bluuebunny/crossref_metadata_2025 huggingface dataset:
A model based on CT radiomic features for predicting RT-PCR becoming negative in coronavirus disease 2019 (COVID-19) patients
Authors: Cai Quan , Du Siyao , Gao Si , Huang Guoliang , Zhang Zheng , Li Shu , Wang Xin , Li Peiling , Lv Peng , Hou Gang , Zhang Lina
Published: October 2020

Background: Coronavirus disease 2019 (COVID-19) has emerged as a global pandemic. According to the diagnosis and treatment guidelines of China, negative reverse transcription-polymerase chain reaction (RT-PCR) is the key criterion for discharging COVID-19 patients. However, repeated RT-PCR tests lead to medical waste and prolonged hospital stays for COVID-19 patients during the recovery period. Our purpose is to assess a model based on chest computed tomography (CT) radiomic features and clinical characteristics to predict RT-PCR negativity during clinical treatment. Methods: From February 10 to March 10, 2020, 203 mild COVID-19 patients in Fangcang Shelter Hospital were retrospectively included (training: n=141; testing: n=62), and clinical characteristics were collected. Lung abnormalities on chest CT images were segmented with a deep learning algorithm. CT quantitative features and radiomic features were automatically extracted. Clinical characteristics and CT quantitative features were compared between RT-PCR-negative and RT-PCR-positive groups. Univariate logistic regression and Spearman correlation analyses identified the strongest features associated with RT-PCR negativity, and a multivariate logistic regression model was established. The diagnostic performance was evaluated for both cohorts. Results: The RT-PCR-negative group had a longer time interval from symptom onset to CT exams than the RT-PCR-positive group (median 23 vs. 16 days, p<0.001). There was no significant difference in the other clinical characteristics or CT quantitative features. In addition to the time interval from symptom onset to CT exams, nine CT radiomic features were selected for the model. ROC curve analysis revealed AUCs of 0.811 and 0.812 for differentiating the RT-PCR-negative group, with sensitivity/specificity of 0.765/0.625 and 0.784/0.600 in the training and testing datasets, respectively. Conclusion: The model combining CT radiomic features and clinical data helped predict RT-PCR negativity during clinical treatment, indicating the proper time for RT-PCR retesting.
The relationship between ratio of serum triglyceride to high-density lipoprotein cholesterol and frequency of sarcopenia in Chinese community adults
Authors: Wang Na , Chen Mengjun , Fang Danhong
Published: October 2020

Background In a previous study, the high ratio of serum triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) was relevant to a high risk of sarcopenia in Korean old males. In this study, the purpose was to discover the association in Chinese community adults.MethodsChinese adults who had physical examinations from May 2016 to August 2017 at the First Affiliated Hospital of Wenzhou Medical University were involved in this study. The univariable and multivariable logistic regression analyses were applied to evaluate possible effect.ResultsIn total, 2613 adults were involved in the study, with 13.85% presenting sarcopenia. The separate results for TG and HDL-C displayed that OR for TG was 0.67(95%CI: 0.51-0.87), and OR for HDL-C was 1.97(95%CI: 1.49-2.61). Additionally, the ratio of TG/HDL-C was independently associated with sarcopenia status(OR: 0.63; 95%CI: 0.49-0.81). ConclusionsIt was indicative that TG was negatively associated with the frequency of sarcopenia in Chinese community population, but HDL-C was positively associated with it. Besides, the negative association was discovered between sarcopenia and TG/HDL-C ratio.
Genome-wide identification and functional characterization of Camelina sativa WRKY gene family in response to abiotic stress
Authors: Song Yanan , Cui Hongli , Shi Ying , Xue Jinai , Ji Chunli , Zhang Chunhui , Yuan Lixia , Li Runzhi
Published: October 2020

Background: WRKY transcription factors are a superfamily of regulators involved in diverse biological processes and stress responses in plants. However, knowledge is limited for WRKY family in camelina (Camelina sativa), an important Brassicaceae oil crop with strong tolerance against various stresses. Here, genome-wide characterization of WRKY proteins is performed to examine their gene-structures, phylogenetics, expressions, conserved motif organizations, and functional annotation to identify candidate WRKYs mediating regulation of stress resistance in camelina.Results: Total of 242 CsWRKY proteins encoded by 224 gene loci distributed uneven on chromosomes were identified, and classified into three groups via phylogenetic analysis according to their WRKY domains and zinc finger motifs. 15 CsWRKY gene loci generated 33 spliced variants. Orthologous WRKY gene pairs were identified, with 173 pairs in C. sativa and Arabidopsis genomes as well as 282 pairs for C. sativa and B. napus, respectively. 137 segmental duplication events were observed but no tandem duplication in camelina genome. Ten major conserved motifs were examined, with WRKYGQK as the most conserved and several variants existed in many CsWRKYs. Expression analysis revealed that half more CsWRKY genes were expressed constitutively, and a set of them had a tissue-specific expression. Notably, 11 CsWRKY genes exhibited significantly expression changes in plant seedlings under cold, salt, and drought stress, respectively, having preferentially inducible expression pattern in response to the stress.Conclusions: The present described a detail analysis of CsWRKY gen family and their expression profiled in twelve tissues and under several stress conditions. Segmental duplication is the major force for large expansion of this gene family, and a strong purifying pressure happened for CsWRKY proteins evolutionally. CsWRKY proteins play important roles for plant development, with differential functions in different tissues. Exceptionally, eleven CsWRKYs, particularly five alternative spliced isoforms were found to be the key players possibly in mediating plant response to various stresses. Overall, our results provide a foundation for understanding roles of CsWRKYs and the precise mechanism through which CsWRKYs regulate high stress resistance to stress as well as development of stress tolerance cultivars for Cruciferae crops.
Physical Exercise for Individuals with Dementia: potential benefits perceived by Formal Caregivers
Authors: Sampaio Arnaldina , Marques-Aleixo I , Seabra A , Mota J , Carvalho J
Published: October 2020

