bluuebunny/crossref_metadata_2025 huggingface dataset:
Superior Labrum Tear Anterior to Posterior Repair Versus Biceps Tenodesis with Concomitant Rotator Cuff Repair in Patients Older Than 40 Years of Age
Authors: McReynolds Joel G. , Bonner Kevin F. , Akehi Kazuma , Friesen Luke , Hilliard Alexandra , Crockett Heber C.
Published: September 2020

The purpose of this study was to evaluate the outcome results in 148 patients older than the age of 40 years who underwent either superior labrum tear anterior to posterior (SLAP) repair or biceps tenodesis with a concomitant rotator cuff repair. Rotator cuff repair with SLAP lesions showed excellent results with either biceps tenodesis or SLAP repair in patients older than 40 with greater than 2-year follow-up (American Shoulder and Elbow Surgeons, p = 0.69; Simple Shoulder Test p = 0.99). Despite evolution toward tenodesis preference over SLAP repair, no difference in outcomes was observed in this study.
The Significance of Metal Sensitivity Testing in Instrumented Orthopaedic Surgery
Authors: Peterkin Brian A. , Reiter Mitchell F. , Drzala Mark R.
Published: September 2020

» A review of the incidence and clinical significance of metal hypersensitivity to better understand the role for testing in the detection and prevention of allergic reactions to orthopedic implants.

» Orthopedic procedures involving metallic implants are increasingly common with projected future growth.

» Allergic reactions to metallic implants have been extensively reported, but debate remains regarding the clinical impact of metal induced allergic reactions following orthopedic device implantation.

» There is no generally accepted standard for testing to detect metal hypersensitivity in patients who are considering implantation of a prosthetic device or who already have a device in place.

» Available testing options to detect metal hypersensitivity typically include skin patch testing and the lymphocyte transformation, which differ in sensitivity, cost, and convenience.

» Current research suggests that preoperative testing may be a safe and cost-effective way to improve outcomes in select patients and reduce the need for revision surgery.
Orthopaedic Tips
Authors: Domingue Grayson , Honeycutt M. Wesley , Riehl John T.
Published: September 2020

Radial head fractures are a common orthopaedic injury, representing up to 4% of all orthopaedic fractures. Although many radial head fractures are managed nonoperatively, appropriately indicated operative management can result in excellent outcomes in those fractures that achieve poorer results with nonsurgical treatment. The 2 primary surgical treatment options are open reduction internal fixation and radial head arthroplasty. Operative management is traditionally guided by the Mason fracture classification with agreement on management of types I, III, and IV fractures. Mason type II fracture management is less clear with varying strategies and results. This article presents a comprehensive review of the epidemiology, relevant anatomy, biomechanics, clinical presentation, diagnosis, and management of radial head fractures.
The pattern of stressful life events prior to suicide among the elderly in rural China: a national case-control psychological autopsy study
Authors: Mo Qiqing , Ma Zhenyu , Wang Guojun , Jia Cunxian , Niu Lu , Zhou Liang
Published: September 2020

Background: There is a lack of evidence concerning the stressful life events experienced prior to suicide which may be associated with an increased suicide risk for Chinese rural elderly. The aim of this study was to identify the pattern of stressful life events prior to suicide among the elderly in China. Methods: A total of 12 counties were randomly selected using two-stage stratified cluster sampling method. Suicide cases aged 60 years and older (n =242) were collected from those counties from June 2014 to September 2015. Matched living controls were selected 1:1 with suicide cases by age, gender, and location. Data in the study were collected through face-to-face interviews by a psychological autopsy method. The Life Event Scale for the Elderly was used to measure the stressful life events prior to suicide/interviews. Results: Approximately 99.6% of suicide cases and 88.4% of controls experienced at least one stressful life event. The suicide group experienced more long-term stressful life events than recent stressful life events. The top three most frequent stressful life events for the suicide group were being diagnosed with chronic disease, hospitalization, and being diagnosed with terminal illness. More female suicide cases experienced the death of a spouse, while more males experienced hospitalization, diagnosis with terminal illness and family poverty. Experiencing at least one stressful life event, having unstable marital status, physical diseases and mental disorders were the factors that increased the risk of suicide.Conclusions: Stressful life events were common for the rural elderly, especially long-term stressful life events. The experience of at least one stressful life event can increase suicide risk for this population. More attention should be given to the rural elderly who experienced more long-term stressful life events and experienced health related life events.
Determining mutational burden and signature using RNA-seq from tumor-only samples
Authors: Jessen Erik , Liu Yuanhang , Davila Jaime , Kocher Jean-Pierre , Wang Chen
Published: September 2020

