bluuebunny/crossref_metadata_2025 huggingface dataset:
Prognostic factors and survival according to tumour subtype in women presenting with breast cancer bone metastases at initial diagnosis: a SEER based study
Authors: Li Xiao , Zhang Xiaoli , Liu Jie
Published: August 2020

Background: Tumour subtype have a significant effect on bone metastasis in breast cancer, but population-based estimates of the prognosis of bone metastases at diagnosis of breast cancer are lacking. The aim of this study was to analyse the influence of tumour subtype and other factors in the prognostic and survival of patients with bone metastases of breast cancer.Methods: Using the Surveillance, Epidemiology, and End Results Program (SEER) data of 2012 to 2016 conducted a retrospective cohort study to investigate stage IV patients with bone metastases in breast cancer. Stage IV Patients characteristic according subtype were compared using chi-square. Overall survival (OS), prognostic factor calculated using the Kaplan-Meier method and the Cox proportional hazards model.Results: A total of 3384 stage IV patients were included in this study. 63.42% were HR+/HER2-, 19.86% were HR+/HER2+, 9.34% were HR-/HER2-, and 7.39% were HR-/HER2+. Median OS for the whole population was 38 months, and 33.9% of the patients were alive at five-year. The median OS and five-year survival rate among the different molecular subtype of breast cancer stage IV patients are significant differences (p<0.05). Multivariate Cox regression analysis showed that age of 55-59 (HR=1.270), black race (HR=1.317), grade in III or IV (HR=1.960), HR-/HER2- (HR=2.808), lung metastases (HR=1.378), live metastases (HR=2.085), brain metastases (HR=1.903) are independent risk factors of prognosis; married (HR=0.819), HR+/HER2+ (HR=0.631), HR-/HER2+ (HR=0.716), insurance (HR=0.587) and surgery (HR=0.504) are independent protection factors of prognosis. There is interaction between HR+/HER2+ subtype and other metastases (except bone metastases, HR=0.694, 95%CI: 0.485-0.992), but interaction between race and substype did not reach significance on prognosis. Conclusions: There were substantial differences in OS according to tumour subtype. In addition to tumour subtype, other independent predictors of OS are age at diagnosis, race, marital status, insurance, grade, surgery and visceral metastases. There is interaction between HR+/HER2+ subtype and other metastases (except bone metastases) on prognosis. Tumour subtype, as a significant prognostic factor, warrant further investigation.
Maple Syrup Urine Disease in Brazilian Patients: Variants and Clinical Phenotype Heterogeneity
Authors: Margutti Ana Vitoria Barban , Silva Wilson Araújo , Garcia Daniel Fantozzi , de Molfetta Greice Andreotti , Marques Adriana Aparecida , Amorim Tatiana , Prazeres Vânia Mesquita Gadelha , Silva Raquel Tavares Boy da , Miura Irene Kazue , Neto João Seda , Santos Emerson de Santana , Santos Mara Lúcia Schmitz Ferreira , Lourenço Charles Marques , Tonon Tássia , Sperb-Ludwig Fernanda , de Souza Carolina Fischinger Moura , Schwartz Ida Vanessa Döederlein , Junior José Simon Camelo
Published: August 2020

Background: Maple syrup urine disease (MSUD) is an autosomal recessive inherited metabolic disease caused by deficient activity of the branched-chain α-keto acid dehydrogenase (BCKD) enzymatic complex. BCKD is a mitochondrial complex encoded by BCKDHA, BCKDHB, DBT, and DLD genes. MSUD is predominantly caused by Variants in BCKDHA, BCKDHB, and DBT genes encoding the E1α, E1β, and E2 subunits of BCKD complex, respectively. The aim of this study was to characterize the genetic basis of MSUD by identifying the point variants in BCKDHA, BCKDHB, and DBT genes in a cohort of Brazilian MSUD patients and to describe their phenotypic heterogeneity. It is a descriptive cross-sectional study with 21 MSUD patients involving molecular genotyping by Sanger sequencing. Results: Eight new variants predicted as pathogenic were found between 30 variants (damaging and non-damaging) identified in the 21 patients analyzed: one in the BCKDHA gene (p.Tyr120Ter); five in the BCKDHB gene (p.Gly131Val, p.Glu146Glnfs*13, p.Phe149Cysfs*9, p.Cys207Phe, and p.Lys211Asn); and two in the DBT gene (p.Glu148Ter and p.Glu417Val). Seventeen pathogenic variants were previously described and five variants showed no pathogenicity according to in silico analysis. Conclusion: Given that most of the patients received late diagnoses, the study results do not allow us to state that the molecular features of MSUD variant phenotypes are predictive of clinical severity.
The state of child nutrition in Ethiopia: an umbrella review of systematic review and meta-analysis reports
Authors: Mohammed Shimels Hussien , Habtewold Tesfa Dejenie , Arero Amanuel Godana , Esmaillzadeh Ahmad
Published: August 2020

