bluuebunny/crossref_metadata_2025 huggingface dataset:
Hepatitis B, hepatitis C and HIV prevalence and related sexual and substance use risk practices among key populations who access HIV prevention, treatment and related services in South Africa: findings from a seven-city cross-sectional survey (2017)
Authors: Scheibe Andrew , Young Katherine , Versfeld Anna , Spearman C Wendy , Sonderup Mark , Prabdial-Sing Nishi , Puren Adrian , Hausler Harry
Published: July 2020

Background: People who use drugs including people who inject drugs (PWUD/ID), sex workers (SWs) and men who have sex with men (MSM) are at increased risk of HIV and viral hepatitis infection. Limited epidemiological data on the infections exists in key populations (KPs) in South Africa. We investigated the prevalence of hepatitis B (HBV), hepatitis C (HCV) and HIV and selected risk factors among these KPs to inform effective responses. Methods: We used convenience sampling to recruit a targeted 3 500 KPs accessing HIV-related health services across Cape Town (SWs, MSM, PWUD/ID), Durban (SWs, PWUD/ID), Pietermaritzburg (SWs), Mthatha (SWs), Port Elizabeth (SWs), Johannesburg (MSM) and Pretoria (MSM and PWUD/ID) into a cross-sectional survey. An interviewer questionnaire to assess socio-demographic characteristics, drug use and sexual risk practices, was administered. HBV surface antigen (HBsAg); HCV antibody, viral load and genotype, and HIV antibody, was tested. Results: Among the 3 439 people included in the study (1 528 SWs, 746 MSM, 1 165 PWUD/ID) the median age was 29 years, most participants were black African (60%), and 24% reported homelessness. 82% reported substance use in the last month, including alcohol (46%) and heroin (33%). 75% were sexually active in the previous month, with condom use at last sex at 74%. HIV prevalence was 37% (highest among SWs at 47%), HBsAg prevalence 4% (similar across KPs) and HCV prevalence was 16% (highest among PWUD/ID at 46%). Conclusions: HBV, HCV and HIV pose a health burden for KPs in South Africa. While HIV is key for all included KPs, HCV is of particular importance to PWUD/ID. For KPs, HBV vaccination and behavioural change interventions that support consistent condom and lubricant access and use are needed. Coverage of opioid substitution therapy and needle and syringe services, and access to HCV treatment for PWUD/ID need to be expanded.
Using short read sequencing to characterise balanced reciprocal translocations in pigs
Authors: Bouwman Aniek C. , Derks Martijn F.L. , Broekhuijse Marleen L.W.J. , Harlizius Barbara , Veerkamp Roel F.
Published: July 2020

Background A balanced constitutional reciprocal translocation (RT) is a mutual exchange of terminal segments of two non-homologous chromosomes without any loss or gain of DNA in germline cells. Carriers of balanced RTs are viable individuals with no apparent phenotypical consequences. These animals produce, however, unbalanced gametes and show therefore reduced fertility and offspring with congenital abnormalities. This cytogenetic abnormality is usually detected using chromosome staining techniques. The aim of this study was to test the possibilities of using paired end short read sequencing for detection of balanced RTs in boars and investigate their breakpoints and junctions. Results Balanced RTs were recovered in a blinded analysis, using structural variant calling software DELLY, in 6 of the 7 carriers with 30 fold short read paired end sequencing. In 15 non-carriers we did not detect any RTs. Reducing the coverage to 20 fold, 15 fold and 10 fold showed that at least 20 fold coverage is required to obtain good results. One RT was not detected using the blind screening, however, a highly likely RT was discovered after unblinding. This RT was located in a repetitive region, showing the limitations of short read sequence data. The detailed analysis of the breakpoints and junctions suggested three junctions showing microhomology, three junctions with blunt-end ligation, and three micro-insertions at the breakpoint junctions. The RTs detected also showed to disrupt genes. Conclusions We conclude that paired end short read sequence data can be used to detect and characterize balanced reciprocal translocations, if sequencing depth is at least 20 fold coverage. However, translocations in repetitive areas may require large fragments or even long read sequence data.
RoadMApp: A feasibility study for a smart travel application to improve maternal health delivery in a low resource setting in Zimbabwe
Authors: Nyati-Jokomo Zibusiso , Dabengwa Israel Mbekezeli , Makacha Liberty , Nyapwere Newton , Dube Yolisa Prudence , Chikoko Laurine , Vidler Marianne , Makanga Prestige Tatenda
Published: July 2020