Background: Traditionally, mutational burden and mutational signatures have been assessed by tumor-normal pair DNA sequencing. The requirement of having both normal and tumor samples is not always feasible from a clinical perspective, and led us to investigate the efficacy of using RNA sequencing of only the tumor sample to determine the mutational burden and signatures, and subsequently molecular cause of the cancer. The potential advantages include reducing the cost of testing, and simultaneously providing information on the gene expression profile and gene fusions present in the tumor. Results: In this study, we devised supervised and unsupervised learning methods to determine mutational signatures from tumor RNA-seq data. As applications, we applied the methods to a training set of 587 TCGA uterine cancer RNA-seq samples, and examined in an independent testing set of 521 TCGA colorectal cancer RNA-seq samples. Both diseases are known associated with microsatellite instable high (MSI-H) and driver defects in DNA polymerase ɛ (POLɛ).From RNA-seq called variants, we found majority (>95%) are likely germline variants, leading to C>T enriched germline variants (dbSNP) widely applicable in tumor and normal RNA-seq samples. We found significant associations between RNA-derived mutational burdens and MSI/POLɛ status, and insignificant relationship between RNA-seq total coverage and derived mutational burdens. Additionally we found that over 80% of variants could be explained by using the COSMIC mutational signature-5, -6 and -10, which are implicated in natural aging, MSI-H, and POLɛ, respectively. For classifying tumor type, within UCEC we achieved a recall of 0.56 and 0.78, and specificity of 0.66 and 0.99 for MSI and POLɛ respectively. By applying learnt RNA signatures from UCEC to COAD, we were able to improve our classification of both MSI and POLɛ. Conclusions: Taken together, our work provides a novel method to detect RNA-seq derived mutational signatures with effective procedures to remove likely germline variants. It can leads to accurate classification of underlying driving mechanisms of DNA damage deficiency.
Development of a tool for identifying and addressing prioritised determinants of quality improvement projects led by healthcare professionals: a mixed-methods study
Authors: Tuijl Anne van , Wollersheim Hub C. , Fluit Cornelia R.M.G. , Gurp Petra. J. van , Calsbeek Hiske
Published: September 2020

Background: Several frameworks have been developed to identify essential determinants for healthcare improvement. These frameworks aim to be comprehensive, leading to the creation of long lists of determinants that are not prioritised based on being experienced as most important. Furthermore, most existing frameworks do not describe the methods or actions used to identify and address the determinants, limiting their practical value. The aim of this study is to describe the development of a tool with prioritised facilitators and barriers supplemented with methods to identify and address each determinant. The tool can be used by those performing quality improvement initiatives in healthcare practice. Methods: A mixed-methods study design was used to develop the tool. First, an online survey was used to ask healthcare professionals about determinants they experienced as most facilitating and most hindering during the performance of their quality improvement initiative. A priority score was calculated for every named determinant, and those with a priority score ≥ 20 were incorporated into the tool. Semi-structured interviews with implementation experts were performed to gain insight on how to analyse and address the determinants in our tool. Results: The 25 healthcare professionals in this study experienced 64 facilitators and 66 barriers when performing their improvement initiatives. Of these, 12 facilitators and nine barriers were incorporated into the tool. Sufficient support from management of the department was identified as the most important facilitator, while having limited time to perform the initiative was considered the most important barrier. The interviews with 16 experts in implementation science led to various inputs for identifying and addressing each determinant. Important themes included maintaining adequate communication with stakeholders, keeping the initiative at a manageable size, learning by doing and being able to influence determinants. Conclusions: This paper describes the development of a tool with prioritized determinants for performing quality improvement initiatives with suggestions for analysing and addressing these determinants. The tool is developed for those engaged in quality improvement initiatives in practice, so in this ways it helps to bridging the research to practice gap of determinants frameworks. More research is needed to validate and develop the tool further.
Identifying Latent Variables in Dynamic Bayesian Networks with Bootstrapping Applied to Type 2 Diabetes Complication Prediction
Authors: Yousefi Leila , Al-Luhaybi Mashael , Sacchi Lucia , Chiovato Luca , Tucker Allan
Published: September 2020

Background: Type 2 Diabetes is a chronic disease with an onset that is commonly associated with multiple life-threatening co morbidities (complications). Early prediction of diabetic complications while discovering the behaviour of associated aggressive risk factors can reduce the patients’ suffering time. Therefore, models of the time series diabetic data (which are often imbalanced, incomplete and involve complex interactions) are needed to better manage diabetic complications. Aims: The aim of this work is to both deals with imbalanced clinical data using a bootstrapping approach, whilst determining the precise position of latent variables within probabilistic networks generated from the observations. The main motivation behind this paper is to stratify patient groups by means of latent variables to discover how complications in diabetes interact. Methods: We propose a time series bootstrapping method for building Dynamic Bayesian Networks that includes hidden / latent variables, applied to a case for predicting T2DM complications. A combination of the IC* algorithm on time series bootstrapped data is utilized to identify the latent variables within Bayesian model. Then, an exploration of inference methods assessed the influences of these latent variables. Results: Our promising findings show how this targeted use of latent variables improves prediction accuracy, specificity, and sensitivity over standard approaches as well as aiding the understanding of relationships between these latent variable sand disease complications / risk factors. The contribution of this paper compared to the previous papers in which time series bootstrapping is used for re-balancing the data and providing confidence in the prediction results. Conclusion: Our results showed that our re-balancing approach by the use of Time Series bootstrapping method for an unequal number of time series visits demonstrated an improvement in the prediction performance. Additionally, the most highlighted contribution of this paper gained insight by interpreting the latent states (looking at the associated distributions of complications), which led to a better understanding of risk factors and patient-specific interventions: here the fact that the latent variable demonstrated that a patient falls into a sub-group that is hypertensive but not suffering from retinopathy.
Obstacle avoidance and multitarget tracking of a super redundant modular manipulator based on Bezier curve and particle swarm optimization
Authors: li chen , Ma Ying , Zhang Yu , Liu Jinguo
Published: September 2020

