bluuebunny/crossref_metadata_2025 huggingface dataset:
Lower Birth Weight-for-age and Length-for-age Z-scores in Infants With in-utero HIV and ART Exposure: A Prospective Study in Cape Town, South Africa
Authors: Nyemba Dorothy Chiwoniso , Kalk Emma , Madlala Hlengiwe P. , Malaba Thokozile R. , Slogrove Amy L. , Davies Mary-Ann , Boulle Andrew , Myer Landon , Powis Kathleen M.
Published: August 2020

Background: Successful scale-up of antiretroviral therapy (ART) during pregnancy has minimized infant HIV acquisition, and over 1 million infants are born HIV-exposed but uninfected (HEU), with an increasing proportion also exposed in utero to maternal ART. While benefits of ART in pregnancy outweigh risks, some studies have reported associations between in utero ART exposure and impaired fetal growth, highlighting the need to identify the safest ART regimens for use in pregnancy. Methods: We compared birth anthropometrics of infants who were HEU with those HIV-unexposed (HU) in Cape Town, South Africa. Pregnant women had gestational age assessed by ultrasound at enrolment. Women living with HIV were on ART (predominately tenofovir-emtricitabine-efavirenz) either prior to conception or initiated during pregnancy. Birth weights and lengths were converted to weight-for-age (WAZ) and length-for-age (LAZ) z-scores using Intergrowth-21st software. Linear regression was used to compare mean z-scores adjusting for maternal and pregnancy characteristics. Results: Among 888 infants, 49% (n=431) were HEU and 51% (n=457) HU. Of 431 HEU infants, 62% (n=268) were exposed to HIV and antiretroviral (ARVs) from conception and 38% (n=163) were exposed to ARVs during gestation but after conception (median fetal ARV exposure of 21 weeks [IQR; 17-26]). In univariable analysis, infants who were HEU had lower mean WAZ compared with HU [β= -0.15 (95% Confidence Interval (CI): -0.28, -0.020)]. After adjustment for maternal age, gravidity, alcohol use, marital and employment status the effect remained [adjusted β -0.14 (95%CI: -0.28, -0.01]. Similar differences were noted for mean LAZ in univariable [β -0.20 (95%CI: -0.42, -0.01] but not multivariable analyses [adjusted β -0.18 (95%CI: -0.41, +0.04] after adjusting for the same variables. Mean WAZ and LAZ did not vary by in utero ARV exposure duration among infants who were HEU. Conclusion: In a cohort with high prevalence of ART exposure in pregnancy, infants who were HEU had lower birth WAZ compared with those HU. Studies designed to identify the mechanisms and clinical significance of these disparities, and to establish the safest ART for use in pregnancy are urgently needed.
Objective Structural Clinical Examinations can be Used to Assess Clinical Nursing Cultural Competence Abilities.
Authors: Lee Yu-Hsia , Lin Shu-Chuan , Wang Pao-Yu , Lin Mei-Hsiang
Published: August 2020

Background: Culture is the adhesive that binds people's lives. However, there is a lack of an objective and useful tool for assessing cultural competence and practice. The purpose of this study were to assess the learning efficacy of nurses after completing the Cultural Competence Cultivation Program using an Objective Structured Clinical Examination (OSCE).Methods: A quasi-experimental research design was used to evaluate nurses working at a medical center in Taiwan. The nurses were randomly allocated into an experimental group (N = 47), which underwent the Cultural Competence Cultivation Program, and a control group (N = 50), which did not partake in an educational program. After the intervention, the nurses’ learning efficacy was assessed using an OSCE. The research data were statistically analyzed using SPSS 22.0 software for Windows. Results: The average score of the experimental group was significantly higher in the “communication ability and skill” category. Furthermore, the OSCE scores, Standardized Patient Survey (SPS) scores and overall SPS scores were significantly and positively correlated.Conclusion: The findings of this study can serve as a reference for the design of future clinical education programs.
Irrational use of antibiotics in Iran from the Perspective of Complex Adaptive Systems: redefining the challenge
Authors: Sharif Zahra , Peiravian Farzad , Salamzadeh Jamshid , Mohammadi Nastaran Keshavarz , Jalalimanesh Ammar
Published: August 2020

Background: Irrational use of antibiotics proves major concerns to the health systems globally. It results in antibiotics resistance and increases health care costs. In Iran, many years of research, appreciable efforts and policy making have been of little avail and indicators still show suboptimal use of antibiotics, pointing out an urgent need to alternative approach to understand the problem and generate new solutions. Applying the Complex Adaptive Systems theory, to explore and research in health systems and their challenges and has become popular. Therefore, this study was aimed to better understand the complexity of irrational use of antibiotic use in Iran and the potential solutions. Method: This research utilized a CAS observatory tool to qualitatively collect and analysis data. Many interviews with key informants were conducted. The data was enriched with documents reviews in order to fully understand the system. MAXQDA software was applied to organize and analyze the data. Result: We could identify several diverse and heterogeneous, yet highly interdependent agents in the antibiotic consumption system in Iran, operating at different levels. The network structure and its adaptive emergent behaviour, information flow, governing rules, feedbacks and values of the system and the way they interact were identified. The gaps and weakness of the system which needs redesigning or modification were recognized as well. Findings describe antibiotic use as an emerge behavior of the system which is formed by interplay of many factors and actors over time.Conclusion: The study suggests re-engineering the system by implementing several system level changes including establishing strong, timely and effective interactions between identified stakeholders which facilitate information flow and provision of on time feedbacks, create win-win rules in participatory manner with stakeholders and distributed control system.
Perspectives of Syrian Refugees on Antibiotic Use and Prescribing in Dutch Primary Care: A Qualitative Study
Authors: Alkirawan Rima , Kawous Ramin , Bloemen Evert , Muijsenbergh Maria E.T.C. van den , Goosen Simone , de Boer Fijgje
Published: August 2020