Background: The social and economic impact of dementia for the development of accessible and sustainable care for individuals with dementia (IwD). Physical exercise has been seen as a beneficial non-pharmacological therapy in the prevention and management of dementia, and possible benefits may not only impact on participants, but also indirectly on their caregivers. Thus, this quasi-experimental non-randomized study aimed to analyze the effects of an exercise intervention on functional capacity, behavioural and psychological symptoms in dementia (BPSD) and quality of life of institutionalized older adults with dementia, perceived by their formal caregivers. Methods: Sixty-four institutionalized older adults (from both genders, aged 65–93 yrs. old), clinically diagnosed with dementia, were divided into two groups: control group (CG, continued with usual care, n= 26) and exercise group (EG, 6-month supervised multicomponent exercise intervention, n= 38). Nine caregivers (female, aged 28-47 yrs old) from nine different nursing homes, reported about their distress related to BPSD and proxy-reported about participants’ functional capacity (Katz index), quality of life (QoL-AD), BPSD (NPI) before and after 6 months of an exercise intervention (aerobic, muscular resistance, flexibility and postural exercises). Results: A two-way ANOVA, with repeated measures, revealed significant group and time interactions on Total Katz index and QoL-AD. The CG's performance functional capacity and quality of life score worsen over time while in EG maintains these values after the exercise intervention. Moreover, formal caregiver´s distress triggered by apathy and disinhibition increased in CG while after 6 months of an exercise intervention no alterations were seen regarding these distress causes in EG. No significant main effects were observed for total NPI score or NPI distress.Conclusions: Overall results show that after the exercise intervention, IwD from the EG, was capable of preserving the functional capacity, quality of life and neuropsychiatric symptoms were attenuate, contributing to a lower load of distress for the caregivers. Trial registration: clinicaltrials.gov, NCT04095962. Registered 19 September 2019, https://clinicaltrials.gov/ct2/show/NCT04095962
Enhanced Antitumor Effects of Follicle-stimulating Hormone Receptor-mediated Hexokinase-2 Depletion on Ovarian Cancer Mediated by a Shift in Glucose Metabolism
Authors: Zhang Meng , Liu Qiyu , Zhang Mingxing , Cao Cong , Liu Xiaoxia , Zhang Mengyu , Li Guiling , Xu Congjian , Zhang Xiaoyan
Published: October 2020

Background: Most cancers favor glycolytic-based glucose metabolism. Hexokinase-2 (HK2), the first glycolytic rate-limiting enzyme, shows limited expression in normal adult tissues but is overexpressed in many tumor tissues, including ovarian cancer. HK2 has been shown to be correlated with the progression and chemoresistance of ovarian cancer and could be a therapeutic target. However, the systemic toxicity of HK2 inhibitors has limited their clinical use. Since follicle-stimulating hormone (FSH) receptor (FSHR) is overexpressed in ovarian cancer but not in nonovarian healthy tissues, we designed FSHR-mediated nanocarriers for HK2 shRNA delivery to increase tumor specificity and decrease toxicity. Results: HK2 shRNA was encapsulated in a polyethylene glycol-polyethylenimine copolymer modified with the FSH β 33-53 or retro-inverso FSH β 33-53 peptide. The nanoparticle complex with FSH peptides modification effectively depleted HK2 expression and facilitated a shift towards oxidative glucose metabolism, with evidence of increased oxygen consumption rates, decreased extracellular acidification rates, and decreased extracellular lactate and glucose consumption in A2780 ovarian cancer cells and cisplatin-resistant A2780CP counterpart cells. Consequently, cell proliferation, invasion and migration were significantly inhibited, and tumor growth was suppressed even in cisplatin-resistant ovarian cancer. No obvious systemic toxicity was observed in mice. Moreover, the nanoparticle complex modified with retro-inverso FSH peptides exhibited the strongest antitumor effects and effectively improved cisplatin sensitivity by regulating cisplatin transport proteins and increasing apoptosis through the mitochondrial pathway. Conclusions: These results established HK2 as an effective therapeutic target even for cisplatin-resistant ovarian cancer and suggested a promising targeted therapeutic approach.
Association of ApoE Gene Polymorphisms With Cardio-cerebrovascular Complications in Type 2 Diabetes Mellitus in the Chinese Population
Authors: Kong Lulu , Gao Yinting , Li Wei , Shi Bimin
Published: October 2020