A super redundant serpentine manipulator has slender structure and multiple degrees of freedom. It can travel through narrow spaces and move in complex spaces. This manipulator is composed of many modules that can form different lengths of robot arms for different application sites. The increase in degrees of freedom causes the inverse kinematics of redundant manipulator to be typical and immensely increases the calculation load in the joint space. This paper presents an integrated optimization method to solve the path planning for obstacle avoidance and discrete trajectory tracking of a super redundant manipulator. In this integrated optimization, path planning is established on a Bezier curve, and particle swarm optimization is adopted to adjust the control points of the Bezier curve with the kinematic constraints of manipulator. A feasible obstacle avoidance path is obtained along with a discrete trajectory tracking by using a follow-the-leader strategy. The relative distance between each two discrete path points is limited to reduce the fitting error of the connecting rigid links to the smooth curve. Simulation results show that this integrated optimization method can rapidly search for the appropriate trajectory to guide the manipulator in obtaining the target while achieving obstacle avoidance and meeting joint constraints. The proposed algorithm is suitable for 3D space obstacle avoidance and multitarget path tracking.
Side Effects of Azathioprine in Patients with Ocular Behçet’s syndrome
Authors: Masoumi Maryam , Davatchi Fereydoun , Shahram Farhad , Akhlaghi Maassoumeh , Faezi Seyedeh Tahereh , Kavosi Hoda , Shadmanfar Soraya , Alikhani Majid , Moradi Soroush , Balasi Javad
Published: September 2020

Background Behçet’s syndrome (BS) is a multifactorial, polygenic, autoinflammatory vasculitis characterized by recurrent oral and genital ulcers, uveitis, skin lesions, and arthritis. Azathioprine has been well established as an effective therapy among other immunosuppressive drugs; however, concerns remain about its safety. This study was conducted to determine the types and prevalence of adverse events related with azathioprine in patients with ocular BS.Methods We carried out a cross-sectional study of 165 patients with a confirmed diagnosis of BS who had ocular involvement. Data were collected retrospectively on disease-related characteristics and events including severity, recurrence, relapse, recovery and flare-up, as well as on azathioprine dosage and the duration of use.Results Of 165 enrolled patients, 103 (62.43%) were male and 62 (37.57%) were female. Adverse events related with azathioprine treatment occurred in 11 patients (6.67%). These side effects included elevated liver enzymes in 4 patients (2.43%), hypersensitivity reaction in 2 patients (1.21%), leukopenia in 2 patients (1.21%), nausea in 1 patient (0.61%), skin tumor in 1 patient (0.61%), and concomitant pancreatitis and hepatitis in 1 patient (0.61%). Six of these patients discontinued treatment, and 5 of them tapered the dose. In addition, we observed severe leukopenia in 2 patients.Conclusion Administration of azathioprine with due attention to the signs, symptoms, and severity of the disease, results in a reduced rate of adverse events and resolution of the ocular involvement in patients with BS.
Establishment of a Pediatric Trigger Tool Based on Global Trigger Tool to Identify Adverse Drug Events of Children: Experience in a Chinese hospital
Authors: LIU YI , YAN JUN FENG , XIE YUN FEI , BIAN YUAN
Published: September 2020

Background: The Global Trigger Tool (GTT)，which is a method using “triggers” to review medical record retrospectively to identify possible adverse events. Several studies showed that the GTT was effective. However, there were only a few localized trigger tools that had been established to detect pediatric adverse drug events (ADEs) in China. This study aimed to establish a pediatric trigger tool based on GTT, to examine the performance by detecting pediatric inpatients ADEs in a Chinese hospital (a retrospective review), and to investigate the factors associating with the occurrence of ADEs. Methods: The triggers were established by three steps including literature search, triggers extraction and revision, and experts investigation. A retrospective cohort study was conducted to detect ADEs by using 200 pediatric inpatient records of Sichuan Provincial People's Hospital.Results: 33 preliminary triggers were established, and 2 rounds of experts investigation were conducted. Finally, 33 triggers were established. In the retrospective review, the positive trigger rate was 64.0%, while the positive predictive value (PPV) was 24.9%. The occurrence of inpatients with ADEs was 20.5%. ADEs/100 patients were 49.0. ADEs/1000 patients days were 46.89. The most common ADE categories were leukocyte abnormalities, skin lesions and platelet abnormalities. The severity of 39 ADEs was grade 1, 55 ADEs was grade 2, 4 ADEs was grade 3. The highest frequency of ADE-related drugs was antineoplastic, followed by antibacterial. The length of stay and the leukemia in the diagnosed diseases were positively correlated with ADEs. Conclusion: The 33 pediatric triggers may detect ADEs effectively, but still need to be optimized. This study may provide some references for further research in order to improve the rationality and safety of medication.
“One-stop shop”: Safety and efficacy of combining atrial septal defect occlusion and left atrial appendage closure for patients with atrial septal defect and atrial fibrillation.
Authors: zhihui zhang , qing yao , haiyun Huang , ping zhu , xiang xu , zhiyuan Song , huakang Li
Published: September 2020

