bluuebunny/crossref_metadata_2025 huggingface dataset:
The changes of corneal biomechanical properties with long-term treatment of prostaglandin analogue measured by Corvis ST
Authors: Wu Na , Chen Yuhong , Yang Yaping , Sun Xinghuai
Published: October 2020

Background: To investigate the corneal biomechanical changes in primary open angle glaucoma (POAG) patients treated with long-term prostaglandin analogue (PGA). Methods: 111 newly diagnosed POAG patients, including 43 high tension glaucoma (HTG) and 68 normal tension glaucoma (NTG), were measured by Corvis ST to obtain intraocular pressure (IOP), central corneal thickness (CCT) and corneal biomechanical parameters at baseline and at each follow-up visit after initiation of PGA treatment. The follow-up measurements were analyzed by the generalized estimate equation model with an exchangeable correlation structure. Restricted cubic spline was employed to estimate the dose-response relation between follow-up time and corneal biomechanics．Results: The mean follow-up time was 10.3 ± 7.02 months. Deformation amplitude (β=-0.0015, P=0.016), the first applanation velocity (AV1, β=-0.0004, P=0.00058) decreased and the first applanation time (AT1, β=0.0089, P<0.000001) increased statistically significantly with PGA therapy over time after adjusting for age, gender, axial length, corneal curvature, IOP and CCT. In addition, AT1 was lower (7.2950 ± 0.2707 in NTG and 7.5889 ± 0.2873 in HTG, P=0.00011) and AV1 was greater (0.1478 ± 0.0187 in NTG and 0.1314 ± 0.0191 in HTG, P=0.00002) in NTG than in HTG after adjusting for confounding factors.Conclusions: Chronic use of PGA probably influences the corneal biomechanical properties directly, which is to make cornea less deformable. Besides, corneas in NTG tended to be more deformable compared to those in HTG with long-term treatment of PGA.
Risk factors and clinical features of deterioration in COVID-19 patients in Zhejiang, China: a single- centre, retrospective study
Authors: Yi Ping , Yang Xiang , Ding Cheng , Chen Yanfei , Xu Kaijin , Ni Qing , Zhao Hong , Li Yongtao , Zhang Xuan , Liu Jun , Sheng Jifang , Li Lanjuan
Published: October 2020

Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection swept through Wuhan and spread across China and overseas beginning in December 2019. To identify predictors associated with disease progression, we evaluated clinical risk factors for exacerbation of SARS-CoV-2 infection. Methods A retrospective analysis was used for PCR-confirmed COVID-19 (coronavirus disease 2019)-diagnosed hospitalized cases between January 19, 2020, and February 19, 2020, in Zhejiang, China. We systematically analysed the clinical characteristics of the patients and predictors of clinical deterioration.Results One hundred patients with COVID-19, with a median age of 54 years, were included. Among them, 49 patients (49%) had severe and critical disease. Age ([36-58] vs [51-70], P=0.0001); sex (49% vs 77.6%, P=0.0031); BMI ([21.53-25.51] vs [23.28-27.01], P=0.0339); hypertension (17.6% vs 57.1%, P<0.0001); IL-6 ([6.42-30.46] vs [16.2-81.71], P=0.0001); IL-10 ([2.16-5.82] vs [4.35-9.63], P<0.0001); T lymphocyte count ([305- 1178] vs [167.5-440], P=0.0001); B lymphocyte count ([91-213] vs [54.5-163.5], P=0.0001); white blood cell count ([3.9-7.6] vs [5.5-13.6], P=0.0002); D2 dimer ([172-836] vs [408-953], P=0.005), PCT ([0.03-0.07] vs [0.04-0.15], P=0.0039); CRP ([3.8-27.9] vs [17.3-58.9], P<0.0001); AST ([16, 29] vs [18, 42], P=0.0484); artificial liver therapy (2% vs 16.3%, P=0.0148); and glucocorticoid therapy (64.7% vs 98%, P<0.0001) were associated with the severity of the disease. Age and weight were independent risk factors for disease severity. Conclusion Deterioration among COVID-19-infected patients occurred rapidly after hospital admission. In our cohort, we found that multiple factors were associated with the severity of COVID19. Early detection and monitoring of these indicators may reduce the progression of the disease. Removing these factors may halt the progression of the disease. In addition, Oxygen support, early treatment with low doses of glucocorticoids and liver therapy, when necessary, may help reduce mortality in critically ill patients.
Challenges to effective governance in a low income healthcare system: a qualitative study of stakeholder perceptions in Malawi
Authors: Masefield Sarah C , Msosa Alan , Grugel Jean
Published: October 2020