Background: Antibiotic resistance is an international public health concern. Medical culture influences antibiotic use. Migrants, like Syrian refugees, are confronted with a different health care system in their new country and also with different culture regarding antibiotic prescription. The aim of this study is to get insight into the perspectives, knowledge and practices among Syrian refugees regarding antibiotic use and prescribing in Dutch primary care.Methods: A qualitative study using semi-structured interviews with 12 Syrian refugees living in the Netherlands was conducted. Results: participants stressed the easy access to antibiotics in Syria and reported storing antibiotics at home for emergencies. In the Netherlands, some of them still self-prescribed antibiotics while others adhered to the Dutch GP’s advice. Syrian refugees believed in having a weaker immunity compared to the Dutch inhabitants. For their young children, they adhered to the new health care system which resulted in not giving the children antibiotics without a prescription. Several complaints about the Dutch health care system were identified such as difficult access to the desired medication and lack of medical care for their complaints. Most respondents preferred the Syrian health care system.Conclusion: Syrian refugees experienced restricted access to antibiotics in Dutch primary care which was contrary to their experiences in Syria. As a reaction, they continued self-medicating with antibiotics. However, some of them adapted to the Dutch health care culture and accepted the alternative treatment proposal. For their children most participants adhered to the prescription policy of antibiotics in the Netherlands.
The Association Between Obstructive Sleep Apnea and Periodontitis in Chinese Male Adults: A Cross-Sectional Study
Authors: Chen Yanlong , Duan Ying , Li Yan , Han Xiaoxia , Gao He , Gao Xuemei
Published: August 2020

Background: Obstructive sleep apnea (OSA) is characterized by complete or partial upper airway obstruction during sleep. Periodontitis is an infectious and inflammatory disease of periodontal tissues. Recent studies suggested that both diseases could alter the host response synergistically by sharing same inflammatory pathways. The study aimed to investigate the association between OSA and periodontitis in Chinese male adults.Methods: This was a cross-sectional study of 93 male adults recruited from a dormitory compound and examined between June and September 2019. All participants were diagnosed OSA using the apnea–hypopnea index (AHI) with a portable, overnight polysomnography (PSG). Periodontal examinations were conducted the same day before PSG measuring: 1) mean probing depth (PD); 2) mean clinical attachment level (CAL); and 3) percentage of sites with bleeding on probing (BOP). An objective nasal airway resistance assessment was also practiced before PSG to reflect on the mouth breathing during sleep.Results: In all, 43.0% participants had periodontitis, 20.4% had OSA and 32.5% of those diagnosed with periodontitis were in combination with OSA. OSA was positively associated with periodontitis (odds ratio (OR) = 3.77, 95% confidence interval (CI) = 1.29 ~ 11.07). The OSA group showed a significantly higher BOP (p = 0.034) and CAL (p = 0.046), but there was no statistically significant difference of PD (p = 0.090) between the two groups. Correlation analysis showed a low but positive correlation between OSA severity and periodontitis severity classifications and periodontal parameters. Further regression analysis identified Lowest oxygen saturation (SaO2) (OR = 0.894, 95% CI = 0.842 ~ 0.949) to be significantly associated with the prevalence of periodontitis.Conclusions: A significant association was observed between OSA and periodontitis. And increasingly severe OSA might increase the severity of periodontitis. Hypoxia parameters might have a predicting effect of periodontitis, suggesting hypoxia related systematic inflammation may be the possible explanation of the association.
A Novel Autophagy-Related lncRNA Gene Signature to Improve the Prognosis of Patients with Melanoma
Authors: Ding Yi , Li Tian , Li Min , Tayier Tuersong , Zhang MeiLin , Chen Long , Feng ShuMei
Published: August 2020

Background: Autophagy and long non-coding RNAs (lncRNAs) have been the focus of research on the pathogenesis of melanoma. However, the autophagy network of lncRNAs in melanoma has not been reported. The purpose of this study was to investigate the lncRNA prognostic markers related to melanoma autophagy and predict the prognosis of patients with melanoma.Methods: We downloaded RNA-sequencing data and clinical information of melanoma from The Cancer Genome Atlas. The co-expression of autophagy-related genes (ARGs) and lncRNAs was analyzed. The risk model of autophagy-related lncRNAs was established by univariate and multivariate COX regression analyses, and the best prognostic index was evaluated combined with clinical data. Finally, gene set enrichment analysis was performed on patients in the high- and low-risk groups.Results: According to the results of the univariate COX analysis, only the overexpression of LINC00520 was associated with poor overall survival, unlike HLA-DQB1-AS1, USP30-AS1, AL645929, AL365361, LINC00324, and AC055822. The results of the multivariate COX analysis showed that the overall survival of patients in the high-risk group was shorter than that recorded in the low-risk group (p<0.001). Moreover, in the receiver operating characteristic curve of the risk model we constructed, the area under the curve (AUC) was 0.734, while the AUC of T and N was 0.707 and 0.658, respectively. The Gene Ontology was mainly enriched with the positive regulation of autophagy and the activation of the immune system. The results of the Kyoto Encyclopedia of Genes and Genomes enrichment were mostly related to autophagy, immunity, and melanin metabolism.Conclusion: The positive regulation of autophagy may slow the transition from low-risk patients to high-risk patients in melanoma. Furthermore, compared with clinical information, the autophagy-related lncRNAs risk model may better predict the prognosis of patients with melanoma and provide new treatment ideas.
Fall Risk Prediction via Classification of Lower Extremity Strength in Older Adults with Exergame-Collected Data
Authors: Becker Hagen , Garcia-Agundez Augusto , Müller Philipp Niklas , Tregel Thomas , Miede André , Göbel Stefan
Published: August 2020

