bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness of oral health education on eight- to ten-year-old school children in rural areas of the Magway Region, Myanmar
Authors: Swe Kyu Kyu , Soe Aung Kyaw , Aung Saw Htun , Soe Htin Zaw
Published: December 2020

Background: Oral diseases are common and widespread around the world. The most common oral diseases are preventable, and early onset is reversible. Myanmar faces many challenges in rendering oral health services, because approximately 70 percent of the total population resides in rural areas. These relate to the availability and accessibility of oral health services. Therefore, oral health education is one key element to prevent oral diseases and to promote oral health.Methods: A quasi-experimental study was carried out at Basic Education Middle Schools in rural areas of Magway Township to study the effectiveness of oral health education on the knowledge and behavior of eight- to ten-year-old school children. A total of 220 school children, 110 from intervention schools and 110 from control schools, participated in this study from 2015 to 2017. Data were collected before and after intervention in the two groups by using a self-administered questionnaire. Tooth brushing method data were collected by direct observation with a checklist. Oral health education was provided at eight weekly intervals for one year. At one and a half years, third-time data collection was done on the intervention group to assess retention. Chi-square test, two samples t-test and one-way repeated measure ANOVA were used for data analysis. The study was approved by the Institutional Review Board of the University of Public Health in Yangon, Myanmar.Results: There were significant differences between the two groups in four out of five knowledge questions (p<0.05) and all behavior questions (p<0.001) after intervention. A positive effect of oral health education for a period of 45 minutes at eight weekly intervals for one year was found in the intervention group. The intervention had a significant effect on the sustainability of the correct knowledge and behavior of the intervention group although the education session was stopped for six months (p<0.001). Their mean knowledge and behavioral scores at three different points in time were (2.45±1.12 and1.56±0.90) at baseline, (3.79±1.12 and 3.60±1.21) at one year after education and (4.07±0.98 and 3.24±1.31) at six months after cessation of education, respectively. Conclusions: Repeated oral health education was effective in promoting and sustaining oral health knowledge and behavior.
Antimicrobial resistance among pathogens that infect the bloodstream: a multicenter surveillance report for 1998–2017
Authors: tian lei , zhang zhen , sun ziyong
Published: December 2020

Background Bloodstream infections (BSIs) are a common consequence of infectious diseases and cause high morbidity and mortality. Appropriate antibiotic use is critical for patients’ treatment and prognosis. Long-term monitoring and analyzing of bacterial resistance are important for understanding the changes in bacterial resistance and infection control. Here, we report a retrospective study on antimicrobial resistance in BSI-associated pathogens.Methods Data from the Hubei Province Antimicrobial Resistance Surveillance System (HBARSS) from 1998–2017 were retrospectively analyzed using WHONET 5.6 software.Results Data from HBARSS (1998–2017) revealed that 40,518 Gram-positive bacteria and 26,568 Gram-negative bacteria caused BSIs, the most common of which were Staphylococcus aureus and Escherichia coli. Salmonella typhi was a predominant BSI-associated pathogen in 1998–2003. Drug susceptibility data showed that the resistance rates of E. coli and Klebsiella pneumoniae to cefotaxime were significantly higher than those to ceftazidime. Carbapenem-resistant (CR) E. coli and K. pneumoniae have also emerged. In 2013–2017, K. pneumoniae showed resistance levels reaching 15.8% and 17.5% to imipenem and meropenem, respectively, and Acinetobacter baumannii showed high resistance rates ranging from 60–80% to common antibiotics. The detection rate of Salmonella typhi resistance to third-generation cephalosporins and fluoroquinolones was less than 5%. Control of methicillin-resistant Staphylococcus aureus (MRSA) remains a major challenge, and in 2009–2017, the MRSA detection rate was 40–50%. The number of extensively drug-resistant A. baumannii and P. aeruginosa has been increasing since 2008. From 1998 to 2017, the total detection rates of extensively drug-resistant A. baumannii and P. aeruginosa were 34.38% (493/1434) and 7.45% (140/1879), respectively.Conclusions Prevalence of CR K. pneumoniae has increased significantly in recent years. Resistance rates of A. baumannii to common antimicrobial agents have increased exponentially, reaching high levels. MRSA remains a challenge to control.
Communities and Testing for Covid-19
Authors: Stillman Steven , Tonin Mirco
Published: December 2020

Between November 18th and 25th, 2020, 348,810 out of 500,607 (69.7 percent) eligible residents of the South Tyrol region of Italy volunteered to take a Covid-19 rapid antigen test. We examine the community characteristics that are associated with higher testing rates. Our findings point to a number of key community determinants of people’s willingness to volunteer. Convenience was an important factor. Beyond that, socioeconomic status and religiosity were also both positively related to greater testing.
Trends in Carriage of Extended Spectrum β-Lactamase and Carbapenemase Producing Enterobacteria Among HIV Infected Patients and Their Antimicrobial Susceptibility Patterns in Western-Cameroon
Authors: Mabeku Laure Brigitte Kouitcheu , EKANGOUO Arnauld EFON , Mewa Jeannette Euranie Kouam
Published: December 2020