BackgroundAll countries face challenging decisions about healthcare coverage. Malawi has committed to achieving Universal Health Coverage (UHC) by 2030, the timeframe set out by the Sustainable Development Goals (SDGs). As in other low income countries, scarce resources stand in the way of more equitable health access and quality in Malawi. Its health sector is highly dependent on donor contributions, and recent poor governance of government-funded healthcare saw donors withdraw funding, limiting services and resources. The 2017 National Health Plan II and accompanying Health Strategic Plan II identify the importance of improved governance and strategies to achieve more effective cooperation with stakeholders. This study explores health sector stakeholders’ perceptions of the challenges to improving governance in Malawi’s national health system within the post-2017 context of government attempts to articulate a way forward.MethodsA qualitative study design was used. Interviews were conducted with 22 representatives of major international and faith-based non-government organisations, civil society organisations, local government and government-funded organisations, and governance bodies operating in Malawi. Open questions were asked about experiences and perceptions of the functioning of the health system and healthcare decision-making. Content relating to healthcare governance was identified in the transcripts and field notes and analysed using inductive content analysis.ResultsStakeholders view governance challenges as a significant barrier to achieving a more effective and equitable health system. Three categories were identified: accountability (enforceability; answerability; stakeholder-led initiatives); health resource management (healthcare financing; drug supply); influence in decision-making (unequal power; stakeholder engagement).ConclusionsHealth sector stakeholders see serious political, structural, and financial challenges to improving governance in the national health system in Malawi which will impact the government’s goal of achieving UHC by 2030. Stakeholders identify the need for improved oversight, implementation, service delivery and social accountability of government-funded service providers to communities. Eighteen months after the introduction of the policy documents, they see little evidence of improved governance and have little or no confidence in the government’s ability to deliver UHC. The difficulties stakeholders perceive in relation to building equitable and effective healthcare governance in Malawi have relevance for other resource-limited countries which have also committed to the goal of UHC.
“Having more women humanitarian leaders will help transform the humanitarian system”: Challenges and Opportunities for Women Leaders in Conflict and Humanitarian Health
Authors: Patel Preeti , Meagher Kristen , Achi Nassim El , Ekzayez Abdulkarim , Sullivan Richard , Bowsher Gemma
Published: October 2020

Background: It is estimated that over 40 percent of the half a million humanitarian workers who provide frontline care during emergencies, wars and disasters, are women. Women are at the forefront of improving health for conflict-affected populations through service delivery, education and capacity strengthening, advocacy and research. Women are also disproportionately affected by conflict and humanitarian emergencies. The growing evidence base demonstrating excess female morbidity and mortality reflects the necessity of evaluating the role of women in leadership driving health research, policy and programmatic interventions in conflict-related humanitarian contexts. Despite global commitments to improving gender equality, the issue of women leaders in conflict and humanitarian health has been given little or no attention. The aim of this paper focuses on three domains: importance, barriers and opportunities for women leaders in conflict and humanitarian health. Following thematic analysis of the material collected, we discuss the following themes: barriers of women’s leadership domain at societal level, and organisational level, which is subcategorized into culture and strategy. Building on the available opportunities and initiatives and on inspirational experiences of the limited number of women leaders in this field, recommendations for empowering and supporting women’s leadership in conflict health are presented. Methods: A desk-based literature review of academic and grey sources was conducted followed by thematic analysis. Results: There is very limited evidence on women leaders in conflict and humanitarian health. Some data shows that women have leadership skills that help to support more inclusive solutions which are incredibly important in this sector. However, deeply imbedded discrimination against women at the organisational, cultural, social, financial and political levels is exacerbated in conflict which makes it more challenging for women to progress in such settings. Conclusion: Advocating for women leaders in conflict and health in the humanitarian sector, governmental bodies, academia and the global health community is crucial to increasing effective interventions that adequately address the complexity and diversity of humanitarian crises.
Consistency between Optical Coherence Tomography and Humphrey Visual Field for Evaluating Glaucomatous Defects in High Myopic Eyes
Authors: Wen Wen , Zhang Yuqiu , Zhang Ting , Sun Xinghuai
Published: October 2020

Background. The study is to investigate the influence of high myopia on the consistency between optical coherence tomography (OCT) and visual field in primary open-angle glaucoma (POAG).Methods. We enrolled 37 patients with POAG with high myopia (POAG-HM group), 27 patients with POAG without high myopia (POAG group), and 29 controls with high myopia (HM group). All subjects underwent Humphrey perimetry (30-2 and 10-2 algorithms). The peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell-inner plexiform layer (GCIPL) thicknesses were measured using Cirrus HD-OCT. Spearman’s rank correlation analysis was used to determine correlations between OCT and perimetric parameters. Agreement was analyzed by cross-classification and weighted κ statistics.Results. In POAG group, the cross-classification analysis showed strong agreement between the inferior temporal GCIPL thickness and the mean sensitivity (MS) of 10-2 algorithms (κ = 0.5447, P = 0.0048), and good agreement between the superior and inferior RNFL thicknesses and 30-2 MS (κ = 0.4407 and 0.4815; P < 0.05). In the POAG-HM group, only the inferior temporal GCIPL thickness showed good agreement with 10-2 MS (κ = 0.3155, P = 0.0289) and none of the RNFL sectors were in good agreement with the corresponding MS.Conclusions. In POAG patients with high myopia, changes in macular measurements were in accordance with visual field defects, and RNFL thickness did not consistently decline with visual field defects due to the effects of high myopia. This study suggests that during diagnosis and follow-up of glaucoma with high myopia, more attention need to be focused on structure and functional defects in macular areas.
Readability of Online COVID-19 Health Information: A Comparison between Four English Speaking Countries
Authors: Worrall Amy P , Connolly Mary J , O'Neill Aine , O'Doherty Murray , Thornton Kenneth P , McNally Cora , McConkey Samuel J , de Barra Eoghan
Published: October 2020

