bluuebunny/crossref_metadata_2025 huggingface dataset:
Providing medical care for suspected human trafficking victims: Perceptions among a cohort of health care providers in Myanmar
Authors: Zachariah Sybil , Sharma Ashish , Bills Corey B , Ohn Htoo Ma (Tony) , Walker Rebecca
Published: May 2020

Background: Myanmar is a source country for men, women, and children who are subject to human trafficking and forced labor. Given that human trafficking and forced labor victims frequently experience physical and mental health concerns, healthcare practitioners have a unique opportunity to identify and assist victims. This study aims to understand the attitudes, perspectives, and levels of comfort for healthcare providers in caring for victims of human trafficking. It also seeks to understand the types of additional educational resources that could better equip medical personnel to improve care for survivors of human trafficking.Methods: A 20-question survey collected data anonymously from a convenience sample of healthcare providers that attended a one-day emergency care conference in Yangon, Myanmar.Results: While a significant number (70%) of medical professionals surveyed reported that they feel the problem of abuses for labor or sex in the community was "serious" or "very serious", a majority of them felt neutral or uncomfortable about identifying patients that are currently being abused in some way. Only 2% of respondents felt comfortable identifying victims of abuse. Over half of the healthcare workers surveyed indicated they would be interested in attending conferences, symposia, or lectures specific to human trafficking and receiving training in identifying victims and assisting victims of exploitation.Conclusions: Health care providers in Myanmar consider labor and sex trafficking as a significant problem in their community, but do not feel adequately trained to identify and help victims of exploitation. Given that even brief educational interventions can increase providers knowledge and self-reported recognition of human trafficking victims, there is a window of opportunity in Myanmar to provide training to currently practicing health providers.
Longitudinal prospective evaluation of oral health-related quality of life in young patients undergoing fixed orthodontic appliance treatment as part of a randomised trial
Authors: Elhussein Mustafa , Benson Philip
Published: May 2020

Background

The objectives of this study were to investigate relationships between change in the aesthetic appearance before and after orthodontic treatment and patient-reported change in oral health-related quality of life (OHRQoL), and to assess the responsiveness of two OHRQoL measures to any changes from orthodontic treatment.
Methods

Two hundred and ten participants in a multicentre (two teaching hospitals and four specialist orthodontic practices), single blinded, randomised clinical trial with 2 parallel groups, were administered one of two age-specific questionnaires, either the Child Perceptions Questionnaire (CPQ11-14-ISF-16) or the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ), before and after orthodontic treatment. Clinical photographs were assessed by two groups of laypeople and orthodontists using the Index of Orthodontic Treatment Need Aesthetic Component (IOTN-AC).
Results

Two hundred and ten participants were randomised, and 197 completed the trial. Before and after OHRQoL data were successfully obtained from 110 participants. There was a mean reduction in the total CPQ11-14-ISF-16 scores of 3.9 (SD = 8.0), and a mean reduction of 34.2 (SD = 18.5) in the total PIDAQ score. CPQ11-14-ISF-16 demonstrated poor longitudinal construct validity (p = 0.155). Correlations between the change in total CPQ11-14-ISF-16 scores and change in IOTN-AC assessments were small for both orthodontists (r=-0.084; p = 0.516) and laypeople (r=-0.140; p = 0.225). There were higher associations between the improvement in the Social well-being (SWB) subdomain and improvement in IOTN-AC. Correlations between the changes in total PIDAQ scores and the IOTN-AC assessments, were higher in comparison to the correlations with CPQ11-14-ISF-16 (orthodontists; r = 0.223, laypeople; r = 0.025). There were no adverse effects.
Conclusion

CPQ11-14-ISF-16 and IOTN-AC measure different attributes. This demonstrated the role of SWB on children OHRQoL. Condition-specific measures (PIDAQ) are more responsive to change in self-reported OHRQoL than generic measures (CPQ11-14-ISF-16) after treatment.
Trial Registration:

The trial was registered at ClinicalTrials.gov NCT01925924.
Comparative In Vitro Quality Evaluation of Different Brands of Ibuprofen Tablets Marketed in Mekelle, Ethiopia
Authors: Welegebrial Brhane Gebrehiwot , Kahsay Getu , Eticha Tadele , Gebretsadik Hailekiros
Published: May 2020

Objective Quality of pharmaceutical products is required to guarantee their safety and efficacy. The aim of this study was to evaluate the physicochemical quality attributes of different brands of ibuprofen tablets marketed in Mekelle, Ethiopia. The methods stated in the British Pharmacopeia were adopted for weight uniformity, hardness, friability, disintegration test and assay of drug content. Dissolution test was also carried out as stated in the United States Pharmacopeia. To compare dissolution profile, statistical analysis of drug release at different time points were employed.Results All the brands were found with acceptable pharmacopeial specifications for weight uniformity, friability, hardness, assay of drug content and dissolution test. Six brands fulfilled the pharmacopeial requirements of disintegration test while one brand failed to disintegrate as per the BP specification. However, there were statistically significant difference in weight, hardness, disintegration, dissolution and amount of drug content among the tested samples. Thus, from this study we can conclude that all the products fulfilled the required quality evaluation parameters as stipulated in pharmacopeias except one brand which failed the disintegration test. However, the in vitro dissolution profile indicated that there may be a potential bio-in equivalence among the pharmaceutical products.
Estimating Sex from second and seventh cervical vertebras in Iranian adult population using Computed Tomography scan images
Authors: Mostafavi Reza Saadat , Memarian Azadeh , Amiri Arezoo , Motamedi Omid
Published: May 2020