Background: One-stop occlusion, which is defined as the combination of atrial septal defect [ASD] or patent foramen ovale [PFO] occlusion and left atrial appendage [LAA] closure, in patients with ASD/PFO and atrial fibrillation (AF) has not yet been investigated systematically. This study aimed to evaluate the safety and efficacy of one-stop occlusion in the treatment of adult patients with ASD/PFO and AF.Methods: Inpatients with AF and ASD/PFO were recruited between August 2014 and April 2019. Preoperatively, transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) were conducted to identify the ASD/PFO size and margin, presence of thrombus in the LAA, and LAA orifice width and depth at 0°, 45°, 90°, and 135°. After confirmation of the indications of LAA closure (LAAC) and ASD/PFO occlusion, the procedures were performed simultaneously under general anesthesia. Oral anticoagulants were administered for 45-60 days, followed with regular evaluation of TTE and TEE.Results: Forty-nine patients (age, 65.6±9.6 years) were recruited in this study, including 24 patients with ASD and 25 patients with PFO. They were treated with LAAC and ASD/PFO occlusion successfully. The mean ASD size and mean diameter of the ASD occluders were 14.2±7.7 and 25.4±8.5 mm, respectively. The mean PFO size was 3.5±0.4 mm. The mean maximal LAA orifice width and depth were 20.5±3.4 and 28.3±3.6 mm, respectively. All patients were implanted with a Watchman device (diameter, 27.1±2.9 mm). Postoperatively, all patients took anticoagulants orally for 45-60 days, and their mean postoperative follow-up duration was 29.0±12.1 months. Postoperative TEE showed that all had normal positioning of the LAA and ASD/PFO occluders. At 45-60 days after operation, TEE showed that the LAA and ASD/PFO occluder were in the normal position; however, two patients who took warfarin and novel oral anticoagulants, respectively, have developed occluder thrombosis. After adjusted anticoagulant therapy, TEE showed that the thrombus disappeared at 6 months after operation.Conclusion: One-stop occlusion is safe and effective for the treatment of adult patients with ASD/PFO and AF. It is also feasible to administer warfarin or novel oral anticoagulants after operation.
Comparison of spatiotemporal characteristics of the COVID-19 and SARS outbreaks in mainland China
Authors: Zhang Xi , Rao Huaxiang , Wu Yuwan , Huang Yubei , Dai Hongji
Published: September 2020

Background: Both coronavirus disease 2019 (COVID-19) and severe acute respiratory syndrome (SARS) are caused by coronaviruses and have infected people in China and worldwide. We aimed to investigate whether COVID-19 and SARS exhibited similar spatial and temporal features at provincial level in mainland China.Methods: The number of people infected by COVID-19 and SARS were extracted from daily briefings on newly confirmed cases during the epidemics, as of Mar. 4, 2020 and Aug. 3, 2003, respectively. We depicted spatiotemporal patterns of the COVID-19 and SARS epidemics using spatial statistics such as Moran’s I and the local indicators of spatial association (LISA).Results: Compared to SARS, COVID-19 had a higher overall incidence. We identified 3 clusters (predominantly located in south-central China; the highest RR=135.08, 95% CI: 128.36-142.08) for COVID-19 and 4 clusters (mainly in Northern China; the highest RR=423.51, 95% CI: 240.96-722.32) for SARS. Fewer secondary clusters were identified after the "Wuhan lockdown". The LISA cluster map detected a significantly high-low (Hubei) and low-high spatial clustering (Anhui, Hunan, and Jiangxi, in Central China) for COVID-19. Two significant high-high (Beijing and Tianjin) and low-high (Hebei) clusters were detected for SARS.Conclusions: COVID-19 and SARS outbreaks exhibited distinct spatiotemporal clustering patterns at the provincial levels in mainland China, which may be attributable to changes in social and demographic factors, local government containment strategies or differences in transmission mechanisms.
Prevalence and Significance of Serum 14-3-3η in Juvenile Idiopathic Arthritis
Authors: Reyhan Iris , Zhukov Olga S. , Lagier Robert J. , Bridgeforth Robert F. , Williams Gary J. , Popov Joanna M. , Naides Stanley J. , Reiff Andreas
Published: September 2020

Background: Prompt diagnosis of juvenile idiopathic arthritis (JIA) is important to avoid long term complications. Elevated serum 14-3-3η levels improve the diagnostic sensitivity of rheumatoid factor (RF) and cyclic citrullinated peptide (CCP) antibody in adult rheumatoid arthritis (RA), and have been associated with more severe phenotype. We investigated the prevalence and clinical significance of serum 14-3-3η in different types of JIA.Methods: JIA patients (n=151) followed by the Pediatric Rheumatology Core at Children’s Hospital of Los Angeles were categorized into 5 groups: polyarticular JIA RF+ (PJIA RF+; n=39), PJIA RF- (n=39), psoriatic arthritis (PsA; n=19), enthesitis-related arthritis (ERA; n=18), and oligoarticular JIA (OJIA [control group]; n=36). RF, CCP antibody, and 14-3-3η were measured for all patients. 14-3-3η serum levels >0.2ng/mL were considered positive. Disease activity was assessed by the Juvenile Arthritis Disease Activity Score-71 (JADAS-71). Results: Elevated 14-3-3h levels were detected in 34/151 (23%) patients, and across all groups tested. Most patients with 14-3-3h had titers ≥4 times above the cutoff value. The majority (22, 65%) of 14-3-3h-positive patients were also positive for RF or CCP antibodies, 16 (47%) were positive for all 3, and 12 (35%) were single-positive for 14-3-3η. The highest prevalence of 14-3-3η was in PJIA RF+ patients (49%), followed by OJIA (22%). Positivity for 14-3-3h was not significantly associated with disease activity or age at diagnosis. Conclusion: Serum 14-3-3h can be detected in all forms of JIA tested but appears to be most common in PJIA RF+. 14-3-3h does not appear to correlate with disease activity in JIA.
Can Computed Tomography-Based Radiomics Potentially Discriminate Between Anterior Mediastinal Cysts and Type B1 and B2 Thymomas
Authors: Liu Lulu , Lu Fangxiao , Pang Peipei , Shao Guoliang
Published: September 2020