BackgroundMalnutrition remains to be a major public health problem in developing countries, particularly among children under-5 years of age children who are more vulnerable to both macro and micro-nutrient deficiencies. Various systematic review and meta-analysis (SRM) studies were done on nutritional statuses of children in Ethiopia, but no summary of the findings was done on the topic. Thus, this umbrella review was done to summarize the evidence from SRM studies on the magnitude and determinants of malnutrition and poor feeding practices among under-5 children in Ethiopia. Methods PubMed, Embase, Scopus, Web of Sciences, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, and Google Scholar were searched for SRM studies on magnitude and risk factors of malnutrition and child feeding practice indicators in Ethiopia. The methodological quality of the included studies was assessed using the Assessment of Multiple Systematic Reviews (AMSTAR) tool. The estimates of the included SRM studies on the prevalence and determinants of stunting, wasting, underweight, and poor child feeding practices were pooled and summarized with random-effects meta-analysis models. ResultWe included nine SRM studies, containing a total of 214,458 under-5 children from 255 observation studies. The summary estimates of prevalence of stunting, underweight, and wasting were 42% (95%CI=37-46%), 33% (95%CI=27-39%), and 15% (95%CI=12-19%), respectively. The proportion of children who met the recommendations for timely initiation of breastfeeding, exclusive breastfeeding during the first 6 months, and timely initiation of complementary feeding were 65%, 60%, and 62%, respectively. The proportion of children who met the recommendations for dietary diversity and meal frequency were 20%, and 56%, respectively. Only 10% of children fulfilled the minimum criteria of acceptable diet. There was a strong relationship between poor feeding practices and the state of malnutrition, and both conditions were related to various health, socio-economic, and environmental factors. ConclusionChild malnutrition and poor feeding practices are highly prevalent and of significant public health concern in Ethiopia. Only a few children are getting proper complementary feeding. Multi-sectoral efforts are needed to improve children’s feeding practices and reduce the high burden of malnutrition in the country.
Semi-supervised Method for Image Texture Classification of Pituitary Tumors via CycleGAN and Optimized Feature Extraction
Authors: ZHU Hong , FANG Qianhao , HUANG Yihe , XU Kai
Published: August 2020

Background: Accurately determining the softness level of pituitary tumors preoperatively by using their image textures can provide a basis for surgical options and prognosis. Existing methods for this problem require manual intervention, which could hinder the efficiency and accuracy considerably. Methods: we present an automatic method for diagnosing the texture of pituitary tumors using unbalanced sequence image data. Firstly, for the small sample problem in our pituitary tumor MRI image dataset where T1 and T2 sequence data are unbalanced (due to data missing) and under-sampled, our method uses a CycleGAN(Cycle-Consistent Adversarial Networks) model for domain conversion to obtain fully sampled MRI spatial sequence. Then, it uses a DenseNet(Densely Connected Convolutional Networks)-ResNet(Deep Residual Networks) based Autoencoder framework to optimize the feature extraction process for pituitary tumor image data. Finally, to take advantage of sequence data, it uses a CRNN(Convolutional Recurrent Neural Network) model to classify pituitary tumors based on their predicted softness levels. Results: Experiments show that our method is the best in terms of efficiency and accuracy(91.78%) compared to other methods. Conclusions: We propose a semi-supervised method for grading pituitary tumor texture. This method can accurately determine the softness level of pituitary tumors, which provides convenience for surgical selection and prognosis, and improves the diagnostic efficiency of pituitary tumors.
Comparative transcriptome combined with metabolome analyses revealed key factors involved in nitric oxide (NO)-regulated cadmium stress adaptation in tall fescue
Authors: Zhu Huihui , Ai Honglian , Hu Zhengrong , Du Dongyun , Sun Jie , Chen Ke , Chen Liang
Published: August 2020

Background: It has been reported that nitric oxide (NO) could ameliorate cadmium (Cd) toxicity in tall fescue; however, the underlying mechanisms of NO mediated Cd detoxification are largely unknown. In this study, we investigated the possible molecular mechanisms of Cd detoxification process by comparative transcriptomic and metabolomic approaches. Results: The application of Sodium nitroprusside (SNP) as NO donor decreased the Cd content of tall fescue by 11% under Cd stress (T1 treatment), but the Cd content was increased by 24% when treated with Carboxy-PTIO (c-PTIO) together with Nitro-L-arginine methyl ester (L-NAME) (T2 treatment). RNA-seq analysis revealed that 904 (414 up- and 490 down-regulated) and 118 (74 up- and 44 down-regulated) DEGs were identified in the T1 vs Cd (only Cd treatment) and T2 vs Cd comparisons, respectively. Moreover, metabolite profile analysis showed that 99 (65 up- and 34-down- regulated) and 131 (45 up- and 86 down-regulated) metabolites were altered in the T1 vs Cd and T2 vs Cd comparisons, respectively. The integrated analyses of transcriptomic and metabolic data showed that 81 DEGs and 15 differentially expressed metabolites were involved in 20 NO-induced pathways. The dominant pathways were antioxidant activities such as glutathione metabolism, arginine and proline metabolism, secondary metabolites such as flavone and flavonol biosynthesis and phenylpropanoid biosynthesis, ABC transporters, and nitrogen metabolism.Conclusions: In general, the results revealed that there are three major mechanisms involved in NO-mediated Cd detoxification in tall fescue, including (a) antioxidant capacity enhancement; (b) accumulation of secondary metabolites related to cadmium chelation and sequestration; and (c) regulation of cadmium ion transportation, such as ABC transporter activation. In conclusion, this study provides new insights into the NO-mediated cadmium stress response.
Nonstructural versus structural bone grafting in the treatment of lumbar tuberculosis: a retrospective cohort study
Authors: Zhao Zenghui , Li Jianxiao , Peng Qiqi , Zhu Yong , Luo Wei , Du Xing , Ou Yunsheng
Published: August 2020