Objectives The study aimed to estimating the sex from several metric dimensions of second and seventh cervical vertebras using Computed Tomography (CT) scan images of a series of Iranian adult populations. In this study, sexual dimorphism of 15 indexes of second cervical vertebra and 10 indexes of the seventh cervical vertebra were investigated. Indexes were obtained from CT scan images of 70 patients who underwent CT scan imaging for other indications.Results Among measured dimensions of the second vertebra, 9 were associated with sex. Of these indexes, Maximum width of the superior Facet and Maximum height of axis were independent predictors of sex with correct sex classification of 81.4% when used in combination. Four of 10 seventh vertebra’s indexes were associated with sex: Length of superior facets, Length of the inferior surface of the vertebral body, Width of the inferior surface of the vertebral body, and the Length of spinous process. Length of the inferior surface of the vertebral body and the Length of spinous process were independent sex predictors and together provided sex classification accuracy of 78.6%. We found considerable accuracy in sex classification by using metric dimensions of second and seventh cervical vertebras in the Iranian adult population.
Association of neutrophil-to-lymphocyte ratio, neutrophil count, and VEGF on metastasis in patients with nasopharyngeal carcinoma
Authors: Ye Xingming , Lu Tianzhu , Bai Wendong , Jia Jing , Wang Lin , Zong Jingfeng , Chen Ying
Published: May 2020

Background

Systemic inflammatory responses have important roles in the development and progression of cancer, including the propensity for metastasis. A high neutrophil-to-lymphocyte ratio (NLR) is associated with poor prognosis in nasopharyngeal carcinoma (NPC), but the underlying mechanisms are not clear. Vascular endothelial growth factor (VEGF) has been reported to be involved in the recruitment of pro-angiogenic neutrophils in tumor metastasis progress. Therefore, we focused on the correlations among NLR, neutrophil count, and VEGF during metastasis and explored the reasons for changes of NLR in advanced NPC.
Methods

Consecutive patients who had been investigated with magnetic resonance imaging and irradiated with intensity-modulated radiotherapy(IMRT) from November 2011 to December 2012 were studied retrospectively. Clinical parameters (NLR, neutrophil count) were measured and their association with NPC stage advancement and VEGF were assessed using the Kruskal–Wallis test. Associations with patient survival were analyzed using the Kaplan–Meier method and log-rank test.
Results

NLR was elevated in advanced N stage (P < 0.0001) and M stage disease (P = 0.0034), but not T stage disease (P = 0.7049). Changes to the NLR in advanced N stage and M stage disease were affected most strongly by neutrophil count (P = 0.0074 and P = 0.0064, respectively) and higher NLR levels were associated with higher neutrophil count (P < 0.0001). NLR > 2.26 and positive VEGF expression (+++) correlated significantly with distant metastasis-free survival (P = 0.0340 and P = 0.0023, respectively). Neutrophil counts correlated positively with VEGF expression (P = 0.0024) in NPC tissue.
Conclusion

Our results demonstrate a positive correlation between NLR, neutrophil count, and VEGF expression in NPC. Higher NLR and VEGF expression are associated with distant metastasis-free survival among patients with NPC, which implies that they set a basis of immune activation in advanced nasopharyngeal carcinoma.
Blood Lipid Levels in Patients with Osteopenia and Osteoporosis: A Systematic Review and Meta-Analysis
Authors: Zhao Hang , Song An , Li Yong , Qi Licui , Zheng Chong , Ren Luping , Song Guangyao
Published: May 2020

Background: Considering the controversial relationship between blood lipid levels and osteopenia and osteoporosis (OP), we performed this meta-analysis.Methods: Using specific keywords and related words, we searched PubMed, Embase, and Cochrane Library databases. The Newcastle-Ottawa Scale form was used to evaluate the quality of the literature. According to the inclusion and exclusion criteria, we systematically screened the literature to extract relevant information and data. Revman 5.3 and Stata 13.0 software were used for statistical analysis. Results were expressed as the mean difference and 95% confidence interval. The heterogeneity test was conducted according to I2 and Q tests. Egger’s test was used to quantitatively evaluate publication bias.Results: This analysis involved 12 studies and included 12,395 subjects. The quality of the literature was acceptable. Among subjects who were not taking lipid-lowering drugs, total cholesterol (TC), triglycerides (TG), and low-density lipoprotein cholesterol (LDL-C) in the osteopenia were not significantly increased/decreased. There were no significant differences in LDL-C in postmenopausal women in osteopenia. TG was unchanged in the OP group in subjects without taking lipid-lowering drugs. HDL-C was elevated in OP group but not in osteopenia group in all subjectsConclusions: HDL-C was elevated in patients with OP.
Preservation of dendritic spine morphology and postsynaptic signaling markers after treatment with solid lipid curcumin particles in the 5xFAD mouse model of Alzheimer’s disease
Authors: Maiti Panchanan , Bowers Zackary L , Bourcier Ali , MOrse Jarod , Dunbar Gary L
Published: May 2020