Objective: The goal of this article is to present and evaluate a sensor-based falling risk estimation system. The system consists of an array of Wii Balance Boards (WBB) and an exergame that estimates if the player is at an increased falling risk by predicting the result of the 30 Second Sit-To-Stand Test (30CST).Methods: 16 participants recruited at a nursing home performed the 30CST and then played the exergame as often as desired during a period of two weeks. For each session, features related to how they walk and stand on the WBBs while playing the exergame were collected. Different classifier algorithms were used to predict the result of the 30CST on a binary basis (able or unable to maintain physical independence). Results: We achieved a maximum accuracy of 91% when attempting to estimate if the player’s 30CST score will be over or under a threshold of 12 points using a Logistic Model Tree. We also believe it is feasible to predict age- and sex-adjusted cutoff scores. Conclusion: An array of WBBs seems to be a viable solution to estimate lower extremity strength and with it the falling risk. In addition, data extracted while playing may form a basis to perform a general screening to identify elderly at an increased falling risk.
Expression of FAP-1 Correlates with Glioblastoma Proliferation, Migration and Treatment Resistance
Authors: Li Bo , Liu Yang , Mahati Shaya , Qin Hu , Maimaitili Aisha , Wang Zengliang , Wang Yongxin
Published: August 2020

Background: Glioblastoma (GBM) is the most severe type of brain cancer, with an extremely high mortality rate and the average survival time less than 15 months. Almost in all GBM cases, the residual tumor cells continue to divide uncontrollably, leading to tumor re-establishment, i.e., tumor recurrence, and ultimately death. Therefore, there is an urgent need to identify critical mediators of GBM progression and resistance to therapy. Fas-associated Phosphatase-1 (FAP-1, also known as PTPN13 or PTPL1) is a member of a large protein tyrosine phosphatase family. It has been shown that FAP-1 expression is downregulated in many types of cancers, which leads to unabated signaling and tumor progression and metastasis. The aim of this study is to evaluate the role of FAP-1 in GBM progression and resistance to therapy.Methods: Cell viability assays, radiotherapy and temozolomide response assays, and Western blot were used to analysis of FAP-1 in GBM based on Oncomine.Results: Our results showed that knockdown of FAP-1 enhanced viability and migration of GBM cell lines, and importantly, increased GBM cell resistance to radiotherapy and temozolomide. Conclusions: FAP-1 is important for GBM cells, and may account for GBM resistance to therapy.
Relationship Between Forest Strata Structure and Regeneration in Subtropical Evergreen Broad-Leaved Forest
Authors: Long Junsong , Tang Mengping
Published: August 2020

Background: Regeneration is an extremely important and complex ecological process, which is disturbed by many factors. The current stand structure has an important influence on regeneration. The aim of this study is to provide theoretical reference for improving the regeneration capacity subtropical evergreen broad-leaved forest and formulating management measures of regeneration restoration.Methods: A permanent plot of 100m × 100m was set up in the evergreen broad-leaved forest of Tianmu Mountain National Nature Reserve, Zhejiang Province, China. The plot was divided into 25 survey units of 20m × 20m by the adjacent grid survey method, and all the trees in the plot were investigated. The tree height, DBH, crown width, density, species richness index, aggregation index, competition index and mingling of each forest stratum were used as the stand structure index. The tree height, DBH, crown width, density and species richness index of regeneration trees were used as regeneration indicators. Redundancy analysis (RDA) was used to explore the relationship between forest strata structure and regeneration of evergreen broad-leaved forest. Results: In the whole stand, DBH, tree species richness index and crown width were the main structure factors affecting regeneration. In the upper forest stratum, the tree height was the main structure factor affecting regeneration. In the middle forest stratum, the tree species richness index and crown width were the main factors affecting regeneration. In the lower forest stratum, crown width, competition index, tree height and tree species richness index were the main factors affecting regeneration. The effects of tree species richness index and crown width on regeneration in the whole stand were mainly reflected in the middle and lower forest strata in each forest stratum. Conclusions: The influencing order of each forest stratum structure on regeneration was: lower forest stratum > middle forest stratum > upper forest stratum. Different regeneration indicators had different responses to the main stand structure indices, while the young tree height and DBH, and the tree species diversity and density of regeneration trees were most affected by the main stand structure indices. In order to promote the regeneration of evergreen broad-leaved forest in the future, different management measures should be taken for different forest strata, and the threshold value of each index should be controlled.
Drivers of differential views of health equity in the U.S.: Is the U.S. ready to make progress? Results from the 2018 National Survey of Health Attitudes
Authors: Towe Vivian , May Linnea Warren , Huang Wenjing , Martin Laurie T. , Carman Katherine , Miller Carolyn E. , Chandra Anita
Published: August 2020