Background Various bone grafting have been reported to achieve anterior column support and bone fusion after one stage posterior debridement in the treatment of lumbar tuberculosis. However, nonstructural bone grafting has been rarely studied. This study aimed to compare the efficacy of nonstructural bone grafting versus structural bone grafting in the treatment of lumbar tuberculosis.Patients and methods We retrospectively reviewed patients with nonstructural (n=27) and structural (n=22) bone grafting after single-stage posterior debridement and instrumentation for lumbar tuberculosis with at least 24 months of follow-up. Plain radiographs, magnetic resonance imaging, computed tomography scans, and health-related outcomes (e.g. Visual Analog Scale for back pain, the Oswestry Disability Index) were collected before surgery and at follow-up.Results Both nonstructural and structural bone grafting were associated with significant improvements in the quality of life parameters, the laboratory tests and the Cobb angle of local kyphosis. A slight loss of Cobb angle correction was observed in two groups. Nonstructural bone grafting resulted in the significantly less operation duration, blood loss and lower bone fusion rate than structural bone grafting group. There were three complications in the nonstructural bone grafting and four complications in the structural bone grafting group, with no significant difference between two groups. Conclusions Nonstructural bone grafting can achieve anterior column support with less surgical trauma and simpler surgical procedure than structural bone grafting, but the lower rate of grafted bone fusion should be taken into consideration when choosing nonstructural bone grafting. Key words Lumbar tuberculous; Single-stage posterior debridement; Anterior column support; Bone fusion; Nonstructural bone grafting; Structural bone grafting
Salt tolerance involved candidate genes in rice: an integrative meta-analysis approach
Authors: Mansuri Raheleh Mirdar , Shobbar Zahra-Sadat , Jelodar Nadali Babaeian , Ghaffari Mohammadreza , Mohammadi Seyed Mahdi , Daryani Parisa
Published: August 2020

Background: Salinity, as one of the main abiotic stresses, critically threatens growth and fertility of main food crops including rice in the world. To get insight into the molecular mechanisms by which tolerant genotypes responds to the salinity stress, we propose an integrative meta-analysis approach to find the key genes involved in salinity tolerance. Herein, a genome-wide meta-analysis, using microarray and RNA-seq data was conducted which resulted in the identification of differentially expressed genes (DEGs) under salinity stress at tolerant rice genotypes. DEGs were then confirmed by meta-QTL analysis and literature review. Results: A total of 3449 DEGs were detected in 46 meta-QTL positions, among which 1286, 86, 1729 and 348 DEGs were observed in root, shoot, seedling, and leaves tissues, respectively. Moreover, functional annotation of DEGs located in the meta-QTLs suggested some involved biological processes (e.g., ion transport, regulation of transcription, cell wall organization and modification as well as response to stress) and molecular function terms (e.g., transporter activity, transcription factor activity and oxidoreductase activity). Remarkably, 23 potential candidate genes were detected in Saltol and hotspot-regions overlying original QTLs for both yield components and ion homeostasis traits; among which, there were many unreported salinity-responsive genes. Some promising candidate genes were detected such as pectinesterase, peroxidase, transcription regulator, high-affinity potassium transporter, cell wall organization, protein serine/threonine phosphatase, and CBS domain cotaining protein. Conclusions: The obtained results indicated that, the salt tolerant genotypes use qualified mechanisms particularly in sensing and signalling of the salt stress, regulation of transcription, ionic homeostasis, and Reactive Oxygen Species (ROS) scavenging in response to the salt stress.
Succeeding with prolonged usage of consumer-based activity trackers in clinical studies: A mixed methods approach
Authors: Henriksen André , Sand Anne-Sofie , Deraas Trygve , Grimsgaard Sameline , Hartvigsen Gunnar , Hopstock Laila
Published: August 2020

Background: Lack of physical activity (PA) is a risk factor for death and non-communicable disease. Despite this, more than one fourth of adults worldwide do not follow PA guidelines. As part of a feasibility study to test a complex intervention for increasing PA, we included a consumer-based activity tracker (AT) as a tool to measure PA outcomes and to track heart rate during exercise sessions. The aim of the present study was to identify factors that increase wear time when using a consumer-based AT for monitoring of participants in clinical research. Methods: Sixteen participants aged 55-74 years, with obesity, sedentary lifestyle, and elevated cardiovascular risk were recruited to a 12-month feasibility study. Participants wore a Polar M430 AT to collect continuous PA data during a six-month intervention followed by six months of follow-up. We performed quantitative wear time analysis, tested the validity of the AT, and completed two rounds of qualitative interviews to investigate how individual wear-time was linked to participant responses. Results: From one year of tracking, mean number of valid wear days were 292 (SD=86), i.e. 80%. The Polar M430 provides acceptable measurements for total energy expenditure. Motivations for increased wear time were that participants were asked to wear it and the ability to track PA progress. Perceived usefulness included time keeping, heart rate- and sleep tracking, becoming more conscious about day-to-day activity, and improved understanding of which activity types were more effective for energy expenditure. Sources of AT annoyance were measurement inaccuracies and limited instruction for use. Suggestions for improvement were that the AT was big, unattractive, and complicated to use.Conclusions: Adherence to wearing a consumer-based AT was high. Results indicate that it is feasible to use a consumer-based AT to measure PA over a longer period. Potential success factors for increased wear time includes adequate instruction for AT use, allowing participants to choose different AT designs, and using trackers with accurate measurements. To identify accurate trackers, AT validation studies in the target cohort may be needed. Trial registration: U.S. National Library of Medicine, Clinical Trial registry: NCT03807323; Registered 16 September 2019 – Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03807323
Bayesian factor analysis in primary care: a systematic review protocol
Authors: Zhang Hao , Schuster Tibor
Published: August 2020

