bluuebunny/crossref_metadata_2025 huggingface dataset:
Is There Any Association Between Undesired Children and Health Status of Under-five Children? Analysis of Nationally Representative Sample From Bangladesh
Authors: Alam Md. Zakiul , Islam Md. Syful
Published: November 2020

Introduction: Child health, especially childhood mortality, is one of the critical indicators of human development. No child mortality is desirable, but it is still high in Bangladesh. We aimed to assess the effect of the child's desired status of mothers on childhood morbidity and mortality of Bangladesh. Data and Method: We used the data from nationally representative cross-sectional Bangladesh Demographic and Health Survey (BDHS) 2014 and restricted the analyses to children born in the past five years preceding the survey. We estimated the undesired status (excess in boy, girl, both, and parity) by subtracting an ideal number of children from the total live birth. We measured childhood mortality (neonatal, infant, and under-five mortality), morbidity (fever, diarrhea, cough, and ARI), and nutritional problems (stunting, wasting, and underweight). Finally, we utilized the chi-square test and multilevel logistic regression analyses. Findings: The prevalence of undesired children was 20.7%, 23.2%, 4.9%, and 30.3% for boys, girls, both boys and girls, and parity, respectively. Age, education, residence, division, and household wealth index were significantly associated with undesired children. The prevalence of under-five mortality was 3.1% among desired children, almost double (5.9%) among undesired children. The likelihood of under-five mortality was 85% (AOR) to 97% (COR) higher among undesired children than the desired one. Childhood malnutrition (stunting and underweight except wasting) was also higher and significantly associated with undesired children. We also found 17% (AOR: 0.83; 95% CI: 0.72, 0.96) lower postnatal checkup for undesired children. Despite lower under-five mortality among higher socioeconomic status, the relative contribution of undesired children to under-fiver mortality was larger. Conclusion: The share of childhood mortality and malnutrition was higher among undesired children. Every child should be wanted, and no unwanted pregnancies are desirable; thereby, the government should reemphasize the proper use of family planning methods to reduce child mortality and malnutrition.
Role of Nicergoline in Corneal Wound Healing in Diabetic Rats
Authors: Portela Amanda , Moreno Rafael , Ribeiro Maria Helena , de Andrade Fernanda , Alves Yale , Alves Mônica , Lira Rodrigo
Published: November 2020

Background: To investigate the effect of nicergoline on the rate of complete corneal ulcer reepithelialization (CCUR) in diabetic rats with diabetic keratopathy.Methods: Forty-eight streptozotocin-induced diabetic rats were randomly divided into two groups. The experimental group (n=24) received nicergoline (10 mg.kg-1.day-1), while the control group (n=24) received a placebo. A corneal epithelial defect was induced using a corneal diamond burr, and defect area was compared at timepoints of 0, 12, 24, 48 and 72 hours after the injury using image analysis software. The probability of CCUR within 72 hours was assessed using the Kaplan–Meier survival analysis log-rank test. Results: When compared, 4 of the 24 rats (17%) in the placebo group and 12 of the 24 rats (50%) in the nicergoline group were found to have CCUR within 72 hours (log-rank = 0.027). Cox regression analysis found no effect of the covariates blood glucose (P=0.601) or weight (P=0.322) on the corneal reepithelialization (survival) curve. Conclusions: Nicergoline increased wound healing rates relative to placebo and may therefore be investigated as a treatment option in diabetic keratopathy.
Clinical Characteristics and Treatment of Acute Fibrinous and Organizing Pneumonia: Two Case Reports and Literature Review
Authors: Chen Haihong , Kuang Yukun , Huang Xinyan , Ye Ziyin , Liu Yangli , Xie Canmao , Tang Ke-Jing
Published: November 2020

BackgroundAcute fibrinous and organizing pneumonia (AFOP) is a rare histologic interstitial pneumonia pattern characterized by the intra-alveolar fibrin deposition and organizing pneumonia. Though a small amount of cases has been reported, its causes and clinical characteristics are still not well known and there is no standard treatment yet. Case presentationWe report two cases with a histological diagnosis of AFOP. Case 1 was idiopathic AFOP and presented with fever, dyspnea, cough, while the case 2 was associated with SLE and fever was her most common symptom. Their chest CT scan revealed bilateral multiple consolidations, predominantly in the lower lobes. Both cases were diagnosed after a second lung biopsy and treated with corticosteroids.ConclusionsWe not only describe two rare AFOP cases but also demonstrate the most comprehensive review to date in AFOP, including 150 patients since 2002. Most common symptoms include dyspnea, cough, and fever. Consolidation was the most common imaging pattern, followed by GGO and nodules. Given the various etiology and nonspecific clinical presentation, AFOP probably had been under diagnosed. Early identification is very important for AFOP management and a lung biopsy is required for a definitive diagnosis. Corticosteroids was recommended to be the most useful therapy, and treatment options should depend on the etiology and disease severity.
Mitochondrial Transfer through Pericardium Contributes to Functional Recovery in Ischemic Cardiomyopathy
Authors: MORI Daisuke , MIYAGAWA Shigeru , KAWAMURA Takuji , YOSHIOKA Daisuke , HATA Hiroki , UENO Takayoshi , TODA Koichi , KURATANI Toru , OOTA Miwa , KAWAI Kotoe , KURATA Hayato , NISHIDA Hiroyuki , HARADA Akima , TOYOFUKU Toshihiko , SAWA Yoshiki
Published: November 2020

