bluuebunny/crossref_metadata_2025 huggingface dataset:
Synergistic Effect of PD-L1 and HLA Class I On Prognosis of Patients With Hepatocellular Carcinoma
Authors: Pei Renguang , Wang Guoxiang , Zhang Weixuan , Wang Sufen , Huang Xi , Zou Yinghua
Published: September 2020

Background: Up-regulating the expression of PD-L1 and down-regulating the expression of HLA class I are the two main means of tumor-induced immune tolerance. The purpose of this study is to explore whether there is synergistic effect of up-regulation of PD-L1 and down-regulation of HLA-I on prognosis in hepatocellular carcinoma (HCC). Methods: A cohort of 185 consecutive HCC patients was included in this study. According to the expression of PD-L1 and HLA class I, patients were divided into three subgroups: group A was PD-L1 negative + HLA class I high expression, group B was PD-L1 positive + HLA class I high expression or PD-L1 negative + HLA class I low expression, group C was PD-L1 positive + HLA class I low expression. Results: PD-L1 positive was significantly associated with cirrhosis and tumor-infiltrating lymphocytes (P = 0.026; P= 0.000, respectively). Neither of PD-L1 positive and HLA class I low expression was significantly associated with shorter survival patients (P = 0.116; P = 0.171, respectively). The overall survival time of group C was significantly lower than that of group A and group B (31 months vs 58 months vs 49 months, P = 0.004), which was further confirmed by multivariate Cox regression analysis (group A/B vs group C, HR 3.652, 95%CI 1.627-8.200, P= 0.002). Conclusions: The synergistic effect of PD-L1 positive and HLA class I low expression could result into a significant reduction in survival of patients with HCC, providing theoretical support for the combination of immunotherapy in future.
Insulin Increases The Central-To-Peripheral Arterial Stiffness Gradient in Response To Hyperglycemia in Healthy Humans: A Randomized Four-Way Crossover Study
Authors: Horton William B , Jahn Linda A , Hartline Lee M , Aylor Kevin W , Barrett Eugene J
Published: September 2020

Background: Increasing arterial stiffness is a physiological feature of vascular aging that is accelerated by conditions that enhance cardiovascular risk, including diabetes mellitus. Emerging evidence demonstrates that reversal of the normal central-to-peripheral arterial stiffness gradient predicts adverse cardiovascular consequences, including target organ damage. Preferential stiffening of central over peripheral arteries has been reported in type 2 diabetes, though mechanisms for this remain unclear.Methods: We tested the effect of acutely increasing plasma glucose, plasma insulin, or both on central arterial stiffness (carotid-femoral pulse wave velocity) and peripheral arterial stiffness (radial artery augmentation index) in a randomized, four-way, crossover study of 19 healthy young adults. We also measured myocardial oxygen supply-demand (subendocardial viability ratio) and hemodynamic function. Results: Carotid-femoral pulse wave velocity increased during hyperglycemic-hyperinsulinemia (+0.4 m/s; p=0.02) but not with euglycemia, hyperglycemia, or euglycemic-hyperinsulinemia. There were no significant changes in radial artery augmentation index within any protocol (all p>0.05), though this value trended lower with hyperglycemic-hyperinsulinemia (opposite of the observed effect on carotid-femoral pulse wave velocity). No changes were observed in subendocardial viability ratio within any protocol. Heart rate significantly increased only during hyperglycemic-hyperinsulinemia (+3.62 bpm; p=0.02). There was a significant inverse correlation between peripheral and arterial stiffness during hyperglycemic-hyperinsulinemia. Conclusions: We conclude that combined hyperglycemia and hyperinsulinemia acutely increases aortic stiffness, diminishes the normal central-to-peripheral arterial stiffness gradient, and increases heart rate in healthy humans. (ClinicalTrials.gov number NCT03520569; registered 9 May 2018).Clinical Trial Information: ClinicalTrials.gov identifier NCT03520569 (registered 9 May 2018).
Correlations of PD-1/PD-L1 Gene Polymorphisms With Susceptibility and Prognosis in Non-Hodgkin Lymphoma in Iranian Population
Authors: Hoseini Hosnie , Yaghmaei Parichehreh , Bahari Gholamreza , Aminzadeh Saeed
Published: September 2020

Background, Programed cell death 1 (PD-1) and its ligand (PD-L1) activity have already detected in various cancers. In non-Hodgkin lymphoma (NHL), however, the prognostic value of PD-1/PD-L1 genes polymorphisms and expression levels remains unclear. In the present study we aimed to investigate the relationship between genetic polymorphisms of PD-1/PD-L1 genes and non-Hodgkin lymphoma in Iranian papulation. Methods, four single nucleotide polymorphisms of the PD-1/PD-L1 genes, including 134 NHL patients and 125 healthy controls were examined using PCR-RFLP method. The expression level of PD-1/PD-L1 genes were analyzed using real time PCR method.Results, our data demonstrated that the PD-L1 rs2890685 (A>C) SNP (p<0.0001) significantly was associated with increased risk of NHL. The AA genotype of PD-L1 rs2890685 polymorphism was found to be more prevalent in NHL patents compared to healthy controls. No significant association were found between PD-L1 rs4143815, PD-1 rs11568821, PD-1rs2227981 SNPs and the risk of NHL incidence. Furthermore, our data showed that the mRNA transcription levels of both PD-1 and PD-L1 were significantly higher than normal healthy controls (p<0.001).Conclusion, Collectively, our finding demonstrated that the functional PD-L1 rs2890685 polymorphism was associated with NHL risk, suggesting that genetic variant of PD-L1 might be a possible prognosis marker for prediction of NHL risk and its development.
TGM2 Has Potential to Be A Prognostic Factor for Lung Squamous Cell Carcinoma and an Indicator of Immune Infiltrates
Authors: Chen Binglin , Liu Wenqi , Liang Chunxiao , Lan Feifeng
Published: September 2020

