bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of an acute Care Surgery Model on the Management of acute Appendicitis in South Korea: A Retrospective Cohort Study
Authors: Yi Gun-Hee , Lee Hak-Jae , Lee Seul , Yoon Jong-Hee , Hong Suk-Kyung
Published: November 2020

BackgroundThe acute care surgery (ACS) system is a new model for the prompt management of diseases that require rapid treatment in patients with acute abdomen. This study compared the outcomes and characteristics of the ACS system and traditional on-call system (TROS) for acute appendicitis in South Korea. MethodsThis single-center, retrospective study included all patients (aged ≥18 years) who underwent surgery for acute appendicitis in 2016 and 2018. The TROS and ACS system were used for the 2016 and 2018 groups, respectively. We retrospectively obtained data on each patient from the electrical medical records. The independent samples t-test and Mann-Whitney U-test were used for continuous and non-normally distributed data, respectively.ResultsIn total, 126 patients were included. The time taken to get from the emergency room admission to the operating room, operation times, and postoperative complication rates were similar between both groups. However, the length of the hospital stay was shorter in the ACS group than in the TROS group (4.3±3.2 days vs. 7.2±9.6 days, p=0.039).ConclusionsSince the introduction of the ACS system, the length of hospital stay for surgical patients has decreased. This may be due to the application of an integrated medical procedure, such as a new clinical pathway, rather than differences in the surgical techniques.Trial registration: Retrospectively registered.
Social Support and Subjective Assessment of Psychophysical Condition, Health, and Satisfaction with Quality of Life among Women after Pregnancy Loss
Authors: Iwanowicz-Palus Grażyna , Mróz Mariola Małgorzata , Bień Agnieszka
Published: November 2020

Background: The task of modern medicine is not just to heal, but also to improve the patient’s well-being and achieve non-medical goals in the therapy process that enable effective physical, mental and social functioning of the patient. Social support in difficult situations mobilizes an individual's strength and resources to cope with problems. Research on social support and women’s condition after pregnancy loss reflects a holistic approach to the patient and is important from the perspective of increasing the level of hospital care. The aim of our study was to assess the impact of social support on the psychophysical condition, health, and satisfaction with quality of life among women after miscarriage and ectopic pregnancy.Methods: The study was carried out among 500 patients after misscariage and 110 with ectopic pregnancy, hospitalized in hospitals in Lublin (Poland). The study was conducted with the use of a diagnostic survey with the application of the Berlin Social Support Scales (BSSS) and original survey questionnaire.Results: Respondents after miscarriage and those after termination of ectopic pregnancy assigned highest scores to the degree of perceived available instrumental support (respectively, miscarriage: M = 3.79, EP: M = 3.77), emotional support (M = 3.68, M = 3.65), and actually received support (M = 3.61, M = 3.57) (p < 0.05). Women after pregnancy loss assigned the highest score to the support obtained from their partner (respectively, miscarriage: M = 9.26, EP: M = 9.23), family (M = 9.09, M = 9.18), midwife (M = 8.70, M = 8.58), and friends (M = 8.49, M = 8.61) (p < 0.05). Social support was significantly correlated with the condition of patients hospitalized as a result of pregnancy loss (p < 0.05).Conclusions: Women hospitalized due to miscarriage and ectopic pregnancy assigned high scores to the level of perceived available instrumental, emotional, and actually received social support. There is a positive relationship between social support and subjective opinion about psychophysical condition, health and satisfaction with quality of life among women after pregnancy loss.
Complex II Subunit SDHD is Critical for Cell Growth and Metabolism, Which can be Partially Restored with A Synthetic Ubiquinone Analog
Authors: Bandara Aloka B , Brown David A , Drake Joshua
Published: November 2020

Background: Succinate dehydrogenase (Complex II) plays a dual role in respiration by catalyzing the oxidation of succinate to fumarate in the mitochondrial Krebs cycle and transferring electrons from succinate to ubiquinone in the mitochondrial electron transport chain (ETC). Mutations in Complex II are associated with a number of pathologies. SDHD, one of the four subunits of Complex II, serves by anchoring the complex to the inner-membrane and transferring electrons from the complex to ubiquinone. Thus, modeling SDHD dysfunction could be a valuable tool for understanding its importance in metabolism and developing novel therapeutics, however no suitable models exist. Results: Via CRISPR/Cas9, we mutated SDHD in HEK293 cells and investigated the in vitro role of SDHD in metabolism. Compared to the parent HEK293, the knockout mutant HEK293ΔSDHD produced significantly less number of cells in culture. The mutant cells predictably had suppressed Complex II-mediated mitochondrial respiration, but also Complex I-mediated respiration. SDHD mutation also adversely affected glycolytic capacity and ATP synthesis. Mutant cells were more apoptotic and susceptible to necrosis. Treatment with the mitochondrial therapeutic idebenone partially improved oxygen consumption and growth of mutant cells. Conclusions: Overall, our results suggest that SDHD is vital for growth and metabolism of mammalian cells, and that respiratory and growth defects can be partially restored with treatment of a ubiquinone analog. This is the first report to use CRISPR/Cas9 approach to construct a knockout SDHD cell line and evaluate the efficacy of an established mitochondrial therapeutic candidate to improve bioenergetic capacity.
Methodology for Comprehensive Cell-Level Analysis of Wound Healing Experiments Using Artificial Intelligence
Authors: Oldenburg Jan , Maletzki Lisa , Strohbach Anne , Bellé Paul H. , Siewert Stefan , Busch Raila , Felix Stephan B. , Schmitz Klaus-Peter , Stiehm Michael
Published: November 2020