Background Synaptic failure is one of the principal events associated with cognitive dysfunction in Alzheimer’s disease (AD). Preservation of existing synapses and prevention of synaptic loss are promising strategies to preserve cognitive function in AD patients. As a potent natural anti-oxidant, anti-amyloid, anti-inflammatory polyphenol, curcumin (Cur) shows great promise as a therapy for AD. However, hydrophobicity of natural Cur limits its solubility, stability, bioavailability and clinical utility for AD therapy. We have demonstrated that solid lipid curcumin particles (SLCP) have greater therapeutic potential than natural Cur in vitro and in vivo models of AD. In the present study, we have investigated whether SLCP has any preservative role on affected dendritic spines and synaptic markers in 5xFAD mice.Methods Six- and 12-month-old 5xFAD and age-matched wild-type mice received oral administration of SLCP (100 mg/kg body weight) or equivalent amounts of vehicle for 2 months. Neuronal morphology, neurodegeneration and amyloid plaque load were investigated from prefrontal cortex (PFC), entorhinal cortex (EC), CA1, CA3 and the subicular complex (SC). Further, dendritic spine density of apical and basal branches were studied by Golgi-Cox stain. Further, synaptic markers, such as synaptophysin, PSD95, Shank, Homer, Drebrin, kalirin-7, CREB and phosphorylated CREB (pCREB) were studied using Western blots. Finally, cognitive and motor functions were assessed using open field, novel object recognition (NOR) and Morris water maze (MWM) tasks after treatment with SLCP.Results We observed an increase number of pyknotic and degenerated cells in all these brain areas in 5xFAD mice and SLCP treatment partially protected against those losses. Decrease in dendritic arborization and dendritic spine density from primary and secondary apical and basal branches were observed in PFC, EC, CA1, CA3 in both 6- and 12-month-old 5xFAD mice and SLCP treatments partially preserved the normal morphology of these dendritic spines. In addition, pre- and post-synaptic protein markers were also restored by SLCP treatment. Furthermore, SLCP treatment improved NOR and cognitive function in 5xFAD mice.Conclusions Overall, these findings indicate that use of SLCP exerts neuroprotective properties by decreasing amyloid plaque burden, preventing neuronal death, as well as preservation of dendritic spine density and synaptic markers in the 5xFAD mice.
Evaluation of Oncological Hyperthermia Centers and Turkey Modeling Oncological Hyperthermia Centers and Turkey Modeling
Authors: Goksel Fatih , Demircioglu Fatih
Published: May 2020

Background Hyperthermia is a radio/chemo sensitizing method effectively used in oncological treatments. These devices, which have been used effectively in many centers around the world in the treatment of cancer, are currently unavailable in our country. In this study, hyperthermia treatments that could be applied, the number of hyperthermia devices required and the potential effects in our country have been investigated in line with the applications of hyperthermia worldwide.Methods Based on the data obtained from certain reference centers the number and ratios of hyperthermia applications were determined and the data obtained was modeled according to the number of cancer cases in our country.Results According to the data obtained, an average of 375 patients are treated annually per hyperthermia device in relevant centers. When a similar projection is applied for our country, hyperthermia treatment can be applied to an average of 400 patients annually with 0,18 hyperthermia devices per one million population. According to this, considering the population and the annual cancer diagnosis rates, it is predicted that 13 deep regional hyperthermia devices are required across the country.Conclusion The presence of deep regional hyperthermia devices in comprehensive oncology centers that play an effective role in oncological treatment with modern radiotherapy devices and have enough radiation oncologists will significantly benefit the capacity to provide oncological treatment options holistically.
Analyzing environmental determinants of tree species distributions and regeneration pattern in Western Himalaya, India
Authors: Thakur Arun Kumar , Kumar Rajesh , Verma Raj Kumar , Kumar Pankaj
Published: May 2020

Proper documentation of tree distribution across the globe has been considered crucial to assess the relationships between species occurrence and changing climate, and accordingly in designing the conservation action plans. Himalaya is one of the regions in the world where the temperature is gradually increasing at a rate higher than the global average. Therefore, it becomes imperative to understand the most influential parameters for major tree species distribution and its regeneration pattern across their habitat in Western Himalaya (WH) via direct gradient analysis. We used National Forest Inventory (NFI) data which has a robust statistical design with data collected in a consistent manner across the timeline in systematic order. This allowed us carrying out detail analysis to reveal the aforesaid relationship and pattern. Three topographical factors (altitude, aspect, slope), four major climatic variables (temperature, temperature seasonality, precipitation and its seasonality) and four edaphic factors (soil depth, soil humus, soil consistency and soil coarse fragments) were considered as defining variables. The results indicated that the altitude and temperature were the most determinant factors followed by precipitation in shaping the distribution of major tree species in WH. The analysis also indicated the upward shift of regenerating individuals of these tree species towards higher altitude. These relevant information about the extent of current tree distribution and their regeneration pattern over the last one and half decade might help in systematic conservation planning and monitoring range dynamics under future climate change conditions.
Characteristics and Treatment of Primary Mediastinal Seminomas: A Single-center Report of 27 Cases
Authors: Zhai Yirui , Chen Bo , Liu Kan , Feng Xiaoli , Feng Qinfu , Li Junling , Xiao Zefen , Lv Jima , Gao Yushun , Wang Shulian , Zhou Zongmei , Li Yexiong
Published: May 2020