Although mesenchymal stem cell transplantation has been efficacious in the treatment of ischemic cardiomyopathy, the underlying mechanisms remain unclear. Herein, we investigated whether mitochondrial transfer could explain the success of cell therapy in ischemic cardiomyopathy. Mitochondrial transfer was examined in co-cultures of human adipose-derived mesenchymal stem cells and rat cardiomyocytes under hypoxic conditions. Functional recovery was monitored in a rat model of myocardial infarction following human adipose-derived mesenchymal stem cell transplantation. In vitro, we observed mitochondrial transfer, which required formation of cell-to-cell contacts and synergistically enhanced energy metabolism. Rat cexhibited mitochondrial transfer three days following human adipose-derived mesenchymal stem cell transplantation to the ischemic heart surface post myocardial infarction. We detected donor mitochondrial DNA in the recipient myocardium concomitant with a significant improvement in cardiac function. In conclusion, mitochondrial transfer is vital for successful cell transplantation therapies and promotes improved treatment outcomes in ischemic cardiomyopathy.
Case Report: Trans-Papillary Free Stenting of the Cystic Duct and of the Common Bile Duct in A Double Biliary Ducts Anastomoses of A Right Lobe Living Donor Transplantation
Authors: Gruttadauria Salvatore , Tropea Alessandro , Pagano Duilio , Calamia Sergio , Ricotta Calogero , Bonsignore Pasquale , Petri Sergio Li , Cintorino Davide , Francesco Fabrizio di
Published: November 2020

Background One of the major issues related to the living donor liver transplantation recipient outcome is still the high rate of biliary complication, especially when multiple biliary ducts are present and multiple anastomoses have to be performed.Case Presentation and Conclusion We report a case of adult-to-adult right lobe living donor liver transplantation performed for a recipient affected by alcohol-related cirrhosis with MELD score of 17. End-stage liver disease was complicated by refractory ascites, portal hypertension, small esophageal varices and portal gastropathy, hypersplenism, and abundant right pleural effusion. Here in the attached video we described the adult-to-adult LDLT procedures, where a right lobe with two biliary ducts draining respectively the right anterior and the right posterior segments has been transplanted. LDLT required a biliary reconstruction using the native cystic and common bile ducts stented trans-papillary with two 5- French 6 cm long soft silastic catheter. None major complications were detected during post-operative clinical courses. Actually, the donor and the recipient are alive and well.The technique we describe in the video, allow to keep the biliary anastomoses protected and patent without having the risk of creating cholestasis and the need of invasive additional procedure. No living donor right lobe transplantation should be refused because of the presence of multiple biliary ducts.
Long-Term Rainfall Forecast Model Based on The TabNet and LightGbm Algorithm
Authors: Xu Tianyu , Yu Yongchuan , Yan Jianzhuo , Xu Hongxia
Published: November 2020

Due to the problems of unbalanced data sets and distribution differences in long-term rainfall prediction, the current rainfall prediction model had poor generalization performance and could not achieve good prediction results in real scenarios. This study uses multiple atmospheric parameters (such as temperature, humidity, atmospheric pressure, etc.) to establish a TabNet-LightGbm rainfall probability prediction model. This research uses feature engineering (such as generating descriptive statistical features, feature fusion) to improve model accuracy, Borderline Smote algorithm to improve data set imbalance, and confrontation verification to improve distribution differences. The experiment uses 5 years of precipitation data from 26 stations in the Beijing-Tianjin-Hebei region of China to verify the proposed rainfall prediction model. The test set is to predict the rainfall of each station in one month. The experimental results shows that the model has good performance with AUC larger than 92%. The method proposed in this study further improves the accuracy of rainfall prediction, and provides a reference for data mining tasks.
Plasmodium Oocysts Respond With Dormancy to Crowding and Nutritional Stress
Authors: Habtewold Tibebu , Sharma Aayushi , Wyer Claudia , Masters Ellen , Windbichler Nikolai , Christophides George
Published: November 2020

Malaria parasites develop as oocysts in the mosquito for several days before they are able to infect a human host. During this time, mosquitoes take regular bloodmeals to replenish their nutrient and energy reserves needed for flight and reproduction. We hypothesized that these bloodmeals are critical for oocyst growth and that experimental infection protocols, typically involving a single bloodmeal at the time of infection, cause nutritional stress to the developing oocysts. Therefore, enumerating oocysts disregarding their growth and differentiation state may lead to erroneous conclusions about the efficacy of transmission blocking interventions. Here, we examine this hypothesis in Anopheles coluzzii mosquitoes infected with the human and rodent parasites Plasmodium falciparum and Plasmodium berghei, respectively. We found that oocyst growth rates decrease at late developmental stages as infection intensities increase; an effect exacerbated at very high infection intensities. Oocyst growth and differentiation are restored with post infection bloodmeals even at high infection intensities. High infection intensities and starvation conditions reduce RNA Polymerase III activity in oocysts unless supplemental bloodmeals are provided. Our results suggest that oocysts respond to crowding and nutritional stress with a dormancy-like strategy, which urges the development of alternative methods to assess the efficacy of transmission blocking interventions.
Quantitative Assessments of Pupillary Light Reflexes in Hospital-Onset Unconsciousness
Authors: Lee Hyunjo , Choi Soh Hyun , Park Bobin , Hong Yoon-Hee , Lee Han-Bin , Jeon Sang-Beom
Published: November 2020