Background: TGM2 is a functionally diverse molecule that has multiple roles in mediating signal transduction and inflammation. However, the prognostic value of TGM2 and its correlation with tumor-infiltrating immune cells in lung squamous cell carcinoma (LUSC) remains elusive. Methods: Datasets of LUSC were downloaded from The Cancer Genome Atlas (TCGA) to analyze the expression of TGM2 in LUSC. Then, Univariable survival and Multivariate Cox analysis was used to analyze the survival effect of several clinical characteristics. The influence of TGM2 on survival of LUSC patients was evaluated by Gene Expression Profiling Interactive Analysis (GEPIA). The relationship between TGM2 and tumor-infiltrated immune cells was analyzed using the Tumor Immune Estimation Resource (TIMER).Results: TGM2 expression was remarkably lower in LUSC tissues than in the corresponding normal tissues. Low TGM2 expression was correlated with better OS in LUSC. Multivariate survival analysis demonstrated that high TGM2 expression was an independent risk factor for OS.TGM2 expression was significantly positively associated with infiltrating levels of macrophages, meanwhile was strongly correlated with various markers of immune cells, especially tumor-associated macrophages (TAMs) and T-regulatory cells (Tregs).Conclusions: TGM2 is a prognostic biomarker and correlated with immune infiltrates in LUSC.
Association Between an Increase in Blood Urea Nitrogen at 24 Hours and Worse Outcomes in COVID-19 Pneumonia
Authors: Ye Bo , Deng Hongbin , Tong Zhihui , Liang Jingjing , Zhou Jing , Li Gang , Mao Wenjian , Zhao Hanwei , Ke Lu , Li Weiqin
Published: September 2020

Background and objectives: The dynamic change of blood urea nitrogen (BUN) have been proved to be related to the worse outcomes in various diseases such as pulmonary embolism, acute pancreatitis and acute nonvariceal upper GI bleeding. In the present study, we aimed to identify the association between blood urea nitrogen (BUN) change and clinical outcomes in patients presenting with COVID-19 pneumonia.Methods: This is a retrospective study conducted in the Huoshenshan hospital. Patients with laboratory-confirmed COVID-19 from Feb 5th to March 5th in 2020 who had BUN level tested on admission and on the second day consecutively were included. Patients were stratified into two groups according to the BUN change (increase vs. no increase) during the first 24 hours. The primary outcome was in-hospital mortality. Moreover, other clinical outcomes were also compared. The potential risk factors of in-hospital mortality were analyzed. Results: There were 266 patients included in the study. The mean change in BUN at 24 hours was 1.0 mg/dL, with 206 patients (77.4%) experiencing no increase in BUN and 60 patients (22.6%) experiencing an increase in BUN. In-hospital mortality was significantly higher in the BUN increase group compared to no increase group (30.0% vs. 5.8%, P<0.001). BUN increase group also had higher requirement for ICU admission, use of invasive mechanical ventilation and incidence of AKI (all P<0.001). After adjusted for related factors, the BUN increase was independently associated with the mortality with an odds ratio of 7.427[95% CI 2.370-23.279]. In the multivariable and survival analysis, BUN increase was also found to be associated with survival regardless of the admission BUN.Conclusions: In patients with COVID-19, BUN increase at 24 hours was an independent predictor for a composite clinical outcome and in-hospital mortality. The association of BUN increase with worse outcomes further emphasizes the importance of monitoring BUN change and kidney function in the course of COVID-19.
Machine learning prediction models based on hub genes related to immune phenotypes in muscle-invasive bladder cancer treated with immune checkpoint blockade
Authors: Li Peiheng , Chen Zhi-Xin , Wang Dong , Zheng Zhi , Ji Zhi-Gang
Published: September 2020

Background

Bladder cancer is one of the most frequent cancer in the world. Muscle-invasive bladder cancer (MIBC) is a more aggressive subtype with higher morbidity and mortality. ICB therapy has shown potential for treating MIBC, but is limited due to the lack of predictive biomarkers.
Methods

1601 MIBC transcriptomic profiles were obtained from 10 datasets. Unsupervised clustering of immune phenotypes in MIBC were performed based on immune-related signature genes. We analyzed the characteristics including immune microenvironments, metabolic pathways, and survival rates in different phenotypes. Multi-omic analysis and WGCNA were performed to identify hub genes distinguishing phenotypes related to prognosis. A model was established and CART was employed to predict the response of patients treated with ICB.
Results

Of various immune phenotypes, cluster 3C was the most “inflamed” subcluster with the best prognosis, while cluster 1A was associated with “non-inflammation” and worse prognosis. WGCNA analysis identified 5 hub genes related to the survival rate of patients, IFNG, CXCR6, IL2RB, LCK, and PSMB10, which were utilized for prognostic score model and decision tree analysis. The areas under the curve (AUC) of the ROC curves predicting 5-year endpoint generated from the risk-based prediction model were 0.652. The mean accuracy, sensitivity, and specificity of CART for predicting stable disease/progressive disease were 70.1%, 70.0% and 71.7%.
Conclusions