Background: Travel time and healthcare financing are critical determinants of the provision of quality maternal health care in low resource settings. Despite the availability of pregnancy-related mHealth and smart travel applications, there is a lack of evidence on their usage to travel to health facilities for routine antenatal care and emergencies. There is a shortage of information about the feasibility of using a custom-made mobile technology that integrates smart travel and mHealth. This paper explores the feasibility of implementing a custom-made geographically enabled mobile technology-based tool (RoadMApp) to counter the adverse effects of long travel times for maternal care in Kwekwe District, Zimbabwe. Methods: We frame the paper using the first two steps (listen & plan) of the Spiral Technology Action Research (STAR model).The paper uses an exploratory case study design and Participatory Learning Approaches (PLA) with stakeholders (community members) and in-depth interviews with key informants (health care service providers, pregnant women, transport operators). 193 participants took part in the study. We conducted focus group discussions with pregnant women, women of childbearing age, men (household heads), and elderly women. The discussion questions centered on travel time, availability of transport, cellular network coverage, and perceptions of the RoadMApp application. Data were analysed thematically using Nvivo Pro 12. Results: Most parts of rural Kwekwe are far from health facilities and have an inefficient road and telecommunications network. Hence, it is hard to predict if RoadMApp will integrate into the lives of the community - especially those in rural areas. Since these issues are pillars of the design of the RoadMApp mHealth, the implementation will probably be a challenge. Conclusion: Communities are keen to embrace the RoadMApp application. However, the feasibility of implementing RoadMApp in Kwekwe District will be a challenge because of maternal health care barriers such as poor road network, poor phone network, and the high cost of transport. There is a need to investigate the social determinants of access to maternity services to inform RoadMApp implementation.
Bioinformatics Analysis Reveals Novel Hub Gene Pathways Associated With IgA Nephropathy
Authors: Jiang xue , Xu Zhijie , Du Yuanyuan , Chen Hongyu
Published: July 2020

Background:Immunoglobulin A nephropathy (IgAN) is the most common primary glomerulopathy worldwide. However, the molecular events underlying IgAN remain to be fully elucidated. This study aimed to identify novel biomarkers of IgAN through bioinformatics analysis and elucidate the possible molecular mechanism. Methods:Based on the microarray datasets GSE93798 and GSE37460 downloaded from the Gene Expression Omnibus database, the diﬀerentially expressed genes (DEGs) between IgAN samples and normal controls were identified. Using the DEGs, we further performed a series of functional enrichment analyses. Protein-protein interaction (PPI) networks of the DEGs were constructed using the STRING online search tool and were visualized using Cytoscape. Next, hub genes were identified and the most important module among the DEGs, Biological Networks Gene Ontology tool (BiNGO), was used to elucidate the molecular mechanism of IgAN.Results:In total, 148 DEGs were identified, comprising 53 upregulated genes and 95 downregulated genes. Gene Oncology (GO) analysis indicated that the DEGs for IgAN were mainly enriched in extracellular exosome, region and space, fibroblast growth factor stimulus, inflammatory response, and innate immunity. Module analysis showed that genes in the top 1 significant module of the PPI network were mainly associated with innate immune response, integrin-mediated signaling pathway and inflammatory response. The top 10 hub genes were constructed in the PPI network, which could well distinguish the IgAN and control group in monocyte and tissue samples. We finally identified the integrin subunit beta 2 (ITGB2) and Fc fragment of IgE receptor Ig (FCER1G) genes that may play important roles in the development of IgAN.Conclusions: We identified key genes along with the pathways that were most closely related to IgAN initiation and progression. Our results provide a more detailed molecular mechanism for the development of IgAN and novel candidate gene targets of IgAN.
Associations of Socioeconomic Factors with Cause-specific Mortality and Burden of Cardiovascular Diseases: Findings from the Vital Registration in Urban Shanghai, China, during 1974-2015
Authors: Zhang Lijuan , Li Qi , Han Xue , Wang Shuo , Li Peng , Ding Yibo , Zhang Tao , Zhao Jia , Chen Yifan , Liu Jiluo , Li Jue , Tan Xiaojie , Liu Wenbin , Zhang Rong , Cao Guangwen
Published: July 2020

Background: Cardiovascular disease (CVD) is the leading cause of mortality worldwide. The effect of socioeconomic factors on cause-specific mortality and burden of CVD is rarely evaluated in low- and middle-income countries, especially in a rapidly changing society.Methods: Original data were derived from the vital registration system in Yangpu, a representative, population-stable district of urban Shanghai, China, during 1974-2015. Temporal trends for the mortality rates and burden of CVD during 1974-2015 were evaluated using Joinpoint Regression Software. The burden was evaluated using age-standardized person years of life loss per 100,000 persons (SPYLLs). Age-sex-specific CVD mortality rates were predicted by using age-period-cohort Poisson regression model. Results: A total of 101,822 CVD death occurred during 1974-2015, accounting for 36.95% of total death. Hemorrhagic stroke, ischemic heart disease, and ischemic stroke were the 3 leading causes of CVD death. The age-standardized CVD mortality decreased from 144.5/100,000 to 100.7/100,000 in the residents (average annual percentage change [AAPC] -1.0, 95% confidence interval [CI] -1.7 to -0.2), which was mainly contributed by women (AAPC -1.3, 95% CI -2.0 to -0.7), not by men. Hemorrhagic stroke, the major CVD death in the mid-aged population, decreased dramatically after 1991. The crude mortality of ischemic heart disease kept increasing but its age-adjusted mortality decreased continually after 1997. SPYLLs of CVD death increased from 1974 to 1986 (AAPC 2.1, 95% CI 0.4 to 3.8) and decreased after 1986 (AAPC 1.8, 95% CI -2.3 to -1.3). These changes were in concert with the implementation of policies including extended medical insurance coverage, pollution control, active prophylaxis of CVD including lifestyle promotion, and national health programs. The mortality of CVD increased in those born during 1937-1945, a period of the Japanese military occupation, and during 1958-1965, a period including the Chinese Famine. Sequelae of CVD and ischemic heart disease are predicted to be the leading causes of CVD death in 2029.Conclusions: Exposure to serious malnutrition in early life might increase CVD mortality in later life. Improvements in medical services, pollution control, and lifestyle could decrease CVD death. New strategy is needed to prevent the aging-related CVD death and burden in the future.
Promoting the use of evidence in health policymaking in the ECOWAS region: the development and contextualization of an evidence-based policymaking guidance
Authors: Uneke Chigozie Jesse , Sombie Issiaka , Johnson Ermel , Uneke Bilikis Iyabo , Okolo Stanley
Published: July 2020

