bluuebunny/crossref_metadata_2025 huggingface dataset:
Profissões, gênero e Sociologia do Direito - Entrevista com Maria da Gloria Bonelli
Authors: Fontainha Fernando De Castro , Leite Maria Carolina Loss
Published: February 2020

No dia 13 de maio de 2019, aproveitando a vinda da professora Maria da Gloria Bonelli para proferir palestra no Instituto de Estudos Sociais e Políticos da UERJ, realizamos uma entrevista com ela, cuja duração foi de quase três horas. Falamos sobre suas origens familiares, engajamentos políticos, formação intelectual e a construção de sua carreira e obra. O leitor tomará conhecimento do contexto dentro do qual ela ocupou e reivindicou diferentes posições políticas e acadêmicas, bem como constituiu redes e produziu trabalhos. Interessa, particularmente, à uma reflexão biobibliográfica, a maneira como Gloria se constituiu enquanto personagem singular no campo de estudos da Sociologia das profissões jurídicas. Esta entrevista se pretende uma fonte para estudos e reflexões sobre uma autora, cuja trajetória se afirma como referência incontornável. A entrevista se apresenta na exata forma em que foi gravada, tendo sido revista e aprovada pela própria Gloria. Boa leitura!
Resenha de 'Ensaios sobre Brecht', de Walter Benjamin [trad. de Cláudia Abeling]
Authors: Marino Rafael
Published: February 2020

Referência completa da obra: Benjamin, Walter. Ensaios sobre Brecht. Trad. de Claudia Abeling. São Paulo: Boitempo, 2017.
Resenha de 'Sociologia Política das Instituições Judiciais', de Fabiano Engelmann (Org.)
Authors: Bento Juliane Sant’Ana
Published: February 2020

Referência completa da obra: Engelmann, Fabiano (Org.). Sociologia Política das Instituições Judiciais. Porto Alegre. Editora da UFRGS/CEGOV, 2017. 276 p. Disponível em: https://www.ufrgs.br/cegov/publicacao/v/95?n=Sociologia_Pol%C3%ADtica_das_Institui%C3%A7%C3%B5es_Judiciais. Acesso em: 10 de agosto de 2019.
On-demand cesarean section: assessing trends and socioeconomic disparities
Authors: Carlotto Kharen , Marmitt Luana Patrícia , Cesar Juraci Almeida
Published: February 2020

OBJECTIVE: to measure prevalence, evaluate trends and identify socioeconomic differences of on-demand cesarean section in the municipality of Rio Grande (RS), extreme south of Brazil, in 2007, 2010, 2013 and 2016. METHODS: all the puerperae residing in this municipality who had cesarean deliveries in one of the only two local maternity hospitals in the period 01/01-31/12 of the aforementioned years were part of this transversal study. Puerperae were interviewed using a single, standardized questionnaire at the hospital within 48 hours after delivery. The outcome was assessed based on the mothers’ report that the cesarean section was performed according to their request. The analysis consisted of the observation of the outcome’s frequency in each year and the evaluation of its prevalence throughout this period through the chi-square linear trend test. Socioeconomic inequalities were assessed based on household income and women’s schooling using the Slope Index of Inequality and the Relative Index of Inequality. RESULTS: In these four years, 5,721 cesarean deliveries were recorded among mothers living in this municipality (1,309 in 2007, 1,341 in 2010, 1,626 in 2013 and 1,445 in 2016). In this period, the rate of on-demand cesarean sections increased by 107%, from 10.5% (95%CI: 8.9% -12.2%) of the deliveries in 2007 to 21.7% (95%CI: 19.5% -23.8%) in 2016. This increase was more evident among those with lower household income and schooling level. Absolute inequality also increased, especially regarding schooling, while relative inequality sharply declined when assessed by household income. CONCLUSIONS: The increased on-demand cesarean sections in the study location is unsettling, despite the decreasing gap between extreme categories as a consequence of higher levels of this procedure among women of lower income and worse schooling.
Major depressive episode among university students in Southern Brazil
Authors: Flesch Betina Daniele , Houvèssou Gbènankpon Mathias , Munhoz Tiago Neuenfeld , Fassa Anaclaudia Gastal
Published: February 2020