Background: In Cameroon, studies on the prevalence of extended-spectrum beta-lactamase-producing Enterobacteriaceae (E-ESBLs) and carbapenemase-producing Enterobacteriaceae (CPE) among HIV infected individuals has not been investigated despite the progressively risen prevalence of HIV infection. The present study is intended determinate the magnitude of ESBL-E and CPE carriage among HIV-infected individuals. Methods: Accordingly, 152 urine, 29 stool, 8 blood, 105 vaginal exudates and 14 wound swab sample were collected from 204 HIV negative and 104 HIV positive patients attending the Regional Hospital of Bafoussam-Cameroon from September 2016 to June 2017. From these specimen, Enterobacteriaceae were isolated based on their morphological features, Gram staining and biochemical characteristics using API 20E galleries (Biomerieux, France). For each HIV infected patient, the CD4 lymphocytes were measured using cytometric technique. The antimicrobial susceptibility was determined by Kirby-Bauer disc diffusion test against 11 antibiotics from β-lactam class. ESBL and CP in suspected strains was confirmed by double disk synergy test and combination disk test.Results: The prevalence of Enterobacteriaceae infection among HIV positive patients was 46.15% versus 27.47% among HIV-negative ones (P=0.0014). Among HIV positive patients, urine (47.91%), vaginal exudates (31.25%) and blood (4.16%) specimens were mostly colonialized and Escherichia coli (37.5%) the predominant species. The rate of Enterobacteraceae infection according to CD4 count range was 20.83%, 37.5%, 35.42% and 6.25% respectively for patients with CD4 T lymphocyte range up to 500, ]300-500], ]100-300] and < 100 cells/mm3. The overall resistance rates were 27.72 and 34.66% respectively among isolates from HIV negative and positive patients. The prevalence of ESBL, AmpC and carbapenemase producing Enterobacteriaceae infection was 16.34, 12.5, and 4.81% respectively among HIV infected patients versus 8.62, 8.65 and 0% among HIV uninfected patients (p = 0.0055). Conclusion: Our findings showed that HIV positive patients are significantly more affected by Enterobacteriaceae infection than negative ones and that the rate of these bacterial infection likely increases with decrease CD4 counts. The present study also indicates that HIV positive patients are more likely to be infected by highly resistant organisms and had the highest carriage rate of ESBL, AmpC and carbapenemase producing Enterobacteriaceae compared to uninfected individuals in Western-Cameroon.
PIGN Spatiotemporally Regulates the Spindle Assembly Checkpoint Proteins in Myelodysplastic Syndromes
Authors: Teye Emmanuel , Lu Shasha , Chen Fangyuan , Yang Wenrui , Abraham Thomas , Stairs Douglas , Wang Hong-Gang , Yochum Gregory , Brodsky Robert , Pu Jeffrey
Published: December 2020

Phosphatidylinositol glycan anchor biosynthesis class N (PIGN) has been previously linked to the suppression of chromosomal instability. The spindle assembly checkpoint complex is responsible for proper chromosome segregation during mitosis to prevent chromosomal instability. In this study, the novel role of PIGN as a regulator of the spindle assembly checkpoint was unveiled in leukemic patient cells and cell lines. Transient downregulation or ablation of PIGN resulted in impaired mitotic checkpoint activation due to the dysregulated expression of spindle assembly checkpoint-related proteins including MAD1, MAD2, BUBR1, and MPS1. Moreover, ectopic overexpression of PIGN restored the expression of MAD2. PIGN regulated the spindle assembly checkpoint by forming a complex with the spindle assembly checkpoint proteins MAD1, MAD2, and the mitotic kinase MPS1. Thus, PIGN could play a vital role in the spindle assembly checkpoint to suppress chromosomal instability associated with the leukemic transformation of myelodysplastic syndromes.
Assessing Health-Related Quality of Life in Chinese Children and Adolescents With Cancer: Validation of the DISABKIDS Chronic Generic Module (DCGM-37)
Authors: Alelayan Hasan , Liang Lizhu , Ye Rui , Meng JiangNan , Liao Xiaoyan
Published: December 2020

Background: With the slightly increasing of cancer incidence rate and the decreasing of cancer mortality, there is an increasing need for a valid and culturally adapted tool to measure health-related quality of life (HRQoL) in children with cancer. This study validated the DISABKIDS Chronic Generic Module (DCGM-37) in Chinese children and adolescents with cancer.Methods: The DCGM-37 was translated and culturally adapted according to the guidelines from its copyright holders. In total, 140 children and adolescents with cancer and their guardians were included in this cross-sectional study. Internal consistency and test-retest reliability were evaluated. Convergent validity was examined using Pearson correlation between the DCGM-37 and the PedsQL 4.0 Generic Core Scale. Dimensionality was clarified using exploratory factor analysis. Discriminant validity was evaluated by comparing DCGM-37 scores across gender, age, family income, and clinical characteristics.Results: Internal consistency (Cronbach’s alpha 0.91) and test-retest reliability proved good (ICC 0.87, 95%CI 0.73-0.94). Strong correlations between the DCGM-37 and the PedsQL 4.0 (r= 0.83) support good convergent validity. Six factors explained 51.94% of the total variances. Children with leukemia scored higher than those with sarcoma in all subscales (effect size ranged from 0.39 to 0.83), especially the “social exclusion” subscales (effect size 0.83). Small to moderate differences (effect size ranged from 0.38 to 0.58) were observed across gender, age, and family income. Neither floor nor ceiling effect was observed.Conclusion: The DCGM-37 is reliable and valid for measuring HRQoL in Chinese children and adolescents with cancer.
The Interplay Between Regular T Cells and Immunotherapy in Cervical Cancer
Authors: Xu Fengying , Zhang Fengying , Wang Qian , Xu Ying , Xu Shuifang , Zhang Caihong , Wang Lihua
Published: December 2020