Objectives: The public health sector has long recognized the role of the social determinants of health in health disparities and the importance of achieving health equity. We now appear to be at an inflection point, as we hear increasing demands to dismantle structures that have perpetuated inequalities. Assessing prevailing mindsets about what causes health inequalities and the value of health equity is critical to the addressing larger, racial inequity issues. Using data from a nationally representative sample of adults in the United States, we examined the factors that Americans think drive health outcomes and their beliefs about the importance of health equity.Methods: Using data from the 2018 National Survey of Health Attitudes, we conducted factor analyses of 21 survey items identified three factors out of the items relating to health drivers—traditional health influencers (THI), social determinants of health (SDoH), and sense of community health (SoC). Beliefs about health equity were measured with three questions about opportunities to be healthy. Latent class analysis identified four groups with similar patterns of response. Factor mixture modeling combined factor structure and latent class analysis into one model. We conducted three separate logistic regressions using latent classes and demographics as predictors and the three equity beliefs as dependent variables. Results: Nearly 90% of respondents comprised one class that was characterized by high endorsement (i.e., rating the driver as having strong effect on health) of THI, but lower endorsement of SDoH and SoC. Logistic regressions showed that respondents endorsing (i.e., rated it as a top priority) all three health equity outcomes tended to be female, older, Black or Hispanic, more educated, and have lower incomes. The class of respondents that endorsed SDoH the most was more likely to endorse all three equity beliefs.Conclusions: Results suggested that people historically most impacted by inequity, e.g., people of color and people with low incomes, had the most comprehensive understanding of the drivers of health and the value of equity. Prevailing beliefs about SDoH and health equity are still generally not aligned with scientific consensus and the prevailing narrative in the public health community.Trial Registration: Not applicable
Premature pap test screening, under 25 years old, a link with the mode of contraception? Analysis of data from the CONSTANCES cohort study
Authors: Mignot Stephanie , Ringa Virginie , Vigoureux Solène , Zins Marie , Panjo Henri , Saulnier Pierre-Jean , Fritel Xavier
Published: August 2020

Background Many countries currently recommend that screening for cervical cancer begin at the age of 25 years. Premature screening (before that age) could lead to unnecessary follow-up examinations and procedures that turn out to be useless. Our objective is to ascertain if the use of particular contraceptive methods are associated with premature screening.Methods This cross-sectional study based on the CONSTANCES cohort enabled us to include 4297 women younger than 25 years. The factors associated with premature screening were modeled by logistic regression. Missing data were handled by multiple imputations. The multivariate analyses were adjusted for sex life, social and demographic characteristics, and health status.Results Nearly half (48.5%) the women younger than 25 years had already undergone premature screening. Women not using contraceptives (aOR 0.3, 95% CI 0.3–0.5) and those using nonmedicalized contraceptives (condom, spermicide, etc.) (aOR 0.5, 95% CI 0.4–0.6) had premature screening less often than women using birth control pills. Higher risks of premature screening were observed in 20-year-old women (aOR 2.7, 95% CI 2.2–3.3) and in those with more than 5 lifetime partners (aOR 2.5, 95% CI 2.0-3.1), compared respectively with those of women who were younger and those with 5 or fewer lifetime partners.Conclusion Young women using contraceptives that require a doctor's prescription are exposed to premature screening more often than both those not using contraception and those with nonmedicalized contraceptives.
EQ-5D results in stroke survivors: What are they suffering from? Results from the Henan Rural Cohort Study
Authors: Mei Yong-xia , Zhang Zhen-xiang , Wu Hui , Hou Jian , Liu Xiao-tian , Sang Sheng-xiang , Mao Zhen-xing , Zhang Wei-hong , Yang Dong-bin , Wang Chongjian
Published: August 2020

Background Stroke is a major health threat and the leading cause of mortality and disability in China. The aims of this study were to identify the possible influencing factors of health-related quality of life (HRQoL) and its domain-specific contents in stroke patients in rural areas in China. Methods A total of 1709 stroke patients aged from 36 to 79 years from the Henan Rural Cohort Study (n=39259) were included in this study. The Chinese version of the European Quality of Life Five Dimension Five Level Scale (EQ-5D-5L) and visual analogue scale (VAS) were used to evaluate HRQoL in stroke patients. Tobit regression models, generalized linear models and binary logistic regressions models were constructed to determine the potential influencing factors of the EQ-5D utility index, as well as influencing factors of each domains and VAS score.Results The mean utility index and VAS scores of stroke patients were 0.885 (SD, 0.204), and 68.39 (SD, 17.31), respectively. Pain/discomfort (PD, 35.2%) and mobility (MO, 30.4%) were the most frequently reported issues. Regression models revealed that stroke patients who were illiterate; had a low monthly income; reported low physical activity intensity; and had diabetes, anxiety, depression or poor sleep quality had lower utility index and VAS scores. For the different dimensions of the EQ-5D, the influencing factors varied. Conclusion Stroke patients in rural areas had a lower HRQoL than those in urban areas. Factors associated with the EQ-5D utility index as well as each domain and VAS score, need attention. Stroke patients in rural areas need to be managed systematically. Clinical trial registration: The Henan Rural Cohort Study has been registered in the Chinese Clinical Trial Register (Registration Number: ChiCTR-OOC-15006699). Date of registration: 2015-07-06.http://www.chictr.org.cn/showproj.aspx?proj=11375.
Social trust and emotional health in older adults in China: The mediating and moderating role of subjective well-being and subjective social status
Authors: Chen Hongsheng , Zhu Zhenjun
Published: August 2020

