bluuebunny/crossref_metadata_2025 huggingface dataset:
Development and validation of a CT radiomics signature for diagnosing COVID-19 pneumonia compared with CO-RADS
Authors: Liu Huanhuan , Ren Hua , Wu Zengbin , Xu He , Zhang Shuhai , Li Jinning , Hou Liang , Chi Runmin , Zheng Hui , Chen Yanhong , Duan Shaofeng , Li Huimin , Xie Zongyu , Wang Dengbin
Published: July 2020

Objectives: To develop and validate a CT radiomics signature for diagnosing COVID-19 pneumonia compared with clinical model and COVID-19 reporting and data system (CO-RADS).Methods: This two-center retrospective study enrolled 115 laboratory-confirmed COVID-19 patients with 1127 lesions and 435 non-COVID-19 pneumonia patients with 842 lesions. In study 1, a radiomics signature and a clinical model was developed and validated in the training and internal validation cohorts (patient/lesion [n] = 379/1325, n = 131/505) for identifying COVID-19 pneumonia. In study 2, the developed radiomics signature was tested in another independent cohort including all viral pneumonia (n = 40/139), compared with clinical model and CO-RADS approach. The predictive performance was assessed by receiver operating characteristics curve (ROC) analysis, calibration curve, and decision curve analysis (DCA). Results: Twenty-three texture features were selected to construct the radiomics model. Radiomics model outperformed the clinical model in diagnosing COVID-19 pneumonia with an area under the ROC (AUC) of 0.98 and good calibration in the internal validation cohort. Radiomics model also performed better in the testing cohort to distinguish COVID-19 from other viral pneumonia with an AUC of 0.96 compared with 0.75 (P=0.007) for clinical model, and 0.69 (P=0.002) or 0.82 (P=0.04) for two trained radiologists using CO-RADS approach. The sensitivity and specificity of radiomics model can be improved to 0.90 and 1.00. The DCA confirmed the clinical utility of radiomics model. Conclusions: The proposed radiomics signature outperformed clinical model and CO-RADS approach for diagnosing COVID-19, which can facilitate rapid and accurate detection of COVID-19 pneumonia.
Microbial interaction: Prevotella spp. reduce P.aeruginosa induced inflammation in Cystic Fibrosis bronchial epithelial cells
Authors: Bertelsen Anne , Elborn Stuart J , Schock Bettina
Published: July 2020

Background: In Cystic Fibrosis (CF) airways, mutations in the Cystic Fibrosis Transmembrane Regulator (CFTR) lead to dehydrated, thick mucus which promotes the establishment of persistent polymicrobial infections and drives chronic airways inflammation. This also predisposes the airways to further infections, a vicious, self-perpetuating cycle causing lung damage and progressive lung function decline. The airways are a poly-microbial environment, containing both aerobic and anaerobic bacterial species. Pseudomonas aeruginosa (P.aeruginosa) infections contribute to the excessive inflammatory response in CF, but the role of anaerobic Prevotella spp., frequently found in CF airways, is not known.Materials: We assessed innate immune signalling in CF airway epithelial cells in response to clinical strains of P.histicola, P.nigresens and P.aeruginosa. CFBE41o- cells were infected with P.aeruginosa (MOI 100, 2h) followed by infection with P.histicola or P.nigrescens (MOI 100, 2h). Cells were incubated under anaerobic conditions for the duration of the experiments.Results: Our study shows that P.histicola and P.nigresens can reduce the growth of P.aeruginosa and dampen the inflammatory response in airway epithelial cells. We specifically illustrate that the presence of Prevotella spp. reduces Toll-like-receptor (TLR)-4, MAPK, NF-kB(p65) signalling and cytokine release (Interleukin (IL)-6, IL-8) in mixed infections. Conclusion: Our work, for the first time, strongly indicates a relationship between P. aeruginosa and anaerobe Prevotella spp. The observed modified NF-kB and MAPK signalling provides some mechanisms of this interaction that could offer a novel therapeutic approach to combat chronic P.aeruginosa infection in people with CF.
Ear mould for congenital auricular deformities: a protocol for systematic review and meta-analysis
Authors: Huang Jincheng , Zou Kun , Yuan Ping , Zhang Longhao , Yang Min , Miao Yunqi , zhao li , Fan Yanjun
Published: July 2020

Background: Congenital auricle deformities (CADs) not only affect the appearance, but may also result in social inferiority or difficulties, influence the hearing and mental health of the children. Although some studies have pointed out CADs have a natural improvement trend, there is still a lack of high-quality research to demonstrate the degree of that. Therefore, related studies agree that early treatment are necessary. Ear mold correction is currently main non-surgical treatment for CADs, but the existing research often involves a small sample size, and the research conclusions are inconsistent. More importantly, there is still no systematic review on ear mold correction for CADs. This study aims to systematically evaluate the effectiveness and safety of ear mold correction for CADs, so as to provide an evidence base for further research.Methods: The study has been designed according to the Preferred Reporting program for Systems Evaluation and Meta-analysis Protocol (PRISMA-P). We will search electronic literature databases of PubMed, Embase, Cochrane Library, Web of science, CBM, CNKI, Wanfang and VIP from their initiative to 1 June 2020 for interventional studies on ear mould for children with CADs. The study selection, data extraction and quality assessment will be performed by two authors. Meta-analysis will be conducted on primary outcome effectiveness rate of physician assessment and secondary outcomes of effectiveness rate of parents’ assessment, effectiveness score, hearing assessment, and adverse reactions using relative ratio or mean difference and their 95% confidence intervals. The heterogeneity of the included studies will be tested using Chi square test and I2, and random-effects model will be used when significant heterogeneity was found, otherwise, fixed-effects model will be used. Sensitivity analysis will be performed using trials with high quality and using alternative [1]models (fixed-effects or random effects model). Publication bias will be tested using funnel plot and Egger’s test. Discussion: This study will be the first to systematically evaluate the effectiveness and safety of ear mold correction for CADs, to provide evidence base for clinical guideline making, clinical decision and future research. Systematic review registration : CRD42020190982.
PELP1 Expressed in Non-Small Cell Lung Cancer and Promotes Tumor Cell Proliferation, Metastasis, and Drug Resistance Through MAPK Signaling Pathway.
Authors: Wang Xingen , Ying Weihua , Liang Li
Published: July 2020