INTRODUCTION: Depression is the leading cause of disability around the world, and it has been increasingly affecting young people. This study evaluates the prevalence and factors associated with major depression in university students, with emphasis on the influence of the academic field, chosen study area and the environment they are inserted. METHODS: A census of students who entered the university in the first semester of 2017 was held at a university in Southern Brazil. The outcome of major depressive episode was evaluated using the Patient Health Questionnaire-9, considered when the individual had five or more depressive symptoms for at least one week. Its prevalence was estimated, and the associated factors were examined by the hierarchical multivariable analysis using the Poisson regression model. RESULTS: A total of 32% (95% confidence interval 29.9–34.2) of university students presented a major depressive episode, and the problem was more frequent among women (prevalence ratio [PR] = 1.59); people aged 21 to 23 years (PR = 1.24); those with a family history of depression (PR = 1.27); minorities’ sexual orientation (homosexuals, PR = 1.64, and bisexuals, PR = 1.69); who lived with friends or colleagues (PR = 1.36); students in the area of applied social and human sciences (PR = 1.28), and linguistics, language and literature, and art (PR = 1.25). The worst academic performance (PR = 2.61), alcohol abuse (PR = 1.25), and illicit drug use (PR = 1.30) were also positively associated with major depressive episode. CONCLUSION: In addition to individual, family, and behavioral aspects, already described as risk factors for major depressive episodes in the general population, academic aspects also influence the occurrence of depression among university students. Considering the high prevalence of major depressive episode and its negative impact on health, public and institutional policies are necessary to focus on students’ mental health promotion and care.
Pre-frailty, frailty and associated factors in older caregivers of older adults
Authors: Máximo Roberta De Oliveira , Lopes Ingrid Cristina , Brigola Allan Gustavo , Luchesi Bruna Moretti , Gratão Aline Cristina Martins , Inouye Keika , Pavarini Sofia Cristina Iost , Alexandre Tiago Da Silva
Published: February 2020

INTRODUCTION: Providing care to an older adult is an activity that requires considerable physical effort and can cause stress and psychological strain, which accentuate factors that trigger the cycle of frailty, especially when the caregiver is also an older adult. However, few studies have analyzed the frailty process in older caregivers. OBJECTIVES: To investigate the prevalence of pre-frailty, frailty and associated factors in older caregivers of older adults. METHODS: A cross-sectional study was conducted including 328 community-dwelling older caregivers. Frailty was identified using frailty phenotype. Socio-demographic, behavioral and clinical aspects, characteristics related to care and functioning were covariables in the multinomial logistic regression. RESULTS: The prevalence of pre-frailty and frailty were 58.8% and 21.1%, respectively. An increased age, female sex, not having a conjugal life, depressive symptoms and pain were commonly associated with pre-frailty and frailty. Sedentary lifestyle was exclusively associated with pre-frailty, whereas living in an urban area, low income and the cognitive decline were associated with frailty. A better performance on instrumental activities of daily living reduced the chance of frailty. CONCLUSION: Many factors associated with the frailty syndrome may be related to the act of providing care, which emphasizes the importance of the development of coping strategies for this population.
Maternal Cardiovascular Disease 3 Decades After Preterm Birth
Authors: Auger Nathalie , Potter Brian J. , He Siyi , Healy-Profitós Jessica , Schnitzer Mireille E. , Paradis Gilles
Published: February 2020

Women who deliver preterm are at risk of cardiovascular disease, but the reason for the association is unclear. We determined whether vascular disorders during pregnancy explain the association between preterm delivery and future maternal cardiovascular disease. We analyzed a longitudinal cohort of 1 199 364 pregnant women with 19 186 983 person-years of follow-up in Quebec between 1989 and 2017. We calculated incidence rates of myocardial infarction, ischemic stroke, and other cardiovascular hospitalizations. We used multivariable Cox regression to estimate adjusted hazard ratios and 95% CIs for the association of very and moderate preterm delivery with maternal cardiovascular hospitalization. We determined the proportion of the association that was due to preeclampsia, acute cardiac events at delivery, antepartum/postpartum hemorrhage, and heart defects. The incidence of maternal cardiovascular hospitalization was greater for very (43.7 per 10 000 person-years) and moderate (39.4 per 10 000) preterm delivery compared with term delivery (26.2 per 10 000). Very preterm delivery was associated with 1.67× the risk of cardiovascular hospitalization (95% CI, 1.56–1.79), and moderate preterm delivery was associated with 1.51× the risk (95% CI, 1.46–1.56). Vascular disorders during pregnancy explained 26.2% of the association of very preterm delivery and 24.0% of the association of moderate preterm delivery, with cardiovascular hospitalization. Preeclampsia was the largest contributor to these proportions. We conclude that vascular disorders during pregnancy, especially preeclampsia, explain up to a quarter of the association between preterm delivery and future maternal cardiovascular hospitalization.
Nonprofit Finance: A Synthetic Review
Authors: Calabrese Thad D.
Published: February 2020