Background: The low incidence of primary mediastinal seminomas has precluded the development of clinical trials on mediastinal seminomas. We evaluated the characteristics, treatments, and prognosis of patients with primary mediastinal seminoma. Methods: We retrospectively collected data on the clinicopathologic characteristics, treatments, toxicities, and survival of 27 patients from a single center between 2000 and 2018. Mediastinal lymph node staging for lung cancer and Masaoka staging for thymic neoplasms were used for disease characterization. Survival was assessed using the Kaplan-Meier method. Univariate analysis was performed using the log-rank test. Results: The median age was 28 (13-63) years. The most common symptoms were chest pain (29.6%), cough (25.9%), and dyspnea (22.2%). Twenty-four patients showed tumor invasion into adjacent structures. Seven and two patients were diagnosed as having lymph node metastasis and distant metastasis, respectively, whereas 48.1% of patients were diagnosed as having Masaoka stage IIIb disease. Sixteen patients (59.3%) had undergone radiotherapy, whereas 25 (92.6%) had undergone chemotherapy. The most widely used chemotherapy regimens were bleomycin, etoposide, and cisplatin. The median follow-up period was 32.23 (2.7-198.2) months. At 5 and 10 years, the rates of local regional relapse-free survival were 90.9% and 90.9%; overall survival, 100.0% and 80.0%; progression-free survival, 86.4% and 86.4%; distant metastasis-free survival, 95.2% and 95.2%; and cancer-specific survival, 100.0% and 100.0%, respectively. Conclusions: Primary mediastinal seminoma was frequently diagnosed in patients with tumor invasion into adjacent structures. Chemotherapy was the most widely used treatment. The disease was sensitive to chemoradiotherapy, and the prognosis was favorable.
MicroRNA-103a curtails the stemness of non-small cell lung cancer cells by binding to OTUB1 through the Hippo signaling pathway
Authors: Hu Zhenzhen , Xiao Dan , Qiu Tingting , Li Jun , Liu Zhentian
Published: May 2020

Background Although dysfunction of microRNA-103a (miR-103a) has been implicated in various cancers, its relevance in non-small cell lung cancer (NSCLC) is unsettled. This study was designed with an aim to examine the molecular mechanism underlying the regulatory role of miR-103a in NSCLC.Methods Kaplan-Meier analysis was carried out to study the correlation between overall survival of NSCLC patients and miR-103a expression. RT-qPCR and Western blot were applied to evaluate the expression of relevant genes in tissues and cells. Sphere formation, MTS, flow cytometry as well as Transwell assays were conducted for characterizing the stemness. Dual-luciferase reporter gene assays were applied to clarify the binding relationship between miR-103a and ovarian tumor domain-containing ubiquitin aldehyde binding protein 1 (OTUB1).Results miR-103a expression was diminished in NSCLC tissues and cells, whereas OTUB1 expression was increased. Higher miR-103 expression indicated better prognosis for patients with NSCLC. After overexpression of miR-103a, the cell viability and stemness were diminished, while the cycle arrest and apoptosis rate were facilitated, and the expression of p-YAP decreased significantly. The opposite trends were observed after miR-103a silencing. miR-103a lowered the expression of OTUB1, while overexpression of OTUB1 blocked the inhibition effects of miR-103a on NSCLC.Conclusion miR-103a/OTUB1/Hippo axis plays a possible role in modulating the malignant behavior and stemness of cells which might function as a possible therapeutic option for the management of NSCLC.
Biochemical response to cryothermal and radiofrequency exposure of the human myocardium at surgical ablation of atrial fibrillation: a randomized controlled trial.
Authors: Boano Gabriella , Aneq Meriam Åström , Spyrou Giannis , Enocsson Helena , Emmanouil Charitakis , Vánky Farkas
Published: May 2020

Background Surgical cryothermia and radiofrequency (RF) ablations for atrial fibrillation (AF) seem to result in similar sinus rhythm restoration, but the biochemical consequences of the two methods are unclear. We aimed to compare the biochemical responses to the two ablative methods in concomitant mitral valve surgery (MVS).Methods Sixty mitral valve surgery patients with AF were prospectively included. Forty-one patients planned for ablation were randomized to cryothermia (n = 20) or radiofrequency (n = 21) ablation and 19 served as controls. Markers for myocardial injury, inflammation, cell stress, apoptosis, and heart failure were analyzed pre- and postoperatively at different time points.Results Troponin T and creatine kinase isoenzyme MB (CK-MB) peak levels were significantly higher in the cryothermia group compared with the RF group (12805 [6140–15700] vs. 2790 [1880–4180] ng/L; P = 0.002 and 271 [217–357] vs. 79 [66–93] µg/L; P < 0.001, respectively). Both groups had significantly higher levels than the no-ablation group. There were no group differences in C-reactive protein (CRP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP), but there were correlations between pre- and postoperative levels of both CRP (rs=0.41, P = 0.001) and NT-proBNP (rs=0.48, P < 0.001). Protease-activated receptor 1 (PAR-1) and heat shock protein 27 (HSP27) were significantly increased in the cryoablation group.Conclusions Cryoablation results in a larger myocardial injury and possibly more elevated apoptotic activity and cell stress compared with the RF technique. The type of ablation device did not have any significant influence on the postoperative inflammatory response nor on the early postoperative levels of NT-proBNP.
Optimisation of displacement selections and structures for the Geothermal Aided Power Generation plant
Authors: Zhou Yin , Qin Jiyun
Published: May 2020