BackgroundPatients who develop hospital-onset unconsciousness should be promptly managed in order to avoid clinical deterioration. Pupillary examination through pupillary light reflex is the mainstay method in the initial evaluation of unconscious patients, but the current method of light shedding and subjective description often shows poor reliability. The objective of this study is to explore whether a quantitative measurement of pupillary light reflexes is useful in detecting brain herniation syndrome and predicting neurological outcomes in non-neurological patients who developed hospital-onset unconsciousness.MethodsThis was a registry-based observational study on patients who activated the neurological rapid response team at Asan Medical Center (Seoul, Korea). Hospital-onset unconsciousness was defined as a newly developed stupor or comatose state during admission. Demographics, comorbidities, pupillometry parameters including Neurological Pupil index, brain herniation syndrome, in-hospital mortality, and modified Rankin Scale at 3-months were analyzed.ResultsIn 214 consecutive patients with hospital-onset unconsciousness, 37 (17%) had brain herniation syndrome. The optimal cut-off value of Neurological Pupil index for detecting brain herniation syndrome was < 1.6 (specificity, 91% [95% confidence interval (CI) = 86−95]; sensitivity, 49% [95% CI = 32−66]). The in-hospital mortality rate was 28% (59/214); the Neurological Pupil index was negatively associated with in-hospital mortality after adjustments for the presence of brain herniation syndrome (adjusted odds ratio = 0.77, 95% CI = 0.62–0.96). Poor neurological outcomes (modified Rankin Scale ≥ 4) at 3 months was observed in 76% (152/201) of the patients; the Neurological Pupil index was negatively associated with poor neurological outcomes after adjustments for clinical variables (adjusted odds ratio = 0.67, 95% CI = 0.49–0.90). ConclusionsQuantitative measurements of pupillary light reflexes may be useful for early detection of potentially life-threatening neurological conditions in patients with hospital-onset unconsciousness.
Role of Umbilical Cord C-Peptide Levels in Early Prediction of Hypoglycemia in Infants of Diabetic Mothers
Authors: Saber Ahlam , Mohamed Magdy , Sadek Abdelrahim , Mahmoud Ramadan
Published: November 2020

Background: Until now, diabetes during pregnancy has been associated with a high risk of maternal, fetal, and neonatal morbidities and mortalities. The main aim of this study was to evaluate the risk factors of hypoglycemia in infants of diabetic mothers (IDMs) and to study the relationship between umbilical cord (UC) C peptide levels and the risk of developing hypoglycemia.Material and methods: UC blood C-peptide and serial serum blood glucose measurements were done for all included singleton newborns born to diabetic mothers during the study period. Maternal and neonatal data such as gestational age, maternal age, maternal weight, types of diabetics and its control, maternal glycated hemoglobin (HbA1C), birth weight, Apgar score, and neonatal complete blood picture were collected.Results: In total, 83 IDMs met the inclusion criteria. Fifty-four (65.06%) developed hypoglycemia and 29 (34.94%) remained normoglycemic. However, there were no significant differences between hypoglycemic and normoglycemic IDMs in terms of types of maternal diabetics (P value = 0.41), its duration (P value= 0.43). The hypoglycemia peak occurred within the first 3 hours of life, with 33.11 ± 8.84 mg/dl for the hypoglycemia group and 54.10 ± 6.66 mg/dl for the normoglycemic group (P value < 0.0001). Most of the babies had no hypoglycemic manifestation (96.30%). Neonates with hypoglycemia their mothers had poor diabetes control in the last trimester (HbA1C 7.09 ± 0.96) compared to normoglycemic babies (HbA1C 6.11 ± 0.38), (P-value < 0.0001). The mean (SD) of UC C-peptide level in hypoglycemic neonates increased to 1.73 ± 1.07 ng/ml compared to normoglycemic ones with 1.08 ± 0.81 ng/ml (P value = 0.005).Conclusion: Poor diabetes control, especially in the last trimester, is associated with neonatal hypoglycemia. Increased UC C-peptide levels could be used as an early indicator for the risk of developing neonatal hypoglycemia and a predictor for babies need neonatal admission.
Understanding and Recognition of the Right Ventricular Function and Dysfunction: A Numerical Study
Authors: Comunale Giulia , Peruzzo Paolo , Castaldi Biagio , Razzolini Renato , Salvo Giovanni Di , Padalino Massimo , Susin Francesca
Published: November 2020

