuifora). Results: The alkaligrass callus growth, viability and membrane integrity were perturbed by 50 mM and 150 mM NaCl treatments. Callus cells accumulated the proline, soluble sugar and glycine betaine for the maintenance of osmotic homeostasis. Importantly, the activities of ROS scavenging enzymes (e.g., SOD, APX, POD, GPX, MDHAR and GR) and antioxidants (e.g., ASA, DHA and GSH) were induced by salinity. The abundance patterns of 55 salt-responsive proteins indicate that salt signal transduction, cytoskeleton, ROS scavenging, energy supply, gene expression, protein synthesis and processing, as well as other basic metabolic processes were altered in callus to cope with the stress. Conclusions: The undifferentiated callus exhibited unique salinity-responsive mechanisms for ROS scavenging and energy supply. Activation of the POD pathway and AsA-GSH cycle was universal in callus and differentiated organs, but salinity-induced SOD pathway and salinity-reduced CAT pathway in callus were different from those in leaves and roots. To cope with salinity, callus mainly relied on glycolysis, but not the TCA cycle, for energy supply. Keywords: Salinity response, ROS scavenging, Energy supply, Osmotic homeostasis, Callus, Halophyte alkaligrass, Proteomics
Robot-Assisted Bronchoscopy for Pulmonary Lesion Diagnosis: Results from the Initial Multicenter Experience
Authors: Chaddha Udit , Kovacs Stephen P. , Manley Christopher , Hogarth Douglas Kyle , Cumbo-Nacheli Gustavo , Bhavani Sivasubramanium V. , Kumar Rohit , Shende Manisha , III John P. Egan , Murgu Septimiu
Published: November 2019

Background: The Robotic Endoscopic System (Auris Health, Inc., Redwood City, CA) has the potential to overcome several limitations of contemporary guided-bronchoscopic technologies for the diagnosis of lung lesions. Our objective is to report on the initial post-marketing feasibility, safety and diagnostic yield of this technology.
Methods: We retrospectively reviewed data on consecutive cases in which robot-assisted bronchoscopy was used to sample lung lesions at four centers in the US (academic and community) from June 15th, 2018 to December 15th, 2018.
Results: One hundred and sixty-seven lesions in 165 patients were included in the analysis, with an average follow-up of 185 ± 55 days. The average size of target lesions was 25.0 ± 15.0 mm. Seventy-one percent were located in the peripheral third of the lung. Pneumothorax and airway bleeding occurred in 3.6% and 2.4% cases, respectively. Navigation was successful in 88.6% of cases. Tissue samples were successfully obtained in 98.8%. The diagnostic yield estimates ranged from 69.1% to 77% assuming the cases of biopsy-proven inflammation without any follow-up information (N=13) were non-diagnostic and diagnostic, respectively. The yield was 81.5%, 71.7% and 26.9% for concentric, eccentric and absent r-EBUS views, respectively. Diagnostic yield was not affected by lesion size, density, lobar location or centrality.
Conclusions: RAB implementation in community and academic centers is safe and feasible, with an initial diagnostic yield of 69.1-77% in patients with lung lesions that require diagnostic bronchoscopy. Comparative trials with the existing bronchoscopic technologies are needed to determine cost-effectiveness of this technology.
Enhanced tolerance to Phytophthora root and stem rot by over-expression of the plant antimicrobial peptide CaAMP1 gene in soybean
Authors: Niu Lu , Zhong Xiaofang , Zhang Yuanyu , Yang Jing , Xing Guojie , Li Haiyun , Liu Dongbo , Ma Rui , Dong Yingshan , Yang Xiangdong
Published: November 2019