Background

Lung cancer is one of the tumors with high morbidity and mortality among males and females worldwide. Proline-, glutamic acid-, and leucine-rich protein 1(PELP1) is an estrogen receptor coactivator and functions as a scaffolding protein. Its oncogenic signaling was involved in the progression of several cancers. However, there is little known about the role of PELP1 in the lung cancer. The aim of this study is to explore the role of PELP1 in non-small cell lung cancer.

Methods

The expression of PELP1 in microarrays of lung cancer tissue and correlation with clinicopathological parameters were performed. RNA interference technology was used to downregulate PELP1 expression in A549 lung cancer cells and the tumor cell’s ability of proliferation, migration, invasion was detected by Cell Count Kit-8 and trans-well essay. In addition, whole genome exon was analyzed by poly-A RNA-sequencing.

Results

Results showed that PELP1 is overexpressed in the lung cancer specimens and its expression correlate with histological type, smoking status, and EGFR status but no significant prognostic value. Knockdown of PELP1 inhibited cell proliferation, migration, invasion of lung cancer cells. Furthermore, silencing PELP1 in lung tumor cells promotes the sensitivity of tumor cells to the tyrosine kinase inhibitor Gefitinib. RNA-sequencing and Western-blotting found that 140 genes were up-regulated and 143 genes were down-regulated in PELP1 silenced lung adenocarcinoma cells, which mainly affected the mitogen-activated protein kinase (MAPK) signal pathway, EGFR tyrosine kinase inhibitor resistance, PPAR signaling pathway, Cytosolic DNA-sensing pathway, cytokine-cytokine receptor interaction, drug metabolism, cAMP signaling pathway, RIG-1-like receptor signaling pathway.

Conclusions

PELP1 plays a key role in non-small cell lung cancer proliferation, progression, and drug resistance. These results suggest that PELP1 could be a potential target for therapeutic intervention for lung cancer.
An Integrative Data Mining for the Identification and Validation of Oncogenic Biomarkers in Pancreatic Carcinoma
Authors: Jin Guihua , Ruan Qingqing , Shangguan Fugen , Lan Linhua
Published: July 2020

Background: Pancreatic carcinoma (PC) is a severe disease associated with high mortality. Although strategies for cancer therapy made great progress, outcomes of pancreatic ductal adenocarcinoma patients remain extremely poor. Therefore, it is urgent to find novel biomarkers and therapeutic targets to improve outcomes of patients. Methods: To identify general applicable targets for early diagnosis and therapy, we selected related microarray data which including three mRNA microarray datasets GSE62165, GSE15471, GSE32676 and two miRNA datasets GSE24279, GSE32678, and combinative analysis was performed by GEO2R. Functional and pathway enrichment analysis were performed using the DAVID database. MiRTarBase, miRWalk, Diana Tools and TBtools were used to get keys. TCGA database, HPA database and western blot experiments were used to verify diagnostic and prognostic value of key genes.Results: By integrating mRNA and miRNA expression profiles, we identified 114 differentially expressed genes (DEGs) and 114 differentially expressed miRNAs (DEMs), respectively. Furthermore, three overlapping key genes, RUNX2, LAMC2 and FBXO32, were found by compared with DEMs target genes and DEGs. In detail, deregulation of 8 key miRNAs were closely related to poor outcomes and participated in crucial genes regulation which may contribute to build a miRNA biomarker panel for prognosis. Moreover, we confirmed that RUNX2 showed a potential property for distinguishing PC and normal people. We also demonstrated that aberrant over-expression of LAMC2 was associated with poor prognosis of PC patients as well as human tumor status and subtypes. The protein levels of RUNX2 and LAMC2 in PC patients were further verified by IHC from Human Protein Atlas and western blot experiments. Conclusions: In summary, our current study identified that RUNX2 and LAMC2 may be promising targets for early diagnosis and therapy of PC patients.
Na+/K+-ATPase-associated FXYD3 Protein As An Intracellular Therapeutic Target in Cancer
Authors: Liu Chia-chi , Kim Yeon Jae , Teh Rachel , Garcia Alvaro , Honda Andrew Woo , Hamilton Elisha J , Cornelius Flemming , Baxter Robert C , Rasmussen Helge H
Published: July 2020