The field of finance is concerned with the management of money and how and where such funds are acquired and used. This article reviews the broad literature on finance related to nonprofit and voluntary organizations, identifies gaps in knowledge, and proposes potential avenues for future researchers. It examines in detail the sources of funds for nonprofit organizations, especially nonprofit agencies—including issues around revenue portfolios and interactions, the uses of these funds—with an emphasis on incentives faced by nonprofit organizations around financial disclosures, the benefits and problems of slack resources and profits, and issues of capital structure in nonprofit organizations.
Waltheria glabribracteata (Byttnerioideae, Malvaceae), a new species with elongate-plumose stigmas from South America

Authors: COUTINHO THALES SILVA , ALVES MARCCUS
Published: February 2020

A new Waltheria species (Malvaceae) is described and illustrated here. Waltheria glabribracteata is known from ecotone areas in Brazil and Bolivia and can be readily distinguished from other Waltheria species by its bracts which are glabrous on the adaxial surface. This study presents a description of the new taxon, taxonomic comments, a distribution map, conservation status and an illustration.
Parametric Subharmonic Instability of the Semidiurnal Internal Tides at the East China Sea Shelf Slope
Authors: Yang Wei , Wei Hao , Zhao Liang
Published: February 2020

On the basis of measurements from an observing mooring system, the observational evidence of parametric subharmonic instability (PSI) that transfers energy from semidiurnal internal tides (ITs) to the subharmonic waves at the East China Sea continental shelf slope is presented for the first time. Although the mooring station is very close to the energetic semidiurnal IT generation site, about 76% of the observed shear variance is contained in the near-inertial band, which is found to have comparable upward- and downward-propagating energy components. Bispectra and bicoherence estimates further confirm the occurrence of PSI transferring energy from the low-mode M2 ITs (vertical wavelength of ~1000 m) to high-mode subharmonic waves (vertical wavelength of ~200 m). The calculated energy transfer rate reveals an averaged net value of ~5 × 10−9 W kg−1. Strong temporal variation of is found that is not exactly in phase with the semidiurnal energy flux. After looking into the local vorticity fields, it is strongly suggested that the varying background relative vorticity associated with the evolving Kuroshio has modified the efficiency of PSI at the mooring location through changing the local effective inertial frequency.
Prognostic value of MELD‐XI score in patients referring to the emergency department with acute ST elevation myocardial infarction
Authors: Çelik Olgun , Çiftci Orçun , Müderrisoğlu İbrahim Haldun
Published: February 2020

Objective:

We aimed to evaluate Model for End‐stage Liver Disease excluding international normalized ratio (MELD‐XI) score for prediction of 30‐day in‐hospital mortality in a cohort of patients with ST elevation myocardial infarction.

Methods:

The medical records of a total of 256 patients admitted with ST elevation myocardial infarction to the emergency department between January 2015 and January 2019 were retrospectively reviewed. A total of 111 patients were found eligible for the study. MELD‐XI score was analyzed and compared on the basis of survival status.

