bluuebunny/crossref_metadata_2025 huggingface dataset:
Economic incentives and survival probabilities for chronic and multimorbidity patients - Do the relationships depend on patient pathways?
Authors: Islam M. Kamrul , Kjerstad Egil , Askildsen Jan Erik
Published: July 2020

Background: The Norwegian Coordination Reform (CR) in 2012 introduced new economic incentives aimed at weaknesses in interaction between primary care, social care and specialist care. This paper studies the association of a new co-payment scheme on the 30-day and 90-day survival probabilities for chronic and multimorbidity patients. We also analyse whether admission types ⸺ planned or emergency ⸺ matters for survival rates, and the importance of patient pathways. Several different pathways are possible, depending on where patients came from before being admitted to hospital and their destination after discharge from hospital. Methods: The study uses data from three different registers for the period 2010 to 2013. We consider 30 common chronic conditions for which administrative data are available (n=563,096 in-patient episodes). We look at three mutually exclusive pathways. They are relevant and important in terms of the number of patients depending on co-operation and co-ordination between health care providers. Using a quasi-experimental design—the difference-in-differences approach—we estimate the associations between the co-payment scheme and survival probability by admission type and by patient pathway. Results: We find that the change in survival probabilities are significant and positively associated with the co-payment scheme for emergency admissions, but no significant association is found for planned admissions for the 30-day survival. A positive and significant relationship is also found for emergency patients for two specific pathways. For planned admissions, the survival probabilities are significantly and negatively associated for patients coming from home and later discharged to social care institutions. Multimorbidity subgroup analysis shows that the positive (negative) association with the 90-day (30-day) survival is significant only for emergency (planned) admissions for the patients coming from home and later discharged to home or social care after in-patient hospitalization. Conclusion: We conclude that the survival probabilities are positively associated with the new economic incentives but the result depends on admission type, patient pathway and multimorbidity status. Without modelling admission type, pathway and multimorbidity explicitly, one may overlook important relationships associated with the economic incentives. Future policy evaluations in any pertinent context should envisage these aspects.
Healthcare utilisation and out-of-pocket expenditure of type 2 diabetes patients with and without comorbidity: A study in primary care in Bhubaneswar, India.
Authors: Pati Sandipana , Swain Subhashisa , Akker Marjan van den , Schellevis F. (François) G. , Burgers Jako S.
Published: July 2020

Background: Globally, non-communicable diseases (NCD) demand a higher healthcare expenditure. Amongst the NCDs, diabetes mellitus, is often associated with multiple, co-existing chronic conditions. In low- and middle-income countries where most of the healthcare expenditure is borne out of pocket, diabetes management may pose a significant financial stress.Methods: A cross-sectional study was conducted in 17 urban primary healthcare facilities of Bhubaneswar to assess the healthcare utilisation and out-of-pocket expenditure among type 2 diabetes patients attending these facilities. Healthcare utilisation was determined by the number of visits to healthcare facilities in the last six months, and out-of-pocket expenditure was assessed by outpatient consultation fees, medicines, travels to health care facilities and diagnostic tests. Total out-of-pocket expenditure was defined as the sum of these costs.Results: The median number of visits in 6 months for diabetes patients with any comorbidity was 4 and 5 for diabetes patients with more than 4 comorbidities. Among the comorbid conditions, depression, stroke, auditory impairment and acid peptic disease were associated with higher healthcare utilisation. The total out-of-pocket expense was 2.3 times higher among diabetes patients with any comorbid condition compared to patients with diabetes only. The total median expenditure was higher for diabetes patients having stroke, heart diseases, kidney diseases and cancer compared to other comorbid conditions. The association of comorbidity in diabetes patients with health care utilization and out-of-pocket expenditure is statistically significant after adjustment for sociodemographic characteristics and diabetes duration.Conclusion: Considerable expenditure is incurred by diabetes patients attending primary healthcare facilities for the management of diabetes and other chronic conditions. This is a significant burden for diabetes patients below the poverty line and with limited or no insurance cover. There is a need to increase the coverage of insurance schemes to address the chronic conditions management expenditure of outpatients.
The prognostic factors in sepsis patients after operation of gastrointestinal tumors in ICU
Authors: Chen Ren-Xiong , Wu Zhou-Qiao , Li Zi-Yu , Wang Hong-Zhi , Ji Jia-Fu
Published: July 2020

Objectives: We studied the clinical profiles and the prognostic factors in patients with sepsis after thegastrointestinal tumor surgery in ICU.Methods: We retrospectively screened patients who underwent the gastrointestinal tumor surgery at the Peking University Cancer Hospital from January 2015 to December 2019. Among them, 181 patients who were diagnosed with sepsis in ICU were enrolled in our study. Cox regression was performed for multivariate adjusted factor analyses.Results: The 90-day all-cause mortality rate was 11.1% in our study. The univariate analysis showed that BMI, shock within 48h after entering ICU, number of blood leukocytes, the ratio of lymphocytes to neutrophils, INR, creatinine, procalcitonin, lactic acid, oxygenation index, SOFA score within 24h after entering ICU, APACHE II score within 24h after entering ICU were statistically significant. In multiple analysis, we found that BMI＞20kg/m2 was a protective factor, while lactic acid＞3 mmol/L after entering ICU and APACHE II score＞20 within 24h after entering ICU were independent risk factors for the prognosis of sepsis after the gastrointestinal tumor surgery in ICU. Conclusions: The 90-day all-cause mortality rate was 11.1% in our study. BMI＞20kg/m2 was a protective factor, while lactic acid＞3 mmol/L after entering ICU and APACHE II score＞20 within 24h after entering ICU were independent risk factors for the prognosis of sepsis after the gastrointestinal tumor surgery in ICU.
Presence of MTHFR Polymorphisms and the Levels of Folic Acid and Homocysteine in Women Enrolled in an Assisted Reproductive Program
Authors: Morales Felipe Arturo , Ruiz Martha Merino , Briseño José A. Elizondo , Garza Laura E. Martínez , Gutiérrez Oscar Vidal , Hernández Luis H. Sordia
Published: July 2020