BackgroundFXYD proteins associate closely with- and protect plasmalemmal Na+/K+-ATPase against oxidative inhibition. One of them, FXYD3, is often overexpressed in cancers, including those of breast and pancreas. Down-regulation of overexpression in MCF-7 breast cancer cells with siRNA augments doxorubicin-induced cytotoxicity. Because down-regulation with siRNA is not readily translated therapeutically, we developed a peptide as an alternative for suppression of FXYD3.MethodsA shortened peptide derivative of the wild-type (WT) FXYD3 protein, FXYD3-pep has the four cysteine residues in the WT protein replaced by serine, which eliminates the WT protein’s protection against oxidative Na+/K+-ATPase inhibition. We exposed human cancer cells to FXYD3-pep and measured cytotoxicity and caspase 3/7 activity with co-exposure to doxorubicin. We also measured effects of the peptide on expression glutathione-S-transferase π (GST-π), implicated in treatment resistance, and on expression of tumor suppressor p53. Selected experiments were performed with parallel FXYD3 suppression with siRNA or FXYD3-pep.ResultsExposure of cells to FXYD3-pep displaced WT FXYD3 from Na+/K+-ATPase. Exposure of MCF-7 breast or pancreatic BxPC-3 cancer cells that highly express FXYD3 to the peptide had little effect alone but combined with doxorubicin it significantly (P < 0.05) increased cytotoxicity. A peptide not mutated to eliminate FXYD3’s protective effect of Na+/K+-ATPase had no effect. FXYD3-pep did not augment doxorubicin’s cytotoxicity against MDA-MB-468 breast and Panc-1 pancreatic cancer cells that have low- or no FXYD3 expression. Cellular FXYD3 expressions was reflected by expression of the α1 Na+/K+-ATPase subunits but not by plasmalemmal Na+/K+-ATPase function. Signals from fluorescently labeled FXYD3-pep were detected in a perinuclear distribution in BxPC-3 cells as reported for overexpressed FXYD3, α- and β Na+/K+-ATPase subunits in cancer. Exposure to FXYD3-pep or to FXYD3 siRNA almost eliminated expression of GST-π. FXYD3-pep alone had no effect on p53 levels but significantly augmented a doxorubicin-induced increase, and, while the peptide alone had no effect on caspase 3/7 activity, it significantly augmented a doxorubicin-induced increase. ConclusionsOverexpressed FXYD3 has intracellular roles beyond its accepted modulation of plasmalemmal Na+/K+-ATPase. These roles can be countered with a membrane-permeable peptide derivative of FXYD3 that suppresses GST-π and enhances chemosensitivity of cancer cells overexpressing FXYD3.
A Retrospective Cohort Study of Anterior Fontanelle Delayed Closure in Healthy Infants and Its Associated Factors
Authors: Tang MengYan , Xiong Fei , Li Ping , Zeng Limin , Yang SuFei
Published: July 2020

Background: Anterior fontanelle (AF) is a regular feature of infant development, and delayed closure of AF (AFDC) is highly valued in the clinical of child health care. Methods: A retrospective cohort study with a 3-year follow-up was conducted to understand the occurrence of AFDC in healthy infants and its associated factors.Results: 792 infants were examined, 61 infants had AFDC and the incidence rate of AFDC in healthy infants was 7.71%. By the age of 24 months, 92.29% of infants had AF closure, with 99.87% achieving closure before 36 months old. Form 1 to 36 months age, the median AF size of AFDC group was significantly larger than that of AF normal closure (AFNC) group; from 6 to 36 months age, the median weight as well as length of AFDC group were all lower than those of AFNC group. There was no difference in head circumference between the two groups. The birth weight (OR=1.001), birth length (OR=0.778), AF size at 1 month (OR=4.196), and gender (OR=1.851) were associated factors of AFDC.Conclusion: AFDC in healthy infants was determined to be within a normal range for AF development and was not related to any disease. AF development was correlated to weight as well as length, but not correlated to head circumference. Congenital factors such as heavier birth weight, longer birth length, larger AF size at birth, and being male were associated with AFDC.
Risk Assessment for Anti-Infectives-Related Acute Kidney Injury Using the Japanese Adverse Drug Event Report Database
Authors: Nakao Satoshi , Hasegawa Shiori , Umetsu Ryogo , Shimada Kazuyo , Mukai Ririka , Tanaka Mizuki , Matsumoto Kiyoka , Yoshida Yu , Inoue Misaki , Satake Riko , Nishibata Yuri , Liao Jun , Nakamura Mitsuhiro
Published: July 2020

Background: Acute kidney injury (AKI) is associated with significant increases in short- and long-term morbidity and mortality. Drug-induced AKI is a major concern in the present healthcare system. Our spontaneous reporting system (SRS) analysis assessed links between AKIs, along with patients’ age, as healthcare-associated risks and administered anti-infectives. We also generated anti-infectives-related AKI-onset profiles.Method: We calculated adjusted reporting odds ratios (RORs) for reports of anti-infectives-related AKIs (per Medical Dictionary for Regulatory Activities) in the Japanese Adverse Drug Event Report database and evaluated associations between anti-infectives and age by association rule mining. We evaluated time-to-onset data and hazard types using the Weibull parameter.Results: Among 534,688 reports (submission period: April 2004–June 2018), there were 21,727 AKI events. Anti-infective treatments including glycopeptide antibacterials, fluoroquinolones, third-generation cephalosporins, triazole derivatives, and carbapenems were associated with 596, 494, 341, 315, and 313 AKI incidences, respectively. Adjusted RORs of anti-infectives-related AKIs increased among older patients and were higher in anti-infective combination therapies [anti-infectives, ≥ 2; ROR, 2.75 (2.56–2.95)] than in monotherapies [ROR, 1.52 (1.45–1.61)]. In association rule mining, the number of anti-infectives and age were associated with anti-infectives-related AKI lift values (as consequent). Moreover, 48.1% of AKIs occurred within 5 days (median, 5.0 days) of anti-infective therapy initiation.Conclusion: Thus, adjusted RORs derived from our new SRS analysis indicate potential AKI risks linked to age and number of administered anti-infectives.
Hypofractionated and single-fraction radiosurgery for brain metastases with sex as a key predictor of overall survival
Authors: Mangesius Julian , Thomas Seppi , Katie Bates , Arnold Christoph Reinhold , Danijela Minasch , Stephanie Mangesius , Johannes Kerschbaumer , Peter Lukas , Ute Ganswindt , Meinhard Nevinny-Stickel
Published: July 2020