Results:

A total of 111 patients with a mean age of 62.5 ± 2.55 years were included in the study. In total, 81% (n = 90) of the patients were male and 19% (n = 21) were female. The mean MELD‐XI score of the patients was 10.1 ± 1.1. A total of 12 patients (12.9%) died within 30 days after hospitalization. The median MELD‐XI score of the patients who died in the hospital was significantly higher than the patients survived (11.0 (10.5–11.6) vs 9.5 (9.4–13.8); p < 0.01). However, Gensini score was not significantly different between the surviving and deceased patients (p > 0.05). MELD‐XI score was significantly correlated to left ventricular ejection fraction (r = −232, p < 0.01), and both parameters and age were significant independent predictors of in‐hospital mortality (odds ratio: 1.73, 95% confidence interval: 1.25–2.39, p < 0.05; odds ratio: 0.89, 95% confidence interval: 0.81–0.99, p < 0.05; and odds ratio: 1.07, 95% confidence interval: 0.99–1.15, p < 0.05, respectively). A MELD‐XI cut‐off point of 10 had a sensitivity of 100% and a specificity of 78.8% for in‐hospital mortality (area under receiver operating characteristics curve: 0.92, 95% confidence interval: 0.87–0.97, p < 0.05). A survival analysis based on a MELD‐XI threshold of 10 revealed that the patients in the high‐MELD‐XI group had a significantly worse in‐hospital survival (log rank test p < 0.001).

Conclusion:

MELD‐XI score is a useful tool for in‐hospital mortality prediction in patients referring to emergency medicine with acute ST elevation myocardial infarction.
pH- and acoustic-responsive platforms based on perfluoropentane-loaded protein nanoparticles for ovarian tumor-targeted ultrasound imaging and therapy
Authors: Li Jianping , Ji Hong , Jing Yong , Wang Shiguang
Published: February 2020

In this study, we developed a multifunctional ultrasound (US) therapeutic agent that encapsulates perfluoropentane (PFP) into ferritin (FRT) and conjugates the tumor-targeting molecule folic acid (FA) (FA-FRT-PFP). The prepared FA-FRT-PFP had an average particle diameter of 42.8 ± 2.5 nm, a zeta potential of − 41.1 ± 1.7 mV and shows good stability in physiological solution and temperatures. FRT is a pH-sensitive cage protein that, at pH 5.0, disassembles to form pores that can load PFP. The adjustment to neutral pH closes the pores and encapsulates the PFP inside the FRT to form nanoparticles. At pH 5.0, 3 min of low-intensity focused ultrasound (LIFU, 2 W/cm2) significantly enhanced the US signal of FA-FRT-PFP through the acoustic droplet vaporization (ADV) effect. Under identical conditions, 4 min of LIFU irradiation caused the bubbles generated by FA-FRT-PFP to break. FA-FRT-PFP could be efficiently targeted into ovarian cancer cells and significantly enhanced the US contrast of FA-FRT-PFP after 3 min of LIFU irradiation. After 4 min of LIFU irradiation, cell viability significantly decreased due to necrosis, likely due to the FA-FRT-PFP mediated release of PFP in the acidic environment of lysosomes after entering the tumor cells. PFP is then transformed into bubbles that burst under LIFU irradiation, forming physical shock waves that lead to the destruction of the cell structure and necrosis, achieving tumor treatment. Taken together, this demonstrates that FA-FRT-PFP is both a novel and promising US theranostics agent for future clinic application.
Diagnostic value of serum soluble triggering expressed receptor on myeloid cells 1 (sTREM-1) in suspected sepsis: a meta-analysis
Authors: Chang Wei , Peng Fei , Meng Shan-Shan , Xu Jing-Yuan , Yang Yi
Published: February 2020

Background

We aim to synthesize the up-to-date studies to investigate the diagnostic value of serum soluble triggering expressed receptor on myeloid cells 1 (sTREM-1) in suspected sepsis.

Results

A total of 19 studies with 2418 patients were finally enrolled in the meta-analysis. The pooled sensitivity was 0.82 (95% CI 0.73 to 0.89), specificity 0.81 (95% CI 0.75 to 0.86), positive likelihood ratio 4.3 (95% CI 3.02 to 6.12), negative likelihood ratio 0.22 (95% CI 0.24 to 0.35), diagnostic odds ratio 20 (95% CI 9 to 41) and AuROC 0.88 (95% CI 0.85 to 0.91). The meta-regression analysis revealed that the sample size, reference standard description, prevalence of sepsis in the trials and consecution of patient recruitment might be the source of heterogeneity.