The role played by the right ventricular (RV) dysfunction has long been underestimated in clinical practice. Recent findings are progressively confirming that when the RV efficiency deteriorates both the right and the left circulation is (significantly) affected, but studies dedicated to a detailed description of RV hemodynamic role still lack. In response to such a gap in knowledge, this work proposes a numerical model that for the first time evaluates the effect of isolated RV dysfunction on the whole circulation. Lumped parameter modelling was applied to represent the physio-pathological hemodynamics. Different grades of impairment were simulated for three dysfunctions i.e., systolic, diastolic, and combined systolic and diastolic. Hemodynamic alterations (i.e., of blood pressure, flow, global hemodynamic parameters), arising from the dysfunctions, are calculated and analysed. Results well accord with clinical observations, showing that RV dysfunction significantly affects both the pulmonary and systemic hemodynamics. Successful validation against in vivo data proved the clinical potentiality of the model i.e., the capability of identifying the degree of RV impairment for given hemodynamic conditions. This study aims at contributing to the improvement of RV dysfunction recognition and treatment, and to the development of tools for the clinical management of pathologies involving the right heart.
A Principal Components Analysis of Factors Associated with Successful Implementation of an LVAD Decision Support Tool
Authors: Kostick Kristin M. , Trejo Meredith , Bhimaraj Arvind , Civitello Andrew , Grinstein Jonathan , Horstmanshof Douglas , Jorde Ulrich P. , Loebe Matthias , Mehra Mandeep R. , Sulemanjee Nasir Z. , Thohan Vinay , Trachtenberg Barry H. , Uriel Nir , Volk Robert J. , Estep Jerry D. , Blumenthal-Barby J. S.
Published: November 2020

BackgroundA central goal among researchers and policy makers seeking to implement clinical interventions is to identify key facilitators and barriers that contribute to implementation success. Despite calls from a number of scholars, empirical insights into the complex structural and cultural predictors of why DAs become routinely embedded in health care settings remains limited and highly variable across implementation contexts.MethodsWe examined associations between “reach”, a widely used indicator (from the RE-AIM model) of implementation success, and multi-level site characteristics of nine LVAD clinics engaged over 18 months in implementation and dissemination of a decision aid for left-ventricular assist device (LVAD) treatment. Based on data collected from nurse coordinators, we explored factors at the level of the organization (e.g. patient volume), patient population (e.g. health literacy; average sickness level), clinician characteristics (e.g. attitudes towards decision aid; readiness for change) and process (how the aid was administered). We generated descriptive statistics for each site and calculated zero-order correlations (Pearson’s r) between all multi-level site variables including cumulative reach at 12 months and 18 months for all sites. We used principal components analysis (PCA) to examine any latent factors governing relationships between and among all site characteristics, including reach.ResultsWe observed strongest inclines in reach of our decision aid across the first year, with uptake fluctuating over the second year. Average reach across sites was 63% (s.d.=19.56) at 12 months and 66% (s.d.=19.39) at 18 months. Our (PCA) revealed that site characteristics positively associated with reach on two distinct dimensions, including a first dimension reflecting greater organizational infrastructure and standardization (characteristic of larger, more established clinics) and a second dimension reflecting positive attitudinal orientations, specifically, openness and capacity to give and receive decision support among coordinators and patients.ConclusionsSuccessful implementation plans should incorporate specific efforts to promote supportive and mutually informative interactions between clinical staff members and to institute systematic and standardized protocols to enhance the availability, convenience and salience of intervention tool in routine practice. Further research is needed to understand whether “core predictors” of success vary across different intervention types.
Effects of Abiotic Elicitors on Expression and Accumulation of Three Candidate Benzophenanthridine Alkaloids in Cultured Greater Celandine Cells 
Authors: Hashemi Seyed Mohammad , Naghavi Mohammadreza , Ghorbani Mehdi , Zandi Peiman
Published: November 2020

Efforts to develop the necessary biotechnologies in Greater Celandine (Chelidonium majus L.), a leading plant resource for the development of plant-derived medicines, have been hampered by the lack of knowledge about transcriptome and metabolome regulations of its medicinal components. Therefore, this study aimed to examine the effect of abiotic elicitors, methyl jasmonate (MJ) and salicylic acid (SA), at different time courses (12, 24, 48, and 72 h), on expression and metabolome of key benzophenanthridine alkaloids (BPAs) in an optimized in vitro culture. Gene expression analysis indicated the up-regulation of CFS to 2.62, 4.85, and 7.28 times higher than the control at 12, 24, and 48 h, respectively, under MJ elicitation. Besides, MJ up-regulated the expression of TNMT to 2.79, 4.75, and 7.21 times at 12, 24, and 48 h, respectively, compared to the control. Investigation of BPAs revealed a significant enhancement in the chelidonine content (9.86 µg/mg) after 72 h of MJ elicitation. Additionally, sanguinarine content increased to its highest level (3.42 µg/mg) after 24 h of MJ elicitation; however, no significant enhancement was detected in its content in shorter elicitation time courses. Generally, higher gene expression and BPAs’ level was observed through longer elicitation courses (48 and 72 h). Our findings take part in improving the understanding of transcription and metabolic regulation of BPAs in cultured Greater Celandine cells.
Associations Between Predialysis Creatinine, SOFA Score, and Mortality in Acute Kidney Injury Patients Requiring Dialysis
Authors: Chang Hsin-Hsiung , Wu Chia-Lin , Chiu Ping-Fang
Published: November 2020