Objective: To analyze and study the relationship between ApoE gene polymorphism and cardio-cerebrovascular complications in type 2 diabetes mellitus(T2DM) in the Chinese Population. Methods: From January 2018 to January 2019, 1140 patients with type 2 diabetes admitted to the Department of Endocrinology, the Affiliated Hospital of Xuzhou Medical University were selected as the case group, including 590 patients with coronary heart disease(CHD) and 550 patients with cerebral infarction(CI), and 1198 patients with type 2 diabetes without complications during the same period were selected as the control group. General baseline data of the two groups were collected, such as gender, age, course of disease, lipid profile, HbA1C, BMI, blood pressure, carotid plaque and complications. ApoE genotypes were identified in all participants who participated in the study.Results: This study showed that the ApoE genotypes in both the case group and the control group had the highest frequency of E3/E3. The E3/E4 genotype frequency and E4 allele frequency in the case group were higher than those in the control group (P<0.05). In the case group, the frequency of E2/E3 and E3/E4 genotypes of CI group was lower than that of CHD group, while the frequency of E3/E3 genotype was higher than that of CHD group. TC and LDL-c levels were significantly increased in patients with ApoE E3/E4 genotype(P<0.05). ApoE genotype E3/E4 was more associated with carotid plaque than E2/E3. ApoE genotype and ApoE allele were positively correlated with TC and LDL-c levels (P<0.05).Logistic regression results show that ApoE gene polymorphism is associated with cardio-cerebrovascular complications in T2DM patients. ApoE E3/E4 genotype and allele E4 may be risk factors for T2DM patients with cardio-cerebrovascular complications.Conclusion: ApoE E3/E4 genotypes and T2DM patients carrying E4 allele have a higher risk of cardio-cerebrovascular complications than other genotypes. ApoE E2 allele has a certain protective effect , however E4 allele may be a risk factor for cardio-cerebrovascular complications in T2DM patients, and its mechanism may be related to the effect of ApoE gene on lipid metabolism.
Intravesical dexmedetomidine instillation reduces postoperative catheter-related bladder discomfort in male patients under general anesthesia: a randomized controlled study
Authors: Chen Hong , Wang Bin , Li Qin , Zhou Juan , Li Rui , Zhang Ye
Published: October 2020

Background: The catheter-related bladder discomfort (CRBD) of male patients is a common clinical problem, albeit lacking effective solutions. The present study aimed to investigate whether intravesical dexmedetomidine instillation alleviates the postoperative urinary discomfort in male patients with catheter under general anesthesia.Methods: This single-blinded, prospective, randomized study included a total of 167 male patients American Society of Anesthesiologists (ASA) physical status I-II scheduled for surgery under general anesthesia were allocated to two groups: 84 in the dexmedetomidine group and 83 in the control group. Dexmedetomidine group patients received intravesical instillation of the drug 0.5 μg/kg and normal saline 20 mL, while the control group received intravesical instillation of 20 mL normal saline. The catheter was clamped for 30 min after intravesical instillation for all patients. CRBD scores and urethra pain numerical rating scale (NRS) scores were measured at admittance to post-anesthesia care unit (PACU) (T0), intravesical instillation (T1), 30 min (T2), 60 min (T3), 2 h (T4) after intravesical instillation, discharged from PACU (T5), and 6 h (T6) and 24 h (T7) after the operation. Patient satisfaction at discharge from PACU and 24 h post-operation were compared between the two groups. Results: CRBD scores and urethra pain NRS scores after 30 min of intravesical dexmedetomidine instillation to 24 h post-operation were significantly lower than the control group (p<0.001), and patient satisfaction was higher at discharge from PACU and 24 h post-operation (p<0.001). No diﬀerences were detected in Steward score out of PACU (p=0.213) and from the time of the end of operation to fully awake (p=0.417).Conclusion: Intravesical dexmedetomidine instillation reduces postoperative urinary discomfort and urethra pain and improves satisfaction in male patients under general anesthesia.Clinical Trial Registration: Chinese Clinical Trial Registry (No. ChiCTR1800016429), date of registration 1st June 2018
The cost‑effectiveness of hypertonic saline inhalations for infant bronchiolitis.
Authors: buendia jefferson , Acuña-Cordero Ranniery
Published: October 2020

BackgroundPharmacological treatment for bronchiolitis is primarily supportive because bronchodilators, steroids, and antibiotics, show little benefit. Clinical studies have suggested that nebulized 3% hypertonic solution is useful for infants with bronchiolitis. This study aims to evaluate the cost-effectiveness of the HS inhalations in infant bronchiolitis in a tropical country Methods Decision tree analysis was used to calculate the expected costs and QALYs. All cost and use of resources were collected directly from medical invoices of 193 patient hospitalized with diagnosis of bronchiolitis in tertiary centers, of Rionegro, Colombia. The utility values applied to QALYs calculations were collected from the literature. The economic analysis was carried out from a societal perspective.ResultsThe model showed that nebulized 3% hypertonic solution, was associated with lower total cost than controls (US $200vs US $240 average cost per patient), and higher QALYs ( 0.92 vs 0.91 average per patient); showing dominance. A position of dominance negates the need to calculate an incremental cost-effectiveness ratio.Conclusion The nebulized 3% hypertonic solution was cost-effective in the inpatient treatment of infant bronchiolitis. Our study provides evidence that should be used by decision-makers to improve clinical practice guidelines and should be replicated to validate their results in other tropical countries.
Evaluating the Implementation of the SWITCH® School Wellness Intervention and Capacity-Building Process through Multiple Methods
Authors: McLoughlin Gabriella M , Candal Priscila , Vazou Spyridoula , Lee Joey A. , Dzewaltowski David A. , Rosenkranz Richard R. , Lanningham-Foster Lorraine , Gentile Douglas A. , Liechty Laura , Chen Senlin , Welk Gregory J
Published: October 2020