Conclusions

The serum sTREM-1 had a moderate ability in diagnosis in suspected sepsis based on the current studies. However, more large-scale studies were needed to further evaluate the diagnostic accuracy of sTREM-1.
Optimal duration of Vitamin K antagonists anticoagulant therapy after venous thromboembolism: a systematic review and network meta-analysis of randomized controlled trials
Authors: Wang Wei , Su Yang , Wu Chunyan , Sun Yuxi , Dai Neng , Chen Wei , Zhang Jie , Xu Yawei , Brindis Ralph G. , Xu Dachun , Li Jue
Published: February 2020

Background

The optimal duration of oral anticoagulant therapy for patients with venous thromboembolism (VTE) remains highly uncertain in clinical practice. It is essential to accurately assess the effect of anticoagulant therapy in reducing recurrent VTE against the risk of inducing major bleeding.

Methods

Randomized controlled trials were identified by searching PubMed, Web of Science, Embase, and the Cochrane library, reporting rates of recurrent VTE and major bleeding in patients taking Vitamin K Antagonists (VKA) with VTE and comparing different durations.

Results

Eleven RCTs with 3109 participants utilizing varied durations were included in the meta-analysis. Longer VKA therapy was associated with significantly lower rates of VTE recurrence compared with shorter duration of VKA therapy (OR 0.75, 95%CI 0.57–0.99), with significant difference noted in major bleeding risk (OR 2.31, 95%CI 1.17–4.56). During anticoagulation duration, patients treated by 6-month VKA had higher risk of major bleeding compared with 3-month VKA regimen (OR 33.45, 95%CI 2.00–559.67).

Conclusions

Regimen longer than 6 months did not show statistical elevation of major bleeding risk. VKA treatment strongly reduces the risk of recurrent VTE during anticoagulation therapy. The absolute risk of recurrent VTE declines over time while the risk for major bleeding after 6 months’ treatment did not demonstrate a continuous significant increase with extended duration of VKA therapy.
Hyperhomocysteinemia accompany with metabolic syndrome increase the risk of left ventricular hypertrophy in rural Chinese
Authors: Yu Shasha , Chen Yintao , Yang Hongmei , Guo Xiaofan , Zheng Liqiang , Sun Yingxian
Published: February 2020

Background

To investigate the influence of hyperhomocysteinemia (HHcy) and metabolic syndrome (MetS) on left ventricular hypertrophy (LVH) in residents in rural Northeast China.

Methods

We performed a cross-sectional baseline data analysis of 6837 subjects (mean age: 54 ± 10 years) recruited from a rural area of China. Anthropometric indicators were measured according to standard methods. MetS was defined by the modified ATP III criteria. HHcy was defined according to the WHO standard: an Hcy level > 15 μmol/L representing HHcy. Four groups were defined: non-HHcy & non-MetS, HHcy & non-MetS, MetS & non-HHcy and HHcy & MetS.

Results

The left ventricular mass index for height2.7 (LVMH2.7) in both sexes was significantly higher in the HHcy & MetS group than in the non-HHcy & non-MetS group (females: 51.23 ± 16.34 vs. 40.09 ± 10.55 g-2.7, P < 0.001; males: 48.67 ± 12.24 g-2.7 vs. 42.42 ± 11.38 g-2.7, P < 0.001). A similar result was observed in those groups when using the left ventricular mass index (LVMI) for body surface area to define LVH (females: 103.58 ± 31.92 g− 2 vs. 86.63 ± 20.47 g− 2, P < 0.001; males: 106.10 ± 24.69 g− 2 vs. 98.16 ± 23.29 g− 2, P < 0.001). The results of multiple regression analysis indicated that the HHcy & MetS group had a higher risk of LVH than the other three groups (OR: 1.628 for LVMI, P < 0.001, OR: 2.433 for LVMH2.7, P < 0.001). Moreover, subjects in the HHcy & non-MetS group [OR (95% CI): 1.297 (1.058, 1.591) for LVMI, P < 0.05; OR (95% CI): 1.248 (1.044, 1.492) for LVMH2.7, P < 0.05] also had a statistically greater risk of LVH than subjects in the non-HHcy & non-MetS group. The HHcy & non-MetS group was also found to be significantly and independently associated with LVH.