Background: Immune checkpoint blockade inhibitors have aroused great expectation on many types of tumor eradication. However, the therapeutic effect of anti-PD-L1 treatment on cervical cancer is unsatisfactory and the potential antagonist is not very clear. Here, we investigated the therapeutic effect of anti-PD-L1 in cervical tumor mouse model and identified the potential threats for anti-PD-L1 therapeutic efficacy. Results: we found that PD-L1 had a moderate expression in human and mouse cervical tumor cell lines and clinical samples compared to other tumor types and para-tumor tissue. Interestingly, our results showed that the anti-PD-L1 treated mice were dichotomously divided into responsive and unresponsive group even with the same genome background C57BL/6 syngeneic tumor model. The unresponsive tumors showed less immune cell infiltration and higher Tregs population induced immunosuppression activity than the responsive ones. Furthermore, we found that anti-PD-L1 autonomously upregulated Tregs proliferation and frequency in multiple immune organs, and, most importantly, Tregs depletion more significantly depressed the tumor growth rate and tumor weight than either anti-PD-L1 or anti-CD25 alone. Finally, we observed that the upregulating effector CD8+ T cell is associated with the better therapeutic effect of anti-PD-L1 therapy post Tregs depletion. Conclusion: In conclusion, anti-PD-L1 therapy upregulates Tregs frequency and proliferation in tumor model, and the depletion of Tregs may be a useful adjuvant strategy for anti-PD-L1 therapy in the immunotherapy of cervical cancer.
Exogenous Gibberellin Promotes the Germination of Phellodendron Chinense Schneid Seeds by Regulating the Expression of Phytohormone Related Genes and Anabolic Proteins
Authors: SUN Wenkai , ZHANG Xuejing , WANG Yahan , LI Huanhuan , YAN Wende , HE Hanjie , CHEN Lili , HE Gongxiu
Published: December 2020

Background: Phellodendron chinense Schneid is an important Chinese herb that contains berberine, phellodendrine, palmatine, and medicinal compounds. The germination rate of Phellodendron chinense Schneid seeds is lower after storage, and the exogenous gibberellin3 (GA3) hormone promotes seed germination, but the mechanism is not cleared. Results: Exogenous GA3 hormone promoted germination of Phellodendron chinense Schneid seeds, elevated germination rates. It also increased the levels of activities of superoxide dismutase (SOD), peroxidase (POD), and catalase (CAT). Moreover, it enhanced the contents of berberine and endogenous GA3, and increased the expression levels of Pc(S)-GA2ox, Pc(S)-GA3ox, and Pc(S)-THBO. However, it reduced the expression level of Pc(S)-ABI5. Furthermore, exogenous GA3 up-regulated the protein levels of DNA guides RNA polymerase β'-subunits, Coffee coenzyme A oxymethyl transferase, and Histone H1. Conclusion: These findings indicated that exogenous GA3 promoted germination of Phellodendron chinense Schneid seeds by regulating the expression levels of phytohormone related genes and anabolic proteins.
Aerosol Box Decreases Aerosol Exposure only in Depressurized Rooms on Intubation and Extubation
Authors: Sakai Wataru , Hasegawa Gen , Chaki Tomohiro , Tachibana Shunsuke , Yamakage Michiaki
Published: December 2020

The aim was to assess the effectiveness of an aerosol box objectively in several clinical settings with our experimental model.Cake flour as an aerosol model was expelled with our experimental cough model. The primary outcomes were the number of 0.3-10-µm-sized particles. Secondary outcomes were high-resolution videography of aerosol dispersal during intubation and extubation with an aerosol box in a pressurized or depressurized room.On post hoc analysis, counts of all particle sizes at the physician position, medical staff position, and in the environment were significantly lower in a depressurized room with an aerosol box than in a pressurized room without an aerosol box during intubation (p<0.05 in all situations and all particle sizes). Counts of all particle sizes at the physician and medical staff positions were significantly lower in the depressurized room with an aerosol box than in a pressurized room without an aerosol box during extubation (p<0.05 in both situations and all particle sizes). Visual assessments supported the results of the primary outcomes and showed that an aerosol box in a depressurized room could effectively decrease aerosol exposure of the physician, medical staff, and environment.In conclusion, an aerosol box decreased aerosol exposure only in a depressurized room.
Epidemiological Impact of Universal Varicella Vaccination on Consecutive Emergency Department Visits for Varicella and Its Cost-Effectiveness Among Children
Authors: Yamaguchi Hiroshi , Nozu Kandai , Ishiko Shinya , Nagase Hiroaki , Ninchoji Takeshi , Nagano China , Takeda Hiroki , Unzaki Ai , Ishibashi Kazuto , Morioka Ichiro , Iijima Kazumoto , Ishida Akihito
Published: December 2020