Background: Overall survival (OS) of patients with brain metastases treated with hypofractionated (HFSRT) or single-fraction (SRS) radiosurgery depends on several prognostic factors. The aim of this study was to investigate the potential of sex as an independent predictor of OS and evaluate the predictive accuracy of common prognostic scores.Methods: Retrospective analysis of 281 consecutive patients receiving radiosurgery of brain metastases was performed. Kaplan-Meier survival curves and Cox proportional hazards models were used to compare OS between SRS and HFSRT and by sex, before and after propensity-score matching (PSM) on key baseline prognostic covariates. Prognostic scores were evaluated using Harrell’s concordance index.Results: Median OS was 11 months after both SRS and HFSRT. After PSM, median OS was 12 months after SRS (95%CI: 7.5-16.5) and 9 months after HFSRT (95%CI: 5.0-13.0; p=0.77). Independent prognostic factors were sex, primary tumor, KPI, and systemic disease status. Median OS was 16 months for women and 7 months for male patients (p<0.001). After excluding sex specific tumors, PSM revealed a median OS of 16 months for women and 8 months for male patients (p<0.01). Evaluation of prognostic indices showed BSBM to be the most accurate (Harrell’s C=0.68), followed by SIR (0.61), GPA (0.60), RPA (0.58), and Rades et al. (0.57).Conclusions: OS after HFSRT and SRS did not differ, although PSM revealed a non-significant advantage for SRS. Female sex was found to be a major independent positive prognostic factor for survival, and thus should be considered in the personalized decision-making of brain metastases treatment.
A Real-World Study of The Efficacy and Safety of Sintilimab in The Treatment of Recurrent or Refractory Lymphoma
Authors: Juan Qiu , Baoxuan Zhang , Ji Ma , Bing Bu , Shu Fang , Qianrun Lu , Qiuyue Liu , Lihua Song
Published: July 2020

Background: Sintilimab (Innovent Biologics, China, Suzhou, China) has been listed in China for only a year and a half. So far, there have been no reports about it in real research. The purpose of this study was to evaluate the efficacy and safety of the real-world use of Sintilimab in the treatment of recurrent or refractory lymphoma and to explore the factors that influence the efficacy and safety of Sintilimab. Methods: Based on real world data, a retrospective analysis of 25 patients with relapsed or refractory lymphoma treated with Sintilimab was performed.Results: Efficacy was evaluable in 19 of 25 patients, objective response rate (ORR), disease control rate (DCR) and clinical response rate (CBR) were 63.2%, 84.2% and 73.7%, respectively. Among the different pathological types, Hodgkin's lymphoma ORR 77.8%, CBR 100%, diffuse large B-cell lymphoma ORR 25%, CBR 0%, peripheral T/NK cell lymphoma ORR 66.7%, CBR 83.3%. The number of previous chemotherapy courses was correlated with the short-term efficacy of the patients (P=0.029). In the safety analysis, 76% of treatment-related adverse events occurred, 80% of which were grade 1 and 2, with the major adverse events being hypothyroidism and anemia. Hypothyroidism is related to sex.Conclusions: Sintilimab is effective in recurrent or refractory lymphoma and the adverse reactions are controllable. The fewer the lines of previous chemotherapies, the better the short-term efficacy of Sintilimab. The use of Sintilimab in female patients should be paid more attention to thyroid function.
Determinants of Intermittent Preventive Treatment with Sulfadoxine-Pyrimethamine in Pregnant Women (IPTp-SP) in Mali, a household survey.
Authors: Sangho Oumar , Tounkara Moctar , Whiting-Collins Lillian Joyce , Beebe Madeleine , Winch Peter J. , Doumbia Seydou
Published: July 2020

Background: In malaria endemic regions, Intermittent Preventive Treatment with Sulfadoxine-Pyrimethamine (IPTp-SP) is recommended for all pregnant women during prenatal consultation from the fourth to the ninth month of pregnancy, up to the time of delivery. The Government of Mali is aiming for universal coverage of IPTp-SP. However, coverage is still low, estimated to be 18% for completion of three doses (IPTp-SP3). The objective of this study was to identify the factors that influence IPTp-SP in the Health District of Sélingué, Mali.Methods: We performed a cross-sectional survey with 30 clusters, proportional to village size with two stages of sampling. We collected data electronically with Magpi software during face-to-face interviews/surveys. The data were analyzed with SPSS version 20. We performed a descriptive analysis, and bivariate and multivariate logistic regression. An equity analysis examined the effect of distance from health care facility on completion of three or more antenatal visits (ANC3+) and three or more doses of Intermittent Preventive Treatment (IPTp-SP3+).Results: Of the 1,021 women surveyed, 87.8% (n = 896) attended at least one ANC visit. Of these, 86.3% (n = 773) received at least 1 dose of IPTp-SP. The frequency of three or more ANC visits was 90.8%. Compliance with three or more malaria treatments was 63.7%. The determinants statistically related to ANC3+ were the early initiation of ANC (OR = 3.22 [1.22, 10.78]), the number of payments made for the malaria treatment (OR = 21.5 [2.64; 09], OR = 11.24 [2.5, 50.46]) and the presence of a Community Health Center (CHC) in the village (OR = 9.69 [1.09, 86.21]). The ability to read (OR = 1.60 [1.01, 2.55]), the early initiation of ANC (OR = 1.46 [1.06, 2.00], knowledge of the utility of the drug (OR = 2.38 [1.24, 4.57]), and knowledge of the recommended dose of the drug (OR = 6.11 [3.98, 9.39]) were related to completion of three or more treatments (IPTp-SP3+).Conclusion: The early initiation of ANC was a good determinant of the completeness of ANC3+ and IPTp-SP3+. Coverage was fair, but still far from universal. Alternative strategies are needed to further increase coverage.
Performance of RIPASA and AIR Scores in an Egyptian Subset of Patients with Suspected Diagnosis of Acute Appendicitis
Authors: Faisal Mohamed , Bayoumi Ahmed A , Bakr Ahmed Abo , Edlehamre Marcus , Khaled Islam
Published: July 2020