Background: School wellness programming is important for promoting healthy lifestyles and academic achievement in youth; however, research is needed on methods that can help schools implement and sustain such programs on their own. The purpose of this study was to investigate factors within and outside the school environment that influenced school capacity for implementation and potential sustainability of wellness programming. Methods: As part of the School Wellness Integration Targeting Child Health (SWITCH®) intervention, elementary school wellness teams (N = 30) were guided through a capacity-building process focused on promoting the adoption of healthy lifestyle behaviors in students. Data on implementation were collected through three standardized surveys and interviews (pre-mid-post) and a post-implementation interview. Indicators of organizational capacity were assessed using the School Wellness Readiness Assessment (SWRA). Paired t-tests were run to assess changes in implementation (classroom, physical education, and lunchroom settings), capacity, and stakeholder engagement over time. One-way analysis of variance (ANOVA) tests were run to examine how implementation of best practices (low, moderate, high) explained differences in capacity gains. Qualitative data were analyzed through inductive and deductive analysis, following the Consolidated Framework for Implementation Research (CFIR). Results: Paired t-tests showed non-significant increases in school and setting-specific capacity and implementation of SWITCH best practices over time, in addition to a consistent level of engagement from key stakeholders. ANOVA results revealed positive, non-significant variances between implementation group and gains in school capacity (F[2,24] = 1.63; p = .21), class capacity (F[2,24]=0.20 p=.82), lunchroom capacity (F[2,24]=0.29; p=.78), and physical education (F[2,24]=1.45; p=.25). Qualitative data demonstrated that factors within the outer setting (i.e., engaging community partners) facilitated programming. Inner-setting factors (i.e., relationships with administration and staff) influenced implementation. Implementation process themes (e.g., planning, adaptation of resources to meet school capacity/needs, and engaging students as leaders) were cited as key facilitators. Schools discussed factors affecting sustainability, such as school culture and knowledge of school wellness policy. Conclusions: Findings suggest a potential relationship between implementation and capacity change, which is the primary goal of SWITCH. The results document the importance of allowing schools to adapt programming to meet their local needs.
Systematic review and bibliometric analysis of African anesthesia and critical care medicine research Part II: A scientometric analysis of the 116 most cited articles
Authors: Kanmounye Ulrick Sidney , Tochie Joel Noutakdie , Mbonda Aime , Solam Cynthia Wafo , Daya Leonid , Atem Thompson Hope , Nyalundja Arsène Daniel , Eyaman Daniel Cheryl
Published: October 2020

BackgroundScientometrics is used to assess the impact of research in several health fields, including Anesthesia and Critical Care Medicine. The purpose of this study was to define the landscape and key players of Anesthesia and Critical Care Medicine research in Africa.MethodsThe authors searched Web of Science from inception to May 4, 2020, for articles on and about Anesthesia and Critical Care Medicine in Africa with ≥ 2 citations. Quantitative (H-index) and qualitative (descriptive analysis of yearly publications and interpretation of document, co-authorship, author country, and keyword) bibliometric analyses were done.ResultsThe search strategy returned 116 articles that had a median of 5 (IQR: 3-12) citations on Web of Science. The most frequent journals were Anesthesia and Analgesia (18, 15.5%), World Journal of Surgery (13, 11.2%), and South African Medical Journal (8, 6.9%). Most (74, 63.8%) articles were published on or after 2013, and seven authors had more than 1 article in the top 116 articles: Epiu I (3, 2.6%), Elobu AE (2, 1.7%), Fenton PM (2, 1.7%), Kibwana S (2, 1.7%), Rukewe A (2, 1.7%), Sama HD (2, 1.7%), and Zoumenou E (2, 1.7%). The bibliometric coupling analysis of documents highlighted 10 clusters with the most significant nodes being Biccard BM, 2018; Baker T, 2013; Llewellyn RL, 2009; Nigussie S, 2014; and Aziato L, 2015. Dubowitz G (5) and Ozgediz D (4) had the highest H-indices among the authors referenced by the most-cited African Anesthesia and Critical Care Medicine articles. The U.S.A. had the largest global node, while South Africa and Uganda had the largest African nodes. The most prominent keywords were anesthesia, mortality, and surgery. ConclusionThis study highlighted a decline in the number of top-cited African articles and the roles of the U.S.A, Southern African, and East African countries in scholarly output. Future studies should focus on understanding the time trends of the publications.
The sniffing bead system, an olfactory dysfunction screening tool for geriatric subjects: A cross-sectional study
Authors: Min Hyun Jin , Kim Sun Mi , Han Doug Hyun , Kim Kyung Soo
Published: October 2020