Background China is becoming an aging society. The emotional health of the elderly is gaining importance. Social trust is an important factor affecting emotional health, but existing studies have rarely considered the various effects of different types of social trust on elderly emotional health. Few studies have analysed the role of subjective well-being and subjective social status in the relationship between social trust and elderly emotional health.Methods Using the data of the China Labor-force Dynamics Survey 2016 (CLDS 2016) and regression models, this study selected 3767 respondents aged 60 years and above to analyse the impact of social trust on their emotional health. Social trust was divided into three categories: trust in family members, trust in friends, and trust in neighbours. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to assess emotional health, and the respondents’ self-assessment scores were adjusted.Results Trust in family members was significantly and positively associated with emotional health (coefficient = 2.854, P < 0.01) and subjective well-being (coefficient = 0.189, P < 0.01). Trust in friends was significantly and positively associated with emotional health and subjective well-being (coefficient = 1.703, P < 0.01; coefficient = 0.171, P < 0.01, respectively). Trust in neighbours was significantly and positively associated with emotional health and subjective well-being (coefficient = 1.461, P < 0.01; coefficient = 0.186, P < 0.01; respectively). Subjective well-being effectively reduced the impact of social trust in family, friends, and neighbours on the emotional health of the elderly by 0.378, 0.341, and 0.370, respectively. Trust in family members, friends, and neighbours, significantly and positively affected respondents’ subjective social status (coefficient = 0.115, P < 0.05; coefficient = 0.095, P < 0.05; coefficient = 0.121, P < 0.01, respectively). Subjective social status effectively reduced the impact of social trust in family, friends, and neighbours on the emotional health of the elderly by 0.092, 0.076, and 0.096, respectively. The positive relationship between trust in family members and emotional health was weakened by subjective well-being, and that between trust in neighbours and emotional health was weakened by subjective social status.Conclusions Family relationships play an important role in maintaining the emotional health of the elderly. In response to population ageing, more social policies must be introduced to care for the elderly and help them lead a happy and satisfactory life.
Heart Transplantation of Patients with Ventricular Assist Devices: Impact of Normothermic Ex-Vivo Preservation Using Organ Care System Compared with Cold Storage
Authors: Nurmykhametova Zhuldyz , Kaliyev Rymbay , Lesbekov Timur , Bekbossynov Serik , Bekbossynova Makhabbat , Novikova Svetlana , Medressova Assel , Smagulov Nurlan , Faizov Linar , Samalavicius Robertas , Pya Yuriy
Published: August 2020

Background: Organ Care System (OCS) minimizes the cold ischemic time and allows for optimization of logistics and meticulous recipient preparation. Impact of normothermic ex-vivo preservation using OCS compared with cold storage (CS) for prolonged heart preservation especially beneficial for high-risk recipients bridged to transplantation with Mechanical Circulatory Support (MCS). Methods: Between 2012 and 2018, we performed a retrospective single-center review of prospectively collected data. All patients who underwent heart transplantation with MCS using the OCS Heart (n=25) versus standard cold storage were included in this study. Results: During this period, 300 patients were implanted with left ventricular assisted device (LVAD) and 35 (11.6 %) were bridged to heart transplantation. There was no significant difference in donor and recipient characteristics and risk factors. The Index for Mortality Prediction after Cardiac Transplantation (IMPACT) score was a trend towards higher estimated risk of death at 1y in the OCS group (14.2 vs. 10.8% p= 0.083). Mean total ischemic time during preservation was statistically significantly longer in CS vs OCS group (210 (23) Vs 74.6 (13) min p=0.001). Median ex vivo normothermic heart perfusion time in OCS was 348.4(132; 955) min. There was significant difference in total out of body time between OCS group 423(67) Vs CS group 210(23) min p=0.002). The allografts were reperfused for 73 (33) vs 121 (45) minutes (p=0.01) before disconnection from cardiopulmonary bypass in OCS vs CS group. All patients were alive on the 30th days post implant in CS groups and 96% in OCS group (p=0.5). Conclusion: Normothermic ex-vivo preservation of the allograft during transportation with the organ care system might be beneficial for long-time out of body organ preservation in comparison of cold storage especially for recipients on mechanical circulatory support.
The Change of Urea to Creatinine Ratio is Associated With Postoperative Complications and Skeletal Muscle Wasting in Pancreatic Cancer Patients Underwent Pancreatoduodenectomy
Authors: Duan Kaipeng , Gong Mengting , Gao Xin , Wei Luxin , Zhu Dongming , Zhou Jin
Published: August 2020