Background: Creatinine is widely used to estimate renal function, but this is not practical in critical illness. Low creatinine has been associated with mortality in many clinical settings. However, the associations between predialysis creatinine level, Sepsis-related Organ Failure Assessment (SOFA) score, and mortality in acute kidney injury patients receiving dialysis therapy (AKI-D) has not been fully addressed. Methods: We extracted data for AKI-D patients in the eICU (n = 1,992) and MIMIC (n = 1,001) databases. We conducted a retrospective observational cohort study using the eICU dataset. The study cohort was divided into the high-creatine group and the low-creatinine group by the median value (4 mg/dL). The baseline patient information included demographic data, laboratory parameters, medications, and comorbid conditions. The independent association of creatinine level with mortality was examined using multivariate logistic regression analysis. We also carried out a sensitivity analysis using the MIMIC dataset.Results: In all 1,992 eICU participants, the 30-day intensive care unit mortality rate was 32.2%. The crude overall mortality rate in the low-creatinine group (43.7%) was significantly higher than that in the high-creatinine group (20.6%; P < 0.001). In the fully adjusted models, the high-creatinine group was associated with a lower risk of all-cause mortality (odds ratio, 0.56; 95% confidence interval, 0.42–0.75; P < 0.001) compared with the low-creatinine group. The nonrenal SOFA score was higher in the low-creatinine group. The results were consistent when the MIMIC dataset was used as an external validation dataset.Conclusions: AKI-D patients with a low predialysis creatinine value had a significantly higher risk of mortality that might be associated with more organ dysfunctions. Moreover, SOFA and nonrenal SOFA scores did not sufficiently reflect the severity of illness without considering the impact of the creatinine value in AKI-D patients.
Content Validation of Educational Materials on Maternal Depression in Nigeria
Authors: Adefolarin Adeyinka Olufolake , Asiki Gershim
Published: November 2020

BackgroundContent validation is a process of obtaining evidence from experts to ensure that the domains or the message of a measurement tool or educational material performs its intended purpose. This study describes the validation of developed educational materials (poster, leaflet and song), which are available in local languages for health education on maternal depression in Ibadan, South-West, Nigeria. MethodsThis cross sectional study used experts’ judgement and clients’ evaluation. Six experts and 50 maternal-child health clients for each material participated. Suitability Assessment of Materials (SAM) tool and its Yoruba translated version were used by the experts and the clients respectively. The outcomes include Cronbach alpha coefficient ≥ 0.8, Item level- Content Validity Index (I-CVI) ≥0.78, Scale – Item Content Validity/ Universal Agreement (S-ICV/UA) ≥ 0.8, interclass coefficient (ICC)0 ≥0.7, and the proportion of of rating of suitability assessment of material among clients. Reliability test, calculation by formula. descriptive statistics and Fisher exact were used respectively for the statistical analysis with SPSS version 25. ResultsThe mean age of the experts was 41.6±7.2 years and that of maternal child health clients was 30.7±5.4 years for poster, 31.3±5.2 for leaflet and 29.0±5.1 for song. Cronbach alpha reliability coefficient of the translated SAM were; 0.69 for poster, 0.87 for leaflet and 0.20 for song. The Interclass Coefficient (ICC) of all the materials were; leaflet (0.97); poster (0.89); song (0.98) and the internal consistency Cronbach alpha coefficients >0.8. The validity index for the materials were; leaflet (0.94), poster (0.94) and song (1.00). The Item Scale Level Universal Agreement (S-ICVI/UA) was >0.8 for all the materials. Nearly all clients (96%) rated song content as superior. The poster and leaflet were rated as superior by 74% and 68% of clients respectively. Clients rated the content, literacy demand and cultural appropriateness domains as superior regardless of their sociodemographic characteristics. ConclusionThese locally developed education materials for maternal depression have excellent content validity of experts and were highly rated by clients. This process should inform the development of content of other education materials in Africa.
Multivariate Logistic Regression Analysis of the Outcomes After Humeral Head Replacement: A Case Series
Authors: Chen Chunhui , Wang Xingyu , Lin Xubo
Published: November 2020

Background: The aim of our study was to explore the risk factors affecting the treatment of humeral head replacement. Methods: 52 patients with humeral head replacement surgery were enrolled in the study. The information of patients were recorded. The treatment outcomes of humeral head replacement were evaluated by ASES scores. The indicators that may affect humeral head arthroplasty surgery effect were analyzed by univariate analysis and multivariate logistic regression analysis. Results: Univariate analysis showed: the differences of age, time from injury to surgery, time to start exercising after surgery, whether the patient regular follow-up, visual Analogue Scale(VSA), whether with shoulder dislocation, and whether with osteoporosis, were statistically significant (P <0.05). Multivariate Logistic regression analysis showed that age, time from injury to surgery, whether with shoulder dislocation, time to start exercising after surgery, and whether the patient regular follow-up were the influencing factors, but whether with osteoporosis and VSA were not illustrated as a risk factor. Conclusion: Age, time from injury to surgery, time to start exercising after surgery, whether with shoulder dislocation, and whether the patient regular follow-up may be the chief factors affecting humeral head replacement surgery. Trial Registration: This trial was registered at the Research Registry on June 22, 2018(researchregistry3243, https://www.researchregistry.com/browse-the-registry).
Association of Menopausal Status with COVID-19 Outcomes: A Propensity Score-Matching Analysis
Authors: Wang Xing-Wang , Hu Hao , Xu Zhi-Yong , Zhang Gong-Kai , Yu Qing-Hua , Yang Hui-Lan , Zheng Ji-Hua
Published: November 2020