Varicella is highly contagious and endemic worldwide. Previous studies reported a dramatic decline in varicella incidence and varicella-related deaths after implementing universal varicella vaccination (VarV). However, its impact and cost-effectiveness remain unknown in single emergency department (ED). We retrospectively reviewed the clinical database of consecutive patients younger than 16 years presenting to our primary ED between January 1, 2011, and December 31, 2019. Of the 265,191 children presenting to our ED, 3,092 were clinically diagnosed with varicella. The annual number of varicella patients was approximately 500 before introduction of the universal two-dose VarV in October 2014, and it decreased to approximately 200 in 2019. The number of varicella patients younger than 1 year (not eligible for vaccination) also decreased. Regarding the cost-effectiveness of VarV, approximately JPY1.5 million (US$14,300) were saved annually by our center. However, our study showed a relatively large percentage of infected unvaccinated children presenting to our ED (59.0%). After implementation of the universal VarV, infection was mainly observed in older children (i.e., the unvaccinated generation). In conclusion, our data showed excellent universal VarV effectiveness and cost-effectiveness in the ED. Additionally, our data suggest that the VarV should be administered to all eligible older patients.
3D Printing 18F Radioactive Phantoms for PET Imaging
Authors: Gillett Daniel , Marsden Daniel , Ballout Safia , Attili Bala , Bird Nick , Heard Sarah , Gurnell Mark , Mendichovszky Iosif A , Aloj Luigi
Published: December 2020

Purpose: Phantoms are routinely used in molecular imaging to assess scanner performance. However, traditional phantoms with fillable shapes do not replicate human anatomy. 3D printed phantoms have overcome this by creating phantoms which replicate human anatomy which can be filled with radioactive material. The problem with these is that small objects suffer from boundary effects and therefore boundary-free objects are desirable. The purpose of this study was to explore the feasibility of creating resin-based 3D printed phantoms using 18 F-FDG. Methods: Radioactive resin was created using an emulsion of printer resin and 18 F-FDG. A series of test objects were printed including twenty identical cylinders, ten spheres with increasing diameters (2 mm to 20 mm) and a double helix. Radioactive concentration uniformity, printing accuracy and the amount of leaching were assessed. Results: Creating radioactive resin was simple and effective. The radioactivity remained bound to the resin for the duration that it was radioactive. The radioactive concentration was uniform among identical objects; the CoV of the mean, max and total signal were 3.6%, 3.8% and 2.6%, respectively. The printed cylinders and spheres were found to be within 4% of the model dimensions. A double helix was successfully printed as a test for the printer and appeared as expected on the PET scanner. The amount of radioactivity leached into the water was measurable (0.72%) but not visible above background on the imaging. Conclusions: Creating an 18F-FDG radioactive resin emulsion is a simple and effective way to create boundary-free, accurate, complex 3D phantoms that can be imaged using a PET/CT scanner. This technique could be used to print clinically realistic phantoms, however, they are single use, and cannot be made hollow without an exit hole. Also, there is a small amount of leaching of the radioactivity to take into consideration.
Pharmacokinetics of Anti-Infective Agents During CytoSorb Hemoadsorption: An Experimental Study
Authors: Schneider Antoine , André Pascal , Scheier Joerg , Schmidt Monika , Ziervogel Heiko , Buclin Thierry , Kindgen-Milles Detlef
Published: December 2020

Background: Cytokine hemoadsorption might be effective in patients with sepsis. However, its effect on anti-infective agents' pharmacokinetics remains largely unknown. We sought to determine the influence of hemoadsorption on the pharmacokinetics of common anti-infective agents. Methods: This is an interventional experimental study, conducted in 24 healthy pigs. Animals were randomly allocated to either hemoadsorption (cases) or sham procedure (controls) and to a drug combination (3 cases and 3 controls for each combination). Hemoadsorption was performed with CytoSorb® (CytoSorbents Corporation, USA). We evaluated 17 drugs (clindamycin, fluconazole, linezolid, meropenem, piperacillin, anidulafungin, ganciclovir, clarithromycin, posaconazole, teicoplanin, tobramycin, ceftriaxone, ciprofloxacin, metronidazole, liposomal amphotericin B, flucloxacillin and cefepime). Repeated blood sampling from the extracorporeal circulation (adsorber inlet/outlet, sham circulation) were performed within six hours of administration. Total clearance and adsorber-specific clearances were computed at each time point.Results: Hemoadsorption was associated with increased clearance of all study drugs, except for ganciclovir. Its impact on total body clearance was major for fluconazole (+282%), linezolid (+115%) and amphotericin B (+75%). It was minor for posaconazole (+32%), teicoplanin (+31%), anidulafungin (+23%), piperacillin (+19%), flucloxacillin (+16%), metronidazole (+16%) and ciprofloxacin (+15%) and insignificant (<10%) for all other drugs. Hemoadsorber clearance declined over time with even delayed desorption for beta-lactams. It was moderately correlated with drug's lipophilicity (p=0.01; r2=0.43). Conclusions: Hemoadsorption with CytoSorb® has limited effect on the pharmacokinetics of most tested anti-infective drugs but appears to increase fluconazole, linezolid and liposomal amphotericin B clearance. Studies in humans with sepsis are required to confirm these findings.
Geographic Distribution of The cagA, vacA, iceA, oipA and dupA Genes of Helicobacter Pylori Strains Isolated in China
Authors: Xue Zhijing , Yang Hong , Su Dongxing , Song Xiangfeng , Deng Xin , Yu Changhong , Sun Chunhua , He Lihua , You Yuanhai , Gong Yanan , Fan Dongjie , Sun Lu , Han Xiurui , Fan Ruyue , Zhai Kangle , Yang Yaming , Zhang Maojun , Yan Xiaomei , Qian Jiaming , Zhang Jianzhong
Published: December 2020