Geothermal Aided Power Generation (GAPG) technology is a method of integrating geothermal energy into a regenerative Rankine cycle (RRC) power plant. In such a power system, the geothermal energy is used to preheat the feedwater to boiler of the power plant. Therefore, the extraction steam of RRC power plant is displaced by the geothermal energy. Then, the displaced extraction steam is expended further in steam turbine to produce power. In a GAPG plant, a heat exchanger system is used to facilitate the heat exchange between the geothermal fluid and the feedwater. As power from geothermal energy comes from displaced extraction steam, different displacement selections for extraction steam would lead to different technical performance of the GAPG plant. When the geothermal fluid flows up from the geothermal well and quench to a lower temperature in the heat exchanger system, the silica scaling occurs in the heat exchanger system. As silica scaling can be controlled by adjusting geothermal fluid temperature, different displacement selections would have different influences on the silica scaling process in the heat exchanger system. There are two kinds of structures for the heat exchanger system of the GAPG plant, which are series structure and parallel structure. The different structures also lead to different performance of the GAPG plant. In present paper, a 300 MW GAPG plant is used as a case study to optimise displacement selections and structures of the GAPG plant. The results show that there is no silica scaling in the heat exchanger system for the displacement selection of geothermal energy to displace extraction to all high-pressure feedwater heaters. For this displacement selection, the power output of the Parallel GAPG plant is higher than the Series GAPG plant.
Diffusion-weighted MRI improves response assessment after definitive radiotherapy in patients with NSCLC
Authors: Jagoda Philippe , Fleckenstein Jochen , Sonnhoff Mathias , Schneider Günther , Ruebe Christian , Buecker Arno , Stroeder Jonas
Published: May 2020

Background
Computed tomography (CT) is the standard procedure for follow-up of non-small-cell lung cancer (NSCLC) after radiochemotherapy. CT has difficulties differentiating between tumor, atelectasis and radiation induced lung toxicity (RILT). Diffusion-weighted imaging (DWI) may enable a more accurate detection of vital tumor tissue. The aim of this study was to determine the diagnostic value of MRI versus CT in the follow-up of NSCLC.
Methods
Twelve patients with NSCLC stages I-III scheduled for radiochemotherapy were enrolled in this prospective study. CT with i.v. contrast agent and non enhanced MRI were performed before and 3, 6 and 12 months after treatment. Standardized ROIs were used to determine the apparent diffusion weighted coefficient (ADC) within the tumor. Tumor size was assessed by the longest longitudinal diameter (LD) and tumor volume on DWI and CT. RILT was assessed on a 4-point-score in breath-triggered T2-TSE and CT.
Results
There was no significant difference regarding LD and tumor volume between MRI and CT (p≥ 0.6221, respectively p≥ 0.25). Evaluation of RILT showed a very high correlation between MRI and CT at 3 (r = 0.8750) and 12 months (r = 0.903). Assessment of the ADC values suggested that patients with a good tumor response have higher ADC values than non-responders.
Conclusions
DWI is equivalent to CT for tumor volume determination in patients with NSCLC during follow up. The extent of RILT can be reliably determined by MRI. DWI could become a beneficial method to assess tumor response more accurately. ADC values may be useful as a prognostic marker.
An epidemiological review of tuberculosis in Sabah, Malaysia, 2012-2018
Authors: Goroh Michelle , Rajahram Giri , Avoi Richard , Boogaard Christel van den , William Timothy , Ralph Anna P , Lowbridge Christopher
Published: May 2020

Background Tuberculosis (TB) is of high public health importance in Malaysia. Sabah State, located on the island of Borneo, has previously reported a particularly high burden of disease and faces unique contextual challenges compared with peninsular Malaysia. The aim of this study is to describe the epidemiology of TB in Sabah to identify risk groups and hot spots of TB transmission.Methods We conducted a retrospective review of TB cases notified in Sabah, Malaysia, between 2012 and 2018. Using data from the state’s ‘myTB’ notification database, we calculated the case notification rate and described trends in the epidemiology, diagnostic practices and treatment outcomes of TB in Sabah within this period.Results Between 2012 and 2018 there were 33,193 cases of TB reported in Sabah (128 cases per 100,000 population). We identified several geographic hotspots, including districts with > 200 cases per 100,000 population per year. TB rates increased with age and were highest in older males. Children < 15 years accounted for only 4.6% of cases. Moderate or advanced disease on chest x-ray and sputum smear positivity was high (58% and 81% of cases respectively), suggesting frequent late diagnosis. Multi-drug Resistant (MDR) TB prevalence was low (0.3% of TB cases), however, rapid diagnostic test coverage was low (1.2%) and only 18% of all cases had a positive culture result. Treatment success was 83% in those with drug-sensitive TB and 33% in cases of MDR-TB.Conclusion Between 2012 and 2018, Sabah State accounted for 20% of Malaysia’s TB notifications, despite representing only 10% of Malaysia’s population. We found hotspots of TB in urbanised population hubs and points of migration, as well as evidence of late presentation and diagnosis. Ensuring universal health coverage and expansion of GeneXpert® coverage is recommended to reduce barriers to care and early diagnosis and treatment for TB.
How to Perform a Reliable Full Spine X-ray Examination in Juvenile and Adolescent Scoliosis Our Experience
Authors: Palandri Sergio , Trucchi Fabrizio
Published: May 2020