Background Antimicrobial peptides play important defense-related roles in both plants and animals. It has been confirmed that overexpression of CaAMP1 ( Capsicum annuum antimicrobial protein1 ), an antimicrobial protein gene isolated from C. annuum leaves infected with Xanthomonas campestris pv. vesicatoria , in Arabidopsis confers broad-spectrum resistance to hemibiotrophic bacterial pathogen and necrotrophic fungal pathogens. Phytophthora root and stem rot (PRR), caused by the fungus Phytophthora sojae , is one of the most devastating diseases affecting the worldwide production of soybean ( Glycine max ).Results In this paper, CaAMP1 was transformed into the soybean genome via Agrobacterium -mediated genetic transformation. Integration of this gene into the transgenic soybean genome and its subsequent translation were verified by Southern and Western blot analyses, respectively. Overexpression of CaAMP1 ( CaAMP1- OX) enhanced the disease tolerance of three consecutive generations of transgenic soybean infected with P. sojae race 1 compared with wild-type Williams 82. Gene expression analyses in the transgenic plants revealed that expression of the salicylic acid (SA)-dependent genes, jasmonic acid (JA)-dependent genes, and plant disease resistance genes (R-genes) were up-regulated after P. sojae inoculation.Conclusions These results indicated that over-expression of the CaAMP1 significantly enhanced PRR tolerance in soybean by eliciting resistance responses mediated by multiple defense signaling pathways, thus suggesting alternative approaches for the development of soybean varieties with improved tolerance against soil-borne pathogenic PRR.
The Relationship Between Spatial Access and Modern Contraceptive Use: Is Proximity to a Healthcare Facility a Determinant of Use Among Women in Kinshasa, DRC?
Authors: Babazadeh Saleh , Hernandez Julie , Anglewicz Philip , Bertrand Jane T
Published: November 2019

Background: Spatial access has a direct effect on health service utilization in many settings. While, all elements of access are usually affected by service delivery points and client characteristics. Distance to facility has proven to affect family planning service use in many Sub-Saharan countries. Studies show that women who reside closer to facilities offering family planning services are more likely to use modern contraceptives. However, researchers often test the theory of distance decay to observe any association between an increased distance of health facilities and health service utilization. This study to analyze the significance of proximity to family planning services, as well as service availability and quality of family planning services in Kinshasa. Method: We used a pool of four rounds of facility- and population-based survey data in Kinshasa. We tested if women who live closer to service delivery points with higher level of availability and quality are more likely to use modern contraceptives or less likely to have unmet need for contraceptive services. Results: Our findings show that living closer to an SDP is not a determinant of modern contraceptive use or having unmet need for FP services. Discussion: Lack of cognitive access, economic barriers, bypassing the closest facility, and sociocultural norms are among the strong barriers for women in Kinshasa to use modern contraceptives. Our analysis shows that proximity to quality services does not necessarily result in increased FP use among women of reproductive age living in Kinshasa, thus suggesting that a bypass phenomenon may occur when obtaining modern contraceptive services. Conclusion: This study indicates that proximity to facilities does not necessarily equate proximity to methods, nor does it necessarily enable current users or women with an unmet need (potential contraceptive users) to easily obtain services for their method of choice. This study notes that other barriers to access may be substantial determinants of contraceptive use or unmet need. More research should be conducted that directly measures multidimensional components of access in order to interpret women’s contraceptive seeking behaviors in urban areas of Sub-Saharan Africa.
DJ-1 exerts anti-inflammatory effects and regulates NLRX1-TRAF6 via SHP-1 in stroke
Authors: Peng Li , Zhou Yang , Jiang Ning , Wang Tingting , Zhu Jin , Chen Yanlin , Li Linyu , Zhang Jinyan , Yu Shanshan , Zhao Yong
Published: November 2019

Background: Acute inflammation developed by reactive astrocytes after cerebral ischemia/reperfusion (I/R) injury is important in protecting the resultant lesion. Our previous study demonstrated the abundant expression of DJ-1 in reactive astrocytes after cerebral I/R injury. Here, we show that DJ-1 negatively regulates the inflammatory response by facilitating the interaction between SHP-1 and TRAF6, thereby inducing NLRX1 dissociation from TRAF6. Methods: We used oxygen-glucose deprivation/reoxygenation (OGD/R) in vitro in primary astrocyte cultures and transient middle cerebral artery occlusion/reperfusion (MCAO/R) in vivo to mimic ischemic reperfusion insult. Results: The inhibition of DJ-1 expression increased the expression of the inflammatory cytokines TNF-α, IL-1β, and IL-6. DJ-1 knockdown facilitated the interaction of NLRX1 with TRAF6. However, the loss of DJ-1 attenuated the interaction of SHP-1 with TRAF6. In subsequent experiments, an SHP-1 inhibitor altered the interaction of SHP-1 with TRAF6 and facilitated the interaction of NLRX1 with TRAF6 in DJ-1-overexpressing astrocytes.. Conclusion: This finding suggests that DJ-1 exerts an SHP-1-dependent anti-inflammatory effect and induces the dissociation of NLRX1 and TRAF6 in cerebral I/R injury. Thus, DJ-1 may be an efficacious therapeutic target for the treatment of I/R injury.
DNA methylation regulates glioma cell cycle through down-regulating MiR-133a expression
Authors: Liu Liang , Zhu Zhengquan , Li Xu , Zheng Yong
Published: November 2019