BackgroundEndothelial healing after deployment of cardiovascular devices is particularly important in the context of clinical outcome. It is therefore of great interest to develop tools for a precise prediction of endothelial growth after injury in the process of implant deployment. For experimental investigation of re-endothelialization in vitro cell migration assays are routinely used. However, automatic analyses of live cell images are often based on gray value distributions and are as such limited by image quality and user dependence. The rise of deep learning algorithms offers promising opportunities for application in medical image analysis. Here, we present an intelligent cell detection (iCD) approach for comprehensive assay analysis to obtain essential characteristics on cell and population scale.ResultsIn an in vitro wound healing assay, we compared conventional analysis methods with our iCD approach. Therefore we determined cell density and cell velocity on cell scale and the movement of the cell layer as well as the gap closure between two cell monolayers on population scale. Our data demonstrate that cell density analysis based on deep learning algorithms is superior to an adaptive threshold method regarding robustness against image distortion. In addition, results on cell scale obtained with iCD are in agreement with manually velocity detection, while conventional methods, such as Cell Image Velocimetry (CIV), underestimate cell velocity by a factor of 0.5. Further, we found that iCD analysis of the monolayer movement gave results just as well as manual freehand detection, while conventional methods again shows more frayed leading edge detection compared to manual detection. Analysis of monolayer edge protrusion by ICD also produced results, which are close to manual estimation with an relative error of 13.2 %. In comparison, the conventional Canny method gave a relative error of 61 %. ConclusionThe results of our experiments indicate that deep learning algorithms such as our iCD have the ability to outperform conventional methods in the field of wound healing analysis. The combined analysis on cell and population scale using iCD is very well suited for timesaving and high quality wound healing analysis enabling the research community to gain detailed understanding of endothelial movement.
The Effect of Indoor Daylight Levels on Patients Admitted to General Surgery
Authors: Li Xiawei , Lou Jianyao , Shi Aiguang , Wang Ning , Zhou Lin , Yuan Zheping , Zhao Mingchen , Ye Fanghe , Pan Zikun , WU YULIAN
Published: November 2020

BackgroundIndoor daylight levels can directly affect people’s physical and psychological state. However, the effect of indoor daylight levels on patient’s clinical recovery process remains controversial.AimTo evaluate the effect of indoor daylight levels on hospital costs and average length of stay (LOS) of a large patient population in general surgery wards.MethodsData were collected retrospectively and analysed of patients in the Second Affiliated Hospital of Zhejiang University, School of Medicine between January 2015 and August 2020. We measured light levels in the patient rooms of general surgery and assessed their association with patients’ total hospital costs and LOS.ResultsA total of 2,998 patients were included in this study with 1,478 each assigned to two light level groups after matching. Overall comparison of hospital total costs and LOS among patients according to light levels did not show a significant difference. Subgroup analysis showed when exposed to higher intensity of indoor daylight, illiterate patients had lower total hospital costs and shorter LOS as compared to those exposed to lower intensity.ConclusionsIndoor daylight levels were not associated with the hospital costs and LOS of patients in the wards of general surgery, except for those who were illiterate. It might be essential to design guidelines for healthcare facilities to enhance indoor environmental benefits of daylight for some specific population.
High-Flow Nasal Cannula Treatment in Patients with COVID-19 Acute Hypoxemic Respiratory Failure
Authors: Alshahrani Mohammed S , Alshaqaq Hassan M. , Alhumaid Jehan , Binammar Ammar A. , AlSalem Khalid H , Alghamdi Abdulazez , Abdulhady Ahmed , Yehia Moamen , AlSulaibikh Amal , Jumaan Mohammed Al , Albuli Waleed H. , Ibrahim Talal , Yousef Abdullah A. , Almubarak Yousef , Alhazzani Waleed
Published: November 2020