Purpose: Folic acid and homocysteine levels are influenced by the circulating levels of estradiol. Little is known about the behavior of these metabolites during an in vitro fertilization cycle, where superovulation protocols induce a major increased in the levels of estradiol and other hormones. Methods: We performed a prospective, comparative, transversal, descriptive and observational study that includes 49 cases (group A), which were patients that entered a fertility program, and 14 controls (group B), which correspond to the donor group. In both groups, the levels of folic acid, estradiol and homocysteine as well as the MTHFR polymorphism were determined. Results: None of the patients has subnormal levels of folic acid or homocysteine and these levels were not modified after ovarian stimulation. We observed that homocysteine concentration tended to decrease with elevated estradiol levels produced by the stimulation of the ovary. The presence of allele C677T MTHFR was high in the populations evaluated in this study, with a particular high incidence of the TT allele. Conclusion: The levels of plasma and intracellular folate, and homocysteine do not change during hormonal stimulation.
Systematic Evaluation of Implemented Strategic Trypanosomosis and Vector control activities by the Application of Insecticides (Deltamethrin base) using Stationary attractive devices (targets), Ground sprays and Live bait techniques in upper Birbir valley, Ethiopia
Authors: Meharenet Behablom , Desta Tekalegn , Shitu Dessalew , Tsegaye Mintesnot
Published: July 2020

Background

Trypanosomosis and vector control methods have evolved from game animal destruction and bush clearing, which mainly targeted on the removal of the source of food and shade, to insecticide spraying following the discovery of DDT. Baseline and control entomological and parasitological surveys or studies were carried out from September 2016 to February 2018, with the purpose intended to systematically evaluate the effectiveness of implemented strategic trypanosomosis and vector control activities.
Results

Baseline and control entomological surveys or studies were compared; and an overall apparent fly density of 2.61 flies/trap/day during the baseline survey was declined to 1.68 flies/trap/day with the rate of 64.37% after control with supporting evidence of a decrease in the daily mean catch of fly per single trap from 5.23 ± 1.58 to 3.35 ± 1.58, (Mean catch ± SD). Based on baseline and control survey or study results the overall prevalence of bovine trypanosomosis was compared and significantly declined from 7.91–4.81%, likelihood-ratio = 13.49, Pr = 0.000, with the rate of 60.81%. Furthermore, significantly better heard mean packed cell volume was observed during control survey or study 22.53 ± 4.48, 25.68 ± 4.04 (Mean PCV ± SD), when compared with baseline 21.87 ± 4.57, 25.41 ± 4.27 (Mean PCV ± SD), in parasite-infected and non- infected cattle respectively.
Conclusions

The study concluded that the use of stationary attractive devices (targets), Ground sprays, and Live bait techniques of Deltamethrin based insecticide had shown a significant decline in the density of tsetse fly (vector hosts) and trypanosomosis prevalence with a better heard mean PCV of infected and non-infected cattle. Therefore, the research recommended that such kind of control methods which are environmentally friendly or non-intrusive, cheap, and non-complicated for farmers and experts living at endemic tsetse belt areas.
Investigation on the Mental Health Status and Risk Factors Among Chinese Overseas Students Under COVID-19 Outbreak
Authors: Anan Cong , Chunfeng Xiao , Shuxin Luan , Lirui Kang , Jingjing Yuan , Chang Liu
Published: July 2020