Background: This study aimed to develop a simple and one-off olfactory screening test, the sniffing bead system, for general clinical use in older adults. Methods: In this cross-sectional study, geriatric subjects (aged > 50 years) who underwent neurocognitive and olfactory function tests were included. Overall, 137 subjects were enrolled, and the study was conducted at Chung-Ang University, Seoul, Korea. Olfactory function was measured by obtaining the scores of the sniffing bead system using 2-phenylethyl alcohol, n-butanol, and the YSK olfactory function test. Time taken for each olfactory function test was also measured. Results: The score of the 2-phenylethyl alcohol sniffing bead test was 2.58 ± 1.52, which was significantly associated with the YSK_threshold (2.41 ± 1.79) (p < 0.001, Pearson's correlation coefficient = 0.429), YSK_identification (8.93 ± 3.25) (p = 0.014, Pearson's correlation coefficient = 0.208) and YSK_threshold-discrimination-identification (17.46 ± 5.49) (p < 0.001, Pearson's correlation coefficient = 0.316) test scores. In the normal cognitive function group, YSK_threshold ( p < 0.001, Pearson's correlation coefficient = 0.479 ) , YSK_identification ( p = 0.003, Pearson's correlation coefficient = 0.316 ), and YSK_threshold-discrimination-identification (p < 0.001, Pearson's correlation coefficient = 0.429) were significantly correlated with the scores of the 2-phenylethyl alcohol sniffing bead system. In the impaired cognitive function group, the YSK_threshold (p = 0.002, Pearson's correlation coefficient = 0.415 ) and YSK_ threshold-discrimination-identification (p = 0.004, Pearson's correlation coefficient = 0.385 ) were significantly correlated with the scores of the 2-phenylethyl alcohol sniffing bead system. Time taken for the 2-phenylethyl alcohol sniffing bead system was 5.00 ± 1.51 min, which was significantly lower than that for the YSK_threshold-discrimination-identification (20.43 ± 5.29 min) (p < 0.001). The scores of the 2-phenylethyl alcohol sniffing bead system were significantly correlated with those of the n-butanol sniffing bead system (3.50 ± 1.21) (p < 0.001, Pearson's correlation coefficient = 0.315). Conclusions: This sniffing bead system was specifically designed for screening olfactory function in older adults, and it may allow for the rapid and accurate assessment of olfactory dysfunction.
Multiple gene targeting siRNAs for down regulation of Immediate Early-2 (Ie2) and DNA polymerase genes mediated inhibition of novel rat Cytomegalovirus (strain All-03)
Authors: Balakrishnan Krishnan Nair , Abdullah Ashwaq Ahmed , Bala Jamilu Abubakar , Jesse Faez Firdaus Abdullah , Abdullah Che Azurahanim Che , Noordin Mustapha Mohamed , Azmi Mohd Lila Mohd
Published: October 2020

Background: Cytomegalovirus (CMV) is an opportunistic pathogen that causes severe complications in congenitally infected newborns and non-immunocompetent individuals. Developing an effective vaccine is a major public health priority and current drugs are fronting resistance and side effects on recipients. In the present study, with the aim of exploring new strategies to counteract CMV replication, several anti-CMV siRNAs targeting IE2 and DNA polymerase gene regions were characterized and used as in combinations for antiviral therapy. Methods: The rat embryo fibroblast (REF) cells were transfected with multi siRNA before infecting with CMV strain ALL-03. Viral growth inhibition was measured by tissue culture infectious dose (TCID50), cytopathic effect (CPE) and droplet digital PCR (ddPCR) while IE2 and DNA polymerase gene knockdown was determined by real-time PCR. Ganciclovir was deployed as a control to benchmark the efficacy of antiviral activities of respective individual siRNAs.Results: There was no significant cytotoxicity encountered for all the combinations of siRNAs on REF cells analyzed by MTT colorimetric assay (P>0.05). Cytopathic effects (CPE) in cells infected by RCMV ALL-03 had developed significantly less and at much slower rate compared to control group. The expression of targeted genes was downregulated successfully resulted in significant reduction (P<0.05) of viral mRNA and DNA copies (dpb+dpc: 79%, 68%; dpb+ie2b: 68%, 60%; dpb+dpc+ie2b: 48%, 42%). Flow cytometry analysis showed a greater percentage of viable and early apoptosis of combined siRNAs-treated cells compared to control group. Notably, the siRNAs targeting gene regions were sequenced and mutations were not encountered, thereby avoiding the formation of mutant with potential resistant viruses. Conclusions: In conclusion. The study demonstrated a tremendous promise of innovative approach with the deployment of combined siRNAs targeting at several genes simultaneously with the aim to control CMV replication in host cells.
RNA sequencing identifies transcriptional changes in the rabbit larynx in response to low humidity challenge
Authors: Bailey Taylor W , Santos Andrea Pires dos , Nascimento Naila Cannes do , Xie Shaojun , Thimmapuram Jyothi , Sivasankar M. Preeti , Cox Abigail
Published: October 2020

Background: Voice disorders are a worldwide problem impacting human health, particularly for occupational voice users. Avoidance of surface dehydration is commonly prescribed as a protective factor against the development of dysphonia. The available literature inconclusively supports this practice and a biological mechanism for how surface dehydration of the laryngeal tissue affects voice has not been described. In this study, we used an in vivo male New Zealand white rabbit model to elucidate biological changes based on gene expression within the vocal folds from surface dehydration. Surface dehydration was induced by exposure to low humidity air (18.6% + 4.3%) for 8 hours. Exposure to moderate humidity (43.0% + 4.3%) served as the control condition. Ilumina-based RNA sequencing was performed and used for transcriptome analysis with validation by RT-qPCR. Results: There were 103 statistically significant differentially expressed genes identified through Cuffdiff with 61 genes meeting significance by both false discovery rate and fold change. Functional annotation enrichment and predicted protein interaction mapping showed enrichment of various loci, including cellular stress and inflammatory response, ciliary function, and keratinocyte development. Eight genes were selected for RT-qPCR validation. Matrix metalloproteinase 12 (MMP12) and macrophage cationic peptide 1 (MCP1) were significantly upregulated and an epithelial chloride channel protein (ECCP) was significantly downregulated after surface dehydration by RNA-Seq and RT-qPCR. Suprabasin (SPBN) and zinc activated cationic channel (ZACN) were marginally, but non-significantly down- and upregulated as evidenced by RT-qPCR, respectively. Conclusions: The data together support the notion that surface dehydration induces physiological changes in the vocal folds and justifies targeted analysis to further explore the underlying biology of compensatory fluid/ion flux and inflammatory mediators in response to airway surface dehydration.
Pregnancy and childbirth during the COVID-19 pandemic in Poland: qualitative evidence from experts interviews.
Authors: Pustułka Paula , Buler Marta
Published: October 2020