The 5 hub genes and generated models showed the potential for predicting the prognosis for patients receiving ICB therapy. The molecular mechanisms regulating the expression of the hub genes require further studies in the future.
REMOTE#RESEARCH - A Telediagnosis Assistance System for Multiple-Lead Electrocardiography
Authors: Bentes Paulo , Nadal Jurandir
Published: September 2020

Background : The diffusion of telemedicine opens up a new perspective for the development of technologies furthered by Biomedical Engineering. In particular, herein we deal with those related to telediagnosis through multiple-lead electrocardiographic signals. Objectives : This study focuses on the proof-of-concept of an internet-based telemedicine system as a use case that attests to the feasibility for the development, within the university environment, of techniques for remote processing of biomedical signals for adjustable detection of myocardial ischemia episodes. Methods : At each signal lead, QRS complexes are detected and delimited with the J -point marking. The same procedure to detect the complex is used to identify the respective T wave, then the area over the ST segment is applied to detect ischemia-related elevations. The entire system is designed on web-based telemedicine services using multiuser, remote access technologies, and database.Results : The measurements for sensitivity and precision had their respective averages calculated at 11.79% and 24.21% for the lead s of lower noise. T he evaluations regarding the aspects of user friendliness and the usefulness of the application, resulted in 88.57% and 89.28% of broad or total acceptance, respectively .Conclusions : They are robust enough to enable scalability and can be offered by cloud computing, besides enabling the development of new biomedical signal processing techniques within the concept of distance services, using a modular architecture with collaborative bias.
Predicting Language Recovery in Post-Stroke Aphasia using Behavior and Functional MRI
Authors: Iorga Michael , Higgins James , Caplan David , Zinbarg Richard , Kiran Swathi , Thompson Cynthia K. , Rapp Brenda , Parrish Todd B.
Published: September 2020

Background: Language outcomes after speech and language therapy in post-stroke aphasia are challenging to predict. This study examines behavioral language measures and resting state fMRI (rsfMRI) as prognostics for response to language therapy. Methods: Seventy patients with chronic aphasia were recruited and treated for one of three deficits: anomia, agrammatism, or dysgraphia. Treatment effect was measured by performance on a treatment-specific language measure, assessed before and after three months of language therapy. Each patient also underwent an additional 27 language assessments and an fMRI scan at baseline. Patient scans were decomposed into 20 components by group independent component analysis, and each component time series was summarized by its fractional amplitude of low-frequency fluctuations (fALFF). Results: Treatment effects were modelled with elastic net regression, using clinical language measures and fALFF imaging predictors independently. Correlation analyses showed high performance for language measures in anomia (r = 0.958, n = 30) and for fALFF predictors in agrammatism (r = 0.940, n = 11) and dysgraphia (r = 0.925, n = 18). These models are state-of-the-art for aphasia recovery prediction. Conclusion: Predicting aphasia recovery with rsfMRI features may outperform predictions from clinical language measures in some patient populations. This suggests rsfMRI may have prognostic value for chronic aphasia patients undergoing language therapy. Differentiating patients who respond to therapy from those who do not is a first step towards personalized treatment in post-stroke aphasia.
Immune Score Closely Associated With Tumor Microenvironment as A Prognostic Factor in Lung Adenocarcinoma
Authors: Li Na , Chen Xiaoling , Liu Chang , Feng Yong , Sun Xiaoqiang , Liu Yongyu
Published: September 2020

Background: The tumor microenvironment plays a vital role in tumor biology and has recently attracted widespread attention. However, the prognostic significance of integrated immune scores in lung adenocarcinoma has not yet been identified. This study aimed to systematically estimate the association between immune scores and prognosis and develop a clinical nomogram to predict the survival of patients with lung adenocarcinoma. This study also systematically explored the underlying prognostic factors of the immune score in lung adenocarcinoma.Methods: Public datasets for lung adenocarcinoma was acquired from The Cancer Genome Atlas data portal. The immune score of each sample was calculated using the ESTIMATE algorithm. Univariate and multivariate Cox regression analyses identified several significant prognostic factors and further developed a prognostic nomogram. The C-index, calibration curve, and ROC curve were used to evaluate the predictive accuracy and discriminative ability of the resultant nomogram. Results: We found that patients with higher immune scores had a better prognosis (log rank test p = 0.0004). The nomogram that integrated the immune score could effectively stratify high-risk LUAD patients in terms of clinical response. Patients in the high-risk groups usually had a worse prognosis (log rank test p < 0.0001) and higher mortality. The mortality rate in high and low risk groups was 42.67% and 26.37%, respectively (p < 0.0001). In addition, correlation analysis showed that the immune score was significantly dependent on the mRNA expression of immunotherapy-associated biomarkers (PD-1, PD-L1, and LAG3) as well as on the presence of certain immune cell subtypes, but had no correlation with tumor mutation burden.Conclusion: The immune score is a prognostic factor in lung adenocarcinoma. The nomogram with an integrated immune score can effectively predict the survival of patients with lung adenocarcinoma. The mechanism by which the immune score estimates the prognosis of patients with lung adenocarcinoma is related to the tumor immune microenvironment.
Genome-wide transcriptomic analysis of n-caproic acid production in Ruminococcaceae bacterium CPB6 with lactate supplementation
Authors: Tao Yong , Lu Shaowen , Wang Yi , Wei Cuicui , Jin Hong , He Xiaohong
Published: September 2020