Background Corona Virus Disease (COVID-19) caused by SARS‐CoV‐2 had caused a global pandemic. According to incomplete statistics, at least 400,000 of Chinese overseas students were now staying abroad during the COVID-19 epidemic. Under the condition of extensive isolation, the social support system was also impacted, all this will lead to various kinds of psychological problems. However, there are no studies on the psychological problems of Chinese overseas students during the epidemic at home and abroad. ObjectivesTo investigate the mental health status and its risk factors among Chinese overseas students during the COVID-19 pandemic. Methods We conducted a cross-sectional survey based on structured questionnaire through various social platforms (WeChat, QQ, etc.). The contents of the structured questionnaire included: demographic characteristics, 9-item Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder 7-item Scale (GAD-7) and 15-item Patient Health Questionnaire (PHQ-15). Results ① The incidence rates of depression, anxiety and physical symptoms were 60.3%, 53.2% and 83.3%, respectively. ② There were significant statistical differences in the incidence rates of depression, anxiety and physical symptoms between different genders (depression: x2= 148.94, P=0.000; anxiety: x2=129.45, P=0.000; physical symptoms: x2=62.73, P=0.000). Significant statistical differences were also found in the incidence rates of depression and anxiety among different education levels (depression: x2=10.82, P=0.013; anxiety: x2=9.09, P=0.028). Additionally, there were significant statistical differences in the incidence rates of depression (x2=12.77, P=0.005) among different ages, and time of daily attention to epidemic-related information were closely associated with physical symptoms (x2=12.14, P=0.007). ③Logistic regression analysis showed that the female have a higher risk of developing depression [OR=0.017, 95% CI: 0.008~0.037, P=0.000], anxiety [OR=0.024, 95% CI: 0.011~0.051, P=0.000] and physical symptoms [OR=0.018, 95%CI: 0.004~0.078, P=0.000], and time of daily attention to epidemic-related information was positively associated with the level of physical symptoms [OR=0.610, 95% CI: 0.415~0.895, P=0.012]. Conclusion During the COVID-19 epidemic, Chinese overseas students were highly susceptible to a series of psychological and mental problems, including depression, anxiety and physical symptoms, and have a relatively higher risk than other populations. The purpose of this study is to call on relevant departments to pay attention to the psychological problems of this special group and propose effective prevention and control measures to ensure the mental health of the masses during the epidemic and promote the scientific development of mental health work.
The Effect of Retail Electricity Price Levels on the Financial Indicators of Smart-Grid Rooftop Solar Power Systems: A Case Study in the Central Highlands of Vietnam
Authors: Lan Tran Thi , Jirakiattikul Sopin , Le Niem Duc , Chowdhury M. S. , Ali Dilawer , Techato Kuaanan
Published: July 2020

Background: There are many constraints on the use of fossil fuels and, many countries have, therefore, conducted research relating to alternative energy resources to replace conventional fuels. On 31 January 2019, the Vietnamese Ministry of Finance enacted a preferential policy relating to the installation of under-50kWp rooftop solar projects. The Central Highlands of Vietnam has a high potential for solar power generation due to the duration of sunshine it enjoys, and the development of both rooftops solar and solar farms is appropriate for the region. The study reported investigated the economic efficiency of smart-grid rooftop solar electricity systems (SG rooftop PV) in the Central Highlands of Vietnam in light of the different levels of retail electricity pricing in Vietnam and the implementation of a feed-in-tariff system. The research reported in this paper will be useful for many groups of stakeholders, including electricity consumers who intend to install rooftop solar panels on their houses, companies who supply SG rooftop PV, and policymakers, who can use the findings relating to SG rooftop PV to adjust the retail price of electricity during different periods.Method: Financial indicators were calculated based on the net present value, payback period, internal rate of return, and the number of hours of sunshine in the Central Highlands of VietnamResult: The study’s results show that the electricity price level affects the economic efficiency of SG rooftop PV. In particular, SG rooftop PV installed to satisfy higher levels of electricity consumption, which attract a higher retail electricity price, result in greater benefits, especially when domestic electricity consumption exceeds 400 kWh, at which level the retail electricity price is at the highest level. In this case, people who install SG rooftop PV and use all the electricity to satisfy domestic consumption will recoup their investment in only 4 years and thereafter will enjoy free electricity. Conclusion: All the financial indicators derived from this research show that people in the Central Highlands of Vietnam can derive benefit from installing SG rooftop PV, whether they sell all the electricity output to the grid or use the power output to satisfy their domestic demand.
Epigenetic alterations of the promoter region of the POMC gene in adolescent depressive disorder patients with non-suicidal self-injury behaviors
Authors: Zheng Doudou , Bi Xiaojiao , Zhang Tianliang , Han Chao , Ma Tantan , Wang Lina , Sun Mengmeng , Cui Kaiyan , Yang Limin , Liu Lanfen
Published: July 2020

Background

The incidence of non-suicidal self-injury (NSSI) behavior among adolescents increases year by year. Patients with a history of both depression and NSSI behaviors tend to have greater risk of suicide. At present, the mechanism of adolescent depressive disorder patients with NSSI behaviors is not clear, epigenetic mechanism may be involved. Proopiomelanocortin (POMC) gene may be associated with depressive disorder. The purpose of this study was to investigate deoxyribonucleic acid (DNA) methylation of POMC gene promoter region of adolescent depressive disorder patients with NSSI behaviors.
Methods

Bisulfite Sequencing PCR (BSP) was used to test the methylation level of POMC promoter of 15 adolescent depressive disorder patients with NSSI behaviors and 15 healthy controls (HC). The online software Methylation Share Rate (MSR) Calcalate was used to draw the lollipop model of the methylation state. Self-made questionnaires were used to collect clinical data of the case group and control group. Hamilton depression scale-24 (HAMD-24), Hamilton anxiety scale (HAMA), Symptom Checklist-90 (SCL-90) were used to evaluate the characteristics and severity of depressive, anxiety and psychotic symptoms. Adolescent self-injury questionnaire was used to assess NSSI behaviors and its severity.
Results

BSP analysis found that the POMC methylation level of cytosine-guanine dinucleotide 1 (CpG1) site was higher in adolescent depressive disorder patients with NSSI behaviors than that of HC (P < 0.05). Overall significance in POMC methylation at CpG1 sites between adolescent depressive disorder patients with NSSI behaviors and HC was gender-independent, methylation level at CpG1 sites was higher in both male and female patients than that in HC. The CpG1 methylation had correlation with the family history (P < 0.05). We also found that POMC methylation level at CpG17 sites in female patients was significantly higher than that of the female HC (P < 0.05).
Conclusions