Background: The COVID-19 outbreak has significantly altered the provisions and shape of medical services for expecting mothers worldwide. In Poland, the country where pregnancy and childbirth are subject to comparably greater medicalization, those shifts are particularly tangible. This study aimed at capturing how maternal health professionals tackle care over pregnant and birthing women during a pandemic, highlighting possible long-term implications for the expecting and new mothers, as well as the reproductive health sector.Methods: This is a qualitative and rapid-response study which addresses the themes around the emerging implications of the viral outbreak. Semi-structured expert interviews were conducted with 46 individuals, all highly-skilled, working in either medical or adjacent sectors connected with reproductive medicine, as well as varied antenatal and postpartum care services. In this analysis, 7 digital experts were excluded as observers rather than field practitioners. Among 38 interviews, 5 have been conducted with OB-GYNs, 13 with midwives, 6 with doulas, 14 broadly-conceived category of maternal support experts including psychologists and physiotherapists. The recorded data were input into thematic grids and meticulously transcribed prior to being subject to an inductive, thematic analysis.Results: The findings revealed that the context of the heightened medicalization of pregnancy and hospital care during birth in Poland, resulted in strong restrictions and immediate fall back to a clinical care model. The majority also claimed that the COVID-19 pandemic exacerbated the implications of the decades of Polish maternal health recommendations contradicting the WHO regulations. Professionals’ anxieties concern limited access to services assisting women during pregnancies. While those linked to hospitals pointed out physiological risks, other maternal support experts drew attention to the effects of stress and uncertainty on maternal mental health. Conclusions: Experts face various challenges when providing care to pregnant and birthing women in Poland. They underscore both the information chaos surrounding recommendations and procedures, and see the pandemic as a moment of reflection, mostly being vocal in their critiques of the over-medicalized Polish care model. The interviewed maternal health experts believe that the pandemic will have multifaceted consequences that are being exacerbated by both a sudden cessation of extensive degree of medicalization during pregnancy, and a fallback to alienation during intervention-focused hospital deliveries.
Too sweet: cheminformatics for deglycosylation in natural products
Authors: Schaub Jonas , Zielesny Achim , Steinbeck Christoph , Sorokina Maria
Published: October 2020

Sugar units in natural products are pharmacokinetically important but often redundant and therefore obstructing the study of the structure and function of the aglycon. Therefore, it is recommended to remove the sugars before a theoretical or experimental study of a molecule. Deglycogenases, enzymes that specialized in sugar removal from small molecules, are often used in laboratories to perform this task. However, there is no standardized computational procedure to perform this task in silico . In this work, we present a systematic approach for in silico removal of ring and linear sugars from molecular structures. Particular attention is given to molecules of biological origin and to their structural specificities. This approach is made available in two forms, through a free and open web application and as standalone open-source software.
Incidence of Airway Complications Associated with Deep Extubation in Adults
Authors: Juang Jeremy , Cordoba Martha , Ciaramella Alex , Xiao Mark , Goldfarb Jeremy , Bayter Jorge Enrique , Macias Alvaro Andres
Published: October 2020

Background: Endotracheal extubation is the most crucial step during emergence from general anesthesia and is usually carried out when patients are awake with return of airway reflexes. Alternatively, extubations can also be accomplished while patients are deeply anesthetized, a technique known as “deep extubation”, in order to provide a “smooth” emergence from anesthesia. Deep extubation is seldomly performed in adults, even in appropriate circumstances, likely due to concerns for potential respiratory complications and limited research supporting its safety. It is in this context that we designed our prospective study to understand the factors that contribute to the success or failure of deep extubation in adults.Methods: In this prospective observational study, 300 patients, age ≥ 18, American Society of Anesthesiologists Physical Status (ASA PS) Classification I - III, who underwent head-and-neck and ocular surgeries. Patients’ demographic, comorbidity, airway assessment, O2 saturation, end tidal CO2 levels, time to exit OR, time to eye opening, and respiratory complications after deep extubation in the OR were analyzed. Results: Forty (13%) out of 300 patients had at least one complication in the OR, as defined by persistent coughing, desaturation SpO2 < 90% for longer than 10s, laryngospasm, stridor, bronchospasm and reintubation. When comparing the complication group to the no complication group, the patients in the complication group had significantly higher BMI (30 vs 26), lower O2 saturation pre and post extubation, and longer time from end of surgery to out of OR (p<0.05). Conclusions: The complication rate during deep extubation in adults was relatively low compared to published reports in the literature and all easily reversible. BMI is possibly an important determinant in the success of deep extubation.
Development of the Labor Pain Relief Attitude Questionnaire for Pregnant Women (LPRAQ-p)
Authors: Hulsbosch Lianne P , Nyklíček Ivan , Potharst Eva S , Boekhorst Myrthe GBM , Pop Victor JM
Published: October 2020

