bluuebunny/crossref_metadata_2025 huggingface dataset:
Community-based rehabilitation service in Chengdu, southwest China: a cross-sectional general survey
Authors: Chen Siliang , Lei Yi , Dai Hua , Wu Jia , Yang Ziyu , Liao Xiaoyang
Published: June 2020

Background World Health Organization initiated community-based rehabilitation (CBR) in 1978, and by now, it has been an essential process of medical services worldwide. China had strengthened primary health care on building more than 35,000 community health centers (CHCs) in cities, and more than 34,000 township health centers (THCs) in the rural area. Nevertheless, it remains unclear that if these primary health centers could provide optional rehabilitation services for disabilities. And this study aims at evaluating the supply capacity of rehabilitation service in primary health centers of Chengdu, a regional center city of southwest China.Method We conducted a general investigation of primary health centers in Chengdu, a city located in southwest China with more than 15 million population. Our investigation covered all of Chengdu’s 390 primary health centers from October to November 2016. We researched these primary health centers on basic rehabilitation services, diseases, and rehabilitation equipment quantity and quality, and traditional Chinese medicine (TCM) physiotherapyResult Rehabilitation therapy is available in 88.9% (337 of 379) of all primary health centers. Meanwhile, CHCs slightly surpass THCs with an available rate of 92.2% (106 of 115) and 87.5% (231 of 264), respectively. Traditional Chinese Medicine (TCM) physiotherapy is available in 97.1% (368 of 379) of all primary health centers, 97.3% (112 of 115) of CHCs and 97.0% (256 of 264) of THCs. Quantitative analysis showed that substantial factors which could make an impact on the number of patients per year contain: categories of rehabilitation disease (P<0.001, 95% confidence interval (CI) [-1.571, -0.702]),number of rehabilitation bed (P<0.001, 95%CI [-1.249, -0.290])Conclusion CBR and TCM physiotherapy has become accessible for disabilities in most basic health centers of Chengdu City, whereas, available rate of CBR in THCs is lesser than in CHCs, which suggests an imbalance in primary health service development between rural and urban area. Categories of rehabilitation diseases, and the number of rehabilitation beds constitute co-factors that make an impact on the CBR capacity of basic health centers.
Effect of Resilience on Infertile Couples’ Quality of Life: An Actor–Partner Interdependence Model Approach
Authors: Ha Ju-Young , Ban Seonhwa
Published: June 2020

Background Infertility is an emerging socioeconomic issue affecting an individual’s life and the nation. However, only few studies have examined the influence of resilience on the quality of life (QoL) of spouses as actors and partners. Hence, this study aimed to analyze the influence of resilience, a positive factor that infertile couples may have, on QoL using the actor–partner interdependence model (APIM).Methods Using the method of couples’ data analysis, we analyzed the effect of resilience on the QoL of infertile couples as actors and partners. This cross-sectional study included 150 infertile couples. The Fertility Quality of Life and Resilience Scale was used to measure couples’ QoL and resilience. APIM was applied to analyze QoL.Results In terms of actor effects, the resilience of both wives (β = 0.201, p < 0.001) and husbands (β = 0.713, p < 0.001) had a significant effect on individual QoL. With regard to partner effects, husbands’ resilience (β = 0.351, p < 0.001) had a significant impact on wives’ QoL and the wives’ resilience (β = 0.219, p = 0.009) had a significant impact on husbands’ QoL.Conclusions The resilience of an infertile actor was found to affect both his/her own QoL and his/her partner’s QoL. In the future, if a program is to be developed to improve couples’ QoL, both spouses should work together to improve their resilience, thereby improving their QoL.
Experiences And Needs Concerning Health Related Information For Newly Arrived Refugees In Sweden
Authors: Mårtensson Lena , Lytsy Per , Westerling Ragnar , Wångdahl Josefin
Published: June 2020

Background: Owing to communication challenges and a lack of knowledge about the health care system, refugees may be at risk of having limited health literacy, meaning that they will have problems in achieving, understanding, appraising and using health information or navigating in the health care system. The aim of this study was to explore experiences and needs concerning health related information for newly arrived refugees in Sweden.Methods: A qualitative design with a focus group methodology was used. The qualitative content analysis was based on seven focus group discussions, including 28 Arabic and Somali speaking refugees.Results: Four categories emerged. ‘Concrete instructions and explanations’ includes appreciation of knowledge about how to act when facing health problems. ‘Contextual knowledge’ comprises experienced needs of information about the health care system, about specific health risks and about rights in health issues. ‘A variation of sources’ describes suggestions as to where and how information should be given. ‘Enabling communication’ includes the wish for more awareness among professionals from a language and cultural point of view.Conclusion: Concrete instructions and explanations are experienced as valuable and applicable. Additional information about health issues and the health care system is needed. Information concerning health should be spread by a variety of sources. Health literate health organizations are needed to meet the health challenges of refugees, including professionals that emphasize health literacy.
A New Modeling Method Base on Candidate Window for Clinical Concept Extraction
Authors: Tang Yongtao , Yu Jie , Li Shasha , Ji Bin , Tan Yusong , Wu Qingbo
Published: June 2020