Background: The internet is now the first line source of health information for many people worldwide. In the current Coronavirus Disease 2019 (COVID-19) global pandemic, health information is being produced, revised, updated and disseminated at an increasingly rapid rate. The general public are faced with a plethora of misinformation regarding COVID-19 and the readability of online information has an impact on their understanding of the disease. The accessibility of online healthcare information relating to COVID-19 is unknown. We sought to evaluate the readability of online information relating to COVID-19 in four English speaking regions: Ireland, the United Kingdom, Canada and the United States, and compare readability of website source provenance and regional origin.Methods: The Google® search engine was used to collate the first twenty webpage URLs for three individual searches for ‘COVID’, ‘COVID-19’, and ‘coronavirus’ from Ireland, the United Kingdom, Canada and the United States. The Gunning Fog Index (GFI), Flesch-Kincaid Grade (FKG) Score, Flesch Reading Ease Score (FRES), Simple Measure of Gobbledygook (SMOG) score were calculated to assess the readability. Results: There were poor levels of readability webpages reviewed, with only 17.2% of webpages at a universally readable level. There was a significant difference in readability between the different webpages based on their information source (p <0.01). Public Health organisations and Government organisations provided the most readable COVID-19 material, while digital media sources were significantly less readable. There were no significant differences in readability between regions. Conclusion: Much of the general public have relied on online information during the pandemic. Information on COVID-19 should be made more readable, and those writing webpages and information tools should ensure universal accessibility is considered in their production. Governments and healthcare practitioners should have an awareness of the online sources of information available, and ensure that readability of our own productions is at a universally readable level which will increase understanding and adherence to health guidelines.
Characterization and validation of long noncoding RNAs as new candidates in prostate cancer
Authors: Ge Shengyang , Mi Yuanyuan , Zhao Xiaojun , Hu Qingfeng , Guo Yijun , Zhong Fan , Zhang Yang , Xia Guowei , Sun Chuanyu
Published: October 2020

Background: Long noncoding RNAs (lncRNAs) have been proved to be an important regulator in gene expression. In almost all kinds of cancers, lncRNAs participated in the process of pathogenesis, invasion, and metastasis. Meanwhile, compared with the large amounts of patients, there is rare knowledge about the role of lncRNAs in prostate cancer (PCa). Material/Method: In this study, lncRNA expression profiles of prostate cancer were detected by Agilent microarray chip, 5 pairs of case and control specimens were involved in. Differentially expressed lncRNAs were screened out by volcano plot for constructing lncRNA-miRNA-mRNA central network. Then, the top ten up-regulated and down-regulated lncRNAs were validated by qRT-PCR in another 5 tumor specimens and 7 para-cancerous/benign contrasts. Furthermore, we searched for the survival curve of the top 10 upregulated and downregulated lncRNAs. Results: A total of 817 differentially expressed lncRNAs were filtered out by the criteria of fold change (FC) and t-test p < 0.05. Among them, 422 were upregulated, whereas 395 were downregulated in PCa tissues. Gene ontology and KEGG pathway analyses showed that many lncRNAs were implicated in carcinogenesis. lnc-MYL2-4:1 (FC = 0.00141, p = 0.01909) and NR_125857 (FC = 59.27658, p = 0.00128) had the highest magnitude of change. The subsequent qPCR confirmed the expression of NR_125857 was in accordance with the clinical samples. High expression of PCA3, PCAT14 and AP001610.9 led to high hazard ratio while low expression of RP11-279F6.2 led to high hazard ratio. Conclusions: Our study detected a relatively novel complicated map of lncRNAs in PCa, which may have the potential to investigate for diagnosis, treatment and follow-up in PCa. Our study revealed the expression of NR_125857 in human PCa tissues was most up-regulated. Further studies are needed to investigate to figure out the mechanisms in PCa.
Limited access to family-based addiction prevention services for socio-economically deprived families in Switzerland: a grounded theory study
Authors: Pfister Andreas , Koschmieder Nikola , Wyss Sabrina
Published: October 2020

Background: Families living in poor socio-economic circumstances, already confronted with social and health inequalities, are often not reached by family-based addiction prevention services. Besides quantitative models and health literacy approaches, qualitative research is lacking that could shed light on the exact circumstances and processes that lead to hindered addiction prevention service uptake by these families. Drawing on the concept of candidacy, we therefore reconstructed how socio-economically deprived parents and their (pre)adolescent children in the German-speaking part of Switzerland (non-)identified their candidacy for family-based addiction prevention services.Methods: Following grounded theory, we collected and analysed data in an iterative-cyclical manner using theoretical sampling and theoretical coding techniques. Sixteen families with children aged 10–14 years were interviewed in depth (parent/s and child separately). All but one family lived below the at-risk-of-poverty threshold.Results: Socio-economically deprived families’ modes of recognizing and handling problems in everyday life were found to be core phenomena that structure the process towards (non)identification of candidacy for family-based addiction prevention services. Four modes anchored within socio-demographic resources were found: Families with mode A perceived their current life situation as existentially threatening and focused daily coping on the main pressing problem. Others (mode B) perceived prevalent multiple problems as normal (now); problems were normalized, often not recognized as such. In mode C families, problems were pragmatically recognized at a low threshold and pragmatically dealt with, mostly within the family. In mode D families, problems were constantly produced and dealt with early by the worried and anxious parents monitoring their child. From modes D to A, vulnerability increased concerning non-identification of candidacy for family-based addiction prevention services. Further, thematic relevance of addiction prevention, past experience with offers, integration in systems of assistance, strategies to protect the family, and families’ search for information influenced whether identification of candidacy took place.Conclusions: Socio-economically deprived families differ in modes of problem construction and handling in everyday life; this differently opens up or closes routes to family-based addiction prevention. Addiction prevention practice should build on a bundle of diverse strategies for outreach to these families, stressing especially interventions on the structural and environmental level.
Effect of lentivirus-mediated growth and differentiation factor-5 transfection on differentiation of rabbit nucleus pulposus mesenchymal stem cells
Authors: Zhu Kun , Zhao Rui , Ye Yuchen , Xu Gang , Zhang Changchun
Published: October 2020