Background: There were geographical differences in the distribution of Helicobacter pylori (H. pylori) genotypes (cagA, vacA, iceA, oipA and dupA, et al). The population in different regions in China have grant different patterns of gastroduodenal diseases which are associated with these genotypes, but the geographical characteristics of H. pylori genotypes were still unknown. Materials and Methods: Gastric biopsy specimens were obtained from 348 patients from five regions in China. The regional distribution was 89 patients from Shandong, 91 from Guangxi, 57 from Hunan, 58 from Qinghai and 53 from Heilongjiang. DNA extracted from cultured isolates were analyzed by polymerase chain reaction (PCR) to determine the presence of cagA, vacA, iceA, oipA and dupA genotypes.Results: A total of 269 H. pylori isolates were obtained, of which 74 isolates were from Shandong, 78 from Guangxi, 46 from Hunan, 33 from Qinghai and 38 from Heilongjiang. The cagA gene was predominant in all the five regions (e.g. 100% in Hunan, Qinghai and Heilongjiang). The predominant vacA genotypes in the 269 isolates were s1a (88.1%) and m1(72.1%). vacA s1b was not detected in our study. In strains from Guangxi and Hunan, s1c was dominant; in contrast, s1a was dominant in Shandong, Qinghai and Heilongjiang. The prevalence of m1 strains in Heilongjiang (92.1%) was significantly higher (P<0.001) than in Shandong (60.8%) and Qinghai (51.5%). The dominant vacA subtype combination was s1a/m1 (62.8%) and detection of vacA s1a/m1 was significantly high 34 (89.5%) in Heilongjiang strains (P<0.001). The prevalence of iceA alleles in Hunan and Qinghai was much higher than that in the other three regions, and the difference was statistically significant. The oipA-positive strains were more prevalent in Guangxi (100%) and Hunan (100%) than in Qinghai (78.8%) (P<0.001). Conversely, the dupA-positive strains were less than half in Guangxi (15.4%) and Shandong (32.4%), whereas it was 73.9% in Hunan and 81.8% in Qinghai (P<0.001).Conclusions: There are significant geographic differences in the distribution of H. pylori genotypes. These datas may be used to explain the gastroduodenal diseases patterns in different geographic regions of China.
Empiric and Conservative Strategy in The Interventional Management of Late Post-Pancreatoduodenectomy Hemorrhage With Negative Angiographic Result
Authors: Huang Qiang , Gao Kun , Wang Jian-Feng
Published: December 2020

Background: The aim of the study was to review the outcome of patients who underwent interventional procedures with negative angiographic results for post-PD hemorrhage. Empiric and conservative interventional strategies were compared. Methods: The consecutive patients who underwent interventional procedures for post-PD hemorrhage in our center between Jan 2016 and Jun 2020 were evaluated. 21 cases were enrolled into this study with negative angiographic results. Two different strategies, empiric and conservative, were applied. Clinical data, including age, sex, pathological diagnosis, lab test results, clinical presentation and onset time of bleeding after surgery, technical and clinical outcome was obtained from the medical records and follow up data. Results: All patients in our series presented with delayed post-PD hemorrhage. In the empiric group, embolization was performed at the hepatic artery in 11 cases and at the left gastric artery (LGA) in 1. Two patients died of hemorrhage recurrence despite embolization during the follow up. Two patients required laparotomy and recovered in this group. Recurrence rate was 33.3% (4/12) in this group and mortality rate was 16.7% (2/12). In the conservative group, one patient required re-angiography with bleeding from the hepatic artery revealed 10 days after the first angiography. Hepatic artery embolization and subsequent relaparotomy was required. Another two patients required relaparotomy for hemorrhage recurrence. Recurrence rate was 33.3% (3/9) in this group and all these 3 cases required relaparotomy as definite treatment. Conclusion: Prompt decision making is required when negative result demonstrated during the angiography for post PD hemorrhage, and the surgeons’ judgement is mandatory. Both empiric and conservative treatment may be effective as indicated when negative angiography presented. Great caution is required following the interventional procedure, because recurrence rate after both treatment methods is significant despite negative angiography.
Comparison of Percutaneous Vertebroplasty and Percutaneous Curved Vertebroplasty for Osteoporotic Vertebral Compression Fractures: Distribution of Bone Cement and Complication
Authors: Jie Li Fan , Yang Li , Jie Wang Yan , YiBin Du
Published: December 2020

Purpose: To evaluate the clinical efficacy and complications of percutaneous curved vertebroplasty in treatment of osteoporotic vertebral compression fractures.Methods: Patients with single vertebral osteoporotic vertebral compression fractures were selected. The patients were divided into Percutaneous curved vertebroplasty group and Percutaneous vertebroplasty group.Distribution and leakage of bone cement and recovery of the height of the anterior edge of the injured vertebra were observed. VAS and ODI were assessed preoperatively 1 day and 1 year postoperatively. Postoperative follow-up was conducted for 1 year to observe the occurrence of adjacent vertebral fractures. The trial was approved by the Ethics Committee of the Third Affiliated Hospital of Anhui Medical University. Results: Compared with the percutaneous vertebroplasty group, distribution of bone cement was more uniform and satisfactory, the leakage rate of bone cement was lower in the percutaneous curved vertebroplasty group. Both the visual analogue scale score and Oswestry disability index of the two groups at 1 day and I year after surgery were significantly improved compared with those before surgery (P < 0.05). There was no significant difference in VAS and ODI. The height of the anterior edge of the injured vertebral body of the two groups improved significantly(P < 0.05), and there was no significant difference between the two groups . There was no significant difference in the incidence of adjacent vertebral fractures between the two groups..Conclusion: The results show that PCVP has beneficial to the uniform distribution of bone cement in the fracture vertebrae and reduce the leakage of bone cement.
Rare Location and Drainage Pattern of Right Pulmonary Veins and Aberrant Right Upper Lobe Bronchial Branch: a Case Report
Authors: Wang Fuqiang , Zhao Rui , Zhang Hanlu , Mo Yunhai , Zheng Yu , Qiu Guanghao , Wang Yun
Published: December 2020