Background Recently, how to structuralize electronic medical records (EMRs) has attracted considerable attention from researchers. Extracting clinical concepts from EMRs is a critical part of EMR structuralization. The performance of clinical concept extraction will directly affect the performance of the downstream tasks related to EMR structuralization. We propose a new modeling method based on candidate window classification, which is different from mainstream sequence labeling models, to improves the performance of clinical concept extraction tasks under strict standards by considering the overall semantics of the token sequence instead of the semantics of each token. We call this model as slide window model. Method In this paper, we comprehensively study the performance of the slide window model in clinical concept extraction tasks. We model the clinical concept extraction task as the task of classifying each candidate window, which was extracted by the slide window. The proposed model mainly consists of four parts. First, the pre-trained language model is used to generate the context-sensitive token representation. Second, a convolutional neural network (CNN) is used to generate all representation vector of the candidate windows in the sentence. Third, every candidate window is classified by a Softmax classifier to obtain concept type probability distribution. Finally, the knapsack algorithm is used as a post-process to maximize the sum of disjoint clinical concepts scores and filter the clinical concepts. Results Experiments show that the slide window model achieves the best micro-average F1 score(81.22%) on the corpora of the 2012 i2b2 NLP challenges and achieves 89.25% F1 score on the 2010 i2b2 NLP challenges under the strict standard. Furthermore, the performance of our approach is always better than the BiLSTM-CRF model and softmax classifier with the same pre-trained language model.Conclusions The slide window model shows a new modeling method for solving clinical concept extraction tasks. It models clinical concept extraction as a problem for classifying candidate windows and extracts clinical concepts by considering the semantics of the entire candidate window. Experiments show that this method of considering the overall semantics of the candidate window can improve the performance of clinical concept extraction tasks under strict standards.
Situations of using white lie during patient care: a qualitative study into nurses’ perspectives
Authors: nasrabadi Alireza Nikbakht , joolaee soodabeh , Navab Elham , esmaeilie Maryam , shali mahboobe
Published: June 2020

Background: Keep the patients well and fully informed about diagnosis, prognosis, and treatments is one of the patient’s rights in any healthcare system. Although all healthcare providers have the same viewpoint about rendering the truth in treatment process, sometimes the truth is not told to the patients and instead, healthcare staff use “white lie”. This study aimed to explore the nurses’ experience of white lies during patient care.Methods: This qualitative and descriptive study was conducted during June to December 2018. Eighteen hospital nurses were purposively recruited with maximum variation from ten teaching and public hospitals affiliated to Tehran University of Medical Sciences. Purposeful sampling was used and data were collected by semi-structured interviews that were continued until data saturation. Data was classified and analyzed by content analysis approach.Results: The data analysis in this study resulted in four main categories and eleven subcategories. The main categories included hope crisis, bad news, cultural diversity, and nurses’ limited professional competence. Conclusion: Results of the present study showed that, the use of white lie by nurses during patient care may be due to a wide range of patient, nurse and organizational-related factors. Communication was the main factor that influenced information rendering. Nurses’ communication with patients should be based on mutual respect, trust and adequate cultural knowledge, and also nurses should provide precise information to patients, so they can make accurate decisions regarding their health care.
Sickness absence trajectories following labour market participation patterns: a cohort study in Catalonia (Spain), 2012-2014
Authors: Hernando-Rodriguez JC , Serra L , Benavides FG , Ubalde-Lopez M
Published: June 2020

Background Previous studies have focused on the relationship between employment pathways and health-related outcomes based on cross-sectional or longitudinal approaches. However, little is known about the cumulative effects of employment status mobility on sickness absence (SA) over time. The aim of the present study was to examine the association between prior labour market participation (LMP) patterns and SA trajectories from a life-course perspective. Methods This cohort study was based on a sample of 11,968 salaried workers affiliated with the Spanish Social Security system, who accumulated more than 15 days on SA in at least one quarter during 2012–2014. Individuals were grouped into three different working life stages: early (18–25 years), middle (26–35 years), and late (36–45 years). To identify LMP patterns, we applied sequence analysis and cluster analysis (2002–2011), and we used latent class growth modelling to identify SA trajectories (2012–2014). Finally, we applied multinomial logistic regression models to assess the relationship between LMP patterns and SA trajectories. Results The analyses yielded six LMP patterns: stable employment (63%–81%), increasing employment (5%–22%), without long-term coverage (7%–8%), decreasing employment (4%–10%), fluctuant employment (13%–14%), and steeply decreasing employment (7%–9%). We also identified four SA trajectories: low stable (value range: 83%–88%), decreasing (5%–9%), increasing (5%–11%), and high stable (7%–16%). However, the only significant association we identified for LMP patterns and SA trajectories was among young men, for whom an increasing employment pattern was significantly associated with a lower risk for increased days on SA (adjusted odds ratio: 0.21; 95% confidence interval: 0.05–0.96). Conclusions SA trajectories are generally not related to prior 10-year LMP patterns at any stage of working life. To disentangle this relationship, future research might benefit from considering working life transitions with a quality-of-work approach framed with contextual factors closer to the SA course.
Education Level as a Predictor of Survival in Patients with Multiple Myeloma
Authors: Xu Limei , Wang Xiuju , Pan Xueyi , Wang Xiaotao , Wang Qing , Wu Bingyi , Cai Jiahui , Zhao Ying , Chen Lijuan , Li Wuping , Li Juan
Published: June 2020