Background：Intervertebral disc degeneration (IDD) is a natural progression of age-related process. Degenerative disc disease (DDD) is a pathologic condition associated with IDD that has been one of the most common causes of chronic low back pain, which can have a severe impact on patients’ quality of life. The purpose of this study is to observe the biological and cytological characteristics of rabbit nucleus pulposus mesenchymal stem cells (NPMSCs), and to determine the effect of growth and differentiation factor-5 (GDF-5) on the differentiation of rabbit NPMSCs transducted with lentivirus vector.Methods: In vitro culture model of rabbit NPMSCs was established and NPMSCs were identified by flow cytometry (FCM) and quantitative real-time PCR (qRT-PCR). Subsequently, NPMSCs were randomly divided into three groups: the lentiviral vector carrying GDF-5 gene used to transfect NPMSCs was recorded as transfection group; the NPMSCs transfected with an ordinary lentiviral vector was recorded as control virus group; the NPMSCs alone was normal group. FCM, qRT-PCR and Western Blot (WB) were used to detect the change of NPMSCs.Results: The transfected NPMSCs by GDF-5 gene displayed elongated shape, the cell density decreased, and the positive rate of GDF-5 in the transfected group was significantly higher than that in the other two groups (P < 0.05). The mRNA expression of KRT8, KRT18, and KRT19 in the transfected group was significantly higher in comparison with the other two groups (P < 0.05), and the result of WB was consistent with that of qRT-PCR.Conclusions: GDF-5 can induce the differentiation of NPMSCs and repair degenerative intervertebral disc. Lentiviral vector carrying GDF-5 gene can be integrated into the chromosome genome of NPMSCs and promote differentiation of NPMSCs into nucleus pulposus cells (NPCs).
Optimization of energy consumption and analysis of the emission of greenhouse gases in the production of rice (Case study: Mazandaran province of Iran)
Authors: Vahedi Adel , Yousefi Zahra , Malvajerdi Ahmad Sharifi
Published: October 2020

The present study has been conducted to investigate the energy consumption pattern, the economic analysis of production and assessing the greenhouse gas emissions (GHG) resulting from the production of rice in the Mazandaran province. The input and output energies were calculated and energy indices were determined. The efficiency of the rice farms and the optimization of energy consumption were estimated by using data envelopment analysis (DEA) method and the amount of greenhouse gas emissions was determined after improving the consumption of inputs. Results showed, the total energies of consumed inputs and outputs for the production of paddy were calculated to be 91061.5 and 100967.95 MJ ha-1, respectively. The energy input of diesel fuel, machinery and chemical fertilizers were determined to be 41.27%, 19.63% and 19.58% of the total energy inputs, representing the most highly consumed energy inputs in the production of paddy.
A retrospective case series of Fournier’s gangrene: necrotizing fasciitis in perineum and perianal region
Authors: Zhang Nan , Yu Xin , Zhang Kai , Liu Tongjun
Published: October 2020

BackgroundTo describe the clinical characteristics and management for Fournier’s gangrene. Experience summary and literature references are provided for future treatment improvement.MethodsWe retrospectively reviewed the cases diagnosed with Fournier’s gangrene in our department from June 2016 to June 2019. Clinical data, including manifestation, diagnosis, treatment and outcomes for Fournier’s gangrene were presented.ResultsThere were 12 patients enrolled in this paper, with the average age of 60 years old. It showed a male predominance with male-to-female ratio of 6:1. The average of laboratory risk indicator for necrotizing fasciitis (LRINEC) score was 10.1. Diabetes mellitus was the main predisposing disease. 11 patients received emergency debridement and 1 patient died of sepsis on the 2nd day after admission. The mortality rate was 8.3%. 6 cases developed complications, including sepsis, pneumonia, renal and heart failure. Negative pressure wound therapy (NPWT) was applied in 10 cases, while the rest 1 received normal daily dressing changes because of fecal contamination. Flaps were utilized in 2 patients to cover the defect, including one with advancement flap and one with pudendal-thigh flap, while others received secondary suture, secondary healing, skin graft or combined management. No relapse was observed during the follow-up visits.ConclusionsFournier’s gangrene is a life-threatening infection that requires early diagnosis and surgery intervention. The predisposing disease, clinical manifestation and LRINEC score should be taken into comprehensive consideration, which is helpful for timely diagnosis. Moreover, further successful treatment depends on the aggressive debridement, broad-spectrum antibiotics therapy, wound management and closure choice.
Seasonal variation in climate and landcover niches of a migratory bird
Authors: Illan Javier Gutierrez , Wang Guiming , Cunningham Fred L , King D Tommy
Published: October 2020