Background: Receiving epidural analgesia during labor can possibly have negative consequences for mother and child. Yet, the use of epidural analgesia rapidly increased in the Netherlands over the last decade. Since antenatal plans for labor pain relief have been related to epidural analgesia use during labor, the aim of the current study was to develop a Labor Pain Relief Attitude Questionnaire for pregnant women (LPRAQ-p).Methods: Three focus group interviews were conducted with pregnant women, new mothers and caregivers and 13 candidate items were derived. Psychometric properties were tested with explorative factor analysis in sample I (N = 429) and a subsequent confirmatory factor analysis in a different sample II (N = 432).Results: The explorative factor analysis suggested a two-factor seven-item solution: a ‘women’s perception’ and ‘social environment’ subscale. The confirmatory factor analysis confirmed an excellent six-item model fit with appropriate internal consistency. Higher scores on the six-item LPRAQ-p indicate greater willingness for request of pain relief medication during labor. Two-tailed t-tests showed that women with elevated levels of depression and pregnancy-specific distress symptoms, nulliparous women and multiparous women with complications during previous delivery had greater willingness for request of pain relief medication during labor. Linear regression showed that the most important association with higher scores on the LPRAQ-p were high pregnancy-specific distress symptoms.Conclusions: This study showed the LPRAQ-p to be a valid instrument to evaluate attitude towards labor pain relief in pregnant women. High scores on this questionnaire are associated with high levels of pregnancy-specific distress symptoms.
si-SNHG5-FOXF2 inhibits TGF-β1-induced fibrosis in human primary endometrial stromal cells by the Wnt/β-catenin signalling pathway
Authors: Liu Limin , Chen Guobin , Chen Taoliang , Shi Wenjuan , Hu Haiyan , Song Kaijing , Huang Ruichun , Cai Huihua , He Yuanli
Published: October 2020

Background: Intrauterine adhesions (IUAs) are manifestations of endometrial fibrosis characterized by inflammation and fibrinogen aggregation in the extracellular matrix (ECM). The available therapeutic interventions for IUA are insufficiently effective in the clinical setting for postoperative adhesion recurrence and infertility problems. In this study, we investigated whether si-SNHG5-FOXF2 can serve as a molecular mechanism for the inhibition of IUA fibrosis ex vivo.Methods: FOXF2, TGF-β1 and collagen expression levels were measured by microarray sequencing analysis in three normal endometrium groups and six IUA patients. We induced primary human endometrial stromal cells (HESCs) into myofibroblasts (MFs) to develop an IUA cell model with various concentrations of TGF-β1 at various times. Downstream target genes of FOXF2 were screened by chromatin immunoprecipitation combined with whole-genome high-throughput sequencing (ChIP-seq). We investigated ECM formation, cell proliferation and Wnt/β-catenin signalling pathway-related proteins in primary HESCs with FOXF2 downregulation by quantitative reverse transcription-polymerase chain reaction (qRT-PCR), western blotting (WB), immunohistochemistry (IHC), flow cytometry, ethylenediurea (EdU) and CCK8 assays. We identified lncRNA SNHG5 as the upstream regulatory gene of FOXF2 through RNA immunoprecipitation (RIP), RNA pulldown and fluorescence in situ hybridization (FISH). Finally, we examined FOXF2 expression, ECM formation, cell proliferation and Wnt/β-catenin signalling pathway-related proteins in primary HESCs upon FOXF2 downregulation.Results: FOXF2 was highly expressed in the endometrium of patients with IUA. Treatment of primary HESCs with 10 ng/ml TGF-β1 for 72 h was found to be most effective for developing an IUA cell model. FOXF2 regulated multiple downstream target genes, including collagen, vimentin (VIM) and cyclin D2/DK4, by ChIP-seq and ChIP-PCR. FOXF2 downregulation inhibited TGF-β1-mediated primary HESC fibrosis, including ECM formation, cell proliferation and Wnt/β-catenin signalling pathway-related protein expression. We identified lncRNA SNHG5 as an upstream gene that directly regulates FOXF2 by RIP-seq, qRT-PCR, WB, and FISH. SNHG5 downregulation suppressed FOXF2 expression in the IUA cell model, resulting in synergistic repression of the Wnt/β-catenin pathway, thereby altering TGF-β1-mediated ECM aggregation in endometrial stromal cells ex vivo. Conclusions: Regulation of the Wnt/β-catenin signalling pathway and ECM formation by si-SNHG5-FOXF2 effectively inhibited the profibrotic effect of TGF-β1 on primary HESCs. This finding can provide a molecular basis for antagonizing TGF-β1-mediated fibrosis in primary HESCs.
Adapted Murine Sepsis Score: Improving The Research In Experimental Sepsis Mice Model
Authors: Sulzbacher Maicon Machado , Sulzbacher Lucas Machado , Passos Felipe Rafael , Bilibio Bruna Letícia Endl , Oliveira Kauana de , Althaus Wellington Felipe , Frizzo Matias Nunes , Ludwig Mirna Stela , Cruz Ivana Beatrice Mânica Da , Heck Thiago Gomes
Published: October 2020

Objective

The Murine Sepsis Score (MSS) is used to assess the severity of sepsis in rats and mice based on observational characteristics. The quantitative variables of blood glucose, body weight and temperature are predictors of severity in experimental models of sepsis. Therefore, our study sought to adapt the MSS with the same variables to indicate earlier the severity of the disease in murine models of the disease.
Results