Background: Despite the growing number of studies on the Coronavirus Disease-19 (COVID-19), little is known about the association of menopausal status with COVID-19 outcomes.Materials and methods: In this retrospective study, we included 336 COVID-19 in-patients between February 15, 2020 and April 30, 2020 at the Taikang Tongji Hospital (Wuhan), China. Electronic medical records, including patient demographics, laboratory results, and chest computed tomography (CT) images were reviewed. Results: In total, 300 patients with complete clinical outcomes were included for analysis. The mean age was 65.3 years and most patients were women (n=167, 55.7%). Over 50% of patients presented with comorbidities, with hypertension (63.5%) being the most common comorbidity. After propensity-score matching, results showed that men had significantly higher odds than premenopausal women for developing severe disease type (23.7% vs. 0%, OR 17.12, 95% CI 1.00–293.60; p=0.003) and bilateral lung infiltration (86.1% vs. 64.7%, OR 3.39, 95% CI 1.08–10.64; p= 0.04), but not for mortality (2.0% vs. 0%, OR 0.88, 95% CI 0.04–19.12, p=1.00). However, non-significant difference was observed among men and post-menopause women in the percentage of severe disease type (32.7% vs. 41.7%, OR 0.68, 95% CI 0.37–1.24, p=0.21) and bilateral lung infiltration (86.1% vs. 91.7%, OR 0.56, 95% CI 0.22–1.47, p=0.24), mortality (2.0% vs. 6.0%, OR 0.32, 95% CI 0.06–1.69, p=0.25).Conclusions: Men had higher disease severity than premenopausal women, while the differences disappeared between postmenopausal women and men. These findings support aggressive treatment for the poor-prognosis of postmenopausal women in clinical practice.
Picomolar Binding Selective Human Ron Inhibitory Antibodies Directed to Surface Displayed Conformational Epitopes for Imaging and Therapy  
Authors: Koh Xin Yu , Koh Xiao Hui , Spiegelberg Diana , Jha Preeti , Nestor Marika , Hwang Le-ann , Tan Ban Xiong , Lane David
Published: November 2020

BackgroundThe RON protein is an exceptionally interesting target in oncology and immunology. It is not only overexpressed in a wide variety of tumors but also has been shown to be expressed on myeloid cells associated with tumor infiltration, where it serves to dampen tumour immune response and reduce the efficacy of anti-CTLA4 therapy. Potent and selective inhibitory antibodies to RON might therefore both inhibit tumor cell growth and stimulate immune rejection of tumors. MethodsWe derived a new panel of exceptionally avid anti-RON antibodies with using traditional hybridoma technologies with picomolar binding affinities that inhibit MSP-induced RON signaling and show remarkable potency in antibody dependent cellular cytotoxicity (ADCC). ResultsWhen radiolabeled with 89-Zirconium, the new antibodies 3F8 and 10G1 also allow effective immuno-positron emission tomography (immunoPET) imaging of RON-expressing tumors and recognize universally exposed RON epitopes at the cell surface. Conclusion In addition to their development as anti-RON cancer therapeutics, the new antibodies have great potential to be developed for tracking RON expressing tumours and metastases in cancer patients as diagnostic PET imaging agents, either as whole IgG or as a minibody.
Integrated Bioinformatics Analysis Reveals Potential Mechanisms Associated with Intestinal Flora Intervention in Non-alcoholic Fatty Liver Disease
Authors: Liu Yingying , Liu Xinkui , Zhou Wei , Zhang Jingyuan , Guo Siyu , Jia Shanshan , Wu Jiarui , Wang Haojia , Li Jialin , Tan Yingying
Published: November 2020

Background

Non-alcoholic fatty liver disease (NAFLD) is a common chronic liver disease that imposes a huge economic burden on global public health. And the gut-liver axis theory supports the therapeutic role of intestinal flora in the development and progression of NAFLD. To this end, we designed bioinformatics study on the relationship between intestinal flora disorder and NAFLD, so as to explore the molecular mechanism of intestinal flora interfering with NAFLD.
Methods

Differentially expressed genes for NAFLD were obtained from GEO database. And the disease genes for NAFLD and intestinal flora disorder were obtained from the disease databases. Using string 11.0 database to establish protein-protein interaction network relationship and cytoscape 3.7.2 software visualization. Cytoscape plug-in MCODE and cytoHubba were used to screen the potential genes of intestinal flora disorder and NAFLD, so as to obtain potential targets for intestinal flora to interfere in the occurrence and process of NAFLD. Enrichment analysis of potential targets was carried out using R 4.0.2 software.
Results

The results showed that PTGS2, SPINK1 and C5AR1 may be the key genes for intestinal flora to interfere with NAFLD. CCL2, IL6, IL1B and FOS may be key genes for the development and progression of NAFLD. The gene function is mainly reflected in basic biological processes, including the regulation of metabolic process, epithelial development and immune influence. The pathway is mainly related to signal transduction, immune regulation and physiological metabolism. The TNF signaling pathway, AGE-RAGE signaling pathway in the diabetic activity, and NF-Kappa B signaling pathways are important pathways for intestinal flora to interfere with NAFLD.
Conclusion