Background: Resource utilization strategies of avian migrants are a major concern for conservation and management. Consequently, the ability to predict potential shifts in migratory species spatial use and migratory behaviour is a pressing challenge for predictive ecology under global changes. There are two main strategies of resource use adopted by migratory birds: niche tracking for similar environmental conditions and niche switching between different environmental conditions between seasons. Our objective was to examine whether the niche tracking/niche switching hypothesis would better explain seasonal variations in the ecological niche overlap of the American White Pelicans (AWPE, Pelecanus erythrorhynchos). We also tested whether recent changes in the non-breeding ground land-use have altered habitat selection and space use by AWPE. Methods: We used Dirichlet-multinomial models to detect differences in habitat selection between regions and over times with the GPS locations of 36 tracked AWPEs. We estimated climatic and land-cover niche overlap between the breeding and non-breeding grounds to test for niche switches between seasons using ordination methods. Results: Our habitat selection models did not detect shifts in habitat selection by AWPE after 2005. American white pelican strongly selected open water and wetland at the non-breeding and breeding grounds. American white pelicans showed little climatic niche overlap but substantial landscape niche overlap between breeding and non-breeding grounds.Conclusions: Declines in aquacultural acreage did not change AWPE habitat selection in the Northern Gulf of Mexico. Our results did not support the hypothesis that AWPE would be a climatic niche tracker. However, AWPE tracked its foraging habitats, exhibiting strong selection for open water and wetland at both the breeding and non-breeding grounds. Climatic niche switching suggests that AWPE may adapt to future climate changes.
Multivariate analysis of factors for failed continuous bladder irrigation in hemorrhagic cystitis patients after hematopoietic stem cell transplantation
Authors: Yang Wenbo , Du Yiqing , Qu Zhan , Bai Wenjun , Yu Luping , Zhang Xiaopeng , Wang Qi , Zhang Xiaowei , Li Qing , Xu Tao
Published: October 2020

Background: Continuous bladder irrigation (CBI) and proper adjustment of saline irrigation speed are important to avoid CBI failure in hemorrhagic cystitis (HC) patients after allogeneic hematopoietic stem cell transplantation (HSCT). Nevertheless, too fast irrigation speed could take away the patient's much heat, contribute to blood coagulopathy, and increase the nursing workload. Evaluation of risk for CBI failure remains an unmet clinical need.Methods: The general information, clinical characteristics, and consultation records of HC patients in 1380 patients with hematopoietic stem cell transplantation in our center from 2017 to 2019 were analyzed retrospectively. The receiver operating characteristic (ROC) curve was used to calculate the cutoff point of the continuous variable, and multivariate logistic regression was used to analyze the risk factors affecting CBI failure in HC patients.Results: The incidence of HC after HSCT was 23%. A total of 227 patients with HC above grade 2 were included. Univariate analysis showed that CRP, age, platelet counts, onset time after transplantation, albumin, and hemoglobin were associated with CBI failure in the short-term (P < 0.05). ROC curve and multivariate logistic regression analysis showed that CRP > 8.89 ng/ml (RR = 7.828, 95% CI 2.885-21.244), age < 14.5 years (RR = 9.940, 95% CI 3.219-30.697), and onset time of HC＞37d after transplantation (RR = 7.021, 95% CI 2.204-22.364), were independent risk factors for failure of CBI (P < 0.05).Conclusions: The study identified CRP > 8.89 ng/ml, age < 14.5 years, and onset time of HC after HSCT > 37d are independent factors for failure of CBI, which could be combined to allow stratification of HC after HSCT patients into low-, intermediate- and high-risk subgroups of CBI failure.
Resection of a retroperitoneal cancer of unknown primary site after chemoradiation therapy: a case report
Authors: Suetsugu Tomonari , Matsuhashi Nobuhisa , Tsuchiya Hiroshi , Takahashi Takao , Fukada Masahiro , Tanaka Hideharu , Iwata Yoshinori , Yasufuku Itaru , Sato Yuta , Imai Takeharu , Imai Hisashi , Tanaka Yoshihiro , Okumura Naoki , Yamaguchi Kazuya , Yoshida Kazuhiro
Published: October 2020