Background: Disparities in multiple myeloma (MM) prognosis based on sociodemographic factors may exist. We investigated whether education level at diagnosis influenced Chinese MM patient outcomes.Methods: We performed a multicenter retrospective analysis of data from 773 MM patients across 9 centers in China from 2006 to 2019. Sociodemographic and clinical factors at diagnosis and treatment regimens were recorded, and univariate and multivariate analyses were performed.Results: Overall, 69.2% of patients had low education levels. Patients with low education levels differed from those with high education levels in that they were more likely to be older, and a higher proportion lived in rural areas, were unemployed, had lower annual incomes and lacked insurance. Additionally, compared to patients with high education levels, patients with low education levels had a higher proportion of international staging system (ISS) stage III classification and elevated lactate dehydrogenase (LDH) levels and underwent transplantation less often. Patients with high education levels had a median progression-free survival (PFS) of 67.50 (95% confidence interval (CI): 51.66-83.39) months, which was better than that of patients with low education levels (30.60 months, 95% CI: 27.38-33.82, p<0.001). Similarly, patients with high education levels had a median overall survival (OS) of 122.27 (95% CI: 117.05-127.49) months, which was also better than that of patients with low education levels (58.83 months, 95% CI: 48.87-62.79, p<0.001). In the multivariable analysis, patients with high education levels had lower relapse rates and higher survival rates than did those with low education level in terms of PFS and OS (hazard ratio (HR)=0.50 [95% CI: 0.34-0.72], p<0.001; HR=0.32 [0.19-0.56], p<0.001, respectively).Conclusions: Low education levels may independently predict poor survival in MM patients in China.
Development of in vitro resistance to fluoroquinolones in Pseudomonas aeruginosa
Authors: Zhao Lei , Wang Shiqi , Li Xiaobing , He Xiaojing , Jian Lingyan
Published: June 2020

Fluoroquinolone resistance in Pseudomonas aeruginosa typically arises through site-specific mutations and overexpression of efflux pumps. In this study, we investigated the dynamics of different resistance mechanisms in P. aeruginosa populations that have evolved under fluoroquinolone pressure, as well as the interactions between these mechanisms in evolutionary trajectories. Bacteria of strain ATCC27853 were selected under different concentrations of ciprofloxacin and levofloxacin for six parallel lineages, followed by amplification of four target genes in the quinolone-resistance determining region (QRDR) and Sanger sequencing to identify the mutations. The expression of four efflux pump proteins was evaluated by real-time polymerase chain reaction using the relative quantitation method, with the ATCC27853 strain used as a control. We found that ciprofloxacin killed P. aeruginosa sooner than did levofloxacin. Further, we identified five different mutations in three subunits of QRDRs, with gyrA as the main mutated gene associated with conferring fluoroquinolone resistance. Additionally, we found a larger number of mutations appearing at 2 mg/L and 4 mg/L of ciprofloxacin and levofloxacin, respectively. Moreover, we identified the main efflux pump being expressed as MexCD-OprJ, with initial overexpression observed at 0.25 mg/L and 0.5 mg/L of ciprofloxacin and levofloxacin, respectively. These results demonstrated gyrA83 mutation and MexCD-OprJ overexpression as the primary mechanism conferring ciprofloxacin and levofloxacin resistance in P. aeruginosa. In addition, we also show that ciprofloxacin exhibited a stronger ability to kill the bacteria while potentially rendering it more susceptible to resistance.
Coronavirus (COVID-19) in Italy: knowledge, management of patients and clinical experience of Italian dentists during the spread of contagion
Authors: Putrino Alessandra , Raso Mario , Magazzino Cosimo , Galluccio Gabriella
Published: June 2020

Background: The coronavirus infection that emerged in China in the last few months of 2019 has now spread globally. Italy registered its first case in the second half of February, and in a short time period, it became the top country in Europe in terms of the number of infected people and the first in the world in terms of deaths. The medical and scientific community has been called upon to manage the emergency and to take measures. Dentists also need to take new precautions during their clinical activity to protect themselves, coworkers and patients from the risks of contagion and to avoid further spread of infection.Methods: Following the data published in the international literature as well as the guidelines and directives constantly updated by the WHO and by the national health authorities, a questionnaire to be completed anonymously was submitted online to Italian dentists using social tools and online professional platforms. The collected data were processed statistically, providing descriptive data and analysis of correlations of the most significant parameters using the Pearson’s χ2, the Likelihood-Ratio χ2, Cramér’s V, Fisher’s exact test, Goodman and Kruskal’s γ, and Kendall’s τb (p<0.05).Results: A total of 535 dentists from Italy participated in the survey. A good level of scientific knowledge about coronavirus and the extra precautionary measures needed to limit the spread was related to the age of respondents and their sex. Coming from areas with higher concentrations of cases affected knowledge, level of attention and perception of risk related to dental activity.Conclusions: At the moment, there are no therapies or vaccines to contain the infection with the new coronavirus that is causing many infections, many of which are fatal, worldwide. Dentists are one of the categories at highest risk of encountering diseases and infections because they work in close proximity with patients, and in their procedures, there is always contact with aerosols with high bacterial and viral potential. Therefore, during this COVID-19 emergency, it is important that dentists are properly informed and take the appropriate precautionary measures.
Finite element analysis of the initial stability of arthroscopic ankle arthrodesis with three-screw fixation: posteromedial versus posterolateral home-run screw
Authors: Wang Sen , Yu Jian , Zhao Dahang , Geng Xiang , Huang Jiazhang , Wang Xu , Ma Xin
Published: June 2020