Background: Anterior mediastinal cysts (AMC) are often misdiagnosed as thymomas and undergo surgical resection, which caused unnecessary treatment and medical resources waste. The purpose of this study was to explore potential possibility of computed tomography (CT)-based radiomics for the diagnosis of AMC and type B1 and B2 thymomas. Methods: A group of 188 patients with pathologically confirmed AMC (106 cases mischarged as thymomas in CT) and thymomas (82 cases) and underwent routine chest CT from January 2010 to December 2018 were retrospectively analyzed. The lesions were manually delineated using ITK-SNAP software, and radiomics features were performed using the Artificial Intelligence Kit (AK) software. A total of 396 tumor texture features were extracted from enhanced CT and unenhanced CT, respectively. The general test, correlation analysis and LASSO were used to features selection and then the radiomics signature (radscore) were obtained. The combined model including radscore and independent clinical factors were developed. The model performances were evaluated on discrimination, calibration curve. Results: Two radscore model were constructed from the unenhanced and enhanced phases based on the selected 4 and 3 features, respectively. The AUC, sensitivity, and specificity of the enhanced radscore model were 0.928, 89.3% and 83.8% in the training dataset and 0.899, 84.6%, 87.5% in the test dataset (higher than the unenhanced radscore model). The combined model of enhanced CT including radiomics features and independent clinical factors yielded an AUC, sensitivity and specificity of 0.941, 82.1%, and 94.6% in the training dataset and 0.938, 92.3%, and 87.5% in the test dataset (higher than the unenhanced combined model and enhanced radscore model). Conclusions: The study suggested the possibility that the combined model in enhanced CT provided a potential tool to facilitate the differential diagnosis of AMC and type B1 and B2 thymomas.
­­­­­­An Integrated Autophagy-Related Gene Signature Predicts Prognosis in Human Endometrial Cancer
Authors: Zhang Jun , Wang Ziwei , Zhao Rong , An Lanfen , Zhou Xing , Zhao Yingchao , Wang Hongbo
Published: September 2020

Background: Globally, endometrial cancer is the fourth most common malignant tumor in women and the number of women being diagnosed is increasing. Tumor progression is strongly related to the cell survival-promoting functions of autophagy. We explored the relationship between endometrial cancer prognoses and the expression of autophagy genes using human autophagy databases.Methods: The Cancer Genome Atlas was used to identify autophagy related genes (ARGs) that were differentially expressed in endometrial cancer tissue compared to healthy endometrial tissue. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes were referenced to identify important biological functions and signaling pathways related to these differentially expressed ARGs. A prognostic model for endometrial cancer was constructed using univariate and multivariate Cox, and Least Absolute Shrinkage and Selection Operator regression analysis. Endometrial cancer patients were divided into high- and low-risk groups according to risk scores. Survival and receiver operating characteristic (ROC) curves were plotted for these patients to assess the accuracy of the prognostic model. Using immunohistochemistry the protein levels of the genes associated with risk were assessed.Results: We determined 37 ARGs were differentially expressed between endometrial cancer and healthy tissues. These genes were enriched in the biological processes and signaling pathways related to autophagy. Four ARGs (CDKN2A, PTK6, ERBB2 and BIRC5) were selected to establish a prognostic model of endometrial cancer. Kaplan–Meier survival analysis suggested that high-risk groups have significantly shorter survival times than low-risk groups. The area under the ROC curve indicated that the prognostic model for survival prediction was relatively accurate. Immunohistochemistry suggested that among the four ARGs the protein levels of CDKN2A, PTK6, ERBB2, and BIRC5 were higher in endometrial cancer than healthy endometrial tissue.Conclusions: Our prognostic model assessing four ARGs (CDKN2A, PTK6, ERBB2, and BIRC5) suggested their potential as independent predictive biomarkers and therapeutic targets for endometrial cancer.
Oral health status of 12-year-old children in Lisu minority ethnic group in China: a cross-sectional study
Authors: Chen Kitty Jieyi , Li Yuexiao , Xu Biao , Liu Juan , Li Yanhong , Zhang Shinan , Chu Chun Hung
Published: September 2020