Background: MiRNAs plays a key role in regulating gene expression networks of various biological processes in many cancers.
Results: Here, we analyzed miRNA expression profiles by miRNA microarray and verified by RT-PCR. It was shown that the expression difference of miR-133a was most significantly and consistently downregulated. The proliferative capacity and cell cycle profile of cells transfected with miR-133a mimic were assessed by colony forming assay and PI staining, respectively. The target gene of miR-133a was predicted using TargetScan and verified by dual luciferase gene reporter assay. Western blotting and RT-PCR were used to analyze the expression levels of relevant factors. Methylation-specific quantitative PCR (MSP) was used to detect miR-133a methylation levels. Epigenetic regulation of miR-133a was assessed by treating the cells with the DNA methyltransferase inhibitor AZA or the histone deacetylase inhibitor TSA. We found that overexpression of miR-133a inhibited cell proliferation, induced a cell cycle arrest and downregulated the expression of Cyclin D1, Cyclin D2, and cycling-dependent killdeer 4 (CdK4). Peroxisome proliferator-activated receptor γ (PPARγ) was verified as a target gene of miR-133a. PPARγ protein levels were significantly higher in the glioma tissues, and overexpression of miR-133a markedly reduced its levels. Furthermore, forced expression of PPARγ partly abrogated the anti-proliferative effects of miR-133a. miR-133a was hypermethylated in glioma cells, and AZA treatment significantly up-regulated its levels.
Conclusions: MiR-133a is downregulated in glioma cells through promoter hypermethylation, and its forced expression inhibits glioma cell proliferation and induces G1 phase arrest by targeting PPARγ.
Health information needs regarding diabetes mellitus in China: an Internet-based analysis
Authors: wang hao tian , Wang Tian-Hao , Zhou Xiao-Feng , Ni Yuan , Pan Zhi-Gang
Published: November 2019

Background The Internet has become an important carrier for consumers to express their health information needs and search for health information,we can analyze a lot of valuable information about what the patients are concerned, and health providers like hospitals can make use of these questions raised by patients to improve their services such as patient health education, patient follow-up to consumers. However, there are no Internet-based analyses of health information needs pertaining to diabetes in China until now. Hereby, The diabetes problems put forward by consumers on the 39 health website were dynamically analyzed in order to know the trends of consumers' demand for health information of diabetes and provide reference to improve health education and patients' self-management ability of blood glucose.Methods we have done a study of statistically analyzing the questions about diabetes collected from 39 health website, the number of which is 151,589. We have divided these questions into 9 categories using a convolutional neural networkResults The diabetes problems of consumer are presented as follows, diagnosis: 34.95%, treatment: 25.17%, lifestyle: 21.09%, complication: 8.00%, maternity-related:5.00%, prognosis: 2.59%, health provider choosing: 1.40%, prevention: 1.23%, others: 0.58%, The elderly are more concerned about the treatment and complications of diabetes, while the young are more concerned about the maternity-related and prognosis of diabetes.The diabetes drugs most frequently mentioned by consumers are insulin, metformin and Xiaoke pills,The most concerned complication is caidiovascular disease and diabetic eye disease.Conclusion Diabetes health education should focus on how to prevent diabetes and the contents of health education should be different for differernt age groups ;on diabetes treatment, the use of insulin and oral hypoglycemic drugs education should be strengthened.
Patient and health system factors associated with pretreatment loss to follow up among patients diagnosed with tuberculosis using Xpert® MTB/RIF testing in Uganda
Authors: Zawedde-Muyanja Stella , Katamba Achilles , Cattamanchi Adithya , Castelnuovo Barbara , Manabe Yukari C
Published: November 2019