BackgroundThe increasing burden of coronavirus disease 2019 (COVID-19)-related acute hypoxemic respiratory failure (AHRF) is straining intensive care unit (ICU) resources globally. Early use of high-flow nasal cannula (HFNC) decreases the need for endotracheal intubation (EI) in different causes of respiratory failure. While HFNC is used in COVID-19-related AHRF, its efficacy remains to be investigated. We aimed to examine whether the use of high-flow nasal oxygen therapy (HFNO) prevents the need for intubation in COVID-19 with (AHRF).MethodsThis is a single-center prospective observational study that was conducted at a tertiary teaching hospital in Saudi Arabia the period from April, 2020 to August, 2020. Adults patients admitted to the ICU with AHRF secondary to COVID-19 pneumonia and managed with HFNC were included. We excluded hemodynamically unstable patients and those who were intubated or managed with non-invasive ventilation. Patients’ data and clinical outcomes were pre-defined. The primary outcome was to determine the rate of EI among patients who were treated with HFNC. Secondary outcomes included predictors of HFNC success/failure, mortality, and hospital length of stay. ResultsWe consecutively screened 111 hospitalized COVID-19 patients with AHRF,. Out of those, 44 (40%) patients received HFNC with a median duration of three days (IQR, 1–5). The median age was 57 years (interquartile range [IQR], 46–64), and 82% were men. HFNC failure and EI occurred in 29 (66%) patients. Patients who failed HFNC treatment had higher risk of death compared to those who did not (52% vs. 0%; p=0.001). At baseline, the prevalence of hypertension, chronic kidney disease, and asthma was higher in the HFNC failure group. After adjustment for possible confounders, a high Sequential Organ Failure Assessment (SOFA) score and a low ROX index were significantly associated with HFNC failure (hazard ratio [HR], 1.42; 95% confidence interval [CI], 1.04–1.93; p=0.025; and HR, 0.61; 95% CI, 0.42–0.88; p=0.008, respectively). ConclusionsIn this prospective study, one-third of hypoxemic COVID-19 patients who received HFNC did not require intubation. High SOFA score and low ROX index were associated with HFNC failure.
Weekly Trastuzumab Therapy Cannot Prevent Severe Trastuzumab-induced Thrombocytopenia: A Case Report
Authors: Wang Xin , Zhu Xiaoli , Zou Jieya , Zhang Xia , Wu Xuemei , Nie Jianyun
Published: November 2020

Background: Trastuzumab can significantly prolong the survival of patients with positive human epidermal growth factor receptor-2 breast cancer. Until now, trastuzumab has been used by millions of people, and trastuzumab-induced thrombocytopenia is rare. There is no report of acute grade 4 thrombocytopenia after weekly trastuzumab therapy. We report a breast cancer patient with severe thrombocytopenia due to trastuzumab (8mg/Kg) who experienced a recurrence of severe thrombocytopenia after attempting weekly trastuzumab therapy (4mg/Kg). Case presentation：A 52-year-old woman with positive human epidermal growth factor receptor-2 breast cancer developed acicular rash with dense skin all over the body and gingival bleeding within 24 hours of trastuzumab infusion (8mg/Kg) and was confirmed to have severe thrombocytopenia, which was quickly recovered after high-dose corticosteroid pulse therapy. When the platelet count recovered, we tried weekly trastuzumab therapy (4mg/kg), Unfortunately, thrombocytopenia recurred within 24 hours. No third trastuzumab treatment was attempted. Conclusion: We are the first report to try weekly trastuzumab therapy after thrombocytopenia induced by first trastuzumab. The patient showed that reducing the dose of trastuzumab was ineffective in preventing trastuzumab-induced thrombocytopenia.
Bioinformatics Analysis and Identification of Potential Biomarkers in Gastric Cancer
Authors: Yang Jingdi , Peng Bo , Qin Xianzheng , Zhou Tian
Published: November 2020

Background: Although the morbidity and mortality of gastric cancer are declining, gastric cancer is still one of the most common causes of death. Early detection of gastric cancer is of great help to improve the survival rate, but the existing biomarkers are not sensitive to diagnose early gastric cancer. The aim of this study is to identify the novel biomarkers for gastric cancer.Methods: Three gene expression profiles (GSE27342, GSE63089, GSE33335) were downloaded from Gene Expression Omnibus database to select differentially expressed genes. Then, Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analysis were performed to explore the biological functions of differentially expressed genes. Cytoscape was utilized to construct protein-protein interaction network and hub genes were analyzed by plugin cytoHubba of Cytoscape. Furthermore, Gene Expression Profiling Interactive Analysis and Kaplan-Meier plotter were used to verify the identified hub genes.Results: 35 overlapping differentially expressed genes were screened from gene expression datasets, which consisted of 11 up-regulated genes and 24 down-regulated genes. Gene Ontology functional enrichment analysis revealed that differentially expressed genes were significantly enriched in digestion, regulation of biological quality, response to hormone and steroid hormone, and homeostatic process. Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis showed differentially expressed genes were enriched in the secretion of gastric acid and collecting duct acid, leukocyte transendothelial migration and ECM-receptor interaction. According to protein-protein interaction network, 10 hub genes were identified by Maximal Clique Centrality method.Conclusion: By using bioinformatics analysis, COL1A1, BGN, THY1, TFF2 and SST were identified as the potential biomarkers for early detection of gastric cancer.
High Expression of SPRR1B Indicates Unfavorable Clinical Outcomes in Lung Adenocarcinoma
Authors: Cao Hao , Feng Ganzhu , Li Min , Chen Sen , Zhu Yi , Chang Xueduan
Published: November 2020

Backgrounds: Small proline-rich protein 1B (SPRR1B) was initially identified as an envelope protein of keratinocytes, which plays essential roles in squamous cell differentiation. Recently its involvement in malignancies was also explored in head and neck squamous cell carcinoma. However, whether SPRR1B participates in adenocarcinoma progression remains unknown. Here we aimed to investigate the expression and function of SPRR1B in lung adenocarcinoma (LAC).Methods: SPRR1B expression level was examined in LAC samples and adjacent nontumorous samples through quantitative RT-PCR assay and immunohistochemistry staining. Univariate and multivariate analyses were performed to estimate the prognostic role of SPRR1B. Cellular experiments were performed to reveal the function of SPRR1B in LAC cells. Results: The SPRR1B level in LAC samples was significantly higher compared with adjacent samples. Moreover, higher SPRR1B level was correlated with poor tumor differentiation and advanced tumor stage. LAC patients with higher SPRR1B level had worse overall survival. Moreover, SPRR1B was confirmed as an independent unfavorable prognosis factor. Cellular data indicated that knockdown of SPRR1B could attenuate the proliferation capacity of LAC cells. Conclusions: Our results demonstrated that high SPRR1B level was significantly correlated with unfavorable clinical features and poor prognosis of LAC patients. SPRR1B might serve as a novel prognostic indicator and potential drug target for LAC treatment.
Pathologic Response Rates for Breast Cancer Stages as a Predictor of Outcomes in Patients Receiving Neoadjuvant Chemotherapy Followed by Breast-Conserving Surgery
Authors: Lu Chang-Yun , Chen Ho-Min , Wu Szu-Yuan
Published: November 2020