Objective: Arthroscopic ankle arthrodesis (AAA) is a standard surgical method for the treatment of advanced traumatic ankle arthritis and has become more popular due to its advantages. To fix the tibiotalar joint, the use of three percutaneous screws is considered to have better mechanical stability than the use of two screws. However, it is sometimes difficult to insert three screws because they might block each other due to the small area of the tibiotalar joint surface and the large diameter of the screws; few articles illustrate how to insert three screws without the screws disturbing each other. The purpose of this study is to explore possible screw configurations of tripod fixation in arthroscopic ankle arthrodesis that avoid the collision of screws and yield better biomechanical performance.Methods: We used the finite element method to examine the impact of different screw positions and orientations on the biomechanical characteristics of a three-dimensional (3D) ankle model. Maximum and average micromotion, pressure on the articular surface, and von Mises stress values of the tibia and the talus were used to evaluate the initial stability of the ankle.﻿Results: Five kinds of three-screw configurations were identified, and finite element analysis results suggested that configurations with the posteromedial home-run screw presented lower micromotion (maximum: 17.96 ± 7.49 μm versus 22.52 ± 12.8 μm; mean: 4.88 ± 1.89 μm versus 5.19 ± 1.92 μm) (especially configuration 3) and better screw distributions on the articular surface than those with the posterolateral home-run screw.Conclusion: Screw configurations with the posteromedial home-run screw avoid collision and are more biomechanically stable than those with the posterolateral home-run screw. Thus, inserting the home-run screw through the posteromedial approach is recommended for clinical practice.
Prediction of lymph node metastasis by tumor-infiltrating lymphocytes in T1 breast cancer
Authors: Takada Koji , Kashiwagi Shinichiro , Asano Yuka , Goto Wataru , Kouhashi Rika , Yabumoto Akimichi , Morisaki Tamami , Shibutani Masatsune , Takashima Tsutomu , Fujita Hisakazu , Hirakawa Kosei , Ohira Masaichi
Published: June 2020

Background: Lymph node metastasis is more likely in early-stage breast cancer with lower tumor-infiltrating lymphocyte (TIL) density. Therefore, we investigated the correlation between TILs and lymph node metastasis in cT1 breast cancer patients undergoing surgery and the usefulness of TILs in predicting sentinel lymph node metastasis (SLNM) in cT1N0M0 breast cancer.Methods: We investigated 332 breast cancer patients who underwent surgery as the first-line treatment after preoperative diagnosis of cT1. A positive diagnosis of SLNM as an indication for axillary clearance was defined as macrometastasis in the sentinel lymph node (SLN) (macrometastasis: tumor diameter >2 mm). Semi-quantitative evaluation of lymphocytes infiltrating the peritumoral stroma as TILs in primary tumor biopsy specimens prior to treatment was conducted.Results: For SLN biopsy (SLNB), a median of 2 (range, 1-8) SLNs were pathologically evaluated. Sixty cases (19.4%) of SLNM (macrometastasis: 46, micrometastasis: 16) were observed. Metastasis was significantly greater in breast cancers with tumor diameter >10 mm than in those with diameter 10 mm (p = 0.016). Metastasis was significantly associated with lymphatic invasion (p <0.001). These two clinicopathological factors correlated with SLNM even in patients diagnosed with cN0 (tumor size; p=0.017, lymphatic invasion; p=0.002). Multivariate analysis for SLNM predictors revealed lymphatic invasion (p=0.008, odds ratio [OR]=2.522) and TILs (p<0.001, OR=0.137) as independent factors.Conclusions: Our results suggest a correlation between lymph node metastasis and tumor immune-microenvironment in cT1 breast cancer. TIL density may be a predictor of SLNM in breast cancer without lymph node metastasis on preoperative imaging.
Abnormal Expression and Prognostic Significance of EPB41L1 in Kidney Renal Clear Cell Carcinoma Based on Data Mining
Authors: Liang Taotao , Sang Siyao , Shao Qi , Chen Chen , Deng Zhichao , Wang Ting , Kang Qiaozhen
Published: June 2020