Background

n-Caproic acid (CA) is gaining increased attention due to its high value as a chemical feedstock. Ruminococcaceae bacterium strain CPB6 is an anaerobic mesophilic bacterium that is highly prolific in its ability to perform chain elongation of lactate to CA. However, little is known about the genome-wide transcriptional analysis of strain CPB6 for CA production triggered by the supplementation of exogenous lactate.
Results

In this study, 0.5% lactate was supplemented into the fermentation with Ruminococcaceae bacterium CPB6 for CA production. Compared to the control (without lactate supplementation), lactate supplementation led to earlier CA production and higher final CA titer and productivity. Transcriptional analysis was carried out using RNA-Seq for the culture with and without lactate supplementation (two groups) at growth and stationary phases, respectively. It has been indicated that 295 genes whose changes in expression patterns were substrate and/or growth dependent. These genes cover crucial functional categories. Specifically, 5 genes responsible for the reverse β-oxidation pathway, 11 genes encoding ATP-binding cassette (ABC) transporters, 6 genes encoding substrate-binding protein (SBP) and 4 genes encoding phosphotransferase system (PTS) transporters were strikingly upregulated in response to the addition of lactate. These genes would be candidates for future studies aiming at understanding the regulatory mechanism of lactate conversion into CA, as well as for the improvement of CA production in strain CPB6.
Conclusions

This study suggested that lactate supplementation can promote CA production by altering the expression patterns of genes involved in the essential metabolic pathways, such as central pyruvate metabolism, the reverse β-oxidation pathway, ABC and PTS transports. The findings presented herein reveal unique insights into the biomolecular effects of lactate on CA production at the gene transcriptional level.
Protocol to Evaluate the Implementation of an Enterprise-Wide Initiative to Increase Access to Lung Cancer Screening in the Veterans Health Administration
Authors: Lewis Jennifer A. , Spalluto Lucy B. , Henschke Claudia I. , Yankelevitz David F. , Aguayo Samuel M. , Morales Providencia , Avila Rick , Audet Carolyn M. , Prusaczyk Beth , Lindsell Christopher J. , Callaway-Lane Carol , Dittus Robert S. , Vogus Timothy J. , Massion Pierre P. , Limper Heather M. , Kripalani Sunil , Moghanaki Drew , Roumie Christianne L.
Published: September 2020

Background

The Veterans Affairs Partnership to increase Access to Lung Screening (VA-PALS) is an enterprise-wide initiative to implement high quality lung cancer screening programs at VA medical centers (VAMCs). VA-PALS will be using implementation strategies that include program navigators to coordinate screening activities, trainings for navigators and radiologists, an open-source software management system, tools to standardize low-dose computed tomography (LDCT) image quality, and access to a support network. Individual VAMCs can utilize strategies according to their local contextual factors. In this protocol, we describe the planned program evaluation for the initial 10 VAMCs participating in VA-PALS.
Methods

The implementation of programs will be evaluated using the Consolidated Framework for Implementation Research to ensure broad contextual guidance. Program evaluation measures have been developed using the Reach, Effectiveness, Adoption, Implementation and Maintenance framework. Adaptations of screening processes will be assessed every six months using the Framework for Reporting Adaptations and Modifications to Evidence Based Interventions. Measures collected will reflect the inner setting at each VAMC, estimate and describe the population reached, adoption by providers, implementation of the programs, report patient clinical outcomes and maintenance of screening programs. Analyses will primarily use descriptive statistics with means, medians, and frequencies. Outcomes will be compared over time and among VA-PALS VAMCs and non-VA-PALS VAMCs in interrupted time series analyses. Assessment of contextual factors and the relationship between predictors, such as organizational readiness and improved implementation, will be evaluated. Adaptations of processes to overcome barriers will be identified and evaluated for association with implementation.
Conclusion

This theory-based protocol will evaluate the implementation of lung cancer screening programs across the Veterans Health Administration (VHA) using scientific frameworks. The findings will inform plans to expand the VA-PALS initiative beyond the original sites and can guide implementation of lung cancer screening programs more broadly within and outside VHA.
Combination of Monocyte Human Leukocyte Antigen-DR and β-d-Glucan for the Early Diagnosis of Invasive Candida Infection in Critically Ill Patients: A Proof of Concept Study
Authors: Jung Boris , Bihan Clément Le , Portales Pierre , Bourgeois Nathalie , Vincent Thierry , Lachaud Laurence , Chanques Gerald , Conseil Matthieu , Corne Philippe , Massanet Pablo , Timsit Jean François , Jaber Samir
Published: September 2020