Background: Lisu is an ethnic minority group and most of them are living in Yunnan, China. This study investigated the oral health status among 12-year-old Lisu children in Yunnan.Method: This survey employed a multistage sampling method to recruit 12-year-old Lisu children. Two calibrated dentists performed the oral examinations in the primary schools. They examined dental caries, gingival bleeding and dental fluorosis using the diagnosis criteria recommended by the World Health Organization. A self-administrated questionnaire was distributed to the children to collect their sociodemographic background information and oral health-related behaviours. A chi-square test, the Mann-Whitney U test, zero-inflated negative binomial (ZINB) regression and multivariate logistic regression were used for statistical analysis.Results: This survey invited 512 children, and 482 children (48% boys) participated in the study (response rate: 94%). Their caries prevalence was 35% and their caries experience in mean (SD) DMFT scores was 0.63 (0.10). The mean (SD) DT score was 0.60 (1.10), consisting 95% of the mean DMFT scores. No dental fluorosis was observed; whereas 426 children (88%) had gingival bleeding. Results of ZINB model indicated sex and sugary-snacking habits were related to the dental caries experience (p<0.05). The gingival-bleeding prevalence was associated with the mother’s education level, the child’s monthly-pocket money and daily toothbrushing frequency (p<0.05).Conclusion: Dental caries and gingival bleeding were prevalent among 12-year-old Lisu children in the Yunnan province in China, and most of the decayed teeth were unrestored. Dental fluorosis was not observed in the children.
Validation of the Palliative Prognostic Index, Performance Status–Based Palliative Prognostic Index and Chinese Prognostic Scale in a Home Palliative Care Setting for Patients with Advanced Cancer in China
Authors: Zhou Jun , Xu Sitao , Cao Ziye , Tang Jing , Qin Ling , Zhou Fangping , He Yuzhen , Zhong Xueren , Hu Mingcai , Wang Yan , Lu Fengjuan , Bao Yongzheng , Dai Xiangheng , Wu Qiang
Published: September 2020

Background: The predictive value of the prognostic tool for patients with advanced cancer is uncertain in mainland China, especially in the home-based palliative care (HPC) setting. This study aimed to compare the accuracy of the Palliative Prognostic Index (PPI), the Performance Status–Based Palliative Prognostic Index (PS-PPI), and the Chinese Prognosis Scale (ChPS) for patients with advanced cancer in the HPC setting in mainland China.Methods: Patients with advanced cancer admitted to the hospice center of Yuebei People’s Hospital between January 2014 and December 2018 were retrospectively calculated the scores according to the three prognostic tools. The Kaplan-Meier method was used to compare survival times among different risk groups. Receiver operating characteristic curve analysis was used to assess the predictive value. The accuracy of 21-, 42- and 90-day survival was compared among the three prognostic tools. Results: A total of 1863 patients were included. Survival time among the risk groups of all prognostic tools was significantly different from each other except for the PPI. The AUROC of the ChPS was significantly higher than that of the PPI and PS-PPI for 7-, 14, 21-, 42-, 90-, 120-, 150- and 180-day survival (P <0.05). The AUROC of the PPI and PS-PPI were not significantly different from each other (P >0.05).Conclusions: The ChPS is more suitable than the PPI and PS-PPI for advanced cancer patients in the HPC setting. More researches are needed to verify the predictive value of the ChPS, PPI, and PS-PPI in the HPC setting in the future.
GIS-based gully erosion susceptibility modeling, adapting bivariate statistical method and AHP approach in Gombe town and environs Northeast Nigeria
Authors: Igwe Ogbonnaya , Ugwuoke Ikechukwu John , Solomon Onwuka , Obinna Ozioko
Published: September 2020

Gully erosion is a major environmental problem in Gombe town, a large area of land is becoming unsuitable for human settlement, hence the need for a gully erosion susceptibility map of the study area. To generate a gully inventory map, a detailed field exercise was carried out, during this investigation one hundred gullies were identified and studied extensively within the study area of about 550 km2. In addition to the mapped gullies, Google EarthPro with high-resolution imagery was used to locate the spatial extents of fifty (50) more gullies. Ten gully erosion predisposing factors were carefully selected considering the information obtained from literature, and multiple field survey of the study area, the factors include elevation, slope angle, curvature, aspect, topographic wetness index (TWI), soil texture, geology, drainage buffer, road buffer and landuse. In this study, a GIS-based Frequency Ratio (FR) and Analytical Hierarchy Process (AHP) models were employed to predict areas prone to gully erosion in Gombe town and environs. The result obtained from FR shows that drainage, soil texture, and slope have the highest correlation with gully occurrence, while the AHP model revealed that drainage buffer, soil texture, geology have a high correlation with the formation of a gully. Gully erosion susceptibility maps (GESM) were produced and reclassified into very high, high, moderate, and low zones. The overall accuracies of both models were tested utilizing area under the curve (AUC) values and gully density distribution.FR and AHP model have AUC values of 0.73 and 0.72 respectively, the outcome indicates that both models have high prediction accuracy. The gully erosion density distribution values revealed that gullies are concentrated in the very high susceptibility class and it decreases towards the low class, therefore the GESM produced using these models in this study area is reliable and can be used for land management and future planning.
Rsp Activates Expression of the Cnt System in Staphylococcus aureus
Authors: Vinué Laura , Hooper David C.
Published: September 2020