There was abnormal methylation in the POMC promoter region of adolescent depressive disorder patients with NSSI behaviors, the methylation of CpG1 sites may act as epigenetic markers for those adolescents.
Purification, Characterization, and Self-Assembly of the Polysaccharides from Allium Schoenoprasum
Authors: Zhang Fengrui , Zheng Jun , Li Zeyu , Cai Zixuan , Wang Fengqiao , Feng Liubin , Yang Dong
Published: July 2020

Background: Allium schoenoprasum is a world-wide common vegetable while only its leave is used in the food factory. Its stalk is largely discarded, for potential heavy metal accumulations, which eventually lead to an environmental contamination. To fully utilize this vegetable and minimize its metal content, the major polysaccharide content is purified and characterized with chemical and computational approaches.Results: The major polysaccharide component from the stalk of Allium schoenoprasum (AssP) was extracted and purified. The gel filtration chromatography purified AssP exhibited a molecular weight of around 1.6 kDa, which was verified by MALDI-ToF-MS. Monosaccharide analysis revealed its composition as rhamnose: arabinose: galactose: glucose: mannose: fructose with a molar ratio of 0.0264:2.46:3.71:3.35:1.00:9.93, respectively. Multiple NMR analysis revealed its backbone as α-Ara/Glu/Gal-(1→2)-linked and β-D-Fru-(4→5)-linked sugar residues. There was no tertiary structure of this polysaccharide, however, it self-assembled into a homogenous nanoparticle with a diameter of ~600 nm. The solution behavior of this AssP polysaccharide was simulated, and there was no specific binding site on one molecule for another. Association of this polysaccharide was concentration dependent. As the AssP concentration increased, the spherical particles increased their sizes and eventually merged into cylindrical micelles. The diversity of AssP hydrodynamic behavior endowed potential versatility in its applications.Conclusions: AssP was characterized as a polysaccharide with identified monosaccharide compositions and linkage between them. Although there is no tertiary structure in one AssP molecule, self-assembly of AssP molecules could form nanoparticles or micelles depending on its solution concentrations. The unique AssP solution behavior endows itself a potential biomaterial for nanoparticles preparations.
A population-based cohort study on the association of dietary patterns with sleep duration: A Joint modeling by mental health status
Authors: Hosseini Somaye , Rikhtehgaran Reyhaneh Rikhtehgaran , Mohammadifard Noushin , Roohafza Hamidreza , Sadeghi Masoumeh , Mansourian Marjan , Sarrafzadegan Nizal
Published: July 2020

Background: We investigated the association of dietary patterns and sleep duration by controlling mental health status (MHS) using a joint modeling approach.Methods and materials: The population based cohort study was conducted within the framework of the Isfahan Cohort Study (ICS), including 1383 participants, aged ≥ 35 years were followed from 2007 to 2013. A validated food frequency questionnaire was applied to obtain dietary patterns. Anthropometric measurements, blood pressure, fasting serum lipids and blood sugars were evaluated in both phases of the study. A random effect joint negative binomial and ordinal model were used to estimate diets effect on sleep duration and MHS.Results: Three dietary patterns were identified: Healthy, Iranian and Western dietary patterns. After adjustment for potential confounders, the higher scores of Western diet were associated with sleep hours (OR=1.08 and 95% CI: 1.02‒1.12), the higher scores of the Western diet during the 5 year follow-up was associated with greater sleep duration. Sleep duration and MHS were adversely associated (-0.097 and 95% CI: -0.09‒-0.05)Conclusion: Joint modeling by MHS, sleep duration was positively affected only by western diet. Iranian and healthy diet weren’t associated by sleep hours.
Anti- SARS-CoV-2 main protease complex (Mpro) activity of Palmatine
Authors: JADHAV VYANKATESH
Published: July 2020

The Pandemic situation caused due to SARS-CoV-2 causing Coronavirus Disease (CoVID-19) around globe. Recent, COVID-19 main protease complex (Mpro), highly modulating enzyme in SARS-CoV-2 was reported for viral replication and transcription. This multifunctionality of Mpro attracts for identification of potential drug target. Considering impact, In silico analysis was performed for Palmatine alkaloid against Mpro. Naturally, present in Tinospora cordifolia, found effective against Cancer, HIV, viral infections, diabetics. In methods, physico-chemical analysis by ProtParam tool and Structure of Mpro was predicted by SWISS-MODEL Workspace homology modeling server. Superimposition Structure and significant equal QMQE, QSQE values were found for eight highly similar templates. Structural assessment validation by Ramachandran plot (97.67% favoured), Local Quality estimate ratio (>0.6) and higher QMEAN score (y-axis). Further, docking was performed with validated Mpro model by SwissDock server. Interaction with -8.281919 ΔG indicates reliable Interaction. Also, comparative docking reveals, most favoured Palmatine interaction. Thus, an attempt was made to find potent inhibitor for SARS-CoV-2, as there is no promising and specific anti-viral drug or vaccine available for prevention and treatment of infections. However, In Vitro studies are required. Toxicity studies reported against Palmatine for acute effect (135 mg/kg body weight) on mouse model LD 50.
Towards an Ontology-Based Decision Support System for Syndrome-Differentiation and Treatment of Psoriasis Vulgaris in Traditional Chinese Medicine
Authors: Long Hai , Wang Zhe , Cui Yidi , Wang Junhui , Gao Bo , Chen Chao , Herre Heinrich , Zhu Yan
Published: July 2020