Background:Ionizing radiations, even at low doses, present side effects that are known as well as girls and toung women constitute the most sensible individuals from a radioprotectional point of view. On the other side full spine x-ray radiography is the gold standard in diagnose and follow-up of AIS, where individuals involved are typicaly girls and young women.For these reasons, a partuicular care permorming radiographics esamination in this scope, in mandatory.The aim of this work is to provide a simple and detailed protocol to perform full-spine X-ray examination in diagnosis and follow-up of AISThis paper is the result of our experience along 7y of work in application and study of the scoliosis in the first two decades of life, combining the orthopaedist’s requirements, the surgical requirements along with the care for the particularly significant relational feature, due to the specific category of most individuals undergoing this radiological examination.Methods:For the maximum usability and Clarity, we considered three main topics: a) single examination b) examination during orthotic treatment and c) pre-op control. For each one we explained number and type of X-ray view used and how we performed them with the assistance of detalide figures. Results:By comparing X-ray images before and after the application of our protocol, we saw a significant increase in the quality of the produced images as well as a positive feedback from patients and parents acceptance.Conclusions:An extended collaboration between the Orthopaedic Surgeons and the Radiographer, has led to a clear improvement in technical execution and in an exposure dose reduction. Furthermore a particular attention to the patient’s comfort, along with some technical stratagems, led to an improving effectiveness of the services supplied.
A Rice Promoter Protein Binding Microarray for Cis-Acting Elements for Rice Transcription Factors
Authors: KIM JOUNG SUG , Chae SongHwa , Jun Kyong Mi , Lee Gang-Seob , Jeon Jong-Seong , Kim Kyungdo , Kim Yeon-Ki
Published: May 2020

The authors have withdrawn this preprint due to author disagreement.
Spad Value Varies With Age And Leaf Of Maize Plant And Its Relationship With Grain Yield
Authors: Kandel Bishnu
Published: May 2020

Objectives A field experiment was conducted to evaluate ten hybrid maize for photosynthetic traits. Ten hybrid were replicate thricely under Randomized Complete Block Design (RCBD) during winter season of 2018. SPAD 502 Plus meter was used for SPAD value measurement. Vegetative stage all photosynthetic measurement taken from T1 (top most leaf) and T3 (2nd leaf from top leaf) leaves of 5 plants of one plot during 30 days interval. For reproductive phase data taken from Eo/ eo (Leaf attach to cob/ear), E2 or e2 (2nd leaf from Eo /eo leaf) leaves during entire period of grain filling at 10 days intervals. Same leaves were used for overall data collection.Results Result showed that significantly different SPAD value were observed for different age and leaves of maize during pre and post anthesis. SPAD value increase with increase in age and decrease at the time of maturity. During vegetative and juvenile phase T3 leaf has more SPAD value than T1. During reproductive stage eo leaves had more SPAD than e2 leaves, so center leaf of maize contributes more to grain yield. Correlation studies showed that there is strong positive correlation between different stage of SPAD with grain yield.
Efficacy and safety of a novel personalized navigation template in proximal femoral corrective osteotomy for the treatment of DDH
Authors: shi qiang , Sun Deyi
Published: May 2020

Background This present study is aimed to retrospectively evaluate the efficacy and safety of a novel personalized navigation template in proximal femoral corrective osteotomy for the treatment of DDH.Methods Twenty-nine consecutive patients with DDH who underwent proximal femoral corrective osteotomy were evaluated between August 2013 and June 2017. Based on the different surgical methods, they were divided into the conventional group (n = 14) and navigation template group (n = 15). The osteotomy degrees, radiation exposure, and operation time were compared between the two groups.Results No major complications relating to osteotomy surgery such as redislocation or avascular necrosis occurred in the navigation template group, which had more accurate osteotomy degrees, less radiation exposure, and shorter operation time when compared with the conventional group (P < 0.05). Moreover, there was significant difference according to the McKay criteria between the two groups (P = 0.0362).Conclusions The a novel personalized navigation template in proximal femoral corrective osteotomy is effective and safe, which could improve the femoral osteotomy accuracy, reduce radiation exposure, and shorten operation time.
The Feasibility Of Co-Registered Solid-State 123i-Mibg Spect And Ct Imaging For The Assessment Of Ventricular And Atrial Sympathetic Innervation In Healthy Individuals
Authors: Nikitin Nikita , Minin Stanislav , Stirrup James , Pokushalov Evgeny , Romanov Alexander
Published: May 2020