Background: EPB41L1 gene (erythrocyte membrane protein band 4.1 like 1) encodes the protein 4.1N, a member of 4.1 family, playing a vital role in cell adhesion and migration, which is associated with the malignant progression of various human cancers. However, the expression and prognostic significance of EPB41L1 in kidney renal clear cell carcinoma (KIRC) remain to be investigated. Methods: In this study, we collected the mRNA expression of EPB41L1 in KIRC through the Oncomine platform, and used the HPA database to perform the pathological tissue immunohistochemistry in patients. Then, the sub-groups and prognosis of KIRC were performed by UALCAN and GEPIA web-tool, respectively. Further, the mutation of EPB41L1 in KIRC was analyzed by c-Bioportal. The co-expression genes of EPB41L1 in KIRC were displayed from the LinkedOmics database, and function enrichment analysis was used by LinkFinder module in LinkedOmics. The function of EPB41L1 in cell adhesion and migration was confirmed by wound healing assay using 786-O cells in vitro. Co-expression gene network was constructed through the STRING database, and the MCODE plug-in of which was used to build the gene modules, both of them was visualized by Cytoscape software. Finally, the top modular genes in the same patient cohort were constructed through data mining in TCGA by using the UCSC Xena browser. Results: The results indicated that EPB41L1 was down-expressed in KIRC, leading to a poor prognosis. Moreover, there is a mutation in the FERM domain of EPB41L1, but it has no significant effect on the prognosis of KIRC. The co-expressed genes of EPB41L1 were associated with cell adhesion and confirmed in vitro. Further analysis suggested that EPB41L1 and amyloid beta precursor protein (APP) were coordinated to regulated cancer cell adhesion, thereby increasing the incidence of cancer cell metastasis and tumor invasion. Conclusions: In summary, EPB41L1 is constantly down-expressed in KIRC tissues, resulting a poor prognosis. Therefore, we suggest that it can be an effective biomarker for the diagnosis of KIRC.
Impact of a theory-informed and user-centered stroke information campaign on the public’s behaviors, attitudes, and knowledge when facing acute stroke: a controlled before-and-after study.
Authors: Haesebaert Julie , Laude C. , Termoz A. , Bravant E. , Perreton N. , Bony T. , Trehard H. , Porthault S. , Derex L. , Nighoghossian N. , Schott AM.
Published: June 2020

Background Public awareness of stroke symptoms is a key factor to ensure access to reperfusion strategies in due time. We designed and launched a regional theory-informed and user-centered information campaign and assessed its impact on emergency medical services (EMS) calls for stroke suspicion, time-to-call, and public attitudes and awareness concerning stroke.Methods A controlled before-and-after study was conducted during 3 sequential time-periods in 2 separate counties. Key messages of the campaign were underpinned by stroke representations and the theory of planned behavior, and focused on recognition of stroke warning signs and the need to call EMS urgently. The campaign included posters, leaflets, adverts and films displayed in bus and subway stations, internet, social networks, and local radio. Outcome measures on behavior, attitudes, and knowledge were assessed before the launch of the campaign, at 3 months, and 12 months.Results The number of EMS calls for stroke suspicion increased by 21% at 12 months in the intervention county and this change was significantly different to that observed in the control county (p = 0.02). No significant changes were observed regarding self-reported attitudes in case of stroke. An 8% significant increase in recognizing at least 2 stroke warning signs was observed in the intervention county (p = 0.04) at 3 months, while it did not change significantly in the control county (p = 0.6). However, there was no significant difference in warning sign recognition between both counties (p = 0.16).Conclusion The campaign significantly improved public’s behavior of calling EMS, although stroke knowledge was not improved as much as expected. Repeating these campaigns over time might further help improve timeliness and access to reperfusion strategies.
prevalence of Helicobacter pylori among Sudanese patients diagnosed with colon polyps and colon cancer using immunohistochemistry technique.
Authors: Mohamed Aziza K. , Elhassan Nazik M. , Awhag Zahra A. , Ali Fadwa S. , Ali Eman T. , Mhmoud Najwa A. , Siddig Emmanuel E. , Hassan Rowa , Ahmed Eiman S. , Fattahi Azam , Ahmed Ayman , Muneer Mohamed S. , Osman Hussam A. , Mohamed Nouh Saad , Edris Ali MM.
Published: June 2020

Objectives: Infection with the bacteria Helicobacter pylori has been classified as class one carcinogen associated with increasing susceptibility of gastritis and gastric carcinoma. This study is aiming at investigating the prevalence of H. pylori among colon polyps and colon cancer patients. A descriptive cross-sectional hospital-based study was conducted between February and June 2017. Sixty-nine formalin-fixed paraffin blocks collected from colon polyps and colon cancer patients to detect H. pylori using immunohistochemistry technique. Results: Of the Sixty-nine patients included in the study, 39 (56.5%) males and 30 (43.5%) were females, their age ranged from 21 to 80 years with a mean age of 47.1±19.7. Of the 69 colon polyps and colon cancer patients, 44 (63.8%) were diagnosed as adenocarcinoma, 10 (14.5%) colitis, 15 (21.7%) juvenile polyposis syndrome. The results of immunohistochemistry technique showed the presence of 16 (23.2%) positive patients for H. pylori infection. Of these 16, 13 (81.3%) patients were diagnosed with adenocarcinoma and 3 (18.7%) patients were diagnosed with juvenile polyps. The results of H. pylori detection among the different colon polyps and colon cancer patients were showing a statistically significant association for H. pylori infection and adenocarcinoma, P value 0.028.
Lung Adenocarcinoma with Metachronous Ovarian Metastasis: a long survival case report
Authors: Yao Shuyang , Wang Leiming , Tian Xiaoru , Zhang Yi
Published: June 2020