Background: Psoriasis is a chronic, non-communicable, painful, disfiguring and disabling disease, which is not curable and strongly declines the patients’ quality of life (QoL). However, diagnose and treatment in traditional Chinese medicine (TCM) based on syndrome differentiation has been used in practice for a long time and has also achieved some effect. Though, up to now, only few studies are available reporting on the use of semantic technologies and pertain to knowledge systems that use TCM-syndrome differentiation for information retrieval and automated reasoning. Nowadays, the diagnosis in TCM relies mainly on the personal expertise and clinical experience of the doctors. For various reasons, misdiagnoses or missed diagnoses cannot be completely excluded, leading to unexpected results.Methods: Firstly, we developed a domain ontology for syndrome differentiation of psoriasis vulgaris. For this purpose, we used the ontology editor Protégé and applied a top-down approach which adopts the framework of general formal ontology (GFO) and its middle-level core ontology GFO-TCM. Furthermore, we implement a prototype which is based on this ontology. Additionally, we also used a case-database for CBR (Case Based Reasoning) combined with fuzzy pattern recognition.Results: A prototype for diagnosis and treatment of psoriasis vulgaris, named ONTOPV-system, is proposed which is based on the principle of syndrome differentiation and treatment in TCM; this system realizes an expert-assisted decision support method which relies on a domain ontology, uses fuzzy logic reasoning, and case retrieval and is intended to support clinical diagnostic decisions for TCM practitioners.Conclusions: We designed and implemented a prototype for psoriasis diagnosis in terms of syndrome differentiation. The system can not only realize the basic functionalities of data collection, querying, browsing and navigation, but also support rule-based knowledge reasoning and customize approximate reasoning based on CBR through fuzzy logic, which can provide users with clinical decision support for TCM syndrome differentiation in diagnosis of psoriasis. In addition, it comprises a domain knowledge base of psoriasis, which is developed based on the GFO framework with good extensibility.
The Prevalence of Human Papillomavirus Among the Indigenous Population in Serian, Sarawak, Malaysian Borneo
Authors: Tan Cheng Siang , Yi Myat San , Lwin Soe , Jerip Abigail Rembui , Kipli Mardiana
Published: July 2020

Introduction: Cervical cancer remains a significant problem worldwide, particularly in resource-limited countries, and having persistent HRHPV infection is a necessary risk factor. HPV16/18 are generally regarded as the cause of 70% cervical cancer incidences worldwide, and effective vaccines have been developed against these two HPVs. Although Malaysia has officially adopted an HPV vaccination strategy into the National Vaccination Program, the comprehensive prevalence data on each endemic HPV genotypes was absent in East Malaysia and most parts of the country except for major cities in Peninsular Malaysia.Objective: The objective of this study is to elucidate the endemic HPV genotypes that are circulating in the suburban population in Serian Division, Sarawak, Malaysia.Methods:Non-virgin women who were attending the Women's health campaign on the 5th and 23rd October 2018 were recruited. Informed consent was obtained, and a cervical swab was clinician-collected. The presence of HPV in the cervical swab was detected using MY09/MY11 followed by GP5+/GP6+ nested-PCR and its corresponding genotypes identified via sequencing. HRHPV positive women were screened using Results: We have recruited 43 sexually active women with median age of 51-year-old. HPV18, 39, 52, 56, and 84 were detected at an equal ratio. The overall prevalence rate of HPV, HRHPV and URHPV were 11.62% (5/43), 9.3% (4/43) and 2.3% respectively. Only 20% (n=1/5) of the HRHPV positive women were positive by VIA.Conclusion: HPV18, 39, 52, 56, and 84 were detected in Serian at an equal ratio. HPV16 was absent, and HPV18 was the only vaccine-genotype detected. HPV 39, 52, 56, and 84 were not covered by the bivalent and tetravalent HPV vaccines.
Early Esophageal Squamous Cell Carcinoma and Precancerous Lesions can be Detected by White Light Endoscopy with the Aid of White Substance
Authors: Yang Guodong , Wang Yingbang , Zhang Xiaoying , Zhang Xiaoming , Wu Linyi , Yu Xiaogang , Zhao Mu , Chen Yuling , Li Zhen
Published: July 2020