Background. To evaluate global and regional ventricular and atrial cardiac iodine-123 meta-iodobenzylguanidine (123I-mIBG) uptake and consistency over time in healthy individuals using co-registered single-photon emission computed tomography (SPECT) and computed tomography (CT) imaging. Fifteen healthy individuals (median age 31 years [26; 41]) were included in the study. All participants underwent CT and subsequent baseline 123I -mIBG SPECT imaging (early and late acquisition) using a dedicated cardiac solid-state gamma camera. The heart-to-mediastinum (H/M) ratio, wash out rate (WR), summed 123I-mIBG defect score (SDS) as well as presence and patterns of left atrium (LA) discrete 123I-mIBG uptake areas (DUA) were assessed. Follow-up SPECT imaging was acquired 5–7 days after initial procedure.Results. At baseline median H/M ratio on the early and late acquisitions were 1.61 [1.57; 1.71] and 1.68 [1.65; 1.71] respectively, the WR was 22.5% [18.8; 22.8]. Areas of reduced 123I-mIBG uptake were detected in 60% (9/15) of cases and the median SDS was 1 [0; 2]. No significant changes were observed in global and regional 123I-mIBG cardiac uptake between baseline and follow-up studies. At baseline 36 DUA were identified, 16 (44%) of which (median per individual 1 [1;1]) had moderate-high confidence score (CS). 5/16, 4/16, 4/16 and 3/16 moderate-high CS DUAs were located around the left sided-, right sided pulmonary veins ostia, LA walls or right atrium (RA) respectively. At follow-up 33 DUAs were identified, 16 (48%) of which (median per individual 1 [1;1], p = 0.5 vs baseline) had moderate-high CS. Moderate-high CS discrete uptake areas had generally the same location as on the baseline procedure.Conclusion. Co-registered solid-state 123I-mIBG SPECT and CT is feasible for the evaluation of left ventricle sympathetic innervation as well as for the detection of discrete sympathetic areas in the typical anatomical sites of left atrial ganglionated plexi with modest variations in the constancy of uptake locations. There were no significant changes in the global and regional 123I-mIBG left ventricular uptake over a short time interval in healthy individuals.
Glide Path Enlargement of Curved Molar Canals Using HyFlex EDM Glide Path File versus PathFile: A Comparative Study of Preparation Times and Postoperative Pain
Authors: Han Yi , Hou Xiao-Mei
Published: May 2020

Background This randomized clinical trial aimed to compare the preparation times and severity of postoperative pain between the HyFlex EDM Glide Path File and PathFile. Methods Eighty patients who were treated by the same specialist were enrolled. After access cavity preparation, the patients were randomly assigned to receive glide path enlargement with either HyFlex EDM GPF or PathFile. ProTaper Next X1 and X2 files were used to prepare the canals. The time of preparation was assessed and the severity of postoperative pain over the next 7 days was recorded. Results Preparation time and postoperative pain severity were significantly lower in the HyFlex EDM GPF group compared to that in the PathFile group ( P < 0.05 for both). Conclusion Postoperative pain and glide path preparation time could be reduced by using the HyFlex EDM GPF system.
Comparison of CPR training by social media networks and workshop on CPR skill of nursing and midwifery students
Authors: Ghorbani Sara , Ghafourifard Mansour , Dinmohammadi Mohammadreza , Fallah Ramezan , aghajanloo ali
Published: May 2020

Background: Smartphone-based education has been recommended in different areas of medical education. Considering the capabilities and features of social media, this study aimed to investigate the effect of social media and workshop on CPR performance of nursing and midwifery students. Methods: In this quasi-experimental study, 59 nursing and midwifery students were randomly divided into two groups (WhatsApp- and workshop-based training). Students' CPR skill was assessed at four time-points including before the training, one week, one month and three months after the training. Results: The results showed that the mean score of CPR skill in the workshop group was higher than WhatsApp in one week, one month, and three month later (p<0.05). Conclusions: Despite the effectiveness of both methods, workshop had a better effect on students' performance. Therefore, social media should not be considered a substitute for conventional training such as the workshop.
Gender Disparity in Cardiovascular Mortality following Radiation Therapy for Hodgkin's Lymphoma: A Systematic Review
Authors: Khalid Yaser , Fradley Michael , Dasu Neethi , Dasu Kirti , Shah Ankit , Levine Adam
Published: May 2020

Background Radiation-induced coronary artery disease (R-CAD) has become an increasingly recognized phenomenon. Although the clinical relationship between radiation therapy and CAD risk is well known, there has been very little investigation of the gender relationship to radiation-induced CAD events and resulting cardiovascular (CV) mortality. We study the gender variation in the incidence of CV events/mortality related to R-CAD in Hodgkin’s Lymphoma (HL) patients. Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used in this systematic review and network meta-analysis. PubMed, google scholar, and Cochrane databases were searched to identify prospective and retrospective observational studies comparing women and men following radiation treatment for Hodgkin's lymphoma. 10 studies were included (4 prospective, 6 retrospective). The primary outcome was incidence of cardiovascular events and mortality. The secondary outcome was all-cause mortality. Meta-regression for age was also performed. Results Of 13,975 patients including 41% females and 59% males, CV events/mortality was noted to be significantly higher in women compared to men (OR 3.74, 95% CI 2.44-5.72, p <0.001). All-cause mortality was also higher in women compared to men (OR 1.94, 95% CI 1.10-3.44, p <0.023). On meta-regression analysis, elderly populations have a higher rate of mortality which was even higher for women than men (coefficient = 0.0458, p=0.0374). Conclusions Women have a higher rate of CAD related CV events/mortality and all-cause mortality compared to men in radiation treated patients. These data highlight the need for increased surveillance to better monitor for CAD in female patients treated with mantle or mediastinal radiation.
Clinical characteristics and risk factors for severe-critically ill COVID-19 adult patients in Jiangsu, China: a multiple-centered, retrospective study
Authors: Zhao Jiangnan , Zhu Meiying , Su Xin , Huang Mao , Yang Yi , Huang Jianan , Songshi Ni , Cao Quan , Gu Qin , Li Jun , Li Jiashu , Zhao Wenjing , Shi Bin , Shi Yi
Published: May 2020