PURPOSE: To determine easy-to-use predictors of overall survival (OS), locoregional recurrence (LRR), and distant metastasis (DM) in patients with breast invasive ductal carcinoma (IDC) receiving neoadjuvant chemotherapy (NACT) followed by breast-conserving surgery (BCS), we obtained pathologic response rates (PRRs) for combined primary and nodal diseases (American Joint Committee on Cancer [AJCC] stages) from clinical and pathologic reports, and we used these as predictors.PATIENTS AND METHODS: We enrolled patients with IDC who had received NACT followed by BCS. Cox regression analysis was used to calculate hazard ratios (HRs) and confidence intervals (CIs) for the patients’ PRRs; other independent predictors were controlled for or stratified in the analysis.RESULTS: We analyzed 1047 patients with IDC (611, 260, and 176 patients in clinical stages IIB, IIIA, and IIIB-C, respectively) receiving NACT and BCS. After multivariate Cox regression analyses, the adjusted HRs (aHRs; 95% CI) in patients with pathologic complete response (ypT0N0) were 0.26 (0.13–0.56), 0.36 (0.15–0.85), and 0.15 (0.08–0.31) for all-cause mortality, LRR, and DM, respectively. The aHRs (95% CI) in patients with downstaging of AJCC stages were 0.55 (0.35–0.89), 0.91 (0.62–0.96), and 0.63 (0.43–0.91) for all-cause mortality, LRR, and DM, respectively. The aHRs (95% CI) in patients with upstaging of AJCC stages were 1.77 (1.06–2.24), 1.08 (1.03–1.82), and 1.19 (1.07–2.01) for all-cause mortality, LRR, and DM, respectively.CONCLUSION: The impacts of AJCC-stage PRRs are useful predictive tools and strong predictors for OS, LRR, and DM in patients with breast IDC receiving NACT followed by BCS.
Incidence and Clinical Impact in Papillary Thyroid Microcarcinoma With Lateral Cervical Node Metastasis
Authors: Lee Kwan Ho , Kim Eun Young , Yun Ji Sup , Park Yong Lai , Park Chan Heun
Published: November 2020

BackgroundsLateral lymph node metastasis (LNM), which significantly impacts papillary thyroid carcinoma (PTC) patients’ prognosis. Papillary thyroid microcarcinoma (PTMC) is known to have a much better prognosis than non-PTMC, but it has not been known whether there is such a difference even with lateral LNM. MethodsThis retrospective study included a series of 3336 consecutive PTC patients who underwent thyroidectomy. Of them, 206 had lateral LNM and were divided into the PTMC and non-PTMC groups by tumor size (1-cm) for comparing the prevalence of prognostic factors. ResultsLNM was in 157/1131 (13.9%) non-PTMC patients and 49/2205 (2.2%) PTMC patients. Eleven of the 206 (5.3%) lateral LNM cases not found on US were only seen on computed tomography. The prevalence of prognostic factors which include an age of >55 years, >5 metastatic lymph nodes (LNs), high metastatic-to-examined LN ratio, and large metastatic LNs (>3 cm) were not significantly different between PTMC and non-PTMC group. ConclusionIn PTC with lateral LNM, the prognosis is likely to be similar regardless of tumor size. Considering the modest risk of lateral LNM in PTMC, FNA for small thyroid tumor and radiologic tests for lateral LNM should be encouraged.
Silencing LncRNA SCAMP1 Inhibits Cell Proliferation in Hepatocellular Carcinoma via Activation of p53 Signaling Pathway
Authors: Ma Xiaochen , Sun Xiangyang , Li Caixia , Zhang Kai , Xie Yang
Published: November 2020

Background: Long noncoding RNA secretory carrier membrane protein 1 (SCAMP1) has been recently reported to be an oncogene in several cancers, including glioma and ovarian cancer. However, its clinical significance and functional role in hepatocellular carcinoma (HCC) remain unknown.Methods: The expression of SCAMP1 was determined in tissue samples and cell lines using quantitative reverse transcription PCR. The clinical significance of SCAMP1 in HCC was evaluated using chi-squared test, Kaplan-Meier survival, as well as univariate and multivariate analysis. Cell proliferation, cell cycle distribution and apoptosis were evaluated using CCK-8 assay, colony formation assay, Flow cytometry analysis. Related protein expression levels were measured by western blot analysis.Results: We found SCAMP1 expression levels were remarkably up-regulated in HCC tissues compared with that in matched adjacent tissues. Increased SCAMP1 expression was significantly correlated with large tumor size, advanced TNM stage and poor survival prognosis in HCC. Knockdown of SCAMP1 significantly inhibited cell proliferation, induced G0/G1 phase arrest and apoptosis in HepG2 and SNU-182 cells. More importantly, knockdown of SCAMP1 downregulated the expression levels of CDK4, Cyclin D1 and Bcl-2, while upregulated the expression levels of p21, p53 and Bax.Conclusions: In summary, our study clarified the oncogenic role of SCAMP1 in HCC, and provided a potential therapeutic target for HCC treatment.
Microwave Ablation for Papillary Thyroid Cancer With Cervical Lymph Node Metastasis
Authors: Zhao Zhen-Long , Wei Ying , Cao Xiao-Jing , Peng Li-Li , Li Yan , Wang Shu-Rong , Guo Jian-Qin , Yu Ming-an
Published: November 2020