Background: Precision medicine risk stratification is desperately needed to both avoid systemic antifungals treatment delay and over prescription in the critically ill with risk factors. The aim of the present study was to explore the combination of host immunoparalysis biomarker (monocyte human leukocyte antigen-DR expression (mHLA-DR)) and Candida sp wall biomarker β-d-glucan in risk stratifying patients for secondary invasive Candida infection (ICI). Methods: Prospective observational study. Two intensive care units (ICU). All consecutive non-immunocompromised septic shock patients. Serial blood samples (n=286) were collected at day 0, 2 and 7 and mHLA-DR and β-d-glucan were assayed. Secondary invasive Candida sp infection occurrence were then followed. Results: Fifty patients were included, 42 (84%) had a Candida score equal or greater than 3 and 10 patients developed a secondary invasive Candida sp infection. ICU admission mHLA-DR expression and β-d-glucan (BDG) failed to predict secondary invasive Candida sp infection. Time-dependent cause-specific hazard ratio of ICI was 6.56[1.24-34.61] for mHLA-DR < 5000 Ab/c and 5.25[0.47-58.9] for BDG > 350pg/mL. Predictive negative value of mHLA-DR > 5000 Ab/c and BDG > 350 pg/mL combination at day 7 was 81% [95%CI 70-92]. Conclusion: This proof of concept study suggests that mHLA-DR predicts ICI in high risk patients with septic shock. The added value of BDG and other fungal tests should be regarded according to the host immune function markers. Trial registration: ClinicalTrials.gov identifier: NCT03136081Take home message: Combination of monocytic HLA-DR expression and beta-D-glucan in patients hospitalized for septic shock failed to predict invasive candida infection but could be useful to rule out infection.
Apo A1 / Apo B Ratio and Acute Coronary Syndrome Among Peritoneal Dialysis Patients
Authors: Chen Tianlei , Yang Min
Published: September 2020

Background: Acute coronary syndrome (ACS) is prevalent in continuous ambulatory peritoneal dialysis (CAPD) patients. But the association between apoprotein profile and ACS is not well known. Therefore, we aimed to investigate the relationship between apoproteins and ACS in CAPD patients.Methods: Eighty-one CAPD patients were included in this retrospective study. The primary endpoint was ACS. Predictors were baseline apoprotein levels, particularly the ratio of apoprotein A1 (Apo A1) / apoprotein B (Apo B). Binary logistics regression was used to determine the relationship between Apo A1 / Apo B and ACS. Results: During follow-up, 34 (41.98%) CAPD patients experienced an ACS. ACS patients had higher levels of total cholesterol (p = 0.03), LDL-C (p = 0.04), CRP (p = 0.01), and Apo B (p < 0.01). However, hemoglobin (p = 0.01) and the Apo A1 / Apo B (p < 0.01) were lower in the ACS group than the non-ACS group. Patients with Apo A1 / Apo B ≥ 1.105 experienced fewer ACS compared with those with Apo A1 / Apo B < 1.105 (33.33% vs. 75.56%, p = 0.03). In binary logistics regression, Apo A1 / Apo B (OR, 0.01; 95% CI, 0.00-0.77; p = 0.04) was independently associated with ACS. Conclusions: Apo A1 / Apo B were strongly associated with ACS, and may be considered as a predictor of future ACS in CAPD patients.
Tanshinone IIA Combined With CsA Inhibit Myocardial Cell Apoptosis Induced by Renal Ischemia-reperfusion Injury by Modulating Mitochondrial Function Through PI3K/Akt/Bad Pathway in Obese Rats 
Authors: Tai He , Jiang Xiao-lin , Li Yue , Kong Liang , Yao Si-cheng , Song Nan , Lv Mei-jun , Wu Jin , Yang Ping , Yang Guan-lin , Kuang Jin-song , Lan Zhi-ming , Jia Lian-qun
Published: September 2020

Background: Acute myocardial injury (AMI), which is induced by renal ischemia-reperfusion (IR), is a significant cause of acute kidney injury (AKI)-related associated death. Obesity increases the severity and frequency of AMI and AKI. Tanshinone IIA (TIIA) combined with cyclosporine A (CsA) pretreatment was used to alleviate myocardial cell apoptosis induced by renal IR, and to determine whether TIIA combined with CsA would attenuate myocardial cell apoptosis by modulating mitochondrial function through the PI3K/Akt/Bad pathway in obese rats. Methods: Male rates were fed a high fat diet for 8 weeks to generate obesity. AKI was induced by 30 min of kidney ischemia followed 24 h of reperfusion. Obese rats were given TIIA (10 mg/kg·d) for 2 weeks and CsA (5 mg/kg) 30 min before renal IR. Related indicators were examined.Results: TIIA combined with CsA alleviated the pathohistological injury and apoptosis induced by renal IR in myocardial cells. In addition, TIIA combined with CsA improved cardiac function and decreased the serum myocardial enzyme spectrum in obese rats after renal IR. At the same time, TIIA combined with CsA improved mitochondrial function. Abnormal function of mitochondria was supported by decreases in the respiration controlling rate (RCR), intracellular adenosine triphosphate (ATP), oxygen consumption rate, and mitochondrial membrane potential (MMP), and increases in mitochondrial reactive oxygen species (ROS), opening of the mitochondrial permeability transition pore (mPTP), mitochondrial DNA damage, and mitochondrial respiratory chain complex enzymes (Ⅰ, Ⅱ, Ⅲ, Ⅳ, and Ⅴ). The injury of mitochondrial dynamic function was assessed by a decrease in Drp1, and increases in Mfn1 and Mfn2, and mitochondrial biogenesis injury was assessed by decreases in PGC-1, NRF1, and TFam. TIIA combined with CsA can attenuate apoptosis through modulating mitochondrial function through the PI3K/Akt/Bad pathway in obese rats.Conclusion: We used isolated mitochondria from rat myocardial tissues to demonstrate that myocardial mitochondrial dysfunction occurred along with renal IR to induce myocardial cell apoptosis; obesity aggravated apoptosis. TIIA combined with CsA attenuated myocardial cell apoptosis by modulating mitochondrial function through the PI3K/Akt/Bad pathway in obese rats.
Development of A Vitamin-related Gene Signature to Predict the Immune Characteristics and Prognosis of Glioma
Authors: Zhang Qing , Liang Qingyu , Guan Gefei , Cheng Wen , Yang Lianhe , Wu Anhua
Published: September 2020