Lung adenocarcinoma which invades ovaries is very rare. However, with the increase of long-survival female lung cancer, more female patients will experience this situation. Because of the paucity of reported cases, the clinicopathological features and treatment strategies of these tumors remain unknown. This patient was stage IV lung adenocarcinoma at first diagnosis. Following multiple-line systemic treatments, she suffered extensive pelvic metastasis. After debulking surgery and reevaluation about the drive genes, she was administered by targeted therapy and finally achieved good efficacy with a long survival time. The comprehensive treatment modality for the bilateral ovarian metastasis is effective in clinical course.
One country's journey to interoperability: Tanzania's experience developing a national health information exchange
Authors: Nsaghurwe Alpha , Dwivedi Vikas , Ndesanjo Walter , Bams Haji , Busiga Moses , Nyella Edwin , Massawe Japhet Victor , Smith Dasha , Onyejekwe Kate , Metzger Jonathan , Taylor Patricia
Published: June 2020

Background and purpose: Robust, flexible, and integrated health information (HIS) systems are essential to achieving national and international goals in health and development. Such systems are still uncommon in most low and middle income countries. This article describes a first-phase activity in Tanzania to integrate the country’s vertical health management information system with the help of an interoperability layer that enables cross-program data exchange. Methods: From 2014 to 2019, the Tanzanian government and partners implemented a five-step procedure based on the “Mind the GAPS” (governance, architecture, program management, and standards) framework and using both proprietary and open-source tools. In collaboration with multiple stakeholders, the team developed the system to address major data challenges via four fully documented “use case scenarios” addressing data exchange among hospitals, between services and the supply chain, across digital data systems, and within the supply chain reporting system. This work included developing the architecture for health system data exchange, putting a middleware interoperability layer in place to facilitate the exchange, and training to support use of the system and the data it generates. Results: Tanzania successfully completed the five-step procedure for all four use cases. Data exchange is currently enabled among 15 separate information systems, and has resulted in improved data availability and significant time savings. The government has adopted the health information exchange within the national strategy for health care information, and the system is being operated and managed by Tanzanian officials. Conclusion: Developing an integrated HIS requires a significant time investment; but ultimately benefit both programs and patients. Tanzania’s experience may interest countries that are developing their HIS programs.
Mature B cell acute lymphoblastic leukemia with MLL-AF9 transcripts: three case reports and literature reviews
Authors: Guo Yuxia , Zhou Min , Zou Pinli , Liao Xin , Xiao Jianwen
Published: June 2020

Background: Mature B cell acute lymphoblastic leukaemia (BAL) is characterized by ALL-L3 morphology and the presence of surface immunoglobulin (sIgM) light chain restriction. t(8;14)(q24;q32) or its variants related to the MYC rearrangement (MYCr) are usually present in BAL, and BAL is considered the leukaemic phase of Burkitt lymphoma (BL). BAL with MLL rearrangement (MLLr) is rare. Methods: Three children with BAL and MLLr are presented. We also reviewed the context of 24 previously reported cases, and the features, treatment and prognosis were analysed. Results: Three BAL patients with MLLr were reported between January 2017 and November 2019, accounting for 1.37% of the B-ALL population; 24 patients were found in the literature. Thirteen males and 14 females were included, and the average age at diagnosis was 19.5 ± 4.95 months. Renal, CNS and skin involvement were present in 6, 4 and 3 patients, respectively. Twenty-six (96.30%) patients showed non-ALL-L3 morphology; negative or suspicious expression of CD20 was found in 64% of patients. MLLr was reported, but MYCr was not observed. Twenty-five (92.59%) patients achieved complete remission. Prospective event-free survival (pEFS) in patients who received allogeneic haematopoietic stem cell transplantation (allo-HSCT) was higher than that in patients who received chemotherapy (83.33% vs 41.91%). Conclusion: BAL patients with MLLr had unique manifestations, including a younger age at diagnosis and overexpression of CD19; expression of CD20 was rare, and MYCr was undetectable. The patients were sensitive to chemotherapy, but the pEFS was higher in patients undergoing allo-HSCT than in patients undergoing chemotherapy.
Comparative Analysis of Titanium Coating on Cobalt Chrome Alloy in Vitro & Vivo-Direct Metal Fabrication vs. Plasma Spraying
Authors: Suh Dongwhan , Jo Woo Lam , Kim Seung Chan , Kim Yong Sik , Kwon Soon Yong , Lim Young Wook
Published: June 2020

BackgroundTitanium surface coating on Cobalt-Chromium (CoCr) alloy has characteristic desirable for orthopedic implant; strength, osteointegrative capability, biocompatibility. Creating such coated surface takes challenging process and two dissimilar metals are not easily welded. In our study, we utilized additive manufacturing with 3D printing called direct metal fabrication (DMF) and compared it to plasma spraying method (TPS), to coat titanium onto CoCr alloy. We hypothesized that this would yield a coated surface quality as acceptable or better than already established method of plasma spraying. For this, we compared characteristics of titanium coated surfaces created by direct metal fabrication method (DMF) and titanium plasma spraying (TPS), both in-vitro & in-vivo, for (1) cell morphology, (2) confocal microscopy images of immunofluorescent assay of RUNX2 and fibronectin, (3) Quantification of cell proliferation rate, (4) push-out biomechanical test, and (5) bone histomorphometry. MethodFor in vitro study, human osteoblast cells were seeded onto the coated surfaces. Cellular morphology was observed with scanning electron microscope. Cellular proliferation was validated with ELISA, immunofluorescent assay. For in vivo study, coated rods were inserted into distal femur of rabbit and then harvested. The rods were biomechanically tested with push out test and observed for histomorphometry to evaluate microscopic bone to implant ratio. ResultFor cell morphology observation, lamellipodia and filopodia, a cytoplasmic projection extending into porous structure, formed on both surfaces created by DMF and TPS. Proliferation of the osteoblasts, the DMF group showed better result at different optic density levels (p = 0.035, 0.005, 0.001). Expression and distribution of fibronectin and Runx-2 genes showed similar degrees of expressions. Biomechanical push-out test yielded similar result (p = 0.714). Histomorphometry analysis also showed similar result (p = 0.657).Conclusion In conclusion, DMF is a method which can reliably create proper titanium surface on CoCr alloy. The resulting product of the surface shows similar quality to that of plasma spraying method, both in vivo and in vitro, in terms of biological and mechanical property.
Social and cognitive interactions through an interactive school service for RTT patients at the COVID-19 time
Authors: Dovigo Lucia , Caprì Tindara , Iannizzotto Giancarlo , Nucita Andrea , Semino Martina , Giannatiempo Samantha , Zocca Lia , Fabio Rosa Angela
Published: June 2020