Background: Bayesian factor analysis allows for efficient use of preliminary data and information that corresponds to the increasing needs of questionnaire construct validation in primary care research. This systematic review will summarise evidence on the current use of Bayesian factor analysis in primary care.Methods: A comprehensive search strategy will be adopted to identify relevant literature (research studies in primary care) indexed in Medline, Scopus, EMBASE, CINAHL and Cochrane Library. The search strategy includes terms and synonyms for Bayesian statistics, factor analysis and primary care. Forward and backward searches will be conducted manually on the references of articles that meet the inclusion and exclusion criteria to further identify eligible studies. Multiple reviewers will conduct data extraction independently. The analyses will include descriptive synthesis summarizing features about the use and reporting of the respective Bayesian factor analysis approach in primary care. Discussion: This systematic review will provide a comprehensive overview of the current use of Bayesian factor analysis in primary care and provide recommendations for its proper future use in primary care and beyond.Systematic review registration: PROSPERO registration number: CRD42018114978
The Clinical Efficacy and Adverse Effects of Entecavir plus Thymosin alpha-1 Combination Therapy versus Entecavir Monotherapy in HBV-related Cirrhosis: A Systematic Review and Meta-analysis
Authors: Peng Dan , Xing Hai-Yan , Li Chen , Wang Xian-Feng , Hou Min , Li Bin , Chen Jian-Hong
Published: August 2020

Background Previous studies have demonstrated the benefits of thymosin alpha-1 (Tα1) in anti-virus, immunological enhancement and anti-inflammation. However, it is controversial about the efficacy and safety of entecavir (ETV) plus T α1 combination therapy versus ETV monotherapy in cirrhotic patients with hepatitis B virus (HBV) infection. Methods The systematic review and meta-analysis of randomized clinical trials (RCTs) were performed to evaluate the efficacy and safety of ETV plus Tα1 combination therapy versus ETV monotherapy in HBV -related patients with cirrhosis. We performed a systematic literature search on seven databases. Relative risk (RR) and standardized mean difference (SMD) with a fixed- or random- effect model were calculated. Heterogeneity was assessed through a Cochrane Q-test and I 2 values. Results Seven RCTs involving 1144 subjects were included in the systematic review and meta-analysis. Compared with ETV monotherapy, ETV plus Tα1 combination therapy led to a higher complete response. In post treatment for 24 weeks, the HBV DNA undetectable rate and HBeAg loss rate were higher in ETV plus Tα1 group than in ETV alone group. However, after 48 and 52 weeks of treatment, there was no significant difference between the combination therapy and ETV monotherapy. At week 52 of treatment, the HBsAg loss rate of ETV plus Tα1 group was no significance with that of ETV alone group. In comparison with ETV alone, the some biochemical parameters and liver fibrosis were obviously improved by ETV plus Tα1 , and there was significant heterogeneity. In addition, the number of adverse events was significantly reduced by ETV plus Tα1, compared to ETV alone. Conclusions ETV plus Tα1 might lead to a higher clinical response and a lower comprehensive adverse reaction rate in HBV-related patients with cirrhosis, compared to ETV alone. However, the whole patients included in this meta-analysis were from Chinese mainland, so that more worldwide RCTs with a larger sample size are needed to verify the current findings.
Growth hormone alleviates oxidative stress and improves the IVF outcomes of poor ovarian responders: A randomized controlled trial
Authors: Gong Yan , Zhang Kun , Xiong Dongsheng , Wei Jiajing , Tan Hao , Qin Shengfang
Published: August 2020

Background

Oxidative stress (OS), defined as an imbalance between excessive reactive oxygen species (ROS) and/or reactive nitrogen species (RNS) production and antioxidant insufficiency, has been suggested to be involved in the pathogenesis of poor ovarian response (POR). Growth hormone (GH) can reduce OS in some cell types. This study investigated whether GH could improve OS in and in vitro fertilization and embryo transfer (IVF-ET) outcomes of poor ovarian responders.

Methods

This study enrolled 105 patients with POR and 58 patients without POR (controls) who were diagnosed according to the Bologna criteria and underwent conventional IVF-ET. Poor ovarian responders were randomly assigned to two groups: the POR-GH group, which received pretreatment with GH 4 IU/d on day 2 of the previous menstrual cycle before IVF until the trigger day , and the POR-C group, which received no pretreatment. The OS markers in follicular fluid (FF), ROS levels in granulosa cells (GCs), and IVF outcomes of the groups were compared.

Result(s)

The endometrial thickness on trigger day, number of cleaved embryos, number of higher quality embryos, and rates of implantation and clinical pregnancy were significantly increased in the POR-GH group compared with the POR-C group ( P < 0.05). Moreover, compared to those in the non-POR group, the FF malondialdehyde (MDA), total oxidant status (TOS), oxidative stress index (OSI) and ROS levels in GCs were significantly higher, whereas superoxide dismutase (SOD) and total antioxidant capacity (TAC) were significantly lower in the POR-C group (P < 0.05). Furthermore, compared with those in the POR-C group, the FF TAC was significantly increased in the POR-GH group, and the TOS, OSI and intracellular ROS levels were significantly reduced ( P < 0.05) .