BackgroundSurgical Patients with depleted skeletal muscle mass tend to have a worse outcome in the perioperative period, but the muscle mass is difficult to quantify. Here, we aimed to evaluate the relationship of perioperative change of serum urea to creatinine ratio (CUCR) with postoperative complication and skeletal muscle mass in pancreatic cancer patients underwent pancreatoduodenectomy (PD).MethodsPancreatic cancer patients underwent PD were included retrospectively. We analyzed the association of serum urea, creatinine, and urea to creatinine ratio (UCR) between patients with and without major postoperative complications. In a subset of patients with serial CT scans, we tested the correlation of the CUCR and the changes of CT-derived skeletal muscle area (SMA). Furthermore, the capacity of complication prediction of CUCR and CT-derived parameter were compared in these patients.ResultsWe included 321 surgical patients from January 2014 to July 2020. Patients were grouped with high- and low CUCR according ROC curve (cut-off: 71.3 for male and 67.4 for female). Patients with high CUCR (n=175) have higher complication rate (30.3% vs. 21.1%, p=0.002), including POPF (23.4% vs. 15.1%, p=0.017), infection rate (16.0% vs. 11.0%, p=0.043) and longer postoperative days to discharge (16.7±6.5, vs. 12.1±4.2, p=0.031). Multivariable logistic regression demonstrated CUCR was an independent predictor for complications in these patients, independent of age, sex and BMI. In a subset patients with serial CT scans, spearman correlation analysis shown both L3 muscle area and L4-psoas area were significantly correlated with CUCR (R2 = 0.64, p < 0.05; R2 = 0.62, p < 0.05, respectively). ConclusionPerioperative CUCR is an independent predictor for postoperative complications in pancreatic cancer patients underwent PD procedure. Elevated CUCR is a reflection of skeletal muscle wasting in postoperative surgical patients.
Prognostic Factors in the Pulmonary Metastasectomy and Efficacy of the Repeat Pulmonary Metastasectomy from Colorectal Cancer
Authors: Fukada Masahiro , Matsuhashi Nobuhisa , Takahashi Takao , Tanaka Yoshihiro , Okumura Naoki , Yamamoto Hirotaka , Shirahashi Koyo , Iwata Hisashi , Doi Kiyoshi , Yoshida Kazuhiro
Published: August 2020

Background Pulmonary metastasectomy from colorectal cancer (CRC) has improved with recent advances in chemotherapy, diagnostic techniques, and surgical procedures. The purpose of this study was to investigate the prognostic factors of response to pulmonary metastasectomy and the efficacy of repeat pulmonary metastasectomy.Methods This study was a retrospective, single-institution study of 126 CRC patients who underwent pulmonary metastasectomy between 2000 and 2019 at the Gifu University Hospital. Among these 126 patients, 47 cases (37.3%) had pulmonary re-recurrence after initial pulmonary metastasectomy, and 26 cases (20.6%) underwent the second pulmonary metastasectomy. ResultsThe 3- and 5- year survival rates of all 126 patients who underwent complete pulmonary metastasectomy were 84.9% and 60.8%, respectively. Univariate analysis in survival identified seven significant factors: 1) gender (p = 0.04), 2) past history of extra thoracic metastasis (p = 0.04), 3) maximum tumor size (p = 0.002), 4) hilar or mediastinal lymph node metastasis (p = 0.02), 5) preoperative carcinoembryonic antigen (CEA) level (p = 0.01), 6) preoperative carbohydrate antigen 19-9 (CA19-9) level (p = 0.03), and 7) repeat pulmonary metastasectomy for pulmonary re-recurrence (p < 0.001). On the multivariate analysis, only hilar or mediastinal lymph node metastasis (p = 0.02, risk ratio: 8.206, 95% confidence interval (CI): 1.566-34.962) and repeat pulmonary metastasectomy for pulmonary re-recurrence (p < 0.001, risk ratio: 0.054, 95% CI: 0.010-0.202) were significant. Furthermore, there was no significant difference in clinical and surgical characteristics between the initial and the second pulmonary metastasectomy except for intraoperative blood loss [10 (range 0-1130) mL vs 20 (range 0-220) mL, p = 0.008]. Conclusions Repeat pulmonary metastasectomy is likely to be safe and effective for re-recurrent cases that meet the indication. However, hilar or mediastinal lymph node metastasis was a significant independent prognostic factor of worse overall survival.
Thermoelastic Closed-Form Solutions of FGM Plates Subjected to Temperature Change in Axial and Thickness Directions
Authors: Chung Yen-Ling
Published: August 2020

An analytical solution of simply supported FGM plates under thermal loads is developed based on medium-thick plate assumption. Further to assume constant Poisson’s ratio and thermal expansion coefficient, the closed-form solutions of the FGM plates with through-the-thickness Young’s modulus under temperature change in x - and z -directions are evaluated, expressed in terms of the thermal axial force and thermal bending moment. The closed-form solutions confirmed by finite element analysis give a complete insight into the thermal-mechanical behavior of FGM plates. Hence, the deflection, strain, stress, axial force, and bending moment of the FGM plate under thermal loads in axial and thickness directions are discussed. Results show that the use of FGM makes the maximum stress from the top or bottom surface move to the inner portion of the FGM plate, and significantly reduces the maximum stress of the plates. Moreover, although the FGM plate is subjected to thermal load in the thickness direction, the deflection of the FGM plate can be zero by properly choosing the steep material gradation, directly derived from the obtained closed-form solution.
The complicated relationship between parental status and disability: A register study of the 1968 to 1970 birth cohorts
Authors: Namatovu Fredinah , Lundevaller Erling Häggström , Vikström Lotta
Published: August 2020