Background: The Cnt system is crucial for the optimal import of essential metals in metal-limiting conditions and contributes to virulence in S. aureus. In a screen for regulators of efflux pumps in a phage-based ultra-high-density transposon library, we identified Rsp as a candidate regulator of the cntE gene. Results: A two-fold decrease in expression of all genes of the cnt operon was observed by RT-qPCR in the rsp mutant compared to the parental strain, indicating that Rsp acts as an activator of the cnt operon. To determine whether the Rsp activation depends on iron, we compared mutant and parent cnt expression under varying metal conditions. A 2-fold reduction in cnt gene expression was detected in the rsp mutant in TSB, and a slightly smaller decrease (1.9, 1.7, and 1.5-fold changes for cntK, cmtA, and cntE respectively) was observed after addition of dipyridyl. The greatest decrease was seen with addition of FeSO4 (4.1, 5.3 and 6.3-fold changes for cntK, cmtA and cntE respectively). These findings suggest that Rsp activates the cnt operon in low and high iron conditions. To study the relationship between Rsp and the cnt repressors Fur and Zur, we created single and double mutants. Both fur and zur single mutants had significant increases in cnt gene expression compared to the parental strain, as did the fur rsp double mutant. The zur rsp double mutant also had a significant increase in cntK expression and a trend in increases in cntA and cntE expression just below statistical significance. Thus, the ability of Fur and Zur to repress cnt gene expression are not eliminated by the presence of Rsp. However, there were significantly smaller increases in cnt gene expression in the double mutants compared to single mutants, suggesting that Rsp activation can still occur in the absence of these repressors. To determine if Rsp directly modulates expression of cnt genes, incubation of purified Rsp caused a DNA-specific band shift for the cntK and cntA promoters. Conclusions: Rsp activation may act to maintain basal cellular levels of staphylopine to scavenge free metals when needed, in addition to metal dependent regulation by Fur and Zur.
Opportunities and challenges to Integrating mental health into HIV programs in a Low- and Middle-Income Country: Insights from the Nigeria Implementation Science Alliance
Authors: Ezeanolue Echezona E , Iheanacho Theddeus , Adedeji Isaac , Itanyi Ijeoma , Olakunde Babayemi , Patel Dina , Dakum Patrick , Okonkwo Propser , Akinmurele Timothy , Obiefune Michael , Khamofu Hadiza , Oyeledun Bolanle , Aina Muyiwa , Eyo Andy , Oleribe Obinna , Oko John , Olutola Ayodotun , Gobir Ibrahim , Aliyu Muktar H , Aliyu Gambo , Woelk Godfrey , Aarons Gregory , Siberry George , Sturke Rachel , ASSISTANT NISA
Published: September 2020

Background: In Nigeria, there is an estimated 1.9 million people living with HIV (PLHIV), 53% of whom utilize HIV care and services. With decreasing HIV-related deaths and increasing new infections, HIV with its associated comorbidities continue to be a key public health challenge in Nigeria. Untreated, comorbid mental disorders are a critical but potentially modifiable determinant of optimal HIV treatment outcomes. This study aimed to identify the challenges and opportunities related to integrating mental health care into existing HIV programs in Nigeria. Method: Attendees at the Nigeria Implementation Science Alliance (NISA)’s 2019 conference participated in nominal group technique (NGT) exercise informed by the “Exploration, Preparation, Implementation, and Sustainment (EPIS)” framework. The NGT process was conducted among the nominal groups in two major sessions of 30-minutes phases followed by a 30-minute plenary session. Data analysis proceeded in four steps: transcription, collation, theming and content analysis. Results: The two major theoretical themes from the study were – opportunities and challenges of integrating mental health treatment into HIV services. Three sub-themes emerged on opportunities: building on health care facilities for HIV services (screening, counseling, task-sharing monitoring and evaluation frameworks) , utilizing existing human resources or workforce in HIV programs (in-service training and including mental health in education curriculum) and the role of social and cultural structures (leveraging existing community, traditional and faith-based infrastructures). Four sub-themes emerged for challenges: double burden of stigma and the problems of early detection (HIV and mental health stigma, lack of awareness) , existing policy gaps and structural challenges (fragmented health system) , limited human resources for mental health care in Nigeria (knowledge gap and burnout) and dearth of data/evidence for planning and action (research gaps) . Conclusions: Potential for integrating treatments for mental disorders into HIV services exist in Nigeria. These include opportunities for clinicians’ training and capacity building as well as community partnerships. Multiple barriers and challenges such as stigma, policy and research gaps would need to be addressed to leverage these opportunities. Our findings serve as a useful guide for government agencies, policy makers and research organizations to address co-morbid mental disorders among PLHIV in Nigeria.
Men perspectives on attending antenatal care visits together with their pregnant partners in Misungwi district, rural Tanzania: a qualitative study
Authors: Boniphace Maendeleo , Matovelo Dismas , Laisser Rose , Swai Hadija , Yohana Victoria , Tinka Sylvia , Mwaikasu Lusako , Mercader Hannah , Brenner Jennifer L , Mitchell Jennifer
Published: September 2020