Conclusion(s)

Pretreatment with GH alleviates OS and improves oocyte quality in and IVF outcomes of poor ovarian responders.

Clinical Trial Registration Number

ChiCTR1900021269 (Chinese Clinical Trial Registry).
Quantitative evaluation of range and metabolic activity of hepatic alveolar echinococcosis lesion microenvironment using PET/CT and multi-site sampling method
Authors: Aini Abudusalamu , Yimingjiang Maiweilidan , Yasen Aimaiti , Ran Bo , Jiang Tiemin , Li Xiaohong , Wang Jian , Aihaiti Kasimu , Ainiwa Aisika , Abulizi Aubuduaini , Shao Yingmei , Aji Tuerganaili , Wen Hao
Published: August 2020

Background: Alveolar echinococcosis (AE) lesion microenvironment (LME) is crucial site where parasite-host interactions happen and of great significance during surgery and obtaining liver samples for basic research targeting immunology. However, little is known about quantification of LME range and its’ metabolic activity regarding different lesion types.Methods: A prospective analysis of LME from consecutive surgical AE cases with relevant imaging results was performed. Patients (n=39) received abdominal computed tomography (CT) and position emission tomography/computed tomography using 18F-fluodeoxyglucose (18F-FDG-PET/CT) within one week prior to surgery. Tumor to background ratios (TBRs) of standard uptake value (SUV) in PET/CT was calculated for corresponding LME regions. Multi-site sampling method (MSS, n=26) was introduced to obtain histological slides from LME at different levels off the lesion to evaluate immune cell infiltrative ranges quantitatively. At last, data was statistically analyzed from the perspective of different lesion types.Results: Altogether six major lesion categories have been identified based on different morphology and calcification pattern (A: non-calcified uniform density lesion; B: diffuse calcified solid lesion; C: half necrotic and half solid lesion with minor calcification; D: half necrotic and half solid lesion with obvious calcification; E: subtotal necrotic lesion with minor calcification; F: total necrotic lesion with obvious calcification). Statistical significances were resulted from TBRs calculation (A>B, A>D, A>F, B<C, BB+D+F, etc.). Less calcified lesions were evidenced with higher TBRs, however, not much was valuable for necrosis. The 95% CI of LME ranges were (10.0, 12.1) mm and (9.9, 14.0) mm by PET/CT and MSS. And, weak regressions between TBRs and LME ranges indicated by PET/CT or MSS (r2 respectively were 0.2436 and 0.3171) were observed.Conclusions: PET/CT showed distinct TBRs for different lesion types with heterogenic calcification. PET/CT and MSS had similar discoverability for LME ranges, which also varied among different lesion types. Higher activity meant wider LME range within certain limit. This pioneering study would be able to provide references for both surgical removal of lesions and sample acquisitions more accurately for basic research targeted to immunology.
Macrolide and fluoroquinolone associated mutations in Mycoplasma genitalium in a retrospective study of male and female patients seeking care at an STI Clinic in Guangzhou, China, 2016-2018.
Authors: Ke Wujian , Li Dongling , Tso Lai Sze , Wei Ran , Lan Yinyuan , Chen Zhengyu , Zhang Xiaohui , Wang Liuyuan , Liang Chunmei , Liao Yuying , Chen Huiru , Liu Yahui , Zheng Heping , Yang Ligang
Published: August 2020

BackgroundAntimicrobial resistance in M. genitalium is a growing clinical problem. We investigated the mutations associated with macrolide and fluoroquinolone resistance, two commonly used medical regimens for treatment in China. Our aim is to analyze the prevalence and diversity of mutations among M. genitalium-positive clinical specimens in Guangzhou, south China.MethodsA total of 154 stored M. genitalium positive specimens from men and women attending a STI clinic were tested for macrolide and fluoroquinolone mutations. M. genitalium was detected via TaqMan MGB real-time PCR. Mutations associated with macrolide resistance were detected using primers targeting region V of the 23S rRNA gene. Fluoroquinolone resistant mutations were screened via primers targeting topoisomerase IV (parC) and DNA gyrase (gyrA).Results98.7% (152/154), 95.5% (147/154) and 90.3% (139/154) of M. genitalium positive samples produced sufficient amplicon for detecting resistance mutations in 23S rRNA, gyrA and parC genes, respectively. 66.4% (101/152), 0.7% (1/147) and 77.7% (108/139) samples manifested mutations in 23S rRNA, gyrA and parC genes, respectively. A2072G (59/101, 58.4%) and S83I (79/108, 73.1%) were highly predominating in 23S rRNA and parC genes, respectively. Two samples had amino acid substitutions in gyrA (M95I and A96T, respectively). Two samples had two amino acid substitutions in parC (S83I + D87Y). 48.6% (67/138) of samples harbored both macrolide and fluoroquinolone resistance-associated mutations. The most common combination of mutations was A2072G (23S rRNA) and S83I (parC) (40/67, 59.7%). One sample had three amino acid changes in 23S rRNA, gyrA and parC genes (A2072G + A96T + S83I).ConclusionsThe high antimicrobial resistance rate of M. genitalium in Guangzhou is a very worrying problem and suggests that antimicrobial resistance testing and the development of new antibiotic regimens are crucially needed.
The Vietnamese Version of the Nursing Critical Thinking in Clinical Practice Questionnaire: Translation and Psychometric Evaluation
Authors: Nguyen Tuan Van , Liu Hsueh-Erh
Published: August 2020