Background Having children is a major life course, yet some disabilities could make it biologically impossible and some others could limit access to necessary socioeconomic resources. To date, there is relatively little data on disability and parental status. Thus, our study investigates the relationship between disability and parental status.Methods This longitudinal cohort study uses register data from all people born in Sweden from 1968 to 1970 (n=440,202). Of these, 146,946 people were excluded as they did not meet the inclusion criteria. Therefore, the analysis was based on 293,256 people whom we followed from birth through the end of the study in 2010. We performed descriptive statistical analyses, graphical plots and logistic regression analyses to investigate the interplay between the use of disability benefits and the chance of having a first child. Additionally, we used contingency tables and multinomial logistic regression to investigate the chances of having a first child at different age intervals based on the age of starting on disability benefits.Results Receiving disability benefits was strongly associated with reduced chances of having children. Starting on disability benefits at a very early age was associated with low chances of having children during the individual’s lifetime. People that had a first child between 13─20 years of age were more likely to receive disability benefits during their 30s and 40s compared to the rest of the population. Men with disabilities were less likely to have children when compared to women with disabilities and to men and women without disabilities. Conclusions We found evidence of a complicated association between disability and parental status. Early recipients of disability benefits had reduced chances of having children, while having children at an early age was linked to increased risk of using disability benefits later in life. Our findings support policies for promotion of quality health to reduce early use of disability benefits and the related consequences. We further highlight a need to strengthen public health policies geared at reducing very early parenthood and support for young parents, this would promote individual health and could contribute to a reduction in early exits from work.
Biotechnological Improvement of Nutritional Value of Rice straw using Fungi
Authors: Salem Mohamed F. , gaafar khalid mahmoud mohamed , elkhair Reham Nabil Abo , Abonama Osama M. , Yasseen Asmaa Abd-Elrasol , Abouelkhair Ahmed Adel
Published: August 2020

BackgroundElimination of most of Egyptian environmental pollution depends on prevention of burning of agricultural wastes specially rice straw. Microbial improvement of nutritive value for rice straw is not only aids in the prevention of Egyptian environmental pollution but also solve the problem of shortage in animal feeds ingredients. The current study was designed to investigate the microbial improvement of rice straw via solid state fermentation using five strains of fungi namely Trichoderma viride, Trichoderma reesei, pleurotus ostreatus, Aspergillus oryzae and Aspergillus Fetidus. ResultsThis fermentation results in improving of nutritive value of rice straw by increasing its dry matter, protein, fat, ash and energy content with decreasing of fiber and organic matter content. These effects were variable according the type of fungi, which were very high for rice straw treated with Trichoderma viride and Trichoderma reesei followed by that treated by pleurotus ostreatus then those treated by Aspergillus oryzae and Aspergillus Fetidus.ConclusionIt could be concluded that the microbial treatment is a good way to improve the nutritional value of rice strawTrial registrationProject Nr.9/2017- Faculty of Veterinary Medicine- University of Sadat City. http://usc.edu.eg/ar/news/13741.aspx
WITHDRAWN: A global carbon and nitrogen isotope perspective on modern and ancient human diet
Authors: Bird Michael I , Crabtree Stefani , Haig Jordahna , Ulm Sean , Wurster Christopher
Published: August 2020

Stable carbon and nitrogen isotope analyses are widely used to infer diet and mobility in ancient and modern human populations, potentially providing a means to situate humans in global food webs. We collated 13,533 globally distributed analyses of ancient and modern human collagen and keratin samples. We converted all data to a common ‘Modern Diet Equivalent’ reference frame to enable direct comparison between ancient and modern human diets and the natural environment. This approach reveals a broad diet in ancient times, consistent with the human ability to consume opportunistically as extreme omnivores within complex natural food webs and across multiple trophic levels in every terrestrial and many marine ecosystems on the planet. In stark contrast, dietary breadth across modern non-subsistence populations has dramatically compressed by two-thirds, largely as a result of the rise of industrial agriculture and animal husbandry practices, as well as the globalization of food distribution networks.
Qigong Mind-Body Program for Caregivers of Cancer Patients: Design of a Pilot Three-Arm Randomized Clinical Trial
Authors: Budhrani-Shani Pinky , Raeesi Kristin , Walter Eli , Lewis Kai , Wang Wanyi , Cohen Lorenzo , Yeh Gloria Y , Lengacher Cecile A. , Wayne Peter M.
Published: August 2020