Background
The closure of all educational institutions and most rehabilitation centers represents a precautionary measure to face the COVID-19 pandemic, but the isolation and social distancing may be particularly challenging for children with special needs and disabilities (SEND), such as Rett Syndrome (RTT). The main aim of this study was to promote cognitive and social interactions among children and girls with RTT, through the interactive school program
Methods
The Interactive School palimpsest was composed of moments in which the teacher spoke directly to the subjects with RTT and expected a response through eye gaze, and moments in which stories-cartoon were presented while tracking the eye gaze of the patients. We investigated behavioural, social and cognitive parameters.
Results
Patients attended both social and cognitive tasks with the spontaneous reduction of stereotypies and with the increase of attention. They recalled more significant indexes when the music or the song was presented together with the cartoon or the cognitive task.
Conclusions
this study provides initial insights in promoting cognitive and social interactions and into the support needs of families with a child with RTT during the COVID-19 pandemic.
Early Differences in Auditory Processing Relate to Autism Spectrum Disorder Traits in Infants with Neurofibromatosis Type 1
Authors: Ali Jannath Begum , Kolesnik Anna , Quiroz Isabel , Mason Luke , Garg Shruti , Green Jonathan , Johnson Mark H. , Jones Emily J. H.
Published: June 2020

Background: Sensory modulation difficulties are common in children with conditions such as Autism Spectrum Disorder (ASD), and could contribute to other social and non-social symptoms. Positing a causal role for sensory processing differences requires observing atypical sensory reactivity prior to the emergence of other symptoms, which can be achieved through prospective studies of elevated likelihood populations. Methods: We examined auditory habituation and change detection in 5 and 10-month-old infants with and without Neurofibromatosis Type 1 (NF1), a condition associated with higher likelihood of developing ASD. Results: in typically developing infants, habituation to vowel repetition and enhanced responses to vowel/pitch change decreased with age over posterior regions; age-related change was diminished in the NF1 group. Whilst both groups detected changes in vowel and pitch, the NF1 group were largely slower to show a differentiated neural response. Auditory responses did not relate to later language but were related to later ASD traits. Conclusions: These findings represent the first demonstration of atypical brain responses to sounds in infants with NF1, and suggests they may relate to the likelihood of later ASD.
Hybrid Resampling Technique to Tackle the Imbalanced Classification Problem
Authors: Gulati Payal
Published: June 2020

In the real-world domain, many learning models faces challenge in handling the imbalanced classification problem. Imbalanced classification is a scenario where the number of data points in minority class is much lower than that of the majority. Our primary concern is the minority class, which is often neglected by learning models while predicting the values. This problem can be tackled at the data-level by using resampling techniques. In this research, hybrid of Synthetic Minority Oversampling Technique (SMOTE) and Neighborhood Cleaning Rule (NCL) is proposed to balance the data points of the classes. For experiment real-world dataset of credit card transaction has been utilized where the fraudulent (or malefactor) transaction needs to be identified. This imbalanced dataset after resampling is classified by using the logistic regression model. The experimental results depict that the learning model has correctly identified the malefactor in the balanced dataset than the original dataset. Through balancing the datasets, the proposed technique aims to enhance the performance of the learning model in order to correctly identify the cases of the minority class.
LncRNAH19 improves insulin resistance in skeletal muscle by regulating heterogeneous nuclear ribonucleoprotein A1
Authors: Gui Weiwei , Zhu WeiFen , Zhu Yiyi , Tang Shengjie , Zheng Fenping , Yin Xueyao , Lin Xihua , Li Hong
Published: June 2020