Background

The Economic Commission of the West African States (ECOWAS), through her specialised health Institution, the West African Health Organization (WAHO) is supporting Members States to improve health outcomes in West Africa. There is a global recognition that evidence-based health policies are vital towards achieving continued improvement in health outcomes. The need to have a tool that will provide systematic guide on the use of evidence in policymaking necessitated the production of the evidence-based policy-making (EBPM) Guidance.

Methods

Google search was performed to identify existing guidance on EBPM. Lessons were drawn from the review of identified guidance documents. Consultation, interaction and interviews were held with policymakers from the 15 West African countries during WAHO organized regional meetings in Senegal, Nigeria, and Burkina Faso. The purpose was to elicit their views on the strategies to promote the use of evidence in policymaking to be included in the EBPM Guidance. A regional Guidance Validation Meeting for West African policymakers was thereafter convened by WAHO to review findings from review of existing guidance documents and validate the EBPM Guidance.

Results

Out of the 250 publications screened, six publications fulfilled the study inclusion criteria and were reviewed. Among the important issues highlighted include: what evidence informed decision-making is; different types of research methods, designs and approaches, and how to judge the quality of research. The identified main target end users of the EBPM Guidance are policy/decision makers in the West African sub-region, at local, sub-national, national and regional levels. Among the key recommendations included in the EBPM Guidance include: properly defining/refining policy problem; reviewing contextual issues; initiating policy priority setting; considering political acceptability of policy; commissioning research; use of rapid response services, use of policy advisory/technical/steering committees; and use of policy briefs and policy dialogue.

Conclusion

The EBPM Guidance is one of the emerging tools that can enhance the understanding of evidence to policy process. The strategies to facilitate the use of evidence in policymaking outlined in the Guidance, can be adapted to local context, and incorporated validated approaches that can be used to promote evidence-to-policy-to-practice process in West Africa.
Clinical characteristics and prognostic factors in elderly patients with COVID-19
Authors: Cheng Qin , Liao Yixuan , Lin Yujing , Tao Liyuan , Wang He , Li Mohan , Ge Qinggang , Li Yanming , Shen Ning
Published: July 2020

Background: The COVID-19 pandemic poses tremendous threats to the world. Elderly patients are among the high-risk population, and apt to experience worse outcomes.Methods: Elderly patients (age ≥60 years old) were enrolled from January 28 to February 29, 2020, in Tongji Hospital, one of designated COVID-19 medical centers in Wuhan, China. A retrospective study was performed to describe clinical characteristics, laboratory findings, chest imaging, treatment, and outcomes of elderly COVID-19 patients. COX regression was used to analyze predictors for 28-day mortality. Linear regression models were constructed to analyze factors associated with length of hospital stay (LOS).RESULT: A total of 186 elderly patients (aged 70.4 ± 7.1 years, 95 males (51.6%)) were enrolled, 120 patients (64.5%) were severe or critical type, and mortality rate was 16.1% (30/186). Of 156 survived patients, 150 were discharged. Fever (83.3%), cough (80.6%) and dyspnea (68.3%) were the most frequent symptoms. Common comorbidities included hypertension (48.9%) and diabetes (32.8%). Ground-glass opacities (97.3%) and peripheral distribution (59.1%) were the most predominant patterns on chest imaging. Patients in non-survival group had a higher smoking rate, more symptoms of dyspnea, lab results indicative of poorer health, and needed more medications or supportive treatment. Age (HR 1.128, 95% CI 1.066-1.194), lymphocyte count (HR 0.261, 95% CI 0.073-0.930), LDH (HR 1.003, 95% CI 1.002-1.005), procalcitonin (HR 1.061, 95% CI 1.002-1.125), and qSOFA (HR 3.162, 95% CI 1.646-6.072) were predictors of independently associated with 28-day mortalitydeath. CURB-65 plus LDH on admission were strong predictors of death by ROC analysis (AUROC=0.891). Among surviving patients, consolidation on CTs (β=8.611), elevated ferritin level (β=0.004) and neutrophil count (β=0.806) were associated with increased LOS.Conclusion: High incidence of comorbidities and mortality were observed in elderly patients. Decreased lymphocyte, older age, higher qSOFA score, procalcitonin and LDH levels were associated with 28-day mortalityindependent factors associated with death, and CURB-65 plus LDH could bewere a strong predictive model of deathfatal outcome. Consolidation on CTs, elevated ferritin and neutrophil level correlated with increased LOS. Further prospective studies should be performed to test our findings and for explore potential treatments.
Feasibility study of using simultaneous multi-slice RESOLVE diffusion weighted imaging to assess parotid gland tumors: comparison with conventional RESOLVE diffusion weighted imaging
Authors: Jiang Jia-Suo , Zhu Liu-Ning , Wu Qian , Sun Yi , Liu Wei , Xu Xiao-Quan , Wu Fei-Yun
Published: July 2020