Objective: To investigate the diagnostic value of white substance in the detection of flat esophageal mucosal lesions and precancerous lesions associated with early esophageal squamous cell carcinoma Methods: Clinical and pathological data of patients diagnosed with flat esophageal mucosal disease were collected. The lesions were divided into a neoplastic group and a non-neoplastic group, and the clinicopathological differences between the groups were analyzed. The patients were also divided into two groups based on the presence of white substance after endoscopic examination: a “white substance” group and a “non-white substance” group. The differences between the two groups were analyzed. The diagnostic value of white substance for detection of early esophageal squamous cell carcinoma and related precancerous lesions was calculated and the pathological nature of white substance inferred. Results: In total, 183 patients with flat esophageal mucosal lesions were enrolled, including 92 (50.3%) with neoplastic lesions and 91 (49.7%) with non-neoplastic lesions. Forty-nine cases (26.8%) presented white substance in the esophageal mucosa. White substance was mainly found in female patients (57.1%), middle esophagus (75.5%), and 60-69-year-old patients (51.0%). Moreover, white substance was more frequently found in neoplastic than in non-neoplastic lesions (43.5% vs. 11.0%, p < 0.05). Consistently, neoplastic lesions were more represented in the white substance group than in the non-white substance group and the difference was statistically significant (79.6 vs. 20.4%, p < 0.05). 51% of the patients in the white substance group, but only 26.1% of those in the non-white substance group, had hyperkeratosis and necrosis, and the difference was statistically significant (p < 0.05). The diagnostic sensitivity of white substance for detection of early esophageal squamous cell carcinoma and precancerous lesions was 42.4% (95% CI, 32.8%–52.6%),the specificity 89.0% (95% CI, 80.8%–94.1%).Conclusions: White substance in the mucosa of flat esophageal lesions exhibited high specificity for the diagnosis of early esophageal squamous cell carcinoma and precancerous lesions. Thus, the presence of white substance in the esophageal mucosa, even in the absence of obvious lesions, may reflect the presence of latent early esophageal squamous cell carcinoma and precancerous lesions. White substance was associated with hyperkeratosis and necrosis.
Treatment of Aneurysmal Bone Cysts with Titanium Elastic Nails in Children
Authors: Wang Yi-chen , Jia Xing , Shen Yang , Wang Sun , Dong Liang-chao , Ren Jing , Zhao Li-hua
Published: July 2020

Background: The main treatment method of the primary aneurysmal bone cyst (ABC) is to curettage and bone grafts with high-speed burring, radiotherapy, sclerotherapy, arterial embolism and hormone therapy can be used for the lesions whose location cannot be easily exposed by the surgery. Regardless of the method, high recurrence rates are a common problem. The purpose of this study was to evaluate retrospectively the use of titanium elastic nails as a internal fixation in the treatment of aneurysmal bone cysts in children.Methods: Children with histological primary aneurysmal bone cyst were evaluated between 2010 to 2017. The patients were divided into 2 groups according to the treatment plan. Patients in the study group operated with curettage and bone grafts with high-speed burring + internal fixation of titanium elastic nails (TEN), and patients in the control group operated with curettage and bone grafts with high-speed burring. The curative effect of the children in the 2 groups were analyzed statistically according to the imaging results (Neer grading) and MSTS functional evaluation.Results: A total of 26 ABC patients (mean 6.5 years at surgery; 21 males;5 female) met the inclusion criteria and were evaluated between 2010 to 2017 after a mean follow-up of 5.2 years (range, 2.5-8.4 years), 16 of which in the study group and 10 in the control group. 9 of the 26 patients recurred (3 cases study group；6 in the control group；). According to the imaging results (Neer grading) and MSTS function evaluation, there was statistically significant difference in the curative effect between the 2 groups (P＜0.05). The recurrence cases in the study group had a better MSTS functioncal recovery.Conclusion: The use of TEN can significantly improve the cure rate, reduce the recurrence rate and improve the quality of life for children with primary aneurysmal bone cyst.
Antibiotic resistance patterns of efflux pumps MexAB-Opr M in pathogenic Pseudomonas aeruginosa isolates
Authors: rasouli Javad , hashemi Behnam , Afkhami Hamed , Khaledi Mansoor , valadan Reza , Fathi Javad , ahanjan mohammad
Published: July 2020

Objectives

Pseudomonas aeruginosa is one of the most important causes of Hospital infection especially in burn victims. The current study aimed to determine antibiotic resistance of the efflux Pumps MexAB-Opr M. In the present study, 115 samples of urine, blood, sputum, and ICU were collected from the reconstructive section of the patients. The drug susceptibility patterns were determined by disk diffusion method. Phenotypic activity of the efflux pump from the E-test was evaluated, in the presence and without the presence of efflux pump inhibitor. The MexAB gene was analyzed by PCR reaction.
Results

The resistant isolated was shown to be Ciprofloxacin 33.91%, Nurfloxacin 38.26%, Gentamicin 71.7%, Nalidixic acid 95.95%, Ceftazidim 38.46%, Emipenem 24.34%, Meropenem 26.36%, and Cefotaxim 40.86%. The highest and lowest resistance rates were Co-trimoxazole and Piperacilin, respectively. The findings of PCR reaction among 115 P. aeruginosa isolates indicated that 62.62% was MexAB gene. The results of MIC with E-test revealed that the role of efflux pumps in antibiotic resistance was 19 isolated. Due to the importance of antibiotic resistance to investigate other efflux pumps, comparison of efflux pump involvement in antibiotic resistance, and relationship between efflux pumps MexAB-Opr M are highly required and suggested.
Design and Analysis of a Novel Compliant Mechanism with RPR Degrees of Freedom
Authors: Zhang Shuang , Liu Jing-Fang , Ding Hua-Feng
Published: July 2020