Background: Many instruments measure critical thinking ability in nursing education. The Nursing Critical Thinking in Clinical Practice Questionnaire (N-CT-4 Practice) is a new tool to measure the level of critical thinking ability of nurses in a clinical setting. However, no study has evaluated the psychometric properties of the N-CT-4 Practice in Vietnam. Therefore, this study translated and evaluated the validity and reliability of the Vietnamese version of the Nursing Critical Thinking in Clinical Practice Questionnaire (V-N-CT-4 Practice). Results: The V-N-CT-4 Practice questionnaire retained the meaning of the original English version and was clear, explicit and easy for nurses to understand. The item content validity index of the V-N-CT-4 Practice was 1.0. The Cronbach’s alpha for the overall scales was .98. The intraclass correlation coefficient was .81. Confirmatory factor analysis indicated that this Vietnamese version fit the proposed model. Conclusions: The findings suggested that the V-N-CT-4 Practice has acceptable reliability and validity for Vietnamese nurses in a clinical setting. Nurse managers and educators can use the V-N-CT-4 Practice to measure the level of critical thinking ability of Vietnamese clinical nurses and make international comparisons possible.
Parents’ health information seeking behaviour – does the child’s health status play a role?
Authors: Baumann Isabel , Jaks Rebecca , Robin Dominik , Juvalta Sibylle , Dratva Julia
Published: August 2020

Background: Digital media are increasingly abundant and being used to seek health information. To date, very little is known about parental seeking behaviour for child health information outside of English-speaking and Nordic countries. Our study “Digital parental counsellors” examines how parents search for health information in digital media, print media and among “personal contacts”, distinguishing between the search for information about general child health and development and child’s acute illness, and comparing information seeking behaviour by disability status of the child. Methods: The population-based sample consisted of 769 parents with children aged 0-2 in the German-speaking region of Switzerland returning the study questionnaire (30% response rate). We developed a frequency score of use of different information sources and conducted bivariate and multivariate linear regression analyses to describe parental search behaviour and the association with child’s disability status. Results: The sample consists of 88% mothers (mean age: 35.7 years SD 4.33). Children’s mean age is 16 months (SD 7.1), 49% of the children are female and 6% have a disability. Parents use digital media significantly more frequently to search for information about general health and development questions than about an acute child’s illness (p<0.001). In case of acute child’s illness, parents refer to their paediatrician, family members and other personal contacts significantly more frequently than other information sources (p<0.001). The use of digital media and “personal contacts” does not significantly vary between parents with and without a disabled child, whereas the use of print media does (p<0.02). Moreover, irrespective of disability, 45% of parents resort to the Internet prior to a paediatric visit and 27% after a visit when a visit did not answer all questions.Conclusions: Despite the high prevalence of digital media, personal contacts are still the most frequent health information resource for parents with young children. Parents combine all information resources (online, print, personal network) to improve their understanding or check the validity of information received regarding their child’s health. It is thus of utmost importance, that the increasingly accessed digital information parents search for is correct, understandable and addresses parent’s concerns. Trial registration: BASEC Req-2017-00817 (30 October 2017)
Hepatic encephalopathy increases the risk of hip fracture: a nationwide cohort study
Authors: Yeh Kuang-Ting , Yu Tzai-Chiu , Lee Ru-Ping , Wang Jen-Hung , Liu Kuan-Lin , Peng Cheng-Huan , Chen Hao-Wen , Chen Ing-Ho , Hsu Chung-Yi , Wu Wen-Tien
Published: August 2020

Background: Osteoporotic hip fracture is a common general health problem with significant impact of human life because it debilitates the patients and largely decrease their life quality. Early prevention of the fracture is essential in the recent decades by finding out the related risk factors as reference of further intervention, especially for the vulnerable patient group with comorbidities. Hepatic encephalopathy, a major complication of liver cirrhosis, may increase the rate of falling down and weaken the bone quality. This paper is aimed to finding out the correlation between hepatic encephalopathy and osteoporotic hip fracture in the aged patients from our national population.Methods: This retrospective cohort study used data from Taiwan’s National Health Insurance Research Database between 2000 and 2012. We focus on people who were older than 50 years old, using hepatic encephalopathy as compare grouping accordance, and finding the influence of the other common chronic illness. Patients with and without hepatic encephalopathy were matched at a ratio of 1:4 for age, sex, and index year. The incidence and hazard ratios of comorbidities related to aging and poor lifestyle were calculated using Cox proportional hazard regression modelsResults: The average age of the enrolled patients was approximately 66.5 years. The incidence ratio of hip fracture in HE group was 68/2496 (2.7 %), which was significantly higher than that in non-HE group as 98/9984 (0.98 %). Patients with hepatic encephalopathy were 2.15-times more likely to develop osteoporotic hip fractures than patients without hepatic encephalopathy in the whole group and the risk ratio was also significantly higher in female and older patients. The results were also similar in the comorbidity subgroups of hypertension, diabetes mellitus, hyperlipidemia, senile cataract, gastric ulcer and depression.Conclusions: Hepatic encephalopathy is significantly associated with an increased risk of osteoporotic hip fractures and the significance was not affected by the comorbidities in people aged more than 50 years old from the results of our study, and the risk cumulated steadily through time goes by. These patients would benefit from controlling their hepatic encephalopathy and reducing the subsequent osteoporotic hip fractures.
Remote ischaemic preconditioning influences the levels of acylcarnitines in vascular surgery: a randomised clinical trial
Authors: Kasepalu Teele , Kuusik Karl , Lepner Urmas , Starkopf Joel , Zilmer Mihkel , Eha Jaan , Vähi Mare , Kals Jaak
Published: August 2020