Background To evaluate the feasibility of using simultaneous multi-slice (SMS) readout segmentation of long variable echo-trains (RESOLVE) diffusion-weighted imaging (DWI) to assess parotid gland tumors, compared with conventional RESOLVE DWIMethods From September 2018 to December 2018, 20 consecutive patients with parotid tumors who underwent MRI scan for pre-surgery evaluation were enrolled. SMS-RESOLVE DWI and conventional RESOLVE DWI were scanned with matched imaging parameters, respectively. The scan time of two DWI sequences was recorded. Qualitative (anatomical structure differentiation, lesion display, artifact, and overall image quality) and quantitative (apparent diffusion coefficient, ADC; ratio of signal-to-noise ratio, SNR ratio; ratio of contrast-to-noise ratio, CNR ratio) assessments of image quality were performed, and compared between SMS-RESOLVE DWI and conventional RESOLVE DWI by using Paired t-test. Two-sided P value less than 0.05 indicated significant difference.[l1] Results The scan time was 3 minutes and 41 seconds for SMS-RESOLVE DWI, and 5 minutes and 46 seconds for conventional RESOLVE DWI. SMS-RESOLVE DWI produced similar qualitative image quality with RESOLVE DWI (anatomical structure differentiation, P=0.164; lesion display, P=0.193; artifact, P=0.330; overall image quality, P=0.083). Meanwhile, there were no significant difference on ADCLesion (P=0.298), ADCMasseter (P=0.122), SNR ratio (P=0.584) and CNR ratio (P=0.217) between two DWI sequences. Conclusion Compared with conventional RESOLVE DWI, SMS-RESOLVE DWI could provide comparable image quality using markedly reduced scan time. SMS could increase the clinical usability of RESOLVE technique for DWI of parotid gland.
Deficits in Skilled Motor and Auditory Learning in a Rat Model of Rett Syndrome
Authors: Adcock Katherine S. , Blount Abigail E. , Morrison Robert A. , Alvarez-Dieppa Amanda , Kilgard Michael P. , Engineer Crystal T. , Hays Seth A.
Published: July 2020

Background

Rett Syndrome is an X-linked neurodevelopmental disorder caused by a mutation in the gene MECP2 . Individuals with Rett Syndrome display developmental regression at an early age, and develop a range of motor, auditory, cognitive and social impairments. Several studies have successfully modeled some aspects of dysfunction and Rett Syndrome-like phenotypes in transgenic mouse and rat models bearing mutations in the MECP2 gene. Here, we sought to extend these findings and characterize skilled learning, a more complex behavior known to be altered in Rett syndrome.

Methods

We evaluated the acquisition and performance of auditory and motor function on two complex tasks in heterozygous female Mecp2 rats. Animals were trained to perform a speech discrimination task or a skilled forelimb reaching task.

Results

Our results reveal that Mecp2 rats display slower acquisition and reduced performance on an auditory discrimination task than wild-type (WT) littermates. Similarly, Mecp2 rats exhibit impaired learning rates and worse performance on a skilled forelimb motor task compared to WT.

Conclusions

Together, these findings illustrate novel deficits in skilled learning consistent with clinical manifestation of Rett syndrome and provide a framework for development of therapeutic strategies to improve these complex behaviors.
Estimation of Breeding Values Using Different Densities of Snp to Inform Kinship in Broiler Chickens
Authors: Salvian Mayara , Moreira Gabriel Costa Monteiro , Reis Ândrea Plotzki , Dauria Brayan Dias , Pilonetto Fabrício , Gervásio Izally Carvalho , Ledur Mônica Corrêa , Coutinho Luiz Lehmann , Spangler Matthew Lee , Mourão Gerson Barreto
Published: July 2020

Background: Traditionally, breeding values are estimated based on phenotypic and pedigree information using the numerator relationship (A) matrix. With the availability of genomic information, genome-wide markers can be included in the estimation of breeding values through genomic kinship. However, the density of genomic information used can impact the cost of implementation. The aim of this study was to compare the rank, accuracy, and bias of estimated breeding values (EBV) for organs [heart (HRT), liver (LIV), gizzard (GIZ), lungs (LUN)] and carcass [breast (BRST), drumstick (DRM) and thigh (THG)] weight traits in a broiler population using pedigree-based BLUP (PBLUP) and single-step genomic BLUP (ssGBLUP) methods using various densities of SNP and variants imputed from whole-genome sequence (WGS). Results: For both PBLUP and ssGBLUP, heritability estimates varied from low (LUN) to high (HRT, LIV, GIZ, BRST, DRM and THG). Regression coefficients values of EBV on genomic estimated breeding values (GEBV) were similar for both the high density (HD) and WGS sets of SNPs, ranging from 0.87 to 0.99 across scenarios. Conclusion: Results show no benefit of using WGS data compared to HD array data using an unweighted ssGBLUP. Our results suggest that 10% of the content of the HD array can yield unbiased and accurate EBV.
Has the Non-Resection Rate Decreased During the Last Two Decades among Patients Undergoing Surgical Exploration for Pancreatic Adenocarcinoma?
Authors: Mattevi Catherine , Garnier Jonathan , Marchese Ugo , Ewald Jacques , Gilabert Marine , Poizat Flora , Piana Gilles , Delpero Jean-Robert , Turrini Olivier
Published: July 2020

Purpose

To determine if improvement in imaging reduces the non-resection rate (NRR) among patients with pancreatic ductal adenocarcinoma (PDAC).