Background: In 2017, Uganda only 53% of incident cases of tuberculosis were started on treatment. Pretreatment loss to follow up is an important contributor to suboptimal treatment coverage. We aimed to describe the patient and health facility-level characteristics associated with pretreatment loss to follow up among patients diagnosed with pulmonary tuberculosis at public health facilities in Uganda. Methods: At ten public health facilities, laboratory register data was used to identify patients aged 15 years who had a positive Xpert®MTB/RIF test. Initiation on TB treatment was ascertained using the clinical register. Factors associated with not being initiated on TB treatment within two weeks of diagnosis were examined using a multilevel logistic regression model accounting for clustering by health facility. Results: From January to June 2018, 510 patients (61% male and 31.5% HIV co-infected) were diagnosed with tuberculosis. One hundred (19.6%) were not initiated on TB treatment within two weeks of diagnosis. Not having a phone number recorded in the clinic registers (aOR 7.93, 95%CI 3.93-13.05); being HIV-infected (aOR 1.83; 95% CI: 1.09-3.26) and receiving care from a high volume health facility performing more than 12 Xpert tests per day (aOR 4.37, 95%CI 1.69-11.29) and were significantly associated with pretreatment loss to follow up. Conclusion: In public health facilities in Uganda, we found a high rate of pretreatment loss to follow up especially among TBHIV co-infected patients diagnosed at high volume health facilities. Interventions to improve the efficiency of Xpert® MTB/RIF testing, including monitoring of the TB care cascade should be developed and implemented.
Resistance of tick microbiome to biological disturbance
Authors: Peña Agustín Estrada , Cabezas-Cruz Alejandro , Obregón Dasiel
Published: November 2019

Background : Ixodes scapularis ticks harbor microbial communities including pathogenic and non-pathogenic microbes. Pathogen infection increases the expression of several tick gut proteins which disturb the tick gut microbiota and impact bacterial biofilm formation. Anaplasma phagocytophilum induces ticks to express I. scapularis IAFGP, a protein with antimicrobial activity while Borrelia burgdorferi induces the expression of PIXR. Here, we tested the resistance of I. scapularis microbiome to A. phagocytophilum infection, antimicrobial peptide IAFGP, and anti-tick immunity specific to PIXR.
Results : We demonstrate that A. phagocytophilum infection and IAFGP affect the taxonomic composition and taxa co-occurrence networks but had no effect on the functional traits of tick microbiome. In contrast, anti-tick immunity disturbed the taxonomic composition and the functional profile of tick microbiome, by increasing both taxonomic and pathways diversity. Mechanistically, we show that anti-tick immunity increases the representation and importance of polysaccharide biosynthesis pathways involved in biofilm formation while these pathways are under-represented in the microbiome of ticks infected by A. phagocytophilum or exposed to IAFGP.
Conclusions : These analyses revealed that tick microbiota is highly sensitive to anti-tick immunity, while it is less sensitive to pathogen infection and antimicrobial peptides. Results suggest that biofilm formation is a defensive response of tick microbiome to anti-tick immunity.
Patient autonomy in dental medical decision making – is there a need for shared decision making?
Authors: Benecke Mareike , Kasper Jürgen , Heesen Christoph , Schäffler Nina , Reissmann Daniel
Published: November 2019

Background: Evidence-based Dentistry (EBD), decision aids, patient preferences and autonomy preferences (AP) play an important role in shared decision making (SDM) and are useful tools in the process of medical and dental decisions as well as in developing of quality criteria for decision making in many fields of health care. However, there aren’t many studies on SDM and AP in the field of dentistry. This study aimed at exploring patients’ autonomy preferences in dentistry in comparison to other medical domains. Methods: As a first step, a consecutive sample of 100 dental patients and 16 dentists was recruited at a university-based prosthodontic clinic to assess and compare patients’ and dentists’ preferences regarding their roles in dental decision making for commonly performed diagnostic and treatment decisions using the Control Preference Scale (CPS). This was followed by a cross sectional survey to study autonomy preferences in three cohorts of 100 patients each recruited from general practices, a multiple sclerosis clinic, and a university-based prosthodontic clinic. A questionnaire with combined items from the Autonomy Preference Index (API) to assess general and the CPS to assess specific preferences was used in this process. Results: Dentists were slightly less willing to deliver control than patients willing to enact autonomy. Decisions about management of tooth loss were however considered relevant for a shared decision making by both parties. Highest AP was expressed by people with multiple sclerosis, lowest by patients in dentistry (CPS means: dentistry 2.5, multiple sclerosis 2.1, general practice 2.4, p=.035). Patients analysis showed considerable differences in autonomy preferences referring to different decision types (p<.001). More autonomy was needed for treatment decisions in comparison to diagnostic decisions, for trivial compared to severe conditions, and for dental care compared to general practice (all: p<.001). Conclusion: The study results showed substantial relevance of patient participation in decision making in dentistry. Furthermore, a need has been discovered to refer to specific medical decisions instead of assessing autonomy preferences in general.
HPV-based cervical cancer screening in Nicaragua: from testing to treatment
Authors: Holme Francesca , Maldonado Francisco , Martinez-Granera Orlando B. , Rodriguez Jose Maria , Almendarez Juan , Slavkovsky Rose , Bansil Pooja , Thomson Kerry A. , Jeronimo Jose , de Sanjose Silvia
Published: November 2019