Background Vascular surgery patients have reduced tissues` blood supply , which may lead to mitochondrial dysfunction and accumulation of acylcarnitines (ACs). It has been suggested that remote ischaemic preconditioning (RIPC) has its organ protective effect via promoting mitochondrial function. The aim of this study was to evaluate the effect of RIPC on the profile of ACs in the vascular surgery patients.Methods This is a randomised, sham-controlled, double-blinded, single-centre study.Patients undergoing open surgical repair of abdominal aortic aneurysm , surgical lower limb revascularisation surgery or carotid endarterectomy were recruited non-consecutively. The RIPC protocol consisting of 4 cycles of 5 minutes of ischaemia, followed by 5 minutes of reperfusion, was applied. A blood pressure cuff was used for RIPC or a sham procedure. Blood was collected preoperatively and approximately 24 hours postoperatively. The profile of ACs was analysed using the AbsoluteIDQp180 kit (Biocrates Life Sciences AG, Innsbruck, Austria).Results Ninety-eight patients were recruited and randomised into the study groups and 45 patients from the RIPC group and 47 patients from the sham group were included in final analysis. There was a statistically significant difference between the groups regarding the changes in C3-OH (p=0.023) - there was a decrease (-0.007 µmol/L, ± 0.020 µmol/L, p=0.0233) in the RIPC group and increase (0.002 µmol/L, ±0.015 µmol/L, p=0.481) in the sham group. Additionally, a decrease from baseline to 24 hours after surgery (p<0.05) was detected both in the sham and the RIPC group in the levels of following ACs: C2, C8, C10, C10:1, C12, C12:1, C14:1, C14:2, C16, C16:1, C18, C18:1, C18:2. In the sham group, there was an increase (p<0.05) in the levels of C0 (carnitine) and a decrease in the level of C18:1-OH. In the RIPC group, a decrease (p<0.05) was noted in the levels of C3-OH, C3-DC (C4-OH), C6:1, C9, C10:2.Conclusions It can be concluded that RIPC may have an effect on the levels of ACs and might therefore have protective effects on mitochondria in the vascular surgery patients. Further larger studies conducted on homogenous populations are needed to make more definite conclusions about the effect of RIPC on the metabolism of ACs.Trial registration: ClinicalTrials.gov database, NCT02689414. Registered 24 February 2016 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02689414.
Dendritic cells transduced with TIPE-2 recombinant adenovirus induces T cells suppression
Authors: Liu Shudong , wang jie , Li Wenyan , Shi Hui , Zhou Changlong , Tang Ge , Zhang Jiangwei , yang zhao
Published: August 2020

Introduction: TIPE-2 has been identified as a negative regulator of both innate and adaptive immunity and is involved in several inflammatory diseases. However, the role of immune suppression of dendritic cells (DCs) transduced with TIPE-2 has not been well studied. Methods: In this study, DCs were transduced with TIPE-2 recombinant adenovirus, and then were cocultured with allogeneic CD4+ or CD8+T cells. The proliferation, cytokine production and activation marker levels of CD4+ or CD8+T cell were detected. Results: The data demonstrated that T cell proliferation, cytokine production and activation marker levels were attenuated after treated with TIPE-2 transduced DCs. Conclusions: These results suggested that TIPE-2 transduced DCs are capable of inducing allogeneic CD4+ or CD8+T cell immune suppression, which provide a promising way for the therapeutical strategies of transplantation or autoimmune diseases.
The treatment strategy of R0 resection in colorectal cancer with synchronous para-aortic lymph node metastasis
Authors: Ushigome Hajime , Yasui Masayoshi , Ohue Masayuki , Haraguchi Naoaki , Nishimura Junichi , Sugimura Keijirou , Yamamoto Kazuyoshi , Wada Hiroshi , Takahashi Hidenori , Omori Takeshi , Miyata Hiroshi , Takiguchi Shuji
Published: August 2020

Background: Synchronous metastatic para-aortic lymph node (mPALN) dissectionin colorectal cancer has relatively good oncological outcomes, though many patients develop recurrence. Universal prognostic factor remain unclear and no definitive perioperative chemotherapy is available, making the treatment of mPALN controversial. In the present study, we aimed to establish a treatment strategy for synchronous mPALN.Methods: This retrospective study involved 20 patients with pathological mPALN below the renal vein who underwent R0 resection. Long-term outcomes, recurrence type, and prognostic factors for survival were investigated.Results: The 5-year overall survival and recurrence-free survival rates were 39% and 25%, respectively. Seventeen patients (85%) developed recurrence, including 13 (76%) within 1 year after surgery, and ~70% of all recurrences were multiple recurrences. Four patients (20%) survived >5 years. Pathological T stage (p=0.011), time to recurrence (p=0.007), and recurrence resection (p=0.009) were identified as prognostic factors for long-term survival.Conclusions: R0 resection of synchronous mPALN in colorectal cancer resulted in acceptable oncological outcomes, though we found a high rate of early unresectable recurrence. If the recurrence occurs late or isolated, surgical resection should be considered for longer survival.
Leaf to panicle ratio (LPR): a new physiological trait indicative of source and sink relation in japonica rice based on deep learning
Authors: Yang Zongfeng , Gao Shang , Xiao Feng , Li Ganghua , Ding Yangfeng , Guo Qinghua , Paul Matthew J. , Liu Zhenghui
Published: August 2020