Methods

From 2000 to 2019, 751 consecutive patients with PDAC were considered eligible for a intention-to-treat pancreatectomy and entered the operating room. In April 2011, our institution acquired a dual energy spectral computed tomography (CT) scanner and liver diffusion weighted magnetic resonance imaging (DW-MRI) was included in the imaging workup. We consequently considered 2 periods of inclusion: period #1 (February 2000–March 2011) and period #2 (April 2011–August 2019).

Results

All patients underwent a preoperative CT scan with a median delay to surgery of 18 days. Liver DW-MRI was performed among 407 patients (54%). Median delay between CT and surgery decreased (21 days to 16 days, P <.01), and liver DW-MRI was significantly most prescribed during period #2 (14% vs 75%, P <.01). According to the intraoperative findings, the overall NRR was 24.5%, and remained stable over the two periods (24% vs 25%, respectively). While vascular invasion, liver metastasis, and carcinomatosis rates remained stable, para-aortic lymph nodes invasion rate (0.4% vs 4.6%; P <0.001) significantly increased over the 2 periods. The mean size of the bigger extra pancreatic tumor significantly decrease (7.9mm vs 6.4mm ( P <.01), respectively) when the resection was not done. In multivariate analysis, CA 19-9<500U/mL ( P <.01), and liver DW-MRI prescription ( P <.01) favoured the resection.

Conclusions

Due to changes in our therapeutic strategies, the NRR did not decrease during two decades despite imaging improvement.
A DROP-IN beta probe for robot-assisted 68Ga-PSMA radioguided surgery: first ex vivo technology evaluation using prostate cancer specimens
Authors: Collamati Francesco , OOsterom Matthias van , De Simoni Micol , Faccini Riccardo , Fischetti Marta , Mancini-Terracciano Carlo , Mirabelli Riccardo , Moretti Roberto , Heuvel Judith olde , Solfaroli-Camillocci Elena , Beurden Florian van , Poel Henk van der , Valdes-Olmos Renato , Leeuwen Pim van , Leeuwen Fijs van , Morganti Silvio
Published: July 2020

Background: Recently, a flexible DROP-IN gamma-probe was introduced for robot-assisted radioguided surgery, using traditional low-energy SPECT-isotopes. In parallel, a novel approach to achieve sensitive radioguidance using beta-emitting PET-isotopes has been proposed. Integration of these two concepts would allow to exploit the use of PET-tracers during robot-assisted tumor-receptor-targeted. In this study, we’ve engineered and validated the performance of a novel DROP-IN beta-particle (DROP-INb) detector.Methods: Seven prostate cancer patients with PSMA-PET positive tumors received an additional intraoperative injection of ~70 MBq 68Ga-PSMA-11, followed by robot-assisted prostatectomy and extended pelvic lymph node dissection. The surgical specimens from these procedures were used to validate the performance of our DROP-INb probe prototype, which merged a scintillating detector with a housing optimized for a 12 mm trocar and prograsp instruments. Results: After optimization of the detector and probe housing via Monte Carlo simulations, the resulting DROP-INb probe prototype was tested in a robotic setting. In the ex vivo setting, the probe – positioned by the robot- was able to identify 68Ga-PSMA-11 containing hot-spots in the surgical specimens: signal-to-background (S/B) was > 5 when pathology confirmed that the tumor was located <1 mm below the specimen surface. 68Ga-PSMA-11 containing (and PET positive) lymph nodes, as found in two patients, were also confirmed with the DROP-INb probe (S/B>3). The rotational freedom of the DROP-IN design and the ability to manipulate the probe with the prograsp tool allowed the surgeon to perform autonomous beta tracing. Conclusions: This study demonstrates the feasibility of beta-radioguided surgery in a robotic context by means of a DROP-INb detector. When translated to an in vivo setting in the future, this technique could provide a valuable tool in detecting tumor remnants on the prostate surface and in confirmation of PSMA-PET positive lymph nodes.
Prognostic Impact of Estimated Remnant-like Particle Cholesterol in Patients with Differing Glycometabolic Status: an Observational Cohort Study from China
Authors: Zhao Qi , Zhang Ting-yu , Cheng Yu-jing , Ma Yue , Xu Ying-kai , Yang Jia-qi , Zhou Yu-jie
Published: July 2020

Background: It is uncertain whether estimated remnant-like particle cholesterol (RLP-C) could predict residual risk in patients with different glycometabolic status. This study aimed to evaluate the relationship between estimated RLP-C and adverse prognosis in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) treated with percutaneous coronary intervention (PCI) and to identify the potential impact of glycometabolism on the predictive value of estimated RLP-C.Methods: The study assessed 2419 participants with NSTE-ACS undergoing PCI at Beijing Anzhen Hospital from January to December 2015. Estimated RLP-C was calculated as follows: total cholesterol (TC) minus low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C). The adverse events included all-cause death, non-fatal myocardial infarction (MI), and ischemia-driven revascularization.Results: Estimated RLP-C was prominently associated with adverse prognosis in the total population [hazard ratio (HR) 1.291 per 1-SD increase, 95% confidence interval (CI) 1.119-1.490, P < 0.001], independent of confounding risk factors. However, subgroup analysis showed that increasing estimated RLP-C was related to a higher risk of adverse events in the diabetic population only [HR 1.385 per 1-SD increase, 95% CI 1.183-1.620, P < 0.001]. Estimated RLP-C failed to be a significant determinant of adverse prognosis in non-diabetic and pre-diabetic subgroups. The addition of estimated RLP-C to a baseline model including traditional risk factors enhanced the predictive performance both in total and diabetic populations.Conclusions: High estimated RLP-C levels are a significant predictor for recurrent adverse events in patients with diabetes and NSTE-ACS treated with PCI.
Clinical analysis of pain after transvaginal mesh surgery in patients with pelvic organ prolapse
Authors: Shi Chang , Zhao Ying , Hu Qing , Gong Runqi , Yin Yitong , Xia Zhijun
Published: July 2020