Background: Vitamins not only play a pivotal role in maintaining homeostasis of the body, but also have complex impacts on the occurrence and progression of tumors. However, the effects of vitamins on glioma and the underlying mechanism have not been fully elucidated. Methods: Vitamin -related genes were extracted from the Molecular Signature Database v7.1 (MSigDB). The overlapping overall survival (OS)-related genes in The Cancer Genome Atlas (TCGA), the Chinese Glioma Genome Atlas (CGGA), and GSE16011 cohorts screened out by univariate COX regression analysis were utilized to construct a risk model based on the TCGA cohort via random survival forest analysis and multivariate COX regression analysis. The powerful prognostic predictive potential of the vitamin-related risk signature was verified by Kaplan–Meier survival analysis and receiver operating characteristic (ROC) analysis in the three datasets. The ssGSEA method of the GSVA package was used for functional enrichment and immune cell component analyses. ESTIMATE score analysis was used for auxiliary analysis of glioma immune characteristics. A nomogram was constructed and assessed based on the TCGA dataset.Results: The vitamin-related six-gene (POSTN, IRX5, EEF2, RAB27A, MDM2, and ENO1) risk signature constructed based on the TCGA dataset accurately predicted the outcomes of glioma patients and credibly distinguished between different levels and molecular subtypes of glioma in the TCGA, CGGA, and GSE16011 cohorts. Gliomas with high risk scores exhibited high immune scores, low tumor purity, and immunosuppressive features. The nomogram constructed by combining the vitamin-related risk signature and clinicopathological factors precisely predicted the 1-, 3-, and 5-year OS of glioma patients.Conclusions: Our study revealed that the vitamin-related six-gene risk signature, as an independent prognostic factor, could accurately distinguish the grade, molecular subtype, and immune characteristics of glioma.
Determinants of Hypnotic Discontinuation One Month After Discharge from an Acute Geriatric Ward: A Prospective, Observational Study
Authors: Brantegem Pieter Van , Liesenborghs Astrid , Hias Julie , Milisen Koen , Flamaing Johan , Tournoy Jos , Linden Lorenz Van der
Published: September 2020

BackgroundDeprescribing long-term hypnotic drug use is recommended in older adults to reduce medication-related harm such as falls. It is currently unknown whether this might be feasible in geriatric inpatients. The aim of this study was hence to determine predisposing factors for discontinuation of benzodiazepines and Z-drugs one month after discharge in geriatric inpatients receiving usual care.MethodsA prospective observational study was performed at the University Hospitals Leuven (UZ Leuven, Belgium). Patient characteristics, hypnotic drug use and sleep quality were gathered up to one month after discharge. A multivariable logistic regression model was used to identify independent determinants.ResultsChronic hypnotic drug use was highly prevalent (26.6%) in the geriatric population of UZ Leuven. Ninety-six patients with a mean age of 85.7 (SD 4.7) years admitted to the acute geriatric ward over a period of 10 months were included for analysis. Upon admission, 74% used a benzodiazepine and 26% a Z-drug. One month after discharge, 35 patients (36.5%) discontinued the hypnotic drug and in 23 cases (24.0%) the equivalent daily dose was reduced. Cessation of the hypnotic drug during hospitalization was found to be the only determinant influencing discontinuation one month after discharge with an odds ratio of 9.43 (95% confidence interval: 3.23 – 32.13). This was not associated with any deterioration of sleep quality.ConclusionsThis study confirms the overuse of long-term BZD and Z-drug use in geriatric patients. Cessation of hypnotic drugs during hospitalization was strongly associated with persistent discontinuation one month after discharge.Trial registrationThe study was approved by the Ethics Committee of UZ Leuven (registration number B322201629331).
A Nomogram Based on Clinical Characteristics for Predicting Multiple Organ Dysfunction Syndrome(MODS) Following Multiple Trauma Patients
Authors: Miao ZhenJun , Wei Faxing , Zhou Feng
Published: September 2020

BackgroundMultiple organ dysfunction syndrome (MODS) is the one of common complications,and the leading cause of late mortality in multiple trauma patients.The present study aims to develop and validate a nomogram based on clinical characteristics in order to identify the patients with multiple trauma who were at risk of developing MODS.MethodsAn retrospective cohort study was performed with data from January 2011 to December 2019,totally 770 patients with multiple trauma were enrolled in our study.They were randomly categorized into training set (n=514) and validation set (n=256).The univariate and multivariate logistic regression analyses were used to screen the predictors for multiple trauma patients who were at risk of developing MODS from training set data.Then we established a nomogram based on these above predictors.The discriminative capacity was assessed by receiver operating characteristic (ROC) curve area under the curve (AUC), and the predictive precision was depicted by calibration plot.The Hosmer-Lemeshow test was used to evaluate the the model’s goodness of fit.ResultsOur study showed that age,ISS,hemorrhagic shock,heart rate,blood glucose,D-dimer and APTT were independent risk factors for MODS in patients with multiple trauma by multivariate logistic regression analysis.A nomogram was established on basis of these above risk factors.The area under the curve (AUC) was 0.868 (95% confidence interval [CI]:0.829-0.908) in the training set and 0.884 (95% confidence interval [CI]:0.833-0.935) in the validation set.The Hosmer-Lemeshow test has a p value of 0.227 in training set and 0.554 in validation set respectively,which confirm the model’s goodness of fit.Calibration plot showed that the predicted and actual incidence of MODS probability were fitted well on both internal and external validations.ConclusionsThe present nomogram had a well predictive precision and discrimination capacity,which can facilitate improved screening and early identification of multiple trauma patients who were at high risk of developing MODS.
A Theoretical Investigation of Hybrid Foil-Magnetic Bearings on Operation Mode and Load Sharing Strategy
Authors: Feng Kai , Zhang Hang , Yin Qianwei , Guan Hanqing , Cao Yuanlong
Published: September 2020