BackgroundComplex aberration in lung is rare, which may increase risk of vascular injury and cause ligation of wrong pulmonary vein or bronchus by mistake during lung surgery, and result in sever complication like pulmonary congestion or atelectasis. Case presentationIn this case, a 44-year-old female was admitted for ground glass nodule (maximum diameter, 24mm) in right upper lobe. During operation, it was found that extremely rare aberrations of right preeparterial bronchus, right upper lobe vein behind pulmonary artery and right middle lobe vein drained into left atrium occurred in this patient simultaneously. Video-assisted thoracoscopic right upper lobectomy with lymph nodes dissection was performed for adenocarcinoma shown by frozen section. The patient was well recovered and discharged at the postoperative-day 4. Based on the literature review, such complex aberrations of pulmonary vessels and bronchus had seldom been reported before.ConclusionPreoperatively, three-dimensional reconstruction can help to identify inconspicuous variation of pulmonary vessels and bronchus effectively. During lung surgery, if anatomic aberration is suspected, careful dissection of vessels and bronchus will help to confirm whether there is an aberration or not.
Effectiveness of Comprehensive Traditional Chinese Therapy in Treating Granulomatous Lobular Mastitis: a Systematic Review and a Meta-analysis
Authors: Liang Hongyi , Chen Hanhan , Shi Guangxi , Liu Xiaofei , Li Jingwei
Published: December 2020

Background: With the development of Traditional Chinese Medicine (TCM), comprehensive traditional Chinese therapy is often used to treat Granulomatous Lobular Mastitis (GLM), but the effectiveness and risk are still controversial. This study is aimed to evaluate the efficacy of comprehensive therapy of traditional Chinese medicine on GLM.Methods: Articles in both international databases (PubMed, EMBASE, Cochrane Library, Web of Science and Clinicaltrials.gov) and Chinese databases (Chinese National Knowledge Internet (CNKI), Chinese Biomedical Databases (CBM), VIP Chinese periodical service platform and Wan Fang Digital Journals)) were searched. Original studies which reported the effective rate and/or recurrence rate and/or maximum diameter of the mass of comprehensive traditional Chinese therapy were included. The 95% confidence interval (95% CI) for effective rate, recurrence rate and maximum diameter of the mass were calculated and analyzed by review manager 5.3.Results: Eight eligible trials with 309 cases and 265 controls were included, six in Chinese and two in English. Statistical analysis suggested a statistical difference in effective rate (RR = 0.86, 95% CI [0.74, 1.00], P = 0.047) between comprehensive traditional Chinese therapy group and control. Meanwhile, there was statistical difference found in recurrence rate between comprehensive traditional Chinese therapy and western medicine therapy (RR = 3.09, 95% CI [1.50, 6.40], P = 0.002). Besides, no statistical difference existed in maximum diameter of the mass between the two therapies (RR = -5.25, 95% CI [-125.42, 114.93], P = 0.93).Conclusion: Although there was no significant difference in the reduction of breast mass size between comprehensive traditional Chinese therapy and western medicine alone, comprehensive traditional Chinese therapy demonstrated the efficacy in improving the effective rate and reducing the recurrence rate. For GLM patients, comprehensive traditional Chinese therapy could be a potential option.
COVID-19 and lockdown in India: Evaluation using analysis of covariance
Authors: Tak Amit , Das Bhaskar , Gahlot Saurabh
Published: December 2020

Background: The lockdown in India has entered into its ninth month to curb the Coronavirus disease-19 (COVID-19) pandemic. The objective of the present study is to evaluate impact of different phases of lockdown on evolution of new cases of infection and deaths due to COVID-19.Methods: In this retrospective longitudinal study, the Indian data on new cases of infection and deaths due to COVID-19 were retrieved from John Hopkins University dashboard. The cases from 25 March to 31 October 2020 were analyzed using analysis of covariance for four phases of lockdown and five phases of unlockdown.Results: The coefficients of regression for new cases did not differ significantly for initial four phases of lockdown and unlock-1, while from unlock-2 the coefficients showed significant decrease till unlock-5. While death cases showed no significant differences between coefficients of regression for initial four phases of lockdown and unlock, but coefficient of unlock-5 was significantly lower than unlock-4. Conclusion: The trends of coefficients of regression of new cases and deaths reveals positive effects of lockdown in flattening the epidemic curve. Though the pandemic is on downslope, till the availability of vaccine, non-pharmaceutical measures such as social distancing, wearing of mask need to be implemented.
Cobalt-containing Calcium Phosphate Induces Resorption of Biomineralized Collagen by Human Osteoclasts
Authors: Pereira Daniel de Melo , Schumacher Matthias , Habibović Pamela
Published: December 2020