Background: To evaluate the feasibility and safety of microwave ablation (MWA) for PTC with metastatic cervical lymph nodes who are ineligible for or refuse surgery. Materials and Methods: Twenty patients of unifocal PTC with metastatic cervical lymph nodes from three hospitals were enrolled in this study, and MWAs were performed. Contrast-enhanced ultrasound was used to evaluate the extent of ablation. The volume of the ablated area and thyroid hormones were measured. Results: PTC nodules in 9 patients completely disappeared at the end of follow-up. Compared with the volume before ablation, the mean volume reduction ratio of ablated lesions was 0.414 ± 0.700 (range: -1.92-0.95) at postoperative 6 months. The patients' thyroid function tests were normal at the end of follow-up. New lymph node metastasis was found in one patient during follow-up visits and she underwent a second MWA procedure. For the other patients, no new PTC nodule, local recurrence or cervical lymph node metastasis were suspected on ultrasound by the end of follow-up. No distant metastasis was encountered during the follow up. None of the patients developed hypocalcemia, permanent hoarseness or skin burns. Conclusions: MWA is a minimal invasive and safe method in treating PTC with cervical lymph node metastasis.
Breasts and the City: An Urban Ethnography of Infant Feeding in Public Spaces within Cardiff, United Kingdom
Authors: Grant Aimee
Published: November 2020

Background: Internationally, women report challenges breastfeeding in public spaces. This study aimed to investigate the social-spatial aspects of public spaces in one UK city, Cardiff, in order to suggest possible barriers and facilitators to breastfeeding in public spaces.Methods: The study observation location guide prioritised places that had been reported as hostile to breastfeeding or breastfeeding friendly in the existing literature. Data were collected at various times of day, in several areas of the city, and included transport (n=4), transport hubs (n=3), high streets (n=4), cafes (n=2), a large city centre shopping complex, comprising of three joined shopping centres and a large city centre department store (containing a third café). Low inference field notes were written on an encrypted smart phone and expanded soon after. Data were analysed thematically using deductive codes based on the observation schedule. Additional inductive codes relating to places were added.Results: Overall, public transport and the city centre were inhospitable environments for those who might need to breastfeed, and even more so for those who need to express breastmilk. The core barriers and facilitators running through the data appeared to be the availability of appropriate seating coupled with either high privacy or civil inattention. The one variation to this model arose from the department store café, where civil inattention was not performed and there was low privacy, but breastfeeding occurred anyway. Conclusions: This research highlights the physical and social barriers to breastfeeding within one urban city centre in the UK and its associated transport links. It is clear that there is an urgent need for change in urban city centres and public transport if countries are to meet their aims in relation to increasing breastfeeding rates. Interventions will need to be multifaceted, accounting for social norms relating to infant feeding as well as changes to the physical environment, policy and potentially legal change. Further research should be undertaken in other countries to examine the extent to which hostile environments exist, and if correcting these could facilitate breastfeeding and reduce gender based violence.
Identification of an Independent Immune-genes Prognostic Index for Renal Cell Carcinoma
Authors: Qin Chao , Li Guangyao , Wei Xiyi , Su Shifeng , Wang Shangqian , Wang Wei , Wang Yichun , Meng Xianghu , Xia Jiadong , Song Ninghong
Published: November 2020