To guide the conceptual design of hybrid foil-magnetic bearings (HFMBs), this paper presents a theoretical investigation on operation mode and load sharing strategy. According to the inherent characteristics of GFBs and AMBs, seven possible work scopes are discussed to understand the operation mode of HFMBs. A numerical model coupling the calculations of the film pressure in GFBs and the magnetic forces in AMBs is conducted to predict the performance of HFMBs. The deflection of top foil and bumps is also included in the prediction model. The analysis, which is conducted for static and dynamic performance of HFMBs within three representative work scopes by varying the load sharing, uncovers the effects of the operation mode and load sharing strategy on bearing behavior. Results show that HFMBs performance including the supporting stiffness and stability can be obviously enhanced by adjusting the operating mode and load sharing strategy.
Effect of Additive Ti3SiC2 Content on Mechanical Properties of B4C–TiB2 Composites Ceramics Sintered by Spark Plasma Sintering
Authors: Yan Xingheng , Zhou Xingui , Wang Honglei
Published: September 2020

B4C-TiB2 composite ceramics with ultra-high fracture toughness were successfully prepared via spark plasma sintering at 1900℃ using B4C and Ti3SiC2 as raw materials. The results show that compared with pure B4C ceramics sintered by SPS, the hardness of B4C-TiB2 composite ceramics is decreased, but the flexural strength and fracture toughness are significantly improved, especially the fracture toughness has been improved by leaps and bounds. When the content of Ti3SiC2 is 30vol.%, the B4C-TiB2 composite ceramic has the best comprehensive mechanical properties: hardness, bending strength and fracture toughness are 27.28 GPa, 405.11 MPa and 18.94 MPa·m1/2, respectively. The fracture mode of the B4C-TiB2 composite ceramics is a mixture of transgranular fracture and intergranular fracture. Two main two reasons for the ultra-high fracture toughness are the existence of lamellar graphite at the grain boundary, and the formation of a three-dimensional interpenetrating network covering the whole composite.
Co-creation of an Acceptable Indigenous Food Diet for Children Under Five in Early Childhood Development Centres
Authors: Nepfumbada Gundo , Dzinamarira Tafadzwa , Mashamba-Thompson Tivani Phosa
Published: September 2020

Background: The use of indigenous food (IF) such as green leafy vegetables and fruits in rural communities has been the main source of food despite being replaced by food high in sugar and fats. Early Childhood Development (ECD) centres are uniquely positioned for positive influence to healthy eating of children. The aim of this study was for ECD stakeholders to co-create an IF diet for children under five in ECD centres.Method: A sequential explanatory mixed method design was employed. We conducted focus group discussion with stakeholders employing the community-based participatory research (CBPR) approach and the nominal group technique ranking method to co-create to an acceptable indigenous food diet for children. Data was analyzed using both qualitative and quantitative methods. A thematic approach to qualitative data analysis with a coding framework guided by Consolidated Framework for Implementation Research (intervention characteristics, inner setting, outer setting, characteristics of individuals involved in implementation and the implementation process) was employed to analyse focus group discussion data. Statistical analysis was employed to analyze quantitative data collected through surveys.Results: Study participants included ECD stakeholders (ECD managers, social workers and dieticians) aged 34-52. Participants identified Ditokomane, Oranges, Mabele soft porridge, Dithotse and Dinawa as components of an IF that are suitable and acceptable for children under five years in ECD centres. Conclusion: ECD stakeholders co-created an IF diet to be implemented in ECD centres for children under five. Stakeholders are of the view that IF diet will have more health benefits on children than the current menu that is being used.
A Case of Easily Misdiagnosed Intramuscular Hemangioma
Authors: Li Yujia , Chou Ke , Zhu Wei , Xiong Jiepeng , Gu Yun , Yu Min
Published: September 2020

Background: Intramuscular hemangioma is a kind of benign vascular tumors often occurs in the lower extremity, which occurs in the gluteus medius muscle, and was misdiagnosed as lumbar disc herniation is rarely reported.Case presentation: A 36-year-old female who complaint of accidental pain of the left buttock. She was diagnosed as lumbar disc herniation, and accept the treatment. The symptom slightly relieved, but will relapse soon. Until she takes the X-ray and MRI, a mass was found in the gluteus medius muscle, which was suspected of malignant tumor. Then the tumor was resected and the final diagnosis is intramuscular hemangioma. The symptoms disappear completely and not recurrent.Conclusion: There are usually no special symptoms in patients with intramuscular hemangioma, so it is often misdiagnosed, when the treatment effect is not satisfied, the cause should be timely and correctly analyzed.
Dietary and Lifestyle Behavior in Adults With Epilepsy Needs Improvement: A Case-control Study From North-eastern Poland
Authors: Kulesza Kamila , Cyuńczyk Monika , Kochanowicz Jan , Witkowska Anna
Published: September 2020