According to the analysis results, there is a certain correlation between intestinal flora disorder and NAFLD. It is speculated that the mechanism by which intestinal flora may interfere with the occurrence and development of NAFLD is mainly related to inflammatory response and insulin resistance. Nevertheless, further research is needed to explore the specific molecular mechanisms.
Impact of Physical Activity and Type of Cooking Oil Amongst Diabetes With Co-existing Hypertension Patients on Length of Stay and Cost: General Linear Model
Authors: Sharma Amit , Baldi Ashish , Sharma Dinesh Kumar
Published: November 2020

Background: Diabetes mellitus with co-existing hypertension contributes to increased morbidity and mortality. The study aimed to investigate the impact of the patients' physical activity status and the type of cooking oil consumed by patients in their daily routine on glycemic profile, lipid profile, the hypertensive profile of the patients, and the length of stay and overall cost of the treatment.Methods: A prospective observational study. All the patients who referred to the medicine department of the three different hospitals located in Moga, City Punjab and those who were hospitalized due to diabetes mellitus (type-I and type-II) with co-existing hypertension were asked to participate in the study.Results: The patients' mean age was found to be M= 53.85, SD= 11.54 years. Out of 1914 patients, 914 were male (47.8%); it was observed that the majority of the patients 525 (27.43%) in North India using butter or ghee- clarified butter as edible oil, followed by mustard oil 517 (27.01%) patients. About 345 (18.03%) of the patients consume soybean oil, whereas 226 (11.81%) of the patients like sunflower oil. Discussion: This study explored that cooking oil and physical activity are associated with length of stay in days & overall cost of the treatment, respectively. Our study results revealed that the type of oil compared with the treatment's overall cost was significant for olive oil, soybean oil, and groundnut oil.Conclusion: The study revealed that moderate and low physical activity increases the length of stay compared to high physical activity. The consumption of olive oil as a regular food habit in daily routine decreases patients' length of stay with diabetes with coexisting hypertension when doing high physical activity but increases the overall cost of treatment.
Spino-pelvic sagittal parameters in patients with degenerative thoracolumbar kyphosis combined with lumbar stenosis syndrome
Authors: Xu Shuai , Guo Chen , Liang Yan , Zhu Zhenqi , Liu Haiying
Published: November 2020

Objective The patients diagnozed degenerative thoracolumbar kyphosis (DTLK) with lumbar spinal syndrome (LSS) were enrolled, to identify the significance of spino-pelvic parameters in this group.Methods An overall 138 (M/F=53/85) patients were enrolled with a mean follow-up of 24.6±11.1 (m). All cases were performed short-segment posterior fusion on LSS region. Radiological parameters were TLK, LL, PI, PT and SVA obtained on the X-ray. Quality of life (QOL) were evaluated by the visual analogue scale (VAS) and the Oswestry disability index (ODI). Accorrding to age-related formula by Lafage, various thresholds on PI-LL, PT and SVA were determined, ensuing three pairs of normal and abnormal groups were respectively divided into based on these parameters. Results Both VAS and ODI statistically improved (P <0.001). At the endpoint, TLK decreased by a mean of 8.2±8.8° and cases got TLK-correction occupied 40.4%. The whole balance status (normal SVA) was improved compared to baseline (P=0.006), so was the ratio of matched PI-LL (P=0.002), but the ratio of normal PT and larger PT was of no significance (P=0.794). The final balance status was irrelevant to QOL whatever balance status at baseline. However, ODI in PI-LL matched group or in normal PT group were respectively less than that of abnormal groups (P=0.022 and P=0.019).Conclusions The mean TLK decreased even a short-segment fusion purely performed on LSS. QOL was related to PI-LL and PT, but not to SVA in DTLK patients.
COVID-19 Outbreaks and Age Mortality Patterns
Authors: Shapiro Vladimir
Published: November 2020

As of the Fall of 2020, many countries are still fighting the COVID-19 pandemic. After the painful first massive wave in the Spring, more and more of them are facing the new outbreaks of varying impact. Understanding the mortality pattern associated with such subsequent outbreaks would help governments better prepare and save lives. These secondary outbreaks are still quite new to the scientists as the data have not been sufficient to identify robust trends. By now, US is dealing with the second outbreak of large magnitude and statistically significant analyses are finally possible. We have analyzed the weekly mortality death counts for various ages in US for the entire COVID-19 pandemic duration. Three somewhat related features involving age at death have been extracted: a) COVID-19 average age at death, b) fraction of deaths at ages 65+, and c) slope of age gradient regression line on the logarithmic scale. It turns out that during the outbreak the mortality age gradient is undergoing the following changes: a) average age at death at the peak is 4-5 years higher than at the lower point; b) fraction of deaths of 65+ is by approximately 10% higher, and c) the higher slope of the age gradient translates into an extra death risk of 5.8% every year. In other words, risks, to which an elderly population is exposed during all phases of the pandemic, rise sharply during and right after the outbreak peaks.
A Serological Survey of Brucellosis in Wildlife in Four Major National Parks of Uganda
Authors: Aruho Robert , MacLeod Ewan T. , Manirakiza Leonard , Rwego Innocent Bidason
Published: November 2020