Background: Early and definitive acute appendicitis (AA) diagnosis remains a great challenge in clinical practice worldwide. Currently, several risk scores are available for the clinical assessment of AA, although there are differences in their accuracy rates. The aim of the study was to assess and analyze the accuracy of the acute inflammatory response (AIR) and Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) scores in an Egyptian population. Methods: A series of 310 patients, 61% male with a median age of 18 years, with Rt. Iliac fossa pain were clinically evaluated for suspicion of AA. All patients were assessed using both the AIR and RIPASA scores. Following evaluation, all patients underwent appendectomy. A final diagnosis of AA was based on histopathology. Two predetermined cutoff values for the AIR score and one cutoff value for the RIPASA score was evaluated for sensitivity, specificity, and accuracy. Statistical analysis was performed using SPSS version 22. Cross tabulation was performed to assess sensitivity, specificity, positive and negative predictive values along with other tests for parametric and non-parametric variables.Results: The sensitivities of the RIPASA score cutoff value of ≥7.5 and AIR score cutoff values of >4 and >8 were 83.8%, 92.2%, and 33.1%, accordingly, while the specificities were 69.2%, 76.7%, and 84.6%, respectively. AIR score of >4 (91%) was more accurate compared to AIR score of >8 (37.4%) and RIPASA score of ≥7.5 (82.5%). Conclusion: An AIR score of >4 had better sensitivity, specificity, and accuracy compared to a RIPASA score of ≥7.5 for the Egyptian population. However, an AIR score of >8 was more specific. Therefore, an evaluation of patients in low-income countries using one of these scoring systems is highly recommended to avoids unnecessary hospitalization along in negative individuals, in addition to preventing complications in positive cases.
Diverting Colostomy is an Effective Procedure for Ulcerative Chronic Radiation Proctitis Patients After Pelvic Malignancy Radiation
Authors: Huang Xiaoyan , Zhong Qinghua , Wang Huaiming , Zhao Jie , Kuang Yingyi , Guan Qi , He Yanjiong , Qin Qiyuan , Wang Hui , Ma Tenghui
Published: July 2020

Background: Chronic radiation proctitis (CRP) with rectal ulcer is a common complication after pelvic malignancy radiation, and gradually deteriorating ulcers will result in severe complications such as fistula. The aim of this study was to evaluate effect of colostomy on ulcerative CRP and to identify associated influence factors with effectiveness of colostomy.Methods: Between November 2011 to February 2019, 811 hospitalized patients were diagnosed with radiation-induced enteritis (RE) in Sun Yat-sen University Sixth Affiliated Hospital, among which 284 patients presented with rectal ulcer, and 61 ulcerative CRP patients were retrospectively collected and analyzed.Results: The overall effective rate of colostomy on ulcerative CRP was 49.2%, with a highest effective rate of 88.2 % within 12 to 24 months after colostomy. 9 (31.1%) CRP patients with ulcers were cured after colostomy and 12 (19.67%) patients restored intestinal continuity, among which including 2 (3.3%) patients ever with rectovaginal fistula. 100% (55/55) patients with rectal bleeding and 91.4% (32/35) patients with anal pain were remarkably alleviated. Additionally, multivariable analysis showed the duration of stoma [OR=1.211, 95% CI (1.060~1.382), P=0.005] and albumin (ALB) level post-colostomy [OR=1.437, 95% CI (1.102~1.875), P=0.007] were two independent influence factors for the effectiveness of colostomy on the rectal ulcer of CRP patients. Conclusions: Colostomy was an effective and safe procedure for treating rectal ulcer of CRP patients, and also a potential strategy for preventing and treating fistula. Duration of stoma for 12~24 months and higher ALB level could significantly improve the effectiveness of colostomy on ulcerative CRP patients.
Clinical characteristics of cerebral venous sinus thrombosis patients with new-onset of headache
Authors: Wang Yugang , Fang Qi
Published: July 2020

Objective : This study aimed to assess the clinical characteristics of cerebral venous sinus thrombosis (CVT) patients with new-onset headache and to identify the risk factors for headache in this population.Methods : We retrospectively reviewed the demographic and clinical data of 69 CVT patients recruited between September 2017 and September 2019. Patients were classified into two groups, the headache group and the non-headache group, according to the presence or absence of new-onset headache symptoms at admission. The following characteristics and parameters were measured and analyzed, including gender, age, Diseased sinus amount(DSA), and so on.Results : The incidence of headache was 75% in this cohort. The proportion of female patients in the headache group was higher than that in the non-headache group. Patients in the headache group were younger than those without headache. CVT patients of headache group showed higher LR, BUN, and (ICP)compared to the non-headache group, whereas MCV and levels of protein (CSF) and LDH (CSF) were lower in headache patients. The data also revealed younger age and the increased level of chloride ion CL - (CSF) were the risk factors for the occurrence of headache in CVT patients.Conclusions: The age, LR, MCV, BUN levels, ICP, protein (CSF), and LDH (CSF) in patients with headache were significantly different from those in the non-headache group at admission. Younger age and a level of CL - (CSF) were risk factors for headache in CVT patients. These findings may provide guidance for clinical diagnosis and treatment of CVT.
The Prevalence and Causes of Visual Impairment among Children in Kenya – The Kenya Eye Study
Authors: Muma Shadrack , Obonyo Stephen
Published: July 2020