Conclusion

Hyperhomocysteinemia has an independent effect on LVH. The combined effect of MetS and hyperhomocysteinemia might increase the strength of the abovementioned effects.
Metformin improves lipid metabolism and reverses the Warburg effect in a canine model of chronic atrial fibrillation
Authors: Liu Yaozhong , Bai Fan , Liu Na , Zhang Baojian , Qin Fen , Tu Tao , Li Biao , Li Jiayi , Ma Yingxu , Ouyang Feifan , Liu Qiming
Published: February 2020

Background

Previous studies demonstrated impaired lipid metabolism and augmented aerobic glycolysis in AF. The authors aimed to investigate whether the use of metformin, an AMPK activator, could reverse this metabolic remodeling in chronic AF and to explore the underlying mechanisms.

Methods

We conducted chronic AF animal models with 18 beagle dogs and divided them into SR (pacemaker implanted without pacing), AF (pacemaker implanted with sustained pacing at a frequency of 400 beats/min for 6 weeks), and metformin+AF group (daily oral administration of metformin was initiated 1 week before surgery and continued throughout the study period). After electrophysiological measurements, the left atrial appendage tissue samples were taken from the beating heart for further analysis. Protein expression, histological analysis, and biochemical measurements were conducted.

Results

The AF groups showed decreased expression of FAT/CD36, CPT-1, VLCAD, increased concentration of free fatty acid and triglyceride, and increased lipid deposition. The activation of AMPK/PGC-1α/PPARα pathway was decreased. The key factors of the Warburg effect, including HIF-1α, GLUT-1, PDK1, HK, and LDH, increased in AF group compared to SR group. The expression of PDH decreased significantly, accompanied by increased atrial lactate production. The extent of fibrosis increased significantly in the left atrial appendage of AF group. dERP, ∑WOV, and AF inducibility increased while ERP decreased in AF group compared to SR group. The use of metformin attenuated all these changes effectively.

Conclusions

Metformin improves lipid metabolism and reverses the Warburg effect in chronic AF via AMPK activation. It attenuates atrial electrical and structural remodeling.
Prevalence of and characteristics associated with in-hospital mortality in a Ugandan neurology ward
Authors: Diaz Monica M. , Hu Xin , Fenton Brenda T. , Kimuli Ivan , Lee Allison , Lindsey Hayley , Bigelow Jeffrey K. , Maiser Samuel , Altalib Hamada H. , Sico Jason J.
Published: February 2020

Background

While the burden of neurologic illness in developing countries is increasing, less is known about mortality among patients admitted to sub-Saharan African hospitals with neurologic disease. We sought to characterize the rate and patient-level predictors of in-hospital mortality in a Ugandan Neurology ward.cc.

Methods

Data was prospectively collected on 335 patients admitted to the Neurology ward of Mulago Hospital, Kampala, Uganda. Kaplan-Meier survival curves and multivariate COX proportional hazard modeling were used to assess survival.

Results

Within our sample (n = 307), 35.8% received no diagnosis at time of hospital admission. Stroke (27.3%), head trauma (19.6%), and malaria (16.0%) were the most common diagnoses. Among the 56 (18.5%) patients who died during the index hospitalization, the most common diagnosis at admission and at death was stroke. Adjusted regression analysis showed that patients without a diagnosis at time of death (HR = 7.01 [2.42–20.35], p < .001) and those with diagnoses of infections (HR = 5.21 [2.16–12.58], p = <.001), stroke (HR = 2.69 [1.20–6.04], p = .017), or head trauma (HR = 3.39, [1.27–9.07], p = 0.15) had worse survival.

Conclusions

In-hospital mortality affected nearly 20% of the cohort, with worse survival among those without a diagnosis and with infections, stroke, head trauma. Future work should identify reasons for increased mortality among these high-risk groups and implement targeted interventions.
The prognostic value of neuromedin U in patients with hepatocellular carcinoma
Authors: Li Qiao , Han Lingyu , Ruan Shengnan , Shen Shunli , Cao Qinghua , Cai Xiuqin , Yan Yuan , Peng Baogang , Hua Yunpeng
Published: February 2020

Background

Neuromedin U (NMU) is a neuropeptide belonging to the neuromedin family. Recently, significant associations between NMU and several cancers have been reported. However, no studies have examined the association between NMU and hepatocellular carcinoma (HCC). The purpose of this study was to examine the role of NMU in HCC.