Background
The purpose of this study was to investigate the relevant factors of pain after transvaginal mesh (TVM) surgery for the treatment of pelvic organ prolapse, and to analyze the management and relief of the pain.
Methods
A retrospective study of a clinical database of patients who underwent TVM surgery was conducted, and pain related aspects were analyzed.
Results
The incidence of pain after TVM surgery was 2.70% (50/1855), with a median occurrence time of 7.5 months. Pain symptoms mainly involved vagina, perineum, buttocks, groin, inner thighs, and lower abdomen. Greater intraoperative blood loss (OR = 1.284, 95%CI 0.868–2.401) and postoperative anatomic failure (OR = 1.577, 95%CI 0.952–3.104) were analyzed as risk factors with statistical significance. Mesh exposure rate in pain group was 38%, showing a significant difference between groups (P < 0.01). Forty patients underwent non-surgical treatments, with a relief rate of 40.0%; 33 patients were performed surgical treatments, 15 of which underwent partial mesh removal and 18 underwent complete mesh removal, with a relief rate of 84.8%. The total relief rate was 88% within all 50 patients suffering from pain.
Conclusions
Excessive intraoperative bleeding and postoperative anatomic failure can increase the risk of postoperative pain; mesh exposure, mesh contracture, and mesh position abnormality are also associated. Most patients can get pain relief with proper management, more than half of which may need mesh removal with differing amounts.
Which Reference Genes to Choose for qPCR Normalization? A Comprehensive Analysis in MCF-7 Breast Cancer Cell Line
Authors: Jain Nityanand , Nitisa Dina , Pirsko Valdis , Cakstina Inese
Published: July 2020

Background
MCF-7 cell line remains the most extensively studied patient derived model in breast cancer research, providing pivotal results that have over the decades translated to constantly improving patient care. Many research groups, in the past have identified suitable reference genes in various breast cancer cell lines including MCF-7. However, over the course of identification of stable internal controls, a comparative analysis comprising these genes together in a single study have not been previously undertaken. Further, very little is known about how these identified reference genes are expressed in MCF-7 sub-clones and when the cell line is cultured over multiple passages (p), given the heterogenic expression behavior often associated with MCF-7 cell line. We investigated the expression dynamics of 12 previously reported and suggested endogenous reference genes using RT-qPCR, available algorithms (NormFinder, geNorm, BestKeeper etc.) and TCGA transcriptomic analysis within identically cultured two sub-clones (culture A1 and A2) of MCF-7 cell line cultured over multiple passages. Further candidate reference genes were used to normalize 4 genes of interest (2 simulated and 2 backed by qPCR data) to make an evidence-based recommendation of the least variable reference genes that could be used in MCF-7 cell line.
Results
The analysis revealed the presence of differential reference gene expression within the sub-clones of MCF-7. In culture A1, GAPDH-CCSER2 were identified as least variable reference gene pair while for culture A2, GAPDH-RNA28S was recommended. However, upon validation using genes of interest, both these pairs were found to be unsuitable control pairs. Normalization with 3 genes and analyzing the combined dataset from culture A1 and A2 (supported by transcriptomic analysis), GAPDH-PCBP1-CCSER2 triplet was found to be least variable and hence potentially more well placed to handle any expression heterogeneity that may arise within sub-clones over multiple passages.
Conclusions
The variance in expression behavior amongst sub-clones shows the need for exercising caution while selecting and using reference genes for MCF-7. Further, using same reference genes amongst sub-clones can lead to misleading results arising from inaccurate normalization. GAPDH-PCBP1-CCSER2 triplet offers a reliable alternative to otherwise traditionally used internal controls in optimizing intra- and inter-assay gene expression differences.
Effect of Balanced Crystalloids versus Saline on Urinary Biomarkers of Acute Kidney Injury in Critically Ill Adults
Authors: Funke Blake , Jackson Karen , Self Wesley , Collins Sean , Saunders Christina , Wang Li , Blume Jeffrey , Wickersham Nancy , Brown Ryan , Casey Jonathan , Bernard Gordon , Rice Todd , Siew Edward , Semler Matthew
Published: July 2020