Background: Complete recovery from retroperitoneal squamous cell carcinoma of unknown primary site treated by multidisciplinary therapy is extremely rare.Case presentation: A 78-year-old man was referred to our hospital due to a mass measuring 8 cm in size in the left pelvic retroperitoneal area, which was diagnosed as a cancer of unknown primary site. The pathological type was squamous cell carcinoma. The left iliac artery/vein and ureter were involved in the tumor, and the tumor caused severe left leg pain. Although inflammation and symptoms were severe, radiotherapy was considered. After that, biweekly combined therapy with docetaxel, cisplatin, and fluorouracil was planned. After 5 courses of chemotherapy, the tumor diameter reduced from 11.6 cm to 4 cm in size. In addition, the border between the iliac vessels, urinary tract and tumor became apparent. The patient underwent radical resection of the tumor 8 months after the treatment started. The left ureter and the external/internal iliac artery were preserved, but the external iliac vein was sacrificed because of the possibility of tumor invasion. The postoperative course was free of complications, and the patient was discharged 10 days after the operation. The histopathological findings showed no residual viable tumor cells or foreign body-type giant cells with necrosis. The pathological effect of chemotherapy was defined as Grade 3 (pathological complete response). The patient has experienced no recurrence or distant metastasis for 4 years.Conclusions: Multidisciplinary therapy succeeded in treating a retroperitoneal squamous cell carcinoma of unknown primary site with preservation of organ function.
Reduced Metagenome Sequencing for strain-resolution taxonomic proles
Authors: Snipen Lars , Angell Inga-Leena , Rognes Torbjørn , Rudi Knut
Published: October 2020

Background: Studies of shifts in microbial community composition has many applications. For studies at species or subspecies levels, the 16S amplicon sequencing lacks resolution, and is often replaced by full shotgun sequencing. Due to higher costs, this restricts the number of samples sequenced. As an alternative to a full shotgun sequencing we have investigated the use of Reduced Metagenome Sequencing (RMS) to estimate the composition of a microbial community. This involves the use of double-digested restriction associated DNA sequencing, which means only a smaller fraction of the genomes are sequenced. The read sets obtained by this approach have properties different from both amplicon and shotgun data, and analysis pipelines for both can either not be used at all or do not explore the full potential of RMS data. Results: We suggest a procedure for analyzing such data, based on fragment clustering and the use of a constrained ordinary least square de-convolution for estimating the relative abundance of all community members. Mock-community data sets shows the potential to clearly separate between strains even when the 16S is 100% identical and genome-wide dierences is < 0:02, indicating RMS has a very high resolution. From a simulation study we compare RMS to shotgun sequencing and show that we get improved abundance estimates when the community has many very closely related genomes. From a real data set of infants guts we show that RMS is capable of detecting a strain-diversity gradient for Escherichia coli across time. Conclusion: We find that RMS is a good alternative to either metabarcoding or shotgun sequencing when it comes to resolving microbial communities at the strain-level. Like shotgun metagenomics, it requires a good database of reference genomes, and is well suited for studies of the human gut or other communities where many reference genomes exist. A data analysis pipeline is offered, as an R package at https://github.com/larssnip/microRMS. Keywords: metagenome; strains; ddRADseq
Identification of co-existence of Alport syndrome and C3 glomerulonephritis in a proband with family history 
Authors: ding yin , tang xuanli , du yuanyuan , chen hongyu , yu dongrong , zhu bin , yuan bohan
Published: October 2020

BackgroundAlport syndrome and C3 glomerulonephritis (C3GN) are rare kidney diseases, frequently responsible for familial haematuria, proteinuria, and renal impairment. With the rapid development of molecular genetic testing, Alport syndrome causes have been restricted mostly to variants in the COL4A5 or COL4A3/COL4A4 genes. Moreover, a broad range of genetic contributors in the complement and complement-regulating proteins are definitely implicated in the pathogenesis of C3GN.MethodsWe sought a family with persistent microscopic haematuria associated with renal failure. Clinicopathologic and follow-up data were obtained, and molecular genetic testing was used to screen for pathogenic variants. ResultsWe describe a three-generation family with Alport syndrome showing a dominant maternal inheritance. Notably, renal biopsy showed the concurrent histological evidence of C3GN in the proband harbouring an uncommon heterozygous variation in CFHR5, c.508G>A. The alteration leads to replacement of a highly conserved residue at position 170 of the β-strand subunit of CFHR5 (p.Val170Met). In silico analysis showed that the variation was predicted to deregulate complement activation by altering the structural properties and enhancing C3b binding capacity to compete with Complement Factor H (CFH), which was in line with experimental data previously published.ConclusionsThe comorbidity findings between Alport syndrome and C3GN indicate an underlying overlap and require further study.
Exogenous melatonin enhances salt secretion from salt glands by upregulating the expression of ion transporter and vesicle transport genes in Limonium bicolor
Authors: Li Junpeng , Yuan Fang , Liu Yanlu , Zhang Mingjing , Liu Yun , Zhao Yang , Wang Baoshan , Chen Min
Published: October 2020