Objective: In Nicaragua, cervical cancer is the leading cause of cancer death among women. Human papillomavirus (HPV) testing, primarily using self-sampling, was introduced between 2014 and 2018 in three provinces. We analyzed data from the HPV screening program with the goal of describing key characteristics including reach, HPV prevalence, triage and treatment, and factors associated with follow-up completion.Methods: We analyzed individual-level data from routinely collected forms for women attending HPV-based cervical cancer screening. HPV-positive women were triaged with Pap or visual inspection with acetic acid (VIA) prior to treatment. Logistic regression was used to identify factors associated with receiving triage and treatment; analyses were adjusted for province, age, and self- vs. provider-collected sampling.Findings: 44,635 women were screened with HPV testing; 96.6% of women used self-sampling. 6,776 women were HPV positive (15.2%), 54.0% of screen-positive women received triage, and 53.1% of triage-positive women were treated, primarily with cryotherapy. If women lost at triage are included, the overall treatment percentage was 27.8%. Province and provider sampling were significantly associated with completing triage. Province and triage type were significantly associated with receiving treatment. Women who were triaged with Pap were 95% less likely to receive treatment than those who were triaged by VIA (aOR: 0.05, 95% CI: 0.04–0.08, p<0.001).Conclusion: Introduction of HPV testing resulted in a substantial number of women screened, and acceptance of self-sampling was high. Management of screen-positive women remained a challenge, particularly with Pap triage. Our results can inform other developing countries as they work to reach World Health Organization (WHO) elimination targets.
Clinical and genetic study of twelve Chinese Han families with non-syndromic deafness
Authors: Wu Di , Huang Weiyuan , Li Shuo , Zhang Jie , Chen Xiaohua , Tang Yan , Qiu Jinhong , Wang Zhixia , Duan Xuchu , Xu Zhenhang , Zhang Luping
Published: November 2019

BACKGROUND: Non-syndromic hearing loss is clinically and genetically heterogeneous. In this study, we characterized the clinical features of twelve Chinese Han deaf families in which mutations in common deafness genes GJB2 , SLC26A4 and MT-RNR1 were excluded. RESULTS: Targeted next-generation sequencing of 147 known deafness genes was performed in probands of ten families, while whole-exome sequencing was applied in those of the rest two. Pathogenic mutations in a total of 11 rare deafness genes, OTOF , CDH23 , PCDH15 , PDZD7 , ADGRV1 , KARS , OTOG , GRXCR2 , MYO6 , GRHL2 , and POU3F4 , were identified in all 12 probands, with 17 mutations being novel. Intrafamilial co-segregation of the mutations and the deafness phenotype were confirmed by Sanger sequencing. CONCLUSIONS: Our results expanded the mutation spectrum and genotype-phenotype correlation of non-syndromic hearing loss in Chinese Hans and also emphasized the importance of combining both next-generation sequencing and detailed auditory evaluation to achieve a more accurate diagnosis for non-syndromic hearing loss.
The combination of CTCs and CEA can help guide the management of patients with SPNs suspected of being lung cancer
Authors: Zheng Jian , Ye Xiong , Zhao Yuxia , He Mudan , Xiao Hui
Published: November 2019