BackgroundVisual impairment impacts negatively on quality of life. Kenya has a total fertility rate of 3.5 an indication of more younger generation. However, little is known on the prevalence and causes of visual impairment in the children population of Kenya.MethodsThis cross-sectional population-based study included 3400 (1800, 52.9% female) randomly selected children with a mean age of 12 ± 2 years (range 5–16 years) in Kenya. Visual acuity was taken using snellens chart at 6 meters. Anterior and posterior segments were assessed using slit lamp and indirect ophthalmoscope. The World Health Organization formed the baseline for calculating prevalence of visual impairment.ResultsVisual acuity measurements were available for 3240 (95.3%) participants. The prevalence of visual impairment, based on pin-hole value, using World Health Organization, was 1.7 ± 0.3%. The prevalence of visual impairment, based on presenting visual acuity value, was 2.4 ± 0.7%, using the World Health Organization definition. Multivariate analysis demonstrated that the presence of visual impairment on pin-hole, according to World Health Organization definition increased significantly with increasing age (odds ratio 1.230, P = .021) and increased astigmatism (odds ratio 0.834, P = .032), but not significantly associated with socioeconomic, ocular conditions after adjusting for age and astigmatism. Lack of refractive error correction was the most common reason for presenting visual impairment. Causes of visual impairment due to presenting visual acuity were amblyopia (24%), nystagmus (14%), myopia (49%) and hyperopia (13%).ConclusionThe prevalence of visual impairment in Kenya increased significantly with socio-economic activities. Uncorrected refractive error remains the major causes of visual impairment.
Development of A Three-Gene Signature Prediction Model for Lymph Node Metastasis in Papillary Thyroid Cancer
Authors: Huang Ziwei , Liu Yuenan , Le Kehao , Xu Ming , Li Wenhui , Zhao Qiuyang , Zhou Jun , Jiang Yujia , Yang Wen , Yang Li , Yi Pengfei
Published: July 2020

Background: Thyroid cancer is one of the most prevalent endocrine cancers with a rising incidence rate over the past years. Papillary thyroid cancer (PTC) is the dominant historical type of thyroid cancer. Early lymph node metastasis happens frequently in PTC. However, some of the lymph node metastasis may be troublesome for detecting because of limited methods.Methods: Robust rank aggregation afforded us the shared differential expression genes among multiple datasets. Gene ontology analysis was performed to identify potential functions. Weighted gene co-expression network analysis was used to research the correlations between gene expression patterns with clinical characteristic. Protein-protein interaction network was performed to identify the hub genes. The least absolute shrinkage and selection operator and Logistic regression were performed to construct a prediction model.Results: We developed a three-gene signature prediction model for lymph node metastasis in PTC through transcriptomic analysis. After quality control, we collected 8 microarray datasets from GEO database and an RNA sequencing dataset from TCGA database. We found the transcriptome profiles were correlated with lymph node metastasis and 3 genes were verified to be independent prediction factors towards those statistic approach. Afterwards, we designed a predicable risk score system and effectively confirmed the model in two independent papillary thyroid cancer cohorts.Conclusions: We recommended a successful predicable model of lymph node metastasis in papillary thyroid cancer patients with moderate accuracy.
Association Between Mean Arterial Pressure and Survival in Patients Admitted to the Intensive Care Unit After Cardiac Arrest With Vasopressor Support: A Retrospective Study
Authors: Li Zhimin , Zhou Dawei , Zhang Shaolan , Wu Lei , Shi Guangzhi
Published: July 2020

BackgroundMortality among patients admitted to the intensive care unit (ICU) after cardiac arrest (CA) is high. Hemodynamic management in the phase of post-resuscitation is recommended by international guidelines, but the optimal mean arterial pressure (MAP) range is still unclear. The main objective of this study is to investigate the association between time spent in different MAP and ICU mortality in PCA patients admitted to ICU with vasopressor support. MethodsIt was a retrospective, observational study in cardiac arrest patients admitted to the ICU with vasopressor support during the first 24 hours. The main exposure was time spent in MAP. The primary outcome was ICU mortality. Associations between time spent in MAP and ICU mortality were evaluated using ten MAP thresholds: 100, 95, 90, 85, 80, 75, 70, 65, 60, and 55 mmHg. Multivariable logistic regression analyses were used to test the association between time spent in different MAP categories and ICU mortality. Results The study included 1018 eligible subjects in ICUs from 156 hospitals, of which 453 (44%) patients died during hospitalization and 208 (37%) patients discharged home. A significant association was found between time spent in MAP and the ICU mortality when MAP thresholds of ≤55mmHg (OR 1.25, 95% CI 1.09-1. 45, p = 0.002) and ≤60 mmHg (OR 1.13, 95% CI 1.02-1.24, p = 0.014) were used. Thresholds of MAP ≥ 65 mmHg were not associated with mortality. The percentage of time spent in MAP of ≤90mmHg (OR 1.09, 95% CI 1.01-1.18), ≤ 95mmHg (OR 1.12, 95% CI 1.01-1.24,) and ≤100mmHg (OR 1.19, 95% CI 1.04-1.38) were associated with a higher odds ratio for discharged home outcome, suggesting that MAP of ≥90mmHg, ≥95mmHg and ≥100mmHg were associated with lower probability of discharged home. ConclusionsThese results imply that for post-cardiac arrest patients with vasopressor support, time spent in MAP of ≤60mmHg or less was associated with higher ICU mortality and MAP of ≥90 mmHg or more was associated with a lower probability for discharged home.
Vitamin D deficiency as a predictor of poor prognosis in patients with acute respiratory failure due to COVID-19
Authors: Carpagnano Giovanna Elisiana , Lecce Valentina Di , Quaranta Vitaliano Nicola , Zito Annapaola , Buonamico Enrico , Capozza Elena , Palumbo Alessandro , Gioia Giuseppe Di , Valerio Vincenzo Nicola , Resta Onofrio
Published: July 2020