Objective: Increasing evidence has indicated an association between immune micro-environment in clear cell renal cell carcinoma (ccRCC) and clinical outcomes. The aim of this research is to comprehensively investigate the effect of tumor immune genes on the prognosis of ccRCC patients. Methods: 2498 immune genes were downloaded from ImmPort database. Additionally, we identified and downloaded the transcriptome data of patients with ccRCC from the TCGA database through the R package, as well as relevant clinical information. We apply certain survival R package to analyse the survival of hub-genes before analyzing the effect of immune genes on the prognosis of clear cell renal cell carcinoma (ccRCC) utilizing Cox regression analysis. Based on the statistical correlation between hub immune gene and survival ,immune risk score model was set up.We finally constructed a nomogram to predict the survival rate of ccRCC overally. In addition, whether the immune gene risk score model is an independent prognostic factor for ccRCC is comprehensively considered applying multivariate cox regression analysis. It is worth noting that throughout the data analysis, P< 0.05 was recognized to be of significance statistically. Results: The results of the difference analysis showed that 556 immune genes exhibited differential expression between normal and ccRCC tissues (p<0. 05). Univariate cox regression analysis revealed 43 immune genes statistically correlated with ccRCC related survival risk (P<0.05). In addition, a 18-genes based immune genes risk scoring model was constructed through lasso COX regression analysis. KM curve indicated that patients in high-risk were associated with poor outcomes (p<0.001). ROC curve indicated that the immune risk score model was reliable in predicting survival risk (5-year OS, AUC=0.802). Our model showed satisfying AUC and survival correlation in the validation dataset ( 5-year OS AUC=0.705, P<0.001). Furthermore, multivariate cox regression analysis confirmed that the immune risk score model was an independent factor for predicting the prognosis of ccRCC. A nomogram was established to comprehensively predict the survival of ccRCC patients with the results of multivariate cox regression analysis. Finally, we found that 15 immune genes and risk scores were significantly associated with clinical factors and prognosis, and were involved in multiple oncogenic pathways.Conclusion: Collectively, tumor immune genes played an essential role in the prognosis of ccRCC. Furthermore, immune risk score was an independent predictive factor of ccRCC, indicating a poor survival.
Curcumin Protects Against Cognitive Impairments in a Rat Model of Chronic Cerebral Hypoperfusion Combined with Diabetes Mellitus by Suppressing Neuroinflammation, Apoptosis, and Pyroptosis
Authors: Zheng Yaling , Zhang Jiawei , Zhao Yao , Zhang Yaxuan , Zhang Xiaojie , Guan Jian , Liu Yu , Fu Jianliang
Published: November 2020

BackgroundChronic cerebral hypoperfusion (CCH) is regarded as a high-risk factor for cognitive decline in vascular dementia (VaD). We have previously shown that diabetes mellitus (DM) synergistically promotes CCH-induced cognitive dysfunction via exacerbating neuroinflammation. Furthermore, curcumin has been shown to exhibit anti-inflammatory and neuroprotective activities. However, the effects of curcumin on CCH-induced cognitive impairments in DM have remained unknown.MethodsRats were fed with a high-fat diet (HFD) and injected with low-dose streptozotocin (STZ), followed by bilateral common carotid artery occlusion (BCCAO), to model DM and CCH in vivo. After BCCAO, curcumin (50 mg/kg) was administered intraperitoneally every two days for eight weeks to evaluate its therapeutic effects. Additionally, mouse BV2 microglial cells were exposed to hypoxia and high glucose to model CCH and DM pathologies in vitro. ResultsCurcumin treatment significantly improved DM/CCH-induced cognitive deficits and attenuated neuronal cell death. Molecular analysis revealed that curcumin exerted protective effects via suppressing neuroinflammation induced by microglial activation, regulating the triggering receptor expressed on myeloid cells 2 (TREM2)/toll-like receptor 4 (TLR4)/nuclear factor-κB (NF-κB) pathway, alleviating apoptosis, and reducing nod-like receptor protein 3 (NLRP3)-dependent pyroptosis.ConclusionsTaken together, our findings suggest that curcumin represents a promising therapy for DM/CCH-induced cognitive impairments.
Alterations and Association of Fecal Microbiota and Amino Acids in Parkinson's Patients
Authors: Yan Zhenzhen , Yang Fan , Cao Jingwei , Ding Wencai , Yan Shi , Shi Wanying , Wen Shirong , Yao Lifen
Published: November 2020

Background: Intestinal microbiota and amino acids that are one of their metabolites play important roles in the mechanism of pathology of Parkinson's disease (PD). It has been reported that the level of amino acids in vivo participate in neurodegeneration by regulating adaptive immune response, while the current researches on alteration of amino acids in intestinal microbiota are still insufficient. Here, we evaluate the correlation between gut microbiota alterations and clinical parameters of PD, amino acid concentrations.Methods: Stool samples from PD and healthy controls were collected for microbiome and targeted metabolome analyses. Results: At the genus level, there was a greater abundance of Rikenellaceae_RC9_gut_group in PD patients with more severe motor symptoms. Metabonomics analysis showed that multiple fecal amino acid concentrations in PD patients were decreased. Moreover, the findings that by spearman analysis Rikenellaceae_RC9_gut_group associated with PD had a significantly negative correlation with phenylalanine (r = -0.488, P < 0.01), tyrosine (r = -0.541, P < 0.01) and isoleucine (r = -0.434, P < 0.01). Conclusions: Our results not only find Rikenellaceae_RC9_gut_group, a new pro-inflammatory genus of intestinal microbiota in PD, but also reveal that it's related to amino acids. These findings are beneficial to identifying microbial therapeutic targets for PD.
Captivity Reduces Diversity and Shifts Composition of the Brown Kiwi Microbiome
Authors: Juan Priscilla A San , Castro Isabel , Dhami Manpreet Kaur
Published: November 2020

BackgroundCaptive rearing is often critical for animals that are vulnerable to extinction in the wild. However, few studies have investigated the extent at which captivity impacts hosts and their gut microbiota, despite mounting evidence indicating that host health is affected by gut microbes. We assessed the influence of captivity on the gut microbiome of the Brown Kiwi (Apteryx mantelli), a flightless bird endemic to New Zealand. We collected wild (n = 68) and captive (n = 38) kiwi feces at seven sites on the north island of New Zealand. ResultsUsing bacterial 16S rRNA and fungal ITS gene profiling, we found that captivity was a significant predictor of the kiwi gut bacterial and fungal communities. Captive samples had lower microbial diversity and different composition when compared to wild samples. History of coccidiosis, a gut parasite primarily affecting captive kiwi, showed a marginally significant effect. ConclusionsOur findings demonstrate captivity’s potential to shape the Brown Kiwi gut microbiome, but further investigation is needed to elucidate the effects of these differences on welfare.
Prevalence and Risk Factors for Gastroesophageal Reflux in Symptomatic Very Preterm Neonates
Authors: Hu Yu , Fu Hua , Zhang Cheng
Published: November 2020