Background: Several factors predispose people with epilepsy to cardiovascular diseases. Among them nutrition and lifestyle have not been sufficiently studied. Methods. The study involved 60 epileptic male and female volunteers and 70 healthy controls, corresponding to age and gender. Medical information was collected during the study and a detailed questionnaire survey concerning eating and lifestyle habits was conducted. Physical activity was evaluated using International Physical Activity Questionnaire (IPAQ). Nutritional status was assessed by bioelectric impedance. Venous blood samples were taken for lipid and 25-hydroxyvitamin D3 (25(OH)D3) analyses. Results. A tendency to an increase in LDL cholesterol was found in epileptics. Significantly higher body fat and insignificantly higher visceral fat was found in epileptic men compared to healthy men. In epileptic women a tendency to lower lean body mass was found. Patients with epilepsy were more sedentary, had lower consumption of cottage cheese, fruit, pulses, nuts and seeds, vitamin C and potassium, and higher intake of sugar-sweetened soda, energy from fat and sodium compared to healthy people. As a positive point, epileptics consumed less coffee and alcoholic beverages. More than 80% of diets of epilepsy people were low in folic acid, vitamin D and calcium, but similar tendency was observed in the healthy people. The diets of patients with epilepsy were in a higher percentage poor in niacin, vitamin C and potassium compared to the control group, 25% to 7%, 50% to 31% and 73 to 56% respectively. A significantly lower serum concentration of 25(OH)D3 was observed in epileptic individuals, which in this group was found to be positively modulated by physical activity.Conclusions. The study indicates that several behavior-related habits, which may predispose epileptic people to cardiovascular disease, need to be improved. For this reason, patients with epilepsy should be provided with more comprehensive medical care, including advice on nutrition and physical activity.
Rural urban differential in Transactional sex among unmarried (Not in Union) Young Women (15-24 years) in Uganda
Authors: Okotel Vincent , Wamala Robert , Mbonye Martin Kayitale
Published: September 2020

Background: Transactional sex, a causal exchange of gifts, money and services for sex is practiced globally. Transactional sex is associated with risky sexual behaviors, unintended pregnancy, gender based violence and HIV infection. Proportionally in 2016, TS among young women not in union in Uganda was almost twice in rural areas (16.4%) compared to urban (8.9%) areas. Despite the negative consequences associated with transactional sex, no study in Sub-Saharan Africa Uganda inclusive has provided a detailed account of the contribution of the variations in characteristics and variations in effects of characteristics to the rural-urban gap in transactional sex among young women not in union. This study therefore provides a detailed account of the rural-urban gap in TS by variations in characteristics and variations in effects of characteristics of young women in Uganda. Methods: The study utilized data from UDHS 2016 comprising of 1,595 records of young women (15-24 years) not in union (not currently married or living with a man). Statistical analysis was done using a Non-linear Oaxaca’ Blinder Multivariate Decomposition of the logistic regression. Results: In the results, the overall gap in rural-urban transactional sex is significantly attributed to both variations in characteristics (30.7%) and variations in effects of characteristics (69.3%) of young women (p<0.05). Specifically, the rural-urban gap in transactional sex among young women in Uganda is attributed to variation in total children ever born (-15.2%), age at first sex (10.3%) and variation in effect of highest education (-1, 1014.1%) and HIV stigma (-84.3%). Conclusion: In order to reduce transactional sex especially among young women in rural residence, government and other development partners need to strengthen comprehensive sex-education programs aimed at creating positive attitudes towards HIV, train young women on viable economic activities together with providing them with educational opportunities aimed at delaying sex.
Identification of Significant Genes with poor prognosis in Liver Metastasis of Colorectal Cancer via Bioinformatical Analysis
Authors: Chen Junsheng , Liu Hongzhou
Published: September 2020

Background: Colorectal cancer (CRC) is a common malignant tumor in the world wild, and more than 50% patients have liver metastases. Purpose: The purpose of this study is to identify significant genes with poor outcome and the underlying mechanisms of CRC liver metastases. Methods: Gene expression profiles of GSE50760, GSE41568 and GSE14297 are available on website of GEO database. Differentially expressed genes (DEGs) between CRC liver metastases and primary tissues were picked out by GEO2R tool and Venn diagram software. The Database for Annotation, Visualization and Integrated Discovery (DAVID) was used to analyze Kyoto Encyclopedia of Gene and Genome (KEGG) pathway and gene ontology (GO). Then protein-protein interaction (PPI) of these DEGs was visualized by Cytoscape with Search Tool for the Retrieval of Interacting Genes (STRING). Results: There were total of 147 consistently expressed genes in the three datasets, including 123 up-regulated genes and 24 down-regulated genes enriched in complement and coagulation cascades, drug metabolism-cytochrome P450, metabolism of xenobiotics by cytochrome P450, prion diseases, chemical carcinogenesis, staphylococcus aureus infection and linoleic acid metabolism. Of PPI network analyzed by Molecular Complex Detection (MCODE) plug-in, all 39 genes were selected. Moreover, for the analysis of CRC survival among those genes, Kaplan–Meier analysis was implemented and 4 (SERPING1 ITIH2 CDH2 APOE) of 39 genes had a significantly worse prognosis. Conclusion: we have identified four significant DEGs with poor prognosis in CRC liver metastases on the basis of integrated bioinformatical methods, which could be potential therapeutic targets for CRC patients with liver metastases.