Magnetic drive pump has gotten great achievement A novel compliant mechanism with RPR degrees of freedom (DOF) is proposed where R and P represent rotation and translation DOFs, respectively. The proposed compliant mechanism is obtained from dimension synthesizing a 2-RPU-UPR rigid parallel mechanism with the method of optimization of motion/force transfer characteristic, where R, P and U represent rotation, translation and universal pairs, respectively. Firstly, inverse kinematics and Jacobian matrix are analyzed for the dimensional synthesis. Then, output transmission indexes of branches in the parallel mechanism are given. Dimensional synthesis is completed based on the normalized design parameter. And optimization of flexure joints based on constrained energy is carried out. Afterwards, the novel compliant mechanism is obtained by direct replacing method. Mechanical model of the compliant mechanism including static stiffness and input stiffness is built based on the pseudo-rigid body model method and virtual work principle for its future application. Finally, FEA simulation by Ansys Workbench is carried out to verify DOF, effectiveness of the dimension synthesis, and compliant model. Optimization of motion/force transfer characteristic is first applied for the design of compliant mechanisms to suppress drift of rotation axis in the paper.
Exploration of the mechanism of Ziyin Tongluo Formula on preventing and treating postmenopausal osteoporosis based on the network pharmacology
Authors: Chen Rong-Bin , Yang Ying-Dong , Sun Kai , Liu Shan , Guo Wei , Zhang Jin-Xin , Li Yong
Published: July 2020

Background

Postmenopausal osteoporosis (PMOP) is a global chronic and metabolic bone disease that poses huge challenges to individuals and society. Previous studies have confirmed that Ziyin Tongluo Formula (ZYTLF) has a good clinical effect in the treatment of PMOP. However, the material basis and mechanism of ZYLTF against PMOP has not been thoroughly explained.
Methods

TCMSP, TCMID, and BATMAN-TCM databases were used to identify the active ingredients and their putative targets. Genes associated with PMOP were mined from GeneCards, OMIM, DisGeNET databases, and then mapped with the putative targets to obtain overlapping target genes. A network model of "herb-active ingredient-overlapping target genes" was constructed and a protein-protein interaction network of overlapping target genes was built and the key genes were selected based on the MCC algorithm. The key genes were imported to the DAVID database to performs GO and KEGG pathway enrichment analyses.
Results

Ninety-two active components of ZYTLF corresponded to 243 targets, with 129 target genes interacting with PMOP, and 50 key genes were selected. GO analysis results showed that biological process mainly included positive regulation of transcription, negative regulation of apoptosis, and cell components were mainly nucleus, cytoplasm, and molecular functions mainly included enzyme binding, protein binding and transcription factor binding. There were two main types of significant KEGG pathways in PMOP, hormone-related signaling pathways (estrogen, prolactin, thyroid hormone) and inflammation-related pathways (TNF, PI3K-Akt, MAPK ).
Conclusions

The underlying therapeutic mechanisms of ZYTLF action on PMOP maybe is that, the active ingredients such as quercetin, kaempferol, luteolin act on ESR1, TNF, IL6, MAPK8 and other key genes, which mainly enrich in estrogen, TNF, PI3K-Akt, MAPK and other signaling pathways.
NRCMS and Rural Household Credit Availability in China: Evidence From CFPS
Authors: Liu Jin , Xu Qing , Yang Qing , Lu Yufeng
Published: July 2020

Background: The Chinese government has, in seeking to enable farmers to obtain and use safe and affordable formal financial services, implemented Inclusive Finance. But disease burden, poor health and other factors have made it difficult for farmers to obtain formal credit servicesMethods: This paper draws on 2010 China family survey (CFPS) data to explore how the New Rural Cooperative Medical Scheme (NRCMS) affected rural households’ credit availability. Results:The results show that, as a public health insurance system sustained by the participation of government investment participation, the NRCMS provides good ‘collateral’ and significantly enhances farmers’ credit availability level. Conclusions: Our study suggests the positive impacts is mainly reflected in the economic effect of the NRCMS. This raises the question of how to make better use of the NRCMS’ mortgage function, promote inclusive finance and provide more financial services for farmers that will promote their income. This serves to confirm and underline the importance of relevant policies.JEL Classifications: I18; G50; O16
A Systematic Review Protocol of The Antiviral Activity of Chloroquine and Hydroxychloroquine Against COVID-19.
Authors: Mensah Kofi Boamah , Mensah Adwoa Bemah Boamah , Bangalee Varsha , Oosthuizen Frasia
Published: July 2020

Background: The recent outbreak of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), or COVID-19 with no approved medicines has led to global health threat. Currently, repositioning of old medicines seems the most responsible strategy for potential cure and prevention COVID-19. Hydroxychloroquine and chloroquine have shown promising efficacy against COVID-19 related pneumonia in clinical studies. However, the mode of drug action of chloroquine and hydroxychloroquine against SARS-CoV-2 infection is not clear. This review aims to gather evidence on antiviral activity and possible mechanism of drug action of chloroquine and hydroxychloroquine on SARS-CoV-2, including in-vitro, animal studies, and studies in humans.Method: A structured search of five bibliographic databases namely; Medline, Web of Science, PubMed, Cochrane CENTRAL, and Google Scholar will be undertaken to retrieve studies that describe the antiviral activity and possible mechanism of drug action of chloroquine and hydroxychloroquine on SARS-CoV-2. No restrictions will be placed on publication date, but studies will be limited to only publications in English. Duplication of studies will be removed using EndNote reference manager. Three authors will screen the citations independently based on inclusion criteria. Data extraction and assessment of risk of bias will be done independently. Meta-analysis of selected studies will be done wherever suitable.Discussion: We expect that data that will be synthesis will provide enough information to inform COVID-19 care pathways and help clinicians caring for COVID-19 patients. Furthermore, this systematic review will expand our knowledge on the benefits and risks of chloroquine and hydroxychloroquine in management of COVID-19 patients and identify areas of controversies, and quality assessment. This review will provide vital information needed in the development of contextualized guidelines for the management of COVID-19 patients.Systematic review registration: https://doi.org/10.17605/OSF.IO/7DJMU
Overexpression of TC2N is associated with poor prognosis in gastric cancer
Authors: Xu Jianbo , Ou Xinde , Li Jin , Cai Qinbo , Sun Kaiyu , Ye Jingning , Peng Jianjun
Published: July 2020