Background: Mens’attendance with their pregnant partners at facility-based antenatal care (ANC) visits is important for maternal and child health and gender equality yet remains uncommon in parts of rural Tanzania. This study examined men’s perspectives on attending ANC with their pregnant partners in Misungwi District, Tanzania.Methods: Twelve individual interviews and five focus group discussions were conducted using semi-structured questionnaires with fathers, expectant fathers, and in-depth interviews were done to health providers, volunteer community health workers, and village leaders. Interviews were recorded and transcribed in Swahili and later translated to English. The research team conducted thematic analysis to identify common themes among interviews. Results: We identified two broad themes on the barriers to male attendance at facility-based ANC visits: (1) Perceived exclusion during ANC visits among men (2) Traditional gender norms resulting to low attendance among men.Conclusion: Attendance at health facility for ANC visits by men with their pregnant partners in the study areas were challenged by structural and local cultural norms. At the facility men were uncomfortable to sit with women due to lack of specific waiting area for men and that they perceived to be neglected. Local cultural norms demanded women to have secrecy in pregnancy while men perceived not to have a role of being with their partners during ANC visits.
WRN modulates translation by influencing nuclear mRNA export in HeLa cancer cells
Authors: Iglesias-Pedraz Juan Manuel , Jara Diego Matia Fossatti , Felice Valeria Del Carmen Valle-Riestra , Visalaya Sergio Rafael Cruz , Felix Jose Antonio Ayala , Comai Lucio
Published: September 2020

BackgroundThe Werner syndrome protein (WRN) belongs to the RecQ family of helicases and its loss of function results in the premature aging disease Werner syndrome (WS). We previously demonstrated that an early cellular change induced by WRN depletion is a posttranscriptional decrease in the levels of enzymes involved in metabolic pathways that control macromolecular synthesis and protect from oxidative stress. This metabolic shift is tolerated by normal cells but causes mitochondria dysfunction and acute oxidative stress in rapidly growing cancer cells, thereby suppressing their proliferation.ResultsTo identify the mechanism underlying this metabolic shift, we examined global protein synthesis and mRNA nucleocytoplasmic distribution after WRN knockdown. We determined that WRN depletion in HeLa cells attenuates global protein synthesis without affecting the level of key components of the mRNA export machinery. We further observed that WRN depletion affects the nuclear export of mRNAs and demonstrated that WRN interacts with mRNA and the Nuclear RNA Export Factor 1 (NXF1).ConclusionsOur findings suggest that WRN influences the export of mRNAs from the nucleus through its interaction with the NXF1 export receptor thereby affecting cellular proteostasis. In summary, we identified a new partner and a novel function of WRN, which is especially important for the proliferation of cancer cells.
Knowledge, Attitude and Practice towards Anthrax in Northern Ethiopia: a mixed approach study
Authors: Romha Gebremedhin , Girmay Weldemelak
Published: September 2020

Background: Anthrax is the second most highly prioritized zoonotic disease in Ethiopia due to its negative impact at the household level, causing disease and production losses in livestock and severe disease in humans. This study seeks to assess the knowledge of, attitudes towards, and practices addressing (KAPs) anthrax in the communities of Eastern Tigray, Northern Ethiopia. Methods : A cross-sectional survey was conducted concurrently with focus group discussions (FGD) and key informant interviews (KII) between May 2019 and April 2020. A total of 862 respondents participated in the questionnaire survey. Of these, 800 were local community members, while 62 were professionals working at health service institutions. In addition, qualitative data were collected using six FGDs and 11 KIIs. Results : Sixty-two percent (496/800) of the community respondents said that they were aware of anthrax while 38% (304/800) of them did not. Only 9.3% (74/800) of the respondents reported that the causative agent of anthrax is germs/microbial. About 56.5% (35/62) of professional respondents said that it is bacterial. More than sixty percent (64.1%, 513/800) of the respondents did not know that whether the disease was zoonotic or not. Regarding clinical signs, 26.3 (210/800) and 36.8% (294/800) of the respondents could identify at least one in animals and humans, respectively, while 21.3 (170/800) and 20.1% (161/800) knew one or more transmission routes in animals and humans, respectively. Moreover, 43.4% (347/800) and 45.6% (365/800) of the respondents mentioned one or more control/prevention method(s) in animals and humans, respectively. Regarding qualitative results, some of the participants knew the disease (in animals) by their local names: Lalish and Tafia (splenomegaly), and Gulbus (abdominal cramps and shivering). Some reported that anthrax was exclusively a human disease while others recognized its zoonotic potential after the clinical signs in both animals and humans were listed. Conclusion : The KAP of the participants regarding anthrax was low. There was no consistent understanding of the disease among the participants. The study also revealed that the participants did not receive consistent, adequate, and continuous education regarding the disease.
M-BiRank: Co-ranking developers and projects using multiple developer-project interactions in open source software community
Authors: Yan Dengcheng , Qi Bin , Zhang Yiwen , Shao Zhen
Published: September 2020

Social collaborative coding is a popular trend in software development and such platforms as GitHub provides rich social and technical functionalities for developers to collaborate on open source projects through multiple interactions. Developers often follow popular developers and projects for learning, technical selection and collaboration. Thus identifying popular developers and projects is very meaningful. In this paper, we propose a multiplex bipartite network ranking model, M-BiRank, to co-rank developers and projects using multiple developer-project interactions. Firstly, multiple developer-project interactions such as commit, issue and watch is extracted and a multiplex developer-project bipartite network is constructed. Secondly, a random layer is selected from this multiplex bipartite network and initial ranking scores are calculated for developers and projects using BiRank. Finally, initial ranking scores diffuse to other layers and mutual reinforcement is taken into consideration to iteratively calculate ranking scores of developers and projects in different layers. Experiments on real world GitHub dataset show that M-BiRank outperforms degree centrality, traditional single layer ranking methods as well as multiplex ranking method.