Objective: Solitary pulmonary nodules (SPNs) is a common radiographic finding and require further evaluation because of the possibility of lung cancer. This study aimed to determine the sensitivity and specificity of circulating tumour cells (CTCs) as a marker for the diagnosis of SPNs and the integration of CTCs, carcinoembryonic antigen (CEA) and imaging findings to improve the sensitivity and specificity of diagnosis in patients with SPNs suspected of being lung cancer.Method: For the serum biomarker assay, the concentration of CEA was measured by an automated electrochemiluminescence analyzer. CTCs were collected from 6 ml of blood by i-FISH method, which detects the gene copy number in eight chromosomes and the tumour-associated antigen CK18.Results: With a threshold of 6 CTC units, the method showed a sensitivity of 67.1% and a specificity of 56.5% in the diagnosis of NSCLC, especially in the upper lobe, in which the diagnostic strength was the highest (P < 0.01). CTCs, CEA and nodule type had the highest diagnostic efficacy (area under the curve, 0.827; 95% confidence interval, 0.752-0.901) in patients with SPNs being suspected lung cancer. Combining CTCs (cut-off value 12 units) with CEA (1.78 ng/ml), the method showed a sensitivity of 77.8% and a specificity of 90% in the diagnosis of NSCLC, especially in the upper lobe, sub solid nodules and nodules ≥8 mm.Conclusion: Our results demonstrated that CTCs are feasible diagnostic biomarkers in patients with SPNs, especially in the upper lobe. Furthermore, CTCs combined with CEA showed higher diagnostic efficacy in the upper lobe, sub solid nodules and nodules ≥8 mm.
Identifying predictive biomarkers of CIMAvaxEGF success in Non–Small Cell Lung Cancer Patients
Authors: Lorenzo-Luaces Patricia , Sanchez Lizet , Saavedra Danay , Crombet Tania , Elst Wim Van der , Alonso Ariel , Molenberghs Geert , Lage Agustin
Published: November 2019

Background: Immunosenescence biomarkers and peripheral blood parameters are evaluated separately as possible predictive markers of immunotherapy. Here we illustrate the use of a causal inference model to identify predictive biomarkers of CIMAvaxEGF success in the treatment of Non–Small Cell Lung Cancer Patients.
Methods: Data from a clinical trial evaluating the effect on survival time of CIMAvax-EGF versus best supportive care were analyzed retrospectively following the causal inference approach. Pre-treatment potential predictive biomarkers included basal serum EGF concentration, peripheral blood parameters and immunosenescence biomarkers (The proportion of CD8 + CD28- T cells, CD4+ and CD8+ T cells, CD4/CD8 ratio and CD19+ B cells. The 33 patients with complete information were included. The predictive causal information (PCI) was calculated for all possible models. The model with a minimum number of predictors, but with high prediction accuracy (PCI>0.7) was selected. Good, rare and poor responder patients were identified using the predictive probability of treatment success.
Results: The mean of PCI increased from 0.486, when only one predictor is considered, to 0.98 using the multivariate approach with all predictors. The model considering the proportion of CD4+ T cell, basal EGF concentration, NLR, Monocytes, and Neutrophils as predictors were selected (PCI>0.74). Patients predicted as good responders according to the pre-treatment biomarkers values treated with CIMAvax-EGF had a significant higher observed survival compared with the control group (p=0.03). No difference was observed for bad responders.
Conclusions: Peripheral blood parameters and immunosenescence biomarkers together with basal EGF concentration in serum resulted in good predictors of the CIMAvax-EGF success in advanced NSCLC. The study illustrates the application of a new methodology, based on causal inference, to evaluate multivariate pre-treatment predictors.
Continuous intravenous infusion of remifentanil improves the experience of parturient undergoing repeated cesarean section under epidural anesthesia, a prospective, randomized study
Authors: yan wei , Xiong Yun , Yao Yu , Zhang Feng-jiang , Yu Li-an , Yan Min
Published: November 2019

Background: Unsatisfactory analgesia would occur frequently during repeated cesarean section under epidural anesthesia. The aim of this study is to observe the effects of intravenous remifentanil on maternal comfort, maternal and neonatal safety during repeated cesarean section under epidural anesthesia.Methods: A total of 80 parturients undergoing repeated cesarean section were involved in the study. The patients were randomly divided into the intravenous remifentanil- assisted epidural group (group R) and epidural group (group E), respectively (n=40). In group R, the remifentanil was continuously intravenously infused as an adjuvant to epidural anesthesia. In group E, 0.75% ropivacaine epidural or intravenous ketamine was administered as needed. Parturient baseline characteristics, vital signs, VAS scores, and comfort scores during surgery were recorded. Adverse effects were also recorded.Results: A total of 80 patients were enrolled in the current study and the final analyses included 39 patients in group R and 38 patients in group E. No differences in patients’ baseline characteristics were found between the two groups (p > 0.05). Compared with group E, the comfort score was significantly higher in group R (9.1±1.0 vs. 7.5±1.3, p<0.001), whereas the maximum VAS score was significantly lower in group R (1.8±1.2 vs. 4.1±1.0, p<0.001). Maternal and neonatal adverse effects did not differ between the two groups during surgery (p>0.05).Conclusions: Continuous intravenous infusion of low-dose remifentanil can significantly improve the experience of parturients undergoing repeated cesarean section under epidural anesthesia, without noticeable maternal or neonatal adverse effects.