Background: Biomineralized collagen, consisting of fibrillary type-I collagen with embedded hydroxyapatite mineral, is a bone-mimicking material with potential application as a bone graft substitute. Despite the chemical and structural similarity with bone extracellular matrix, no evidence exists so far that biomineralized collagen can be resorbed by osteoclasts. The aim of the current study was to induce resorption of biomineralized collagen by osteoclasts by a two-fold modification: increasing the calcium phosphate content and introducing cobalt ions (Co2+), which have been previous shown to stimulate resorptive activity of osteoclasts.Methods: To this end, we produced biomineralized collagen membranes and coated them with a cobalt-containing calcium phosphate (CoCaP). Human osteoclasts, derived from CD14+ monocytes from peripheral blood, were differentiated directly on the membranes. Their morphology was assessed by laser confocal microscopy and their capacity for resorption observed by scanning electron microscopy (SEM), as well as indirectly quantified by calcium release into cell culture supernatant. Results: The CoCaP coating increased the mineral content of the membranes by 4 wt.% and their elastic modulus from 1 to 10 MPa. The coated membranes showed a sustained Co2+ release of about 7 nM per 2 days. In contrast to uncoated membranes, on CoCaP-coated biomineralized collagen membranes, osteoclasts sporadically formed actin rings, and caused resorption lacunae to form, as observed by SEM and confirmed by increase in Ca2+ concentration in cell culture medium. The effect of the CoCaP layer on osteoclast function is thought to be mainly caused by the increase of membrane stiffness, although the effect of Co2+, which was released in very low amounts, cannot be fully excluded.Conclusions: This work shows the potential of this relatively simple approach to induce osteoclast resorption of biomineralized collagen, despite the fact that the extent of osteoclast resorption was limited, and the method needs further optimization,. Moreover, the coating method is suitable for incorporating bioactive ions of interest into biomineralized collagen, which is typically not possible using the common biomineralization methods, such as polymer-induced liquid precursor method.
Clinical Associations Between Serial Electrocardiography Measurements and Sudden Cardiac Death in Patients with End-Stage Renal Disease Undergoing Hemodialysis: Multi-Center, Retrospective Cohort Study
Authors: Lee Hyun Jin , Choe A Reum , Lee HaeJu , Ryu Dong Ryeol , Kang Ea Wha , Park Jung Tak , Lee Su Hwan , Park Junbeom
Published: December 2020

BackgroundThe rate of sudden cardiac death (SCD) for hemodialysis (HD) patients is significantly higher than that observed in the general population and have the highest risk for arrhythmogenic death. In this study, we examined serial electrocardiography (ECG) data in patients undergoing HD and determined their associations with the occurrence of SCD.Method In the retrospective review of three tertiary referral hospitals from November 1986 to November 2016, Patients starting HD in each hospital were enrolled; they underwent regular check-ups at least twice a Measurements and Main Results Of 678 enrolled subjects who underwent serial ECG before and after HD, 291 died and 39 developed SCD. In the pre-HD ECG, SCD patients had significantly longer QT peak-to-end (QTpe) intervals in all leads (II, III, aVF, and V1-6, P<0.001) and a longer QRS duration (92.6±14.0 vs. 100.6±14.9 ms, P=0.015) than survivors. However, in the post-HD ECG, there were no significant differences in any of the variables (QTpe interval at all leads, QRS duration, and proportion of patients with atrial fibrillation) that showed differences in the pre-HD ECG analysis. Moreover, the SCD group showed a significant change in the QTpe interval of the inferior, anterior, and lateral leads before and after HD compared with the survivor group (all leads, P<0.001). A cut-off value of 148.1 ms for the QTpe interval at the V2 lead in pre-HD was determined using receiver operating characteristic curve analysis, and QTpe intervals >148.1 ms were significantly associated with SCD after adjusting for age and sex in multivariable analysis (hazard ratio: 5.675, confidence interval: 2.373–13.575).Conclusions In end-stage kidney disease patients, the QTpe interval at all leads and QRS duration were shortened after HD. Patients with a longer QTpe interval before HD and large changes in ECG parameters after HD might be at a higher risk of SCD. Therefore, changes in the ECG before and after HD could help to predict SCD.
Rapid Versus Traditional Qualitative Analysis Using the Consolidated Framework for Implementation Research (CFIR)
Authors: Nevedal Andrea , Reardon Caitlin , Widerquist Marilla Opra , Jackson George , Cutrona Sarah , White Brandolyn , Damschroder Laura
Published: December 2020

BackgroundQualitative approaches, alone or in mixed methods, are prominent within implementation science. However, traditional qualitative approaches are resource intensive, which has led to the development of rapid qualitative approaches. Published rapid approaches are often inductive in nature and rely on transcripts of interviews; we describe a deductive rapid approach using the Consolidated Framework for Implementation Research (CFIR) that relies on notes and audio recordings. This paper compares our rapid approach to a traditional qualitative approach. MethodsSemi-structured interviews were conducted for two cohorts of the Veterans Health Administration (VHA) Diffusion of Excellence (DoE). The CFIR guided data collection and analysis. In Cohort A, we used a traditional analysis approach, where two analysts completed line-by-line independent coding of interview transcripts. In Cohort B, we used a rapid analysis approach, where the primary analyst wrote detailed notes during interviews and immediately “coded” them into a MS Excel CFIR construct by facility matrix; a secondary analyst then listened to audio recordings and edited notes. We tracked time for the traditional and rapid approaches using a spreadsheet and captured transcription costs from invoices. We retrospectively compared approaches in terms of effectiveness and rigor. ResultsCohort A and B were relatively equivalent in terms of data collected. However, the rapid approach required significantly fewer analyst hours and eliminated $7,250 in transcription costs. Despite these differences, both approaches were effective in meeting our evaluation objectives and establishing rigor. ConclusionOur rapid approach was less time intensive and eliminated transcription costs, yet effective in meeting evaluation objectives and establishing rigor.
Identification and screening of host proteins interacting with ORFV-ORF047 protein
Authors: Chen Guohua , He Xiaobing , jia Huaijie , Fang Yongxiang , Wang Xiaoxia , Lou Zhongzi , yang Fan , Li Weike , Jing Zhizhong
Published: December 2020