Background: Salt stress inhibits plant growth and reduces yields. Melatonin is a pleiotropic molecule and can regulate plant growth and alleviate environmental stress in plants. Previous research has focused on the use of melatonin to improve the relatively low salt tolerance of glycophytes by promoting growth and enhancing antioxidant ability. It is unclear whether exogenous melatonin can increase the salt tolerance of halophytes, particularly recretohalophytes, by enhancing salt secretion from the salt glands. Results: We explored the effects of exogenous applications of melatonin on the secretion of salt from the salt glands of Limonium bicolor (a kind of recretohalophyte) seedlings and on the expression of associated genes. 5 μM exogenous melatonin significantly improved the growth of L. bicolor seedlings under 300 mM NaCl. Furthermore, exogenous melatonin significantly increased the dry weight and endogenous melatonin content of L. bicolor . In addition, this treatment reduced the content of Na + and Cl – in leaves, but increased the K + content. Both the salt secretion rate of the salt glands and the expression level of genes encoding ion transporters and vesicular transport proteins were significantly increased by exogenous melatonin treatment. These results indicate that melatonin improves the salt tolerance of the recretohalophyte L. bicolor via the upregulation of salt secretion by the salt glands. Conclusions: Our results showed that melatonin can upregulate the expression of genes encoding ion transporters and vesicle transport proteins to enhance salt secretion from the salt glands. Combining the results of the current study with previous research, we formulated a novel mechanism by which melatonin increases salt secretion in L. bicolor . Ions in mesophyll cells are transported to the salt glands through ion transporters located at the plasma membrane. After the ions enter the salt glands, they are transported to the collecting chamber adjacent to the secretory pore through vesicle transport and ions transporter and then are secreted from the secretory pore of salt glands, which maintain ionic homeostasis in the cells and alleviate NaCl-induced growth inhibition.
OKlahoma Nitrone-007: Novel Treatment for Diffuse Intrinsic Pontine Glioma
Authors: Thomas Lincy , Smith Nataliya , Saunders Debra , Zalles Michelle , Gulej Rafal , Lerner Megan , Fung Kar-Ming , Carcaboso Angel M. , Towner Rheal A.
Published: October 2020

Background: Diffuse intrinsic pontine glioma (DIPG) is the most common brainstem cancer in childhood. This rapidly progressing brainstem glioma holds a very dismal prognosis with median survival of less than 1 year. Despite extensive research, no significant therapeutic advancements have been made to improve overall survival in DIPG patients. Methods: Here, we used an orthotopic xenograft pediatric DIPG (HSJD-DIPG-007) mouse model to monitor the effects of anti-cancer agent, OKlahoma Nitrone-007 (OKN-007), as an inhibitor of tumor growth after 28 days of treatment. Using magnetic resonance imaging (MRI), we confirmed the previously described efficacy of LDN-193189, a known activin A receptor, type I (ACVR1) inhibitor, in decreasing tumor burden and found that OKN-007 was equally efficacious.Results: After 28 days of treatment, the tumor volumes were significantly decreased in OKN-007 treated mice (p<0.01). The apparent diffusion coefficient (ADC), as a measure of tissue structural alterations, was significantly decreased in OKN-007 treated tumor-bearing mice (p<0.0001). Histological analysis also showed a significant decrease in CD34 expression, essential for angiogenesis, of OKN-007 treated mice (p<0.05) compared to LDN-193189 treated mice. OKN-007-treated mice also significantly decreased protein expression of the human nuclear antigen (HNA) (p<0.001), ACVR1 (p<0.0001), and c-MET (p<0.05), as well as significantly increased expression of cleaved caspase 3 (p<0.001) and histone H3 K27-trimethylation (p<0.01), compared to untreated mouse tumors.Conclusions: With the dismal prognosis and limited effective chemotherapy available for DIPG, there is significant room for continued research studies, and OKN-007 merits further exploration as a therapeutic agent.
Berberine exhibits neuroprotective effects through inhibited autophagy and promoted microglial M1 transferred to M2 polarization
Authors: Lei Qiang , Hu Zhiping , Yang Binbin , Jiang Zheng , Zhou Fangfang
Published: October 2020

Background: Intracerebral haemorrhage (ICH) induces autophagy excessive activation and microglia mainly switched into proinflammatory M1 type, which can cause severe secondary injury. Current evidence has implied that berberine has a protective effect against ischaemic stroke through mediated autophagy and microglial polarization. However, the neuroprotective effect of berberine in intracerebral hemorrhage (ICH) remains unclear.Method: In this study the effect of berberine on rats model of intracerebral hemorrhage were investigated through Immunofluorescence, qPCR, ELISA, and western blot.Result: Berberine administration significantly reduces neurological deficits and the brain water content via inhibited autophagy, promoted M1 type microglia to M2 type, and subsequently exerts anti-inflammation effects in a rat model of ICH.Conclusion: These results suggest that berberine reduced secondary injury and improved neurological outcomes in ICH model.
Combined effects of intrinsic host gene (TRAPPC9) and extrinsic nutrient (folate) on resistance against S. aureus induced bovine mastitis
Authors: Mi Siyuan , Song Minyan , Dong Yichun , Zhang Zhichao , Fan Lijun , Shi Liangyu , Wang Xin , Shi Kerong , Yu Ying
Published: October 2020