Background: Informal caregivers, often family and friends, experience significant psychological and physical distress leading to reductions in health and quality of life (QOL). Mind-body interventions focused on caregivers are often limited and do not address multiple barriers, including caregivers’ economic, geographic, and time constraints. Translation of in-person, community-based interventions to internet-based delivery may offer greater accessibility for caregivers, leading to increased adherence.Methods: Caring for Caregivers with Mind-Body Exercise implements a three-arm, pilot, randomized controlled trial to evaluate the feasibility of delivering a Qigong intervention (Eight Brocades) to cancer caregivers. A total of 54 cancer caregivers will be randomized into one of three 12-week programs: (1) community-based Qigong; (2) internet-based Qigong; or (3) a self-care control group. Study specific aims include 1) Modify intervention content for online delivery; 2) Evaluate the feasibility of recruiting and retaining cancer caregivers into a 12-week clinical trial; and 3) Evaluate the feasibility of collecting and managing data, and the suitability of questionnaires for this population. Several outcomes will be assessed, including caregiver QOL, caregiver burden, caregiver distress, perceived social support, physical function, and cognitive function. A 6-month follow-up will also assess longer-term changes in QOL and psychosocial wellbeing.Discussion: Findings will be used to inform the design and conduct of a large-scale comparative effectiveness trial evaluating caregivers who received Qigong training delivered through community-based vs internet-based programs. A finding that either or both programs are effective would inform care and options for caregivers.Trial registration: NCT04019301; registered on July 15, 2019; clinicaltrials.gov.
Interleukin-7 loaded oncolytic adenovirus improves CAR-T cell therapy for glioblastoma
Authors: Huang Jianhan , Zheng Meijun , Zhang Zongliang , Tang Xin , Chen Yaxing , Tong Aiping , Zhou Liangxue
Published: August 2020

Background: T cell with chimeric antigen receptors (CAR-T) has presented remarkable efficacy for blood cancer as an emerging immunotherapy. However, for solid tumors, the therapeutic efficacy is much impaired due to the lack of infiltration and persistence of CAR-T in tumor tissue. Thus, we constructed an interleukin-7-loaded oncolytic adenovirus and combined the use of oncolytic virus and CAR-T to improve the therapeutic outcome.Methods: We constructed an interleukin-7 loaded oncolytic adenovirus (oAD-IL7) and a B7H3-targeted CAR-T, and explored the efficacy of the single use of oAD-IL7, B7H3-CART or the combined therapy for glioblastoma in vitro and in vivo. The improved CAR-T anti-tumor efficacy was evaluated according to the proliferation, survival, persistence, exhaustion of T cells, and tumor regression.Results: Constructed oAD-IL7 and B7H3-CART presented moderate cytotoxicity during in vitro study, but failed to induce a thorough and persistent anti-tumor therapeutic efficacy in vivo. The combination of oAD-IL7 and B7H3-CART in vitro resulted in enhanced T cell proliferation and reduced T cell apoptosis. The joint efficacy was further confirmed using tumor-bearing xenograft mice. During in vivo study, the mice treated with both oAD-IL7 and B7H3-CART showed prolonged survival and reduced tumor burden. According to the ex vivo study, oAD-IL7 improved the proliferation and persistence of tumor-infiltrating B7H3-CART, but failed to reverse the exhaustion.Conclusions: Our results indicated that oAD-IL7 is a promising auxiliary therapy to improve the therapeutic efficacy of B7H3-CART in glioblastoma by providing the activating signals for tumor-infiltrating T cells. Our results also lay the basis for the future clinical trials for the combination of IL7-loaded oncolytic adenovirus and CAR-T therapy for glioblastoma.
LRRC3B polymorphisms contributed to breast cancer susceptibility in Chinese Han Population
Authors: Jin Tianbo , Peng Linna , Xing Shishi , Li Dandan , He Chunjuan , He Xue , Wang Li
Published: August 2020

Purpose

LRRC3B gene, as a tumor suppressor gene was involved in the development and progress of breast cancer (BC). However, the effect of LRRC3B polymorphisms on BC has rarely been reported. In the study, we aims to evaluate the relation between LRRC3B variants and BC risk.
Methods

Among 563 BC patients and 552 healthy controls, ten single-nucleotide polymorphisms (SNPs) in LRRC3B were genotyped by Agena MassARRAY. Odds ratios (OR) and 95% confidence interval (CI) was calculate using logistic regression model.
Results

Our study demonstrated that rs1907168 polymorphism (OR = 0.71, p = 0.017) reduced the risk of BC in the overall. In stratified analyses by age, rs1907168 decreased (OR = 0.53, p = 0.002) while rs78205284 (OR = 2.83, p = 0.034) increased BC susceptibility among the population at age ≤ 51 years. Clinical parameters such as tumor size, the status of PR and Ki67 were associated with LRRC3B variants. Furthermore, we found that the association of ‘GATT’ haplotype with an increased risk for BC. In addition, LRRC3B gene was down-regulated in BC tumor and had a poor prognosis in BC in silico analysis.
Conclusion

Our study firstly found LRRC3B SNPs contributed to the risk of BC, suggesting LRRC3B variants might help to predict BC progression.
Identification of Differential mRNA and lncRNA Expression in AcMNPV- Infected Sf9 Cells
Authors: Zhao Tiejun , Deng Riqiang , Chen Mengqiu , Wang Xunzhang
Published: August 2020

Autographa californica multiple Nucleopolyhedrovirus (AcMNPV) is the archetypal species of the alphabaculovirus. Sf9 are the ovarian cells of their host—Spodoptera frugiperda. In this study, a total of 3,463 pieces of time-series differentially expressed RNA are identified, including 1,200 mRNA and 2,263 lncRNA, with high-throughput sequencing technology using samples collected from Sf9 cells at different time points after AcMNPV infection. The result could provide a reference for the further study of the interaction and regulatory mechanism between the virus and the host.