Bankground：Orf virus (ORFV) is a member of the genus Parapoxvirus and family Poxviridae. The virus has a worldwide distribution and infects sheep, goats, humans, and wild animals. However, due to the complex structure of the poxvirus, the underlying mechanism of the entry and infection by ORFV remains largely unknown. ORFV ORF047 encodes a protein named L1R. Poxviral L1R serves as the receptor-binding protein and blocks virus binding and entry independently of glycosaminoglycans (GAGs). The study aimed to identify the host interaction partners of ORFV ORF047. Methods: Yeast two-hybrid cDNA library of sheep testicular cells was applied to screen the host targets with ORF047 as the bait. ORF047 was cloned into a pBT3-N vector and expressed in the NMY51 yeast strain. Then, the expression of bait proteins was validated by Western blot analysis. Results: Sheep SERP1and PABPC4 were identified as host target proteins of ORFV ORF047, and a Co-IP assay further verified their interaction. Conclusions: New host cell proteins SERP1and PABPC4 were found to interact with ORFV ORF047 and might involve viral mRNA translation and replication.
The CYP19A1 (TTTA)n repeat polymorphism, but not Arg264Cys polymorphism, may affect the risk of prostate cancer: evidence from a meta-analysis
Authors: Guo Lei , Liu Yanan , Liu Lijun , Shao Shixiu , Cao Yanwei , Guo Jiaming , Haitao Niu
Published: December 2020

Background: Abnormal aromatase (CYP19A1) expression has been proposed to take part in the carcinogenesis of prostate cancer (PCa).However, results of studies on the CYP19A1 gene polymorphisms and PCa are conflicting.This meta-analysis aimed to systematically evaluate the association between the CYP19A1 Arg264Cys polymorphism and (TTTA)n repeat polymorphism and PCa.Methods: Electronic databases (PubMed, EmBase, ScienceDirect, and Cochrane Library) were comprehensively searched to identify eligible studies. The strength of association between the CYP19A1 Arg264Cys polymorphism and PCa was assessed by pooled odds ratio (OR) and 95% confidence interval (95% CI) in allelic, dominant, recessive, homozygous, and heterozygous genetic models. To analyze the impact of the (TTTA)n repeat polymorphism, we took sequentially the N-repeat allele (where N equals 7,8,10,11,12, and 13) as the minor allele and the sum of all the other alleles as the major allele. The ORs and 95%CIs were calculated in the allelic model; this analysis was performed individually for each repeat number.Results: Pooled estimates of nine eligible studies addressing the Arg264Cys polymorphism indicated that this polymorphism was not associated with the risk of PCa in the overall population and in the Caucasian and Asian subgroups. A meta-analysis of six studies addressing the (TTTA)n repeat polymorphism revealed that the 8-repeat allele increased PCa risk in the overall population (OR=1.34, 95% CI=1.14–1.58, P=0.001) and in the subgroup with population-based (PB) controls (OR=1.41, 95% CI=1.13–1.74, P=0.002). ﻿Conclusions: The meta-analysis indicated that the CYP19A1 (TTTA)n repeat polymorphism, but not Arg264Cys polymorphism may affect PCa risk.
Predicting the COVID-19 patients’ status using chest CT scan findings: A risk assessment model based on Decision tree
Authors: Talebi Atefeh , Borumandnia Nasrin , Jafari Ramezan , Pourhoseingholi Mohamad Amin , Jafari Nematollah Jonaidi , Ashtari Sara , Roozpeykar Saeid , Bashar Farshid R. , Vahedian-Azimi Amir
Published: December 2020

Background:The role of chest computed tomographic (CT) to diagnosis coronavirus disease-2019 (COVID-19) is still an open field to be explored. The aim of this study was to apply the decision tree (DT) model to predict critical or non-critical status of patients infected with COVID-19 based on available information on non-contrast chest computed tomography (CT) scan.Method:This study was performed onpatients with COVID-19 who underwent chest CTscan atBaqiyatallahHospital, Tehran, Iran. The age, gender, types of lesions, other specific signs of high-resolution computed tomography (HRCT), presence of diffuse opacity, underlying diseases, number of involved lobe and total opacity score of 1078 patients were evaluated. Decision tree (DT) model was used to analyze and establish a risk assessment model of critical and non-critical situation. Results:Data included 169 critical cases and 909 non-critical cases. The bilateral distribution and multifocal lung involvement were165 (97.6%) and 766 (84.3%) in critical patients, respectively.According to DT model, total opacity score, age, lesion types and gender were statistically significant predictors incritical patients.Moreover, the results showed that the accuracy, sensitivity and specificity of the DT model were 93.3%, 72.8% and 97.1%, respectively.Conclusions:The presented algorithm demonstrates the factors affecting the patient's condition. In addition, this model has the potential characteristics for clinical applicationsand canalso identify high-risk subpopulations that need specific prevention.