Purpose: Hypovitaminosis D is a highly spread condition correlated with increased risk of respiratory tract infections. Nowadays, the world is in the grip of the Coronavirus disease 19 (COVID 19) pandemic. In these patients, cytokine storm is associated with disease severity. In consideration of the role of vitamin D in the immune system, aim of this study was to analyse vitamin D levels in patients with acute respiratory failure due to COVID-19 and to assess any correlations with disease severity and prognosis. Methods: In this retrospective, observational study, we analysed demographic, clinical and laboratory data of 42 patients with acute respiratory failure due to COVID-19, treated in Respiratory Intermediate Care Unit (RICU) of the Policlinic of Bari from March, 11 to April 30, 2020. Results: Eighty one percent of patients had hypovitaminosis D. Based on vitamin D levels, the population was stratified into four groups: no hypovitaminosis D, insufficiency, moderate deficiency, and severe deficiency. No differences regarding demographic and clinical characteristics were found. A survival analysis highlighted that, after 10 days of hospitalization, severe vitamin D deficiency patients had a 50% mortality probability, while those with vitamin D ≥10 had a 5% mortality risk (p=0.019). Conclusions: High prevalence of hypovitaminosis D was found in COVID-19 patients with acute respiratory failure, treated in a RICU. Patients with severe vitamin D deficiency had a significantly higher mortality risk. Severe vitamin D deficiency may be a marker of poor prognosis in these patients, suggesting that adjunctive treatment might improve disease outcomes.
Modelling COVID-19 cases in Nigeria: Forecasts, uncertainties, projections and the link with weather
Authors: O.E. Adeyeri , K.S.A. Oyekan , S.O. Ige , A. Akinbobola , E.C. Okogbue
Published: July 2020

The World Health Organization (WHO) declared COVID-19 a global pandemic on 11 March 2020 due to its global spread. In Nigeria, the first case was documented on 27 February 2020. Since then, it has spread to most parts of the country. This study models, forecasts and projects COVID-19 incidence, cumulative incidence and death cases in Nigeria using six estimation methods i.e. the attack rate, maximum likelihood, exponential growth, Markov chain monte Carlo (MCMC), time-dependent and the sequential Bayesian approaches. A sensitivity analysis with respect to the mean generation time is used to quantify the associated reproduction number uncertainties. The relationship between the COVID-19 incidence and five meteorological variables are further assessed. The result shows that the highest incidences are recorded in days with either religious activities or market days while the weekday trend decreases towards the weekend. It is also established that COVID-19 incidence significantly increases with increasing sea level pressure (0.7 correlation coefficient) and significantly decreases with increasing maximum temperature (-0.3 correlation coefficient). Also, selecting an optimal period for reproduction number estimates reduces the variability between estimates. As an example, in the EG approach, the epidemic curve that optimally fits the exponential growth is between 1- and 53-time units with reproduction number estimate of 1.60 [1.58; 1.62] at 95% confidence interval. However, this optimal reproduction number estimate is different from the default reproduction number estimate. Using the MCMC approach, the correlation coefficients between the observed and forecasted incidence, cumulative death and cumulative confirmed cases are 0.66, 0.92 and 0.90 respectively. The projections till December shows values approaching 1,000,000, 120,000 and 3,000,000 respectively. Therefore, timely intervention and effective preventive measures are immediately needed to mitigate a full-scale epidemic in the country.
Purification and heterologous expression of a novel antifungal protein from Bacillus subtilis strain Z-14
Authors: Zhang Xuechao , Guo Xiaojun , Wu Cuihong , Li Chengcui , Zhang Dongdong , Zhu Baocheng
Published: July 2020

Background: Wheat sheath blight, a soil borne fungal disease caused by Rhizoctonia cerealis, is considered as one of the most serious threats to wheat worldwide. Bacillus subtilis Z-14 was isolated from soil sampled from a wheat rhizosphere and has been confirmed to have strong antifungal activity against R. cerealis. Results: An antifungal protein, termed F2, was isolated from the culture supernatant of Z-14 strain using precipitation with ammonium sulfate, anion exchange chromatography, and reverse phase chromatography. Purified F2 had a molecular mass of approximately 9 kDa, as assessed using sodium dodecyl sulfate polyacrylamide gel electrophoresis. Edman degradation was used to determine the amino acid sequence of the N-terminus, which was NH2-ASGGTVGIYGANMRS. This sequence is identical to a hypothetical protein RBAM_004680 (YP_001420098.1) synthesized by B. amyloliquefaciens FZB42. The recombinant F2 protein (rF2) was heterologously expressed in the yeast host Pichia pastoris, purified using Ni‑affinity column, and demonstrated significant antifungal activity against R. cerealis. The purified rF2 was thermostable, retaining 91.5% of its activity when incubated for 30 min at 100 °C. rF2 maintained its activity under treatment by proteinase K and trypsin.Conclusions: A novel antifungal protein F2 was purified from biocontrol Bacillus subtilis Z-14 strain fermentation supernatant and heterologously expressed in Pichia pastoris to certificate the antifungal activity against R. cerealis and the validity of gene sequence of protein F2. Considering its significant antifungal activity and stable characteristics, protein F2 presents an alternative compound to deal with fungal infections caused by R. cerealis.
Confocal laser endomicroscopy under propofol-based sedation for early gastric cancer and pre-cancerous lesions is associated with better diagnosing accuracy: a retrospective cohort study in China
Authors: Chu Lihua , Zhao Jialian , Sheng Cheng , Yue Min , Wang Feifei , Song Shengwen , Fang Xiangming , Cheng Baoli , Xie Guohao
Published: July 2020