Objectives Because of immature development, preterm infants are prone to respiratory and digestive symptoms, such as dyspnea, vomiting, and aspiration pneumonia. These symptoms are often observed in infants with gastroesophageal reflux (GER). However, the relationship between GER and these symptoms remains unclear.Methods A cohort of 61 preterm infants born at 32 weeks of gestation or earlier with respiratory or digestive symptoms were retrospectively reviewed. All the preterm infants underwent 24-hour pH-multichannel intraluminal impedance monitoring. Clinical data were analyzed using logistic regression analyses.Results Among the 61 symptomatic preterm infants, 34 were positive for pathologic GER with a prevalence of 55.7%. The GER-associated symptoms included apnea (42.6%), cyanosis (19.7%), vomiting (14.8%), pneumonia (9.8%), and poor weight gain (13.1%). These respiratory and digestive symptoms were more frequent in infants with pathologic GER than in those without (p<0.05). The risk factors for GER included severe bronchopulmonary dysplasia (odds ratio [OR], 6.890; 95% confidence interval [CI], 1.125-42.209). Probiotics and delayed full oral feeds reduced the risk of GER (OR, 0.642; 95% CI, 0.457-0.901, p<0.05; OR, 0.234, 95% CI, 0.069-0.794, p<0.05). Conclusions The prevalence of GER is high in symptomatic preterm infants. GER aggravates the respiratory and digestive symptoms; however, such symptoms are not always GER-associated. Probiotics and delayed full oral feeds can decrease the prevalence of GER.
A validation study of Perceived Social Support (PSS) of chronic patients in Antiretroviral clinics
Authors: Yousuf Abdilahi , Musa Ramli , Md. Muhammad Lokman , Arifin SitiRoshaidai Mohd
Published: November 2020

Background: Perceived Social Support which referred to an individual's extent of satisfaction regarding his/her necessary support, information, and interactions. According to (Procidano, 1983), PSS is a key element for understanding supportive behavior and is assumed to determine its association with depression. This 12-item scale is considered a substantial component that influences the emotional well-being of chronic patients. Hence, this paper is intended to validate the English version of Perceived Social Support among WLHIV. Methods: A facility-based cross-sectional study was conducted in WLHIV who attends the ART treatment of selected hospitals. A total of 357 attendees were recruited for a broader mixed-method designed study. The English version of PSS was translated into a national Somali language. The internal consistency was measured to analyze the reliability and Principle Component Analysis (PCA) was used to determine the validity of the study.Results: The findings of this study reveals that the PSS has shown a good internal consistency with Cronbach alpha greater than 0.60. Based on the principle component analysis, the validity construct of the scale was also measured showing a Varimax rotation of the components was successfully loaded and eigenvalue was greater than 1. Conclusion: This version, Perceived Social Support (PSS) is fit to be introduced in the health institutions for screening the level of support of chronic patients particularly its suitability for applications in the ART treatment services.
Knowledge and Attitude towards 2019 Novel Coronavirus (COVID-19) Among Health Care Workers in Tripoli, Libya
Authors: Atia Ahmed , Abdo Mohammed
Published: November 2020

The rising incidence of COVID-19 continues to cause distress, worry, and fear amongst the public, mostly for healthcare workers, as they are the most vulnerable individuals at risk of contracting this new SARS-CoV-2 outbreak. This study measured levels of knowledge and attitude regarding COVID-19 among health care workers in Libya. A cross-sectional survey was conducted among healthcare workers in Libya between April 22 and June 16, 2020 using online pre-validate questionnaire. We obtained 272 valid participants from 28.7% nurses, 25.3% physicians, 34.2% pharmacists, and 11.8% other health care workers. The majority of respondents (54.4%) were from the western part of Libya, and most of participants (41.2%) used international health websites as a source of information. Most of the participants (89.3%) perceived that they had adequate knowledge about COVID-19, and (95.6%) of respondents affirmed that COVID-19 can be life-threatening disease. All participants agreed that the transmission of COVID-19 can be prevented by using standard and isolation precautions given by the health care authorities. In addition, most participants had good attitude toward the adequate information about COVID-19 in Libyan society. Readiness for the pandemic were low among government institutions as spotted from this study. Therefore, an effective educational training program should be implemented to ensure maintenance of appropriate practices during the COVID-19 pandemic.
The effectiveness and cost effectiveness of a hospital avoidance program in a residential aged care facility: a prospective cohort study and modelled decision analysis
Authors: Carter Hannah , Lee Xing J. , Dwyer Trudy , O’Neill Barbara , Jeffrey Dee , Doran Chris , Parkinson Lynne , Osborne Sonya , Reid-Searl Kerry , Graves Nicholas
Published: November 2020