Background A number of reports have documented the clinical characteristics of patients with severe coronavirus disease 2019 (COVID-19) in Wuhan. Clinical features of severe-critically ill COVID-19 patients in Jiangsu, outside Wuhan, remains unknown. Methods This multi-centered retrospective study collected the information of 631 laboratory-confirmed COVID-19 patients hospitalized at 28 authorized hospitals in Jiangsu province between January 23, 2019 and March 13, 2020. Epidemiological and demographic information, clinical and radiological characteristics, laboratory results and treatment of these patients were analyzed. Results A total of 583 adult patients with laboratory-confirmed COVID-19 were enrolled for final analysis, including 84 severe-critically ill patients and 499 mild-moderate patients. Median age of the severe-critically ill patients was 57.0 years [interquartile range (IQR), 49.0-65.8], and 50 (59.5%) were males. Multisystemic laboratory abnormalities were observed on admission in severe-critically ill patients. The severe-critically ill patients showed more noticeable radiologic abnormalities and more coexisting health issues as compared to mild-moderate patients. Most of the severe-critically ill COVID-19 patients become deteriorated in two weeks after diagnosis. Age [odds ratio (OR) 1.08, 95% confidence interval (CI) (1.03-1.14)], D-dimer (OR 3.21, 95% CI 1.39-7.40), and lymphocytes (OR 0.28, 95% CI 0.04-0.88) were independently associated with the progression of severe-critically illness. Conclusions Older age, higher D-dimer levels and less lymphocyte counts on admission are potential risk factors for COVID-19 patients to develop into severe and critically illness. The results would help clinicians to identify high-risk patients in advance.
Synergic effects of decellularized bone matrix, hydroxyapatite, and extracellular vesicles on repairing of the rabbit mandibular bone defect model
Authors: Emami Asrin , Talaei-Khozani Tahereh , Tavanafar Saeid , Zareifard Nehleh , Azarpira Negar , Vojdani Zahra
Published: May 2020

Background: Extracellular vesicles (ECV) and bone extracellular matrix (ECM) have beneficial effects on the treatment of some pathological conditions. The purpose of this study was to find the synergic effects of decellularized bone (DB) ECM and ECVs on the repair of rabbit. Methods: The quality of decellularized sheep bones was confirmed by H&E, Hoechst, DNA quantification, immunohistochemistry, histochemical staining, and scanning electron microscopy (SEM). Osteoblast-derived ECVs were evaluated by internalization test, Transmission electron microscopy, Dynamic light scattering, and flow cytometry for CD9, CD63, CD81 markers. The hydrogel containing DB and hydroxyapatite (HA) with or without ECVs was evaluated for osteoblast functions and bone repair both in vitro and in vivo. Results: The data indicated ECM preservation after decellularization as well as cell depletion. In vitro assessments revealed that mineralization and alkaline phosphatase activity did not improve after treatment of MG63 cells by ECVs, while in vivo morphomatrical estimations showed synergic effects of ECVs and DB+HA hydrogels on increasing the number of bone-specific cells and vessel and bone area compared to the control, DB+HA and ECV-treated groups. Conclusion: The DB enriched with ECVs can be an ideal scaffold for bone tissue engineering and may provide a suitable niche for bone cell migration and differentiation.
Prevalence of human cytomegalovirus in colorectal cancer and viral gene expression profiles
Authors: Cai Zhengzai , ye lele , Zhu Yuesheng , Lin Ying , Guo Gangqiang , Yan Kejing , Wu Yuqing , Yu Xiaoxiao , Ding Ning , Lin Feng , Zhu Shanli , Xue Xiangyang
Published: May 2020

Background Human cytomegalovirus (HCMV) infection plays a crucial role in the development and progression of cancer. However, the effect of HCMV on colorectal cancer (CRC) remains controversial. This study was performed to explore the pathogenesis of HCMV in CRC. Methods HCMV DNA was detected in 74 CRC and paired normal samples by PCR. HCMV IEA protein expression was confirmed in 717 CRC biopsies by immunohistochemistry. HCMV gene expression profiles (GEPs) were further analyzed in 5 CRC tissues by transcriptome sequencing. The associations of HCMV infection with clinical features and prognosis were also evaluated. Results The prevalence rates of HCMV in CRC tissues were 29.73% and 23.17% at the DNA and protein levels respectively, which was significantly higher than those in normal tissues (0%). Transcriptome sequencing to evaluate the GEPs revealed 119 HCMV genes in CRC tissues. The high reads of transcriptions were RNA2.7, RNA4.9, RNA5.0, RL5A, UL82, UL83, and UL70, which correlate with gene expression or regulation. Survival analysis showed that patients with CRC patients and pIEA(++) had longer overall survival (OS) than those with pIEA(+)s at the protein level. However, there was no correlation between pIEA expression and clinical features. Conclusions HCMV, a common virus found in CRC tissues, is related to the development and progression of CRC. GEP analysis revealed genes correlated with lytic infection. Additionally, genes functioning in gene expression or regulation showed high expression in CRC. We found that CRC patients with HCMV lytic infection have a better prognosis than those with non-HCMV infection. Here, we revealed features of the pathogenic mechanism and provide insight that may be useful for targeted treatment of CRC.