Background
Skeletal muscle is essential for glucose and lipid metabolism. Growing evidence reveals the importance of long non-coding RNAs (LncRNAs) in metabolism. This study aimed to investigate the function of LncRNA H19 (H19) in lipid metabolism of skeletal muscle and its potential mechanisms.
Methods
Glucose tolerance, serum insulin and lipid content in serum and skeletal muscle were determined in control and H19-overexpressed db/db mice. Lipid metabolism was evaluated in H19-overexpressed or H19-silencing muscle cells by detecting lipid contents and mitochondria related functions. The underlying mechanisms were explored by RNA pull-down, mass spectrometry and RNA immunoprecipitation (RIP).
Results
H19 was downregulated in skeletal muscle of db/db mice. H19 overexpression in db/db mice inhibited lipid ectopic deposition in skeletal muscle, meanwhile improved glucose intolerance and insulin resistance as compared with control db/db mice treated with ad-GFP. Furthermore, overexpression of H19 reversed FFA-induced lipid accumulation and increased cellular respiration in muscle cells, while H19 knockdown exhibited opposite effects in muscle cells. Mechanistically, H19 interacted with heterogeneous nuclear ribonucleoprotein (hnRNPA1) which was validated by RNA pulldown and RIP analysis, which increased translation of fatty acid oxidation closely related genes PGC1a and CPT1b.
Conclusion
Our data suggest that overexpression of H19 ameliorates insulin resistance by reducing ectopic lipid accumulation in skeletal muscle. The possible underlying mechanisms are that overexpression of lncRNAH19 promotes fatty acids oxidation via targeting of hnRNPA1.
Luks-pv Induces Apoptosis Through Methyltransferase Set8 in Human Acute Myeloid Leukaemia Cells
Authors: Xu Liangfei , Shi Lan , Ding Pengsheng , Ma Fan , Wang Yangyan , Liu Xueer , Song Kaidi , Qiang Ping , Chang Wenjiao , Dai Yuanyuan , Mei Yide , Ma xiaoling
Published: June 2020

Background We previously reported that LukS-PV induces apoptosis in human acute myeloid leukaemia (AML) cells. Furthermore, SET8 is a member of the SET domain-containing methyltransferase family and overexpressed in numerous tumours, including AML and indicated a poor prognosis. However, it is unclear whether LukS-PV induce apoptosis via SET8. In current study, we aimed to investigate the regulatory mechanisms of SET8 and effects on AML cells under the LukS-PV.Methods Flow cytometry was performed to detect apoptosis in AML primary blasts/cell lines treated with LukS-PV and invasion of AML cells in vivo. The expression of SET8 was quantified through reverse-transcription PCR and western blotting. Chromatin-immunoprecipitation (ChIP) sequencing and bioinformatic methods was performed to explore transcriptional target genes which regulated by SET8-H4K20me1 axis. All experiments were performed in triplicate, and all statistical analyses were conducted using SPSS 16.0.Results In this research, we found that LukS-PV induce cell apoptosis in vitro and inhibit cell invasion in vivo. Our results further confirmed SET8 and H4K20me1 were downregulated in LukS-PV-treated AML cells. Furthermore, we confirmed that LukS-PV induced apoptosis via downregulating SET8/H4K20me1. Finally, Genome-wide analysis identified PIK3CB is the target gene for cell apoptosis mediated by SET8/H4K20me1. In a nutshell, LukS-PV induces apoptosis via the PIK3CB/PI3K/AKT/FOXO1 signal pathway by targeting SET8.Conclusions The present results indicate that LukS-PV induces apoptosis in AML cells by downregulating SET8 and regulating downstream molecular targets, suggesting that SET8 is a potential target for AML therapy using LukS-PV for anti-leukaemia treatment.
A One Health Framework to Estimate Costs of Antimicrobial Resistance
Authors: Morel Chantal , Alm Richard , Ardal Christine , Bandera Alessandra , Bruno Giacomo , Carrara Elena , Colombo Giorgio , de Kraker Marlieke , Essack Sabiha , Frost Isabel , Gonzalez-Zorn Herman Bruno , Guardabassi Luca , Harbarth Stephan , Jørgensen Peter S. , Kanj Souha , Kostyanev Tomislav , Laxminarayan Ramanan , Leonard Finola , Hara Gabriel Levy , Mendelson Marc , Mikulska Malgorzata , Mutter Nico , Outterson Kevin , Baňo Jesus Rodriguez , Scudeller Luigia , Tacconelli Evelina
Published: June 2020

Objectives/PurposeThe costs attributable to antimicrobial resistance (AMR) across human, animal, and environmental health remain theoretical and largely unspecified. Current figures fail to capture the full health and economic burden caused by AMR; historically many studies have considered only direct costs associated with human infection from a hospital perspective, primarily from high-income countries. The Global Antimicrobial Resistance Platform for ONE-Burden Estimates (GAP-ON€) network aimed to develop a global, One Health AMR Cost Framework, that can be used by countries, regions, and other entities to quantify the economic burden attributable to AMR.MethodsGAP-ON€ (funded under the JPIAMR 8th call (Virtual Research Institute) is composed of 19 international networks and institutions active in the field of AMR. It operated by means of Delphi rounds, teleconferences (TCs) and face-to-face (F2F) meetings. It assumes a bottom-up cost estimate, at the National level, with a global scope across all One Health Areas.ResultsThe resulting framework consists of the epidemiological data and the direct and indirect cost components, linked by the likelihood of each AMR-related health state that imposes such costs, across all One Health Areas for a large number of relevant pathogens. It represents a first step towards more comprehensive analyses for comparing cost-effectiveness of AMR interventions at the local level as well as more harmonised analyses at the global level.ConclusionThis is the first full AMR costing framework to be developed for bacterial pathogens in human and animal health and the environment. It aims to provide guidance on the data items necessary to calculate AMR costs in a global, One Health perspective to facilitate harmonized, full economic analyses. It is only through building a realistic cost picture that we can make informed decisions about potential strategies and political priorities.