Background: Residential aged care facility residents experience high rates of hospital admissions which are stressful, costly and often preventable. The EDDIE program is a hospital avoidance initiative designed to enable nursing and care staff to detect, refer and quickly respond to early signals of a deteriorating resident. The program was implemented in a 96-bed residential aged care facility in regional Australia. Methods: A prospective pre-post cohort study design was used to collect data on costs of program delivery, hospital admission rates and length of stay for the 12 months prior to, and following, the intervention. A Markov decision model was developed to synthesize study data with published literature in order to estimate the cost-effectiveness of the program. Quality adjusted life years (QALYs) were adopted as the measure of effectiveness. Results: The EDDIE program was associated with a 19% reduction in annual hospital admissions and a 31% reduction in the average length of stay. The cost-effectiveness analysis found the program to be both more effective and less costly than usual care, with 0.06 QALYs gained and $249,000 health system costs saved in a modelled cohort of 96 residents. A probabilistic sensitivity analysis estimated that there was an 86% probability that the program was cost-effective after taking the uncertainty of the model inputs into account. Conclusions: This study provides promising evidence for the effectiveness and cost-effectiveness of a nurse led, early intervention program in preventing unnecessary hospital admissions within a residential aged care facility. Further research in multi-site randomised studies is needed to confirm the generalisability of these results.
Dysphagia and Masticatory Performance as a Mediator of the Xerostomia to Quality of Life Relation in the Older Population
Authors: Lu Ting-Yu , Chen Jen-Hao , Du Je-Kan , Lin Ying-Chun , Ho Pei-Shan , Lee Chien-Hung , Hu Chih-yang , Huang Hsiao-Ling
Published: November 2020

Background: The impact of poor oral health on older adults’ quality of life is a public health problem. In this study, the mediating effects of dental status, occlusal condition, dysphagia, and masticatory performance on the association between xerostomia and oral health-related quality of life (OHRQoL) were assessed in the older adult population. Methods: Stratified cluster sampling was used to recruit 1076 community-dwelling adults aged 65 years and older from Kaohsiung, Taiwan. Community care centers were randomly selected according to their geographic classifications (urban, rural, or mountainous areas). Assessments of dental status and occlusal condition were performed by dentists. Information on demographics, physical function, xerostomia, dysphagia and depression was collected through face-to-face interviews. Masticatory performance was evaluated using color-changeable chewing gum. OHRQoL was measured using the Geriatric Oral Health Assessment Index. Hierarchical regression models were used to assess the relationships between OHRQoL and physical function, dental status and oral function in older adults. Path analysis was used to estimate direct and indirect pathways between xerostomia and OHRQoL.Results: Participants with xerostomia exhibited a 0.20 OHRQoL reduction (p < .001) compared with patients with no xerostomia, and the direct effect accounted for 83.3% of the total effect. Dysphagia and masticatory performance were found to exert significant mediating effects on the association between xerostomia and OHRQoL (βs = 0.20 and −0.12, respectively; both p < .001; βs = 0.06 and −0.09, respectively; both p < .05). Moreover, potential mediating effects of the number of functional teeth (βs = −0.11 and −0.43, respectively; both p < .001) and occlusal condition (βs = 0.09 and 0.13, respectively; both p < .05) on the relationship between xerostomia and masticatory performance were noted.Conclusions: Dysphagia and masticatory performance may serve as pathways through which xerostomia affects quality of life. Early oral function intervention may be a valuable and actionable target for older adults to maintain quality of life. Our results further suggest that checkup and screening for oral dysfunction are essential to prevent or delay the onset of complications.
Progesterone levels predict pregnancy outcome in individuals with fallopian tube associated infertility
Authors: BO Wenjia , Zhang Ning
Published: November 2020

Background: To investigate the predictive value of human chorionic gonadotropin and progesterone levels on pregnancy outcomes in patients receiving in vitro fertilization due to simple fallopian tube factors. METHODS:We retrospectively analyzed the clinical data of 854 cycles from the simple fallopian tube factor in vitro fertilization fresh embryo transfer. The clinical data of 854 cycles from January 2010 to December 2018 was divided into 7 groups according to the progesterone level on human chrionic gonadotropin day. Live birth rates and observe trends were calculated. The receiver operating characteristic curve was established to determine the optimal cutoff value for progesterone, which was used to further divide the data into 3 groups: Group 1 (progesterone ≦ 1.0 ng/ml), Group 2 (1.0 ng/ml ≤ progesterone ≤ 1.25 ng/ml), and Group 3 (progesterone≥1.25ng/ml). We then compared the ovulation results and clinical outcomes between the 3 groups. RESULTS There were no significant differences in age, infertility years, Gonadotropin dosage, Gonadotropin days, Luteinizing hormone level on human chrionic gonadotropinday, 2pronuclear fertilization rate, clinical pregnancy rate, live birth rates, full-term birth rate, and preterm birth rate among the three groups, but body mass index(P = 0.001), basal luteinizing hormone (P = 0.034), estrogen peak (P ＜0.001), number of oocytes obtained (P＜0.001) were significantly different. CONCLUSION The level of progesterone on human chrionic gonadotropin day does not affect the clinical pregnancy rate and live birth rates after in vitro fertilization. However, progesterone levels between 1.0-1.25ng/ml may lead to good clinical pregnancy outcomes.