Background : Identification and characterization of new traits with a sound physiological foundation is essential for crop breeding and management. Deep learning has been widely used in image data analysis to explore spatial and temporal information on crop growth and development, thus strengthening the power of the identification of physiological traits. This study aims to develop a novel trait that indicates source and sink relation in japonica rice based on deep learning. Results : We applied a deep learning approach to accurately segment leaf and panicle and subsequently developed the procedure of GvCrop to calculate the leaf to panicle ratio (LPR) of rice populations during grain filling. Images of the training dataset were captured in the field experiments, with large variations in camera shooting angle, the elevation angle and the azimuth angle of the sun, rice genotype, and plant phenological stages. Accurately labeled by manually annotating all the panicle and leaf regions, the resulting dataset were used to train FPN-Mask (Feature Pyramid Network Mask) models, consisting of a backbone network and a task-specific sub-network. The model with the highest accuracy is then selected to study the variations in LPR among 192 rice germplasms and among agronomical practices. Despite the challenging field conditions, FPN-Mask models achieved a high detection accuracy, with Pixel Accuracy being 0.99 for panicles and 0.98 for leaves. The calculated LPRs showed large spatial and temporal variations as well as genotypic differences. Conclusion : Deep learning techniques can achieve high accuracy in simultaneously detecting panicle and leaf data from complex rice field images. The proposed FPN-Mask model is applicable for detecting and quantifying crop performance under field conditions. The newly identified trait of LPR should provide a high throughput protocol for breeders to select superior rice cultivars as well as for agronomists to precisely manage field crops that have a good balance of source and sink.
Transplanted Hair Follicle Stem Cells Migrate to the Penumbra and Express Neural Markers in a Rat Model of Cerebral Ischaemia/Reperfusion
Authors: Zhang Xuemei , Tang Hao , Mao Senlin , Li Bing , Zhou Yinglian , Yue Hui , Wang Duo , Wang Yifei , Fu Jin
Published: August 2020

Background: Ischaemic stroke has become the main cause of death and severe neurological disorders, for which effective restorative treatments are currently limited. While stem cell transplantation offers therapeutic potential through neural regeneration, this approach is associated with challenges of limited applicable sources. Hair follicle stem cells (HFSCs) are multipotential cells that can differentiate into ectodermal and mesodermal lineages and proliferate for long periods. The therapeutic potentials of HFSCs have not been investigated in ischaemic stroke models and, therefore, in this study, we aimed to determine whether they could survive and migrate to ischaemic areas after stroke attack.Methods: A rat model of middle cerebral artery ischaemia/reperfusion was established and intravenously administered HFSCs. The potential of HFSCs to migrate and differentiate into neuron-like cells as well as their ability to reduce the infarct size was evaluated. Rat brain tissue samples were collected 2 weeks after cell transplantation and analysed via TTC staining, immunofluorescence, and immunohistochemistry methods. The data were statistically analysed and presented as the means ± standard deviations.Results: Intravenously administrated rat HFSCs were able to migrate to the penumbra where they expressed neuron-specific markers, reduced the infarct volume, and promoted neurological recovery.Conclusion: HFSC transplantation has therapeutic potential for ischaemic stroke, and is, therefore, worthy of further investigation toward possible clinical development for treating stroke patients.
Ex-Utero Intrapartum Treatment (EXIT): indications and outcome in fetal cervical and oropharyngeal masses
Authors: García-Díaz Lutgardo , Chimenea Ángel , de Agustín Juan Carlos , Pavón Antonio , Antiñolo Guillermo
Published: August 2020

Background: The “Ex-Utero Intrapartum Treatment” (EXIT) procedure allows to ensure fetal airway before completion of delivery and umbilical cord clamping while keeping uteroplacental circulation. Airway obstruction in fetal oropharyngeal and cervical masses can be life-threatening at birth. In those situations, controlled access to fetal airway performed by a trained multidisciplinary team allows safe airway management, while feto-maternal circulation is preserved. We aim to review the indications and outcome of the EXIT procedure in a case series of fetal cervical and oropharyngeal masses.Methods: We have carried out a retrospective review of all patients with fetal cervical and oropharyngeal masses who underwent an EXIT procedure between 2008 and 2019. Variables evaluated included indication for EXIT, ultrasound and MRI findings, the need of amnioreduction, gestational age at EXIT, birth weight, complications, operative time, survival rate, pathological findings, and postnatal evolution. Five patients are included in this series. One additional case has already been published.Results: The diagnosis were cervical teratoma (n=1), epulis (n=1) and lymphangioma (n=3). Polyhydramnios was present in 2 patients, requiring amnioreduction in one of them. Mean gestational age at EXIT was 36-37 weeks (range, 34-38 weeks). Median EXIT time in placental support was 9 minutes (range, 3-22 minutes). Access to airway was successfully established in EXIT in all cases. All children born by EXIT are currently healthy and without complications. Conclusion: The localization and characteris­tics of the mass, its relationship to the airway, and the presence of polyhydramnios seem to be major factors determining indications for EXIT and clinical outcome.