Background

Tac2-N (TC2N) is a tandem C2 domain-containing protein, acting as a novel oncogene or suppressor in different kinds of cancers. However, the status of TC2N expression and its significance in gastric cancer (GC) is still unclear. The present study is aimed to elucidate the clinicopathological significance and prognostic value of TC2N level in GC.
Methods

We used sequencing data from the Cancer Genome Atlas (TCGA) database to analyze TC2N expression in GC by UALCAN database and Gene Expression Profiling Interactive Analysis tools (GEPIA). TC2N expression level in 12 pairs of fresh GC tissues and adjacent nontumorous tissues was detected by quantitative real-time reverse-transcription polymerase chain reaction(RT-PCR)and Western blot(WB) assays. Immunohistochemical (IHC) staining was used to detect TC2N protein expression in Paraffin-embedded tissues in our center. In vitro proliferation, migration and invasion assays were used to evaluate the effect of TC2N on functional capability of gastric cancer cells. LinkedOmics was used to identify gene expressions associated with TC2N.
Results

The mRNA and protein expression of TC2N in gastric cancer were both significantly higher than normal gastric mucosa. It was also elevated in gastric cancer cells compared with normal gastric epithelium cell. In vitro assays suggested that TC2N facilitated proliferation, migration and invasion of gastric cancer cells. Bioinformatic analysis showed a widespread impact of TC2N on the transcriptome and a strong interaction with tumor associated genes. We also found that TC2N was an independent prognostic factor for long-term survival in GC patients and its high expression was significantly associated with poor overall survival and recurrence-free survival.
Conclusions

Our results show that high level of TC2N correlates with poor prognosis in patients with gastric cancer and promotes the development of gastric cancer. Thus, TC2N expression can serve as a prognostic biomarker for patients with gastric cancer.
Artificial Neural Network-Based Predicting the Risk of Complicating Ventricular Tachyarrhythmia after Acute Myocardial Infarction During Hospitalization
Authors: Zheng Xifeng , Nong Weidong , Feng Dehui , Wang Junxian , He Yan
Published: July 2020

An artificial neural network (ANN) model was developed to predict the risks of complicating ventricular tachyarrhythmia (VTA) in patients with acute myocardial infarction (AMI). We enrolled information of 503 patients with 13 risk factors from the affiliated hospital of Guangdong medical university from January 2017 to December 2019. Risk factors were dimensionally reduced and simplified as new variables by principal component analysis (PCA). The cohort were randomly divided into a training set and a testing set at the ratio of 70%:30%. Training set was used to develop a model for the prediction of VTA while testing set was used to evaluate the performance of the model. Three new comprehensive variables by PCA are able to reflect all information of the original data. We determined the prediction model with optimizing parameters by cyclic searching which includes an input layer of three comprehensive variables, a single hidden layer composed of two neurons and a output layer. The area under curve (AUC) is 0.812 in training set and confusion matrix with accuracy 94.60%, sensitivity 63.04%, specificity 99.35%, positive predicative value 93.55%, negative predictive value 94.70%. The model displayed a decreased but medium discrimination with an AUC of 0.688 in the independent testing cohort, confusion matrix with accuracy 87.42%, Sensitivity 39.26%, specificity 98.37%, positive predicative value 84.62%, negative predictive value 87.68%. The research suggests that ANN model could be used to predict the risk of complicating ventricular tachyarrhythmia after acute myocardial infarction while should be further improved.
Randomized Longitudinal Study Comparing 3 Nasal Respiratory Support Modes to Prevent Intermittent Hypoxia in Very Preterm Infants
Authors: Gross Maximilian , Poets Anette , Steinfeldt Renate , Urschitz Michael S. , Böckmann Katrin , Haase Bianca , Poets Christian F.
Published: July 2020

Background: Nasal continuous positive airway pressure (NCPAP) devices using variable (vf-) and continuous (cf-) flow or synchronized nasal intermittent positive pressure ventilation (s-NIPPV) are used to prevent or treat intermittent hypoxia (IH) in preterm infants. Results on which is most effective vary. We aimed to investigate the effect of s-NIPPV and vf-NCPAP compared to cf-NCPAP on the rate of IH episodes.Methods: Preterm infants with a gestational age of 24.9-29.7 weeks presenting with IH while being treated with cf-NCPAP were monitored for 8 hours, then randomized to 8 h of treatment with vf-NCPAP or s-NIPPV. Data from 16 infants were analyzed. Due to an unexpectedly low sample size, results are only reported descriptively.Results: No relevant changes in the rate of IH events were detected between cf- vs. vf-NCPAP or between cf-NCPAP vs. s-NIPPV.Conclusion: Although limited by its small sample size, s-NIPPV, vf- and cf-NCPAP seemed to be similarly effective in the treatment of IH in these infants.Trial registration: This study was registered with the German Clinical Trials register - DRKS00005387. Registered 12 November 2013, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00005387