BACKGROUND Recent trials have suggested use of balanced crystalloids may decrease the incidence of major adverse kidney events compared to saline in critically ill adults. The effect of crystalloid composition on biomarkers of early acute kidney injury remains unknown.METHODS From February 15 to July 15, 2016, we conducted an ancillary study to the Isotonic Solutions and Major Adverse Renal Events Trial (SMART) comparing the effect of balanced crystalloids versus saline on urinary levels of neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) among 261 consecutively-enrolled critically ill adults admitted from the emergency department to the medical ICU. After informed consent, we collected urine 36 ± 12 hours after hospital admission and measured NGAL and KIM-1 levels using commercially available ELISAs. Levels of NGAL and KIM-1 at 36 ± 12 hours were compared between patients randomized to balanced crystalloids versus saline using a Mann-Whitney U test.RESULTS The 131 patients (50.2%) assigned to the balanced crystalloid group and the 130 patients (49.8%) assigned to the saline group were similar at baseline. Urinary NGAL levels were significantly lower in the balanced crystalloid group (median, 39.4 ng/mg [IQR 9.9 to 133.2]) compared with the saline group (median, 64.4 ng/mg [IQR 27.6 to 339.9]) (P < 0.001). Urinary KIM-1 levels did not significantly differ between the balanced crystalloid group (median, 2.7 ng/mg [IQR 1.5 to 4.9]) and the saline group (median, 2.4 ng/mg [IQR 1.3 to 5.0]) (P = 0.36).CONCLUSIONS In this ancillary analysis of a randomized trial comparing balanced crystalloids to saline among critically ill adults, balanced crystalloids were associated with lower urinary concentrations of NGAL and similar urinary concentrations of KIM-1, compared with saline. These results suggest only a modest reduction in early biomarkers of acute kidney injury with use of balanced crystalloids compared with saline.TRIAL REGISTRATION: ClinicalTrials.gov numbers, NCT02444988 and NCT02547779
Total Versus Subtotal Hysterectomy for Benign Uterine Disease: Which Advantages
Authors: federici francesca , Greta Benvenga , Teresa Polimeno , Federica Renzulli , Francesca Turchiano , Francesca Vitiello , Flavia Costanzi , Paola De Marco Maria , Chiara Assorgi , Ilary Ruscito , Donatella Caserta
Published: July 2020

BACKGROUND: to evaluate the impact of total vs subtotal hysterectomy on vaginal bleeding and intestinal, sexual and bladder disfunction.METHODS: observational study conducted on women who underwent hysterectomy for benign uterine disease at S. Andrea university hospital in Rome between July 2013 and December 2017.We selected 236 women that underwent hysterectomy for benign disease to submit a validated questionnaire during the follow up evaluation at 12 months from the surgery. One hundred and sixty-two accepted to answer (84 subtotal hysterectomy, 78 total hysterectomy).RESULTS: Twenty-one percent (n=18) of subtotal hysterectomy (SAH) and eight percent (n=6) of total(TAH) showed vaginal bleeding (p=0,015). The difference was not statistically significant for pelvic pain,nausea, alvus changes and urinary incontinence.Thirteen percent (n=10) of women subjected to subtotal hysterectomy and twenty-nine percent (n=21) ofthe totals has declared to experience pain during sexual intercourse (p=0,0159). Thirty-one percent(n=22) of TAH noted a deterioration in the quality of sex intercourses (p=0.026).Concomitant bilateral salpingo-ovariectomy, compared to salpingectomy alone, resulted in an increase in sexual dysfunction for all the analyzed outcomes with a statistically significant difference in the group of total hysterectomies (perception of pain during intercourse [p=0,029], worse quality [p=0,015] and alteredvaginal length [p=0,003]).CONCLUSION: SAH is superior to TAH in terms of sexual function but is related to more vaginalbleeding. There are no differences between the groups regarding bowel and bladder function and thedevelopment of other symptoms after surgery. For these reasons the type of surgery should be decided bythe patient after accurate medical counselling, minimizing, the incidence of salpingo-ovariectomy associatedwith hysterectomy.
Malignant Ventricular Arrhythmias After Surgery for Uncomplicated Congenital Atrial Septal Defect-Case Report
Authors: Liang Ying , Guan Yulong
Published: July 2020

Background:Malignant ventricular arrhythmias (MVA) occurring subsequent to a repair of uncomplicated congenital heart disease is scarcely described in literature.Case presentation:One adult patient following congenital atrial septal defect (ASD) repair underwent immediate postoperative refractory MAV and ventricular fibrillation. The recurrent episodes of shocks cannot be suppressed by drugs. Emergent re-exploration was performed and repeated closure of ASD and DeVega's annuloplasty were completed. The patient had uneventful recovery and no occurrence of arrhythmia.Conclusion: Malignant ventricular arrhythmias are rare and should never be overemphasized even during the repair of uncomplicated congenital heart defect. Re-exploration should be taken into consideration when MVA occurred in the early stage postoperatively.
Embedding atomic cobalt into graphene lattices to active room-temperature ferromagnetism
Authors: Hu Wei , Wang Chao , Tan Hao , Duan Hengli , Li Guinan , Li Na , Ji Qianqian , Lu Ying , Wang Yao , Sun Zhihu , Hu Fengchun , Yan Wensheng
Published: July 2020

Graphene is extremely promising for next-generation spintronics applications; however, realizing graphene-based room-temperature magnets remains a great challenge. Here, for the first time, we demonstrate that robust room-temperature ferromagnetism with TC up to ~400 K and saturation magnetization of 0.11 emu/g (300 K) can be achieved in graphene by embedding isolated Co atoms with the aid of coordinated N atoms. Extensive structural characterizations show that square-planar Co-N4 moieties were formed in the graphene lattices, where atomically dispersed Co atoms provide local magnetic moments. Detailed electronic structure calculations reveal that the d-p orbital hybridization between the embedded Co and matrix N/C atoms generates spin polarization for the delocalized N/C 2pz electrons and consequently enhances the long-range coupling through Stoner ferromagnetism. This work provides an effective means to induce room-temperature ferromagnetism in graphene and may open the possibilities for developing graphene-based spintronics devices.
Comparison of Clinical Features Between Patients with Positive and Negative Appendectomy
Authors: Cakmak Guner , Ozdemir Kayhan
Published: July 2020