Sepsis mice presented hypoglycemia, weight loss, and hypothermia. Therefore, these variables were included in the Adapted Murine Sepsis Score (A-MSS). The A-MASS presented 100% specificity and 87.5% sensibility been able to differentiate the early sepsis symptoms and its severity. The A-MSS allows an early and more complete diagnosis of sepsis in mice and might be considered as a procedure to improve the analysis of systemic sepsis dysfunction in murine experimental models.
Precise microwave ablation in hepatic neoplasms adjacent to high-risk structures: a prospective pilot study
Authors: Yang Liping , Li Qinying , Dong Gang , Sun Lulu , Xia Yan , Wu Longjun , Qi Gaoang , Wang Jianhua , Song Yanjun , Yu Jie , Liang Ping
Published: October 2020

Objective

To evaluate the safety and efficiency of ultrasound (US)-guided precise MWA assisted by artificial pleural effusion and/or ascites in hepatic neoplasms adjacent to high-risk structures based on a 3D preoperative planning system.
Methods

Twenty-five patients with hepatic neoplasms adjacent to high-risk structures were enrolled. CT images of all patients were reconstructed with 3D visualization software for preoperative planning. The puncture path and needle layout were estimated. US-guided precise MWA assisted by artificial pleural effusion and/or ascites was performed. Patients were followed by clinical and imaging examinations at 3, 6, and 12 months after the MWA. Study outcomes including complications, liver function, AFP level, and ablation lesion volumes were evaluated.
Results

Thirty-two tumors in 25 patients underwent precise MWA. Except for 4 patients with tumors near the macrovascular, 21 patients received artificial pleural effusion and/or ascites, achieving a complete separation. Based on preoperative 3D planning, patients with tumors near the diaphragmatic dome underwent administration of artificial pleural effusion and ascites, while patients with tumors near the gastrointestinal tract or gallbladder received artificial ascites. Of the 32 tumors, 30 achieved complete ablation in the first MWA session, and 29 achieved conformal ablation with a safe boundary of 0.5-1 cm. No severe complications were observed. Only one tumor exhibited local progression. Moreover, serum levels of ALT, AST and AFP were significantly decreased during the follow-up period.
Conclusion

Based on the 3D preoperative planning system, US-guided precise MWA assisted by artificial pleural effusion and ascites, is a safe and effective tool to treat hepatic neoplasms adjacent to high-risk structures.
Primary Immunodeficiencies Diseases (Pid) In Senegalese Children: A Cross Sectional Observational Study
Authors: Kane Awa , Deme-Ly Indou , Gueye Mame Sokhna , Niang Babacar , Mbaye-Dieyla Aminata , Diagne Guilaye , Coundoul Aliou Mar , Dieng Yaye Joor , Cissé Diénaba Fafa , Ba Idrissa Demba , Thiongane Aliou , Ba Abou , Nakoulima Aminata , Diouf Aminata , Keita Younoussa , Faye Pape Moctar , Fall Amadou Lamine , Sylla Assane , Diagne Ibrahima , Ndiaye Ousmane , Dièye Tandakha Ndiaye
Published: October 2020

Objective:

Primary immunodeficiencies are rarely related in sub-Saharan Africa. The aim of this study was to identify their different clinical patterns, to describe their biological phenotypes and to analyse treatment. A cross-sectional observational study over a period of 4 years and 2 months in 5 Senegalese paediatric departments was conducted. Children were recruited according to the recommendations of African society for immunodeficiencies (ASID) or the 10 warning signs for PID's diagnosis. Biological explorations were performed in these patients.
Results:

30 cases of PID were recorded. The sex ratio was 1:1; with a median age at diagnosis of 24 months. The most common clinical patterns were respiratory infections (18 patients) including tuberculosis pneumonia in almost one-third of cases (22%), followed by digestive and then cutaneous manifestations. This signs occurs in a specific context; as inbreeding (36, 7% of cases), death in sibling (30% of cases), or previous hospitalizations (66, 7%). Biological exploration made it possible to obtain immunological confirmation in 10 children, including one genetically confirmed. The most common category of PID was syndromic PID. Treatment was based mainly on antibiotic prophylaxis. PID are a reality in Senegal, but are certainly underestimated. Continue recruitment will enable advocacy for access to certain treatment.
Schistocytes Evaluation in Iron Deficiency: An Assessment Adopted From ICSH Nomenclature Guideline
Authors: Ratnaningsih Tri , Martani Galih R , Putri Dhia C , Sukorini Usi
Published: October 2020

Objective The diagnostic validity of schistocyte count in diagnosing iron deficiency in the microcytic population is critical to evaluate. The purpose of this study is to identify the correlation between schistocyte count and iron parameters, and the performance of schistocyte count in diagnosing iron deficiency in the microcytic population.Results Out of 805 general check-up participants, 65 subjects consisting of 17 males and 48 females aged 18–56 years had Mean Corpuscular Value (MCV) < 80 fL. Serum ferritin examination showed 25 patients with iron deficiency and the other 40 subjects without iron deficiency. There was a significant difference in the schistocyte count between the two groups (p < 0,001). Correlation analysis obtained a significant relationship between schistocyte count and serum ferritin (r=-0,67, p < 0,001). The Receiver Operating Characteristic (ROC) curve analysis provided Area Under the Curve (AUC) of schistocyte count is 0.827 with Youden Index (YI) 55% for a cut-off of ≥0.75%.