Background: Drug-resistance and immunological escape of Staphylococcus aureus and its “superbug”, methicillin-resistant S. aureus (MRSA), have become one of main causes of bacterial infection in both human and animals. In dairy cattle, elimination of bovine mastitis induced by S. aureus is of importance because S. aureus-infected cows normally are culled passively. Methods: Here, we investigated the beneficial effects of bovine trafficking protein particle complex 9 (TRAPPC9) gene and folic acid supplementation in the control of mastitis induced by S. aureus or MRSA by a series of in vivo and in vitro experiments. Results: The data showed that the genetic mutations and DNA methylation of TRAPPC9 were highly linked with the mastitis resistance of dairy cows. Additionally, knockdown of bovine TRAPPC9 was significantly involved in the mRNA expression levels of interleukin’s genes (increased IL-1β and IL-6), and down-regulated the protein level of NF-κB-P65 in the mastitis cell model induced by MRSA. Meanwhile, dose-dependent folic acid addition can inhibit the invasion of MRSA into Mac-T cells and improve TRAPPC9 expression in dairy cows. Conclusions: Altogether, our data suggest that an appropriate dose of folic acid can significantly reduce the inflammation caused by MRSA partially through TRAPPC9 mediated NF-κB pathway. These findings provide new insights to control the drug-resistant pathogens and to restrict the overuse of antibiotics through combined effects of the intrinsic host gene and extrinsic nutrient.
Quasi-Equivalence of Width and Depth of Neural Networks
Authors: Fan Fenglei , Lai Rongjie , Wang Ge
Published: October 2020

While classic studies proved that wide networks allow universal approximation, recent research and successes
of deep learning demonstrate the power of the network depth. Based on a symmetric consideration,
we investigate if the design of artificial neural networks should have a directional preference, and what the
mechanism of interaction is between the width and depth of a network. We address this fundamental question
by establishing a quasi-equivalence between the width and depth of ReLU networks. Specifically, we formulate a
transformation from an arbitrary ReLU network to a wide network and a deep network for either regression
or classification so that an essentially same capability of the original network can be implemented. That is, a
deep regression/classification ReLU network has a wide equivalent, and vice versa, subject to an arbitrarily small
error. Interestingly, the quasi-equivalence between wide and deep classification ReLU networks is a data-driven
version of the DeMorgan law.
Source Identification and Variation in the Chemical Composition of Rainwater in Southern-Eastern Region of Bangladesh
Authors: Hossen Md. Arif , Hoque Asiful , Salauddin Md , Pal Sudip K. , Muktadir Mohammad G. , Jahan Hasin
Published: October 2020

The present study portrayed a better understanding of the chemical characteristics of rainwater in South-Eastern region of Bangladesh (e.g. Chattogram) as well as to identify the potential sources of different precipitation constituents in the study region that were often unexplored and not well understood. Rainwater pH, major ions, and trace metals were measured in samples collected from five different locations with different land use patterns of Chattogram Metropolitan area (CMA) during the two rainy seasons. The samples were tested following standard protocols. The results of this study exhibit variability in rainwater quality across the sites signifying site-specific influences. The mean concentration of all measured physicochemical parameters, ions and trace metals in rainwater samples were found significantly lower compared to the drinking water quality standard of Bangladesh. In context of ionic constituents, the higher concentrations of nitrate (NO3-) and sulphate (SO42-) were generally in commercial area. The correlation matrix and principal component analysis (PCA) indicated that NO3- and SO42- were from anthropogenic sources, e.g. automobile exhaust, incomplete fuel combustions, and industrial emissions. The average concentration of trace metals in rainwater was followed a decreasing order: Zn ˃ Cu ˃ Fe ˃ Cr ˃ Mn ˃ Pb ˃ Cd. Trace metals concentration, especially copper (Cu) and zinc (Zn) were found maximum in the industrial catchment area. The resulting outcomes of this study could be useful to investigate the influences of industrial, urban, and agricultural emissions that elaborate the physical processes regulating the chemical characteristic of the atmosphere in the investigated area.
Does Preoperative Balance Training Reduce Pain and Improve Joint Function in Patients After Total Knee Arthroplasty? A Randomized Controlled Trial
Authors: Chen Wang , Sun Jian-Ning , Hu Zheng-Hao , Chen Xiang-Yang , Feng Shuo
Published: October 2020

Background Part of patients undergoing TKA did not achieve the expected physiological function results. The purpose of this study was to investigate whether preoperative balance training can reduce pain and improve joint function after TKA.Methods 100 patients with knee osteoarthritis (OA) prepared for TKA, according to the inclusion and exclusion criteria, were randomly divided into balance training group (50 patients) and control group (50 patients). The main evaluation outcomes of the study included early functional milestones, ROM, WOMAC score, keen society score (KSS), KOOS score, and complications at 1 month (baseline) and 1 day before surgery, 6 weeks (main endpoint) and 52 weeks (1 year) after surgery.Results 4 patients lost to follow-up at 1 month before surgery, 96 received planned surgery and 86 underwent a complete postoperative evaluation. After TKA, many indicators of the two groups, including WOMAC score, KSS, KOOS score, were significantly improved compared with before surgery. At 52 weeks after TKA, no statistically significant difference between the balance training group and control group in attain early functional milestones, ROM, WOMAC score, KSS, KOOS score, and complications; however, at 6 weeks after surgery, balance training group had better early benefits in stopping all narcotics (P = 0.045), relieving pain (P = 0.037), improving function (P = 0.017) and quality of life (QOL) (P = 0.028).Conclusions Although there were no difference between preoperative balance training group and control group at the 52 weeks after surgery, however, preoperative balance training can relieve pain and improve function in the early stage (6 weeks), but adequately statistically powered trials are needed to confrm the accuracy of the study resultsTrial Registration ChiCTR2000032789.