Background: Brucellosis is a contagious zoonotic disease of great public health and economic significance especially in developing countries. The disease affects humans and several species of livestock and wildlife. Studies on Brucellosis in wildlife in Uganda have been limited to single populations particularly in Queen Elizabeth National Park. This study aimed at estimating the seroprevalence of Brucella spp. in wildlife in four major national parks of Uganda. This was a retrospective survey which utilized archived samples collected from wildlife during the annual disease surveillance activities between 2013 and 2017. Results: A total of 241 samples from seven species namely African buffalo (Syncerus caffer, n = 109), African elephant (Loxodonta africana, n = 22), giraffe (Giraffa camelopardalis rothschildi, n = 41), Uganda kob (Kobus kob thomasi, n = 36), lion (Panthera leo, n = 6), plain zebra (Equus quagga, n = 25), and bushbuck (Tragelaphus scriptus, n = 2), were tested for antibodies using the Rose Bengal Plate Test. The overall seroprevalence in the four national parks was 31.1% (75/241; 95% CI: 25.6 - 37.2). Kidepo Valley National Park had a significantly higher seroprevalence of 55.9% (19/34; 95% CI: 39.5 - 71.1) compared to other sampled national parks (p < 0.05). Lions had significantly higher seroprevalence at 66.7% (4/6) than African buffalo at 48.6% (53/109; p < 0.0001). There were no antibodies for Brucella spp. detected in African elephant and bushbuck. Conclusion: This study shows variations in prevalence of brucellosis between species and across national parks and notably a high prevalence of brucellosis in wildlife in Uganda than that recorded elsewhere in sub-Saharan region of Africa. Potential for transmission to other wildlife and spill over to livestock is high especially in national parks with high livestock-wildlife interaction.
Effect of activity level after a posterior-stabilized TKA on the relative bone mineral density measured on standard radiographs in periprosthetic tibial bone: a five-year follow-up study
Authors: Liu Yong , He Peiheng , Li Xing , Ye Yongheng , Liu Minghao , Chen Weizhi , XU Dongliang
Published: November 2020

Background: The aim of this study was to evaluate the effect of activity level after a posterior-stabilized TKA on the relative bone mineral density measured on standard radiographs in periprosthetic tibial bone. Methods: A retrospective review identified 110 patients (110 knees，20 men/90 women) who underwent PS TKA with 5-year follow-up. Patients activity level was evaluated by University of California Los Angeles (UCLA) activity score, and the relative BMD in periprosthetic tibial bone was measured by ImageJ software on anteroposterior X-ray images. Clinical assessments included Western Ontario and McMaster Universities (WOMAC), Knee Society score, VAS score and UCLA activity score. Nonlinear regression analysis was used to assess the impact of activity levels on periprosthesis bone density.Results: During 5-year follow-up period, the bone density in the medial, lateral and distal areas decreased compared with that before surgery (p<0.0001). There was a U-shaped distribution between UCLA activity rating and rBMD loss, with the lowest rBMD loss when the UCLA activity score was between 6-8 at 1 and 3 years. The curve fitting of UCLA activity level and rBMD% showed there was a parabolic relationship between UCLA activity level and rBMD% at 1 and 3 years after surgery (P<0.001, P=0.001), while there was no significant relationship between UCLA activity level and rBMD% at 5 years after surgery (P=0.436).Conclusions: We found that activity level had a significant effect on radiographic measurements of BMD at early years after surgery and moderate activity was associated with a minimal reduction in proximal tibial BMD.
How Does Globalization Affect COVID-19 Responses?
Authors: Bickley Steve J. , Chan Ho Fai , Skali Ahmed , Stadelmann David , Torgler Benno
Published: November 2020

Background: The ongoing COVID-19 pandemic has highlighted the vast differences in approaches to the control and containment of coronavirus across the world and has demonstrated the varied success of such approaches in minimizing the transmission of coronavirus. While previous studies have demonstrated high predictive power of incorporating air travel data and governmental policy responses in global disease transmission modelling, factors influencing the decision to implement travel and border restriction policies have attracted relatively less attention. This paper examines the role of globalization on the pace of adoption of international travel-related non-pharmaceutical interventions (NPIs) during the coronavirus pandemic. This study aims to offer advice on how to improve the global planning, preparation, and coordination of actions and policy responses during future infectious disease outbreaks with empirical evidence.Results: The results of our survival analysis suggest that more globalized countries, accounting for the country-specific timing of the virus outbreak and other factors, are quicker to adopt international travel restrictions policies. However, countries with high government effectiveness were more cautious in the implementation of travel restrictions if they are more globalized, particularly if through formal political and trade policy integration. This finding is supported by a placebo analysis on domestic NPIs, where such a relationship is absent. Additionally, we find that globalized countries with high state capacity are more likely to have higher numbers of confirmed cases by the time a first restriction policy measure was taken. Conclusions: The findings highlight the dynamic relationship between globalization and protectionism when governments respond to significant global events such as a public health crisis. We suggest that the observed caution of policy implementation by countries with high government efficiency and globalization is a by-product of commitment to existing trade agreements, a greater desire to ‘learn from others’ and also perhaps of ‘confidence’ in a government’s ability to deal with a pandemic through its health system and state capacity. Our results suggest further research is warranted to explore whether global infectious disease forecasting could be improved by including the globalization index and in particular, the de jure trade and political (sub)dimensions and de facto interpersonal and cultural (sub)dimensions of globalization. By acting as proxies for a countries’ likelihood and speed of implementation for international travel restriction policies, such measures may predict the likely time delays in disease emergence and transmission across national borders.