Objective: The objective of this study was to retrospectively compare clinical features and prognostic values between the patients who were referred to the general surgery clinic of our hospital with the presumed diagnosis of acute appendicitis and underwent positive or negative appendectomy.Methods: Patients were divided into two groups as positive (PA) (n:425) and negative appendectomy (NA) (n:425) and the data obtained were compared between these two groups. Laboratory investigations were performed in all patients, and white blood cell (WBC), mean platelet volume (MPV), neutrophils count (NEU), neutrophils (%) (NEU%), C-reactive protein (CRP) and total bilirubin (TBIL) values were studied. Results: The mean MPV value was found as 7.66 in PA groups and 7.90 in NA group, and the mean MPV value was statistically significantly lower in PA group, compared to NA groups (p=0.034). The mean TBIL value was 0.75 in PA group and 0.90 in NA group, and the mean TBIL value was statistically significantly lower in PA group (p=0.034).There was no statistically significant difference between the two groups in terms of the other studied laboratory parameters (for all p>0.05).Conclusion: The mean MPV and TBIL values can be used as specific biomarkers in predicting positive acute appendicitis. We believe that these results will contribute to the literature and will be guiding for future studies.
Effect of High Sulfur Diet on Rumen Fermentation, Microflora and Epithelial Barrier Function in Steers
Authors: Wu Hao , Li Yan , Meng Qingxiang , Zhou Zhenming
Published: July 2020

Background: Sulfur is essential for maintaining animal health and functional processing, but high sulfur in the diet can be toxic. The underlying mechanism for this toxicity is not clear in ruminants. Thus, we conducted experiments to evaluate the effect of excessive sulfur on rumen fermentation, microflora, and epithelial barrier function in steers through in vitro gas production and animal feeding trials.Results: The results showed that increasing the level of sulfur in substrates, decreased the total gas and methane production linearly while increasing the hydrogen sulfide gas (P<0.01). Though the high sulfur diet did not affect the rumen fermentation parameters (P>0.05), the volatile fatty acid concentration, especially the butyric acid, was increased by extra sulfur (P<0.01). Sulfur content in the diet had no significant effect (P>0.05) on most of the rumen microbes, expect Desulfovibrio, one of the major sulfate-reducing bacteria (SRB) in the rumen, whose population increased by adding extra sulfur (P<0.001). Changes in the morphology of rumen epithelium and thickening of the total epithelial layer were mainly attributed to the increase in the acanthosis cell layer and stratum basale (P<0.05). Also, the relative expression of two tight junction protein regulating genes, CLDN-1 and TJP1, were reduced with an increase in sulfur level in the diet (P<0.05).Conclusion: These results indicate that excessive sulfur in the diet can change the type of rumen fermentation, sulfate metabolism and SRB population, and the rumen epithelial barrier function.
Development of Real World Learning Opportunities in Community Exercise Prescription for Health Professional Programmes - ‘Physio Hub’
Authors: Cunningham Caitriona Gabrielle , Blake Catherine , Donoghue Grainne O , Purcell Ciaran , Persson Ulrik Mc Carthy , Craddock Karen , Mahon Sinead Mc
Published: July 2020

Background Given the challenge of chronic lifestyle diseases, the shift in healthcare focus to primary care and recognised importance of a preventive approach to health, including exercise prescription, the embedding of related learning in health professional programmes is critical.Methods In response to these contemporary demands, a complex curriculum development project was undertaken at University College Dublin, employing a four dimensional curriculum framework for the development of health professional curricula that focused on (1) future orientation of healthcare practices (the why?), (2) defining capabilities of graduates (the what?), (3) teaching, learning and assessment (the how?) and (4) organisation/institution delivery (the where)? The process was informed by latest exercise, health promotion, educational and health policy literature, alongside engagement with multiple internal university and external community stakeholders. Results Having sufficient clinical education opportunity for translating exercise theory into practice was identified as a key need (the Why?). Development of strategies for health promotion and design and delivery of evidence based exercise programmes with inter-professional and inter-sectoral network building were some of the graduate capabilities identified as being critically important. (the what?) The resultant UCD Physio Hub model of clinical education combines ‘on campus’ and ‘community outreach’ activity to facilitate inter-sectoral ‘real world’ experiential student learning in health promotion and exercise prescription for both healthy and clinical populations. Underpinned by social constructivist educational theory, students are encouraged to be creative and to collaborate in responding to identified health needs of specific community groups by designing and delivering community services. (the how?) In developing new student learning opportunities to enhance curriculum, a supportive organisational culture and context was critical with UCD having excellent exercise infrastructure and the Physio Hub project aligning with a community engagement ethos articulated in the university’s strategy. (the where?) Conclusion This paper provides an overview of Physio Hub, its services, educational practices and translational research ethos, all of which are combined to deliver a rich exercise and health promotion learning experience. Although developed for physiotherapy in this instance, the curriculum process and resultant education model could be applied across medical and other health professional programmes and to facilitate interdisciplinary learning.