Background: Confocal laser endomicroscopy (CLE) has advantages in detecting gastric neoplastic lesions, meanwhile it requires strict patient cooperation. Sedation could improve patient cooperation and quality of endoscopy. However, sedation is still not very popular in some resource-limited countries and regions. The purpose of this study was to compare propofol-based sedated versus un-sedated CLE in the value of diagnosing early gastric cancer (EGC) and precancerous lesions.Methods: A retrospective, cohort, single center study of 226 patients who underwent CLE between January 1, 2015 and December 31, 2017 was performed.Patients enrolled were allocated into propofol-based sedated group (n=126) and un-sedated group (n=100). The comparison of validity and reliability of CLE for identifying EGC and precancerous lesions between the two groups was performed through analyzing CLE diagnose and pathological diagnose. Results: The area under receiver operating characteristic curve (AUROC) of diagnosing EGC in sedated group was 0.97 (95% CI: 0.95 to 0.99), which was higher than that in un-sedated group (0.88 (95% CI: 0.80 to 0.97), P =0.0407). CLE with sedation performed better than without sedation in diagnosing intraepithelial neoplasia and intestinal metaplasia (P =0.0008 and P =0.0084, respectively). For patients considered as high-grade intraepithelial neoplasia or EGC by endoscopists, they would not get biopsy during CLE but receive ESD subsequently, and the misdiagnosis rate of CLE was 0 in sedated group and 27.59% in un-sedated group (P =0.006).Conclusion: Propofol based sedation was associated with improved diagnostic value of CLE for detecting EGC as well as precancerous lesions.
High Dust Mite specific Immunoglobulin E (sIgE): a Promising Indicator of Allergic Rhinitis to Asthma
Authors: Tang Rui , Lyu Xiaohong , Zhang Yuelun , Chen Shi , Li Hong
Published: July 2020

Background: House dust mites are the most prevalent allergens in patients with asthma and/or rhinitis in China. Cross-sectional data in 2009 have shown that allergic rhinitis often preceded or occurred at the same time as asthma in patients which was used to investigate the association of serum specific immunoglobulin E (sIgE) levels to house dust mite with the onset of asthma in patients with allergic rhinitis. Methods: 321 patients with allergic rhinitis were face-to-face interviewed and underwent sIgE tests to house dust mite. The temporal sequence of allergic rhinitis and asthma was documented. Univariate analysis, multinomial logistic regression, and Kaplan-Meier survival analysis were performed. Results: Of the 321 participants, 213 (66.4%) had asthma, which occurred after or simultaneously with rhinitis, and 108 (33.6%) suffered from allergic rhinitis only. After controlling basic parameters, factors correlated to sIgE, and essential factors considered by clinical allergists, the risk of developing asthma always increased with the levels of sIgE to house dust mite in all four models (p < 0.01). In Kaplan–Meier analysis, in the first ten years with allergy rhinitis, a high sIgE level represented a high probability of the coexistence of allergic rhinitis and asthma (p < 0.01). For house dust mite sIgE level 5-6, 5 years Rhinitis-Asthma Conversion Rate (RACR) had reached almost 70%. Conclusion: High-level house dust mite sIgE can exist as an indicator of rhinitis to asthma. It provides a theoretical basis for early intervention in patients with high sIgE levels in order to prevent asthma. This assessment and intervention should be performed at the early stage of rhinitis.
Prevalence Of Glycaemic Variability (GV) And Factors Associated With The Glycaemic Arrays Among End-Stage Kidney Disease (ESKD) Patients On Chronic Haemodialysis.
Authors: Khan Abdul Hanif Khan Yusof , Zakaria Nor Fadhlina , Abidin Muhammad Adil Zainal , Kamaruddin Nor Azmi
Published: July 2020

Introduction: Glycaemic variability (GV) or glycaemic fluctuations carries a significant higher risk of diabetic-related complications, especially cardiovascular. Extensive researches have been reported, but study on the end-stage-kidney-disease (ESKD) patients on chronic haemodialysis are scarce. This study aims to determine the magnitude of GV among ESKD (diabetic vs non-diabetic) patients and its associated factors during haemodialysis day (HDD) and non-haemodialysis day (NHDD). Methods: We recruited 150 patients on haemodialysis, 93 patients had diabetic (DM-ESKD), and 57 non-diabetic (NDM-ESKD). The GV indices (standard deviation [SD] and percentage co-efficient variant [%CV]) were obtained from 11-point and 7-point self-monitoring blood glucose (SMBG) profiles during haemodialysis and non-haemodialysis day. The GV indices and its associated factors were analysed comparing between both groups during the HDD and NHDD. Results: Mean blood glucose during HDD was 9.33 [SD 2.7, %CV 30.6%] mmol/L in DM-ESKD compared to 6.07 [SD 0.85, %CV 21.3%] mmol/L in NDM-ESKD (p =<0.01). The DM-ESKD group experienced significantly higher GV indices compared to NDM-ESKD; both during haemodialysis and non-haemodialysis day, particularly in the group with HbA1c 8-10% (p= <0.01). Presence of diabetes, older age group, hyperlipidaemia, HbA1c, ferritin levels, and albumin were recognised as factors associated with GV. Conclusion: DM-ESKD patients has high glycaemic variability, especially during the haemodialysis day, therefore increasing their chance to develop future devastating complications. We identified high HbA1c, older age group, presence of hyperlipidaemia, ferritin levels, and albumin as factors associated with GV. Since these groups of patients are vulnerable to CVD mortality, urgent attention is needed to rectify it.