Methods

An enzyme-linked immunosorbent assay was used to measure the level of NMU protein in the sera of patients with hepatic hemangioma and HCC. NMU and cytokine mRNA expression was assessed in HCC samples via RT-qPCR. A tissue microarray consisting of 228 HCC peri- and intra-tumor tissues was used to detect NMU expression via immunohistochemical analysis. The association between NMU expression and overall survival (OS) and disease-free survival (DFS) was analyzed by Kaplan-Meier curves, the log-rank test, and Cox proportional hazard model.

Results

The level of NMU protein was increased in the sera of HCC patients (p = 0.006). NMU was expressed in intercellular space, rather than in hepatocytes or HCC cells. The prognosis of HCC patients with high NMU expression in peri-tumor tissue was significantly poorer than that of patients with low NMU expression (OS: p = 0.002, DFS: p = 0.033). Peri-tumor NMU expression was also a significant independent prognostic factor for OS (hazard ratio: 1.541, 95% confidence interval: 1.092–2.175, p = 0.014). The level of NMU expression was positively associated with M2 macrophage percentage and the levels of type-2 inflammatory cytokines in HCC tissue.

Conclusions

NMU may serve as a novel prognostic biomarker for HCC patients, although further validation is needed in the future. The activation of M2 macrophages and a type-2 inflammatory response may involve in the role of NMU in patients with HCC.
The effect of adjunctive intravitreal conbercept at the end of diabetic vitrectomy for the prevention of post-vitrectomy hemorrhage in patients with severe proliferative diabetic retinopathy: a prospective, randomized pilot study
Authors: Jiang Tingting , Gu Junxiang , Zhang Peijun , Chen Wenwen , Chang Qing
Published: February 2020

Background

To investigate the effect of intravitreal conbercept (IVC) injections on the incidence of postoperative vitreous hemorrhage (VH) in eyes undergoing surgery for severe proliferative diabetic retinopathy.

Methods

This was a pilot prospective, comparative, and randomized study. Thirty patients, who underwent vitrectomy for severe proliferative diabetic retinopathy, were assigned randomly to either group 1 (intravitreal conbercept [IVC] injection at the end of pars plana vitrectomy) or group 2 (no IVC injection). Postoperative follow-up was performed on the first day, first week, first month, third month, sixth month and first year after surgery. The primary outcome was the incidence of postoperative VH. Secondary outcomes were the initial time of vitreous clearing (ITVC), best-corrected visual acuity (BCVA) and central retinal thickness (CRT) after surgery.

Results

A total of 30 eyes, from 30 patients, were included. Fifteen eyes were enrolled in the IVC group and fifteen in the control group. The incidence of early and late postoperative VH was not significantly different between the control and IVC groups. ITVC was shorter in the IVC group than that in the control group, but this was not significant (7.38 ± 10.66 vs 13.23 ± 17.35, P = 0.31). Final BCVA, 1 year after surgery, showed significant improvement compared to baseline in both groups. However, analysis of the BCVA at any postoperative visit after surgery showed no significant differences between the two groups. There were two cases of recurrent VH identified at 3 and 6 months after surgery in each group, requiring a second round of surgery. Foveal thickness was significantly different between the two groups at the 3-month, 6-month and 1-year follow-up visits.

Conclusions

In this pilot study, the effect of IVC injection in reducing the incidence of postoperative VH after diabetic vitrectomy at the end of vitrectomy was not shown.

Trial registration

The study was registered with the Chinese Clinical Trial Registry. (Reference Number: ChiCTR1800015751).
Rapamycin prevents retinal neovascularization by downregulation of cyclin D1 in a mouse model of oxygen-induced retinopathy
Authors: Jiang Feng , Wang Ying , Du Shufang , Jin Heng , Han Jindong
Published: February 2020

Background

Rapamycin (RAPA) is a potent angiogenic inhibitor and the aim of this study is to identify the inhibitory effect of RAPA on retinal neovascularization (RNV) in experimental oxygen-induced retinopathy (OIR).

Methods

Forty-two 7-day-old C57BL/6 J mice were randomly divided into normoxia control group (14 mice), OIR group (14 mice), and rapamycin (RAPA) group. OIR model was induced in OIR and RAPA group. Vehicle and RAPA (2 mg/kg/d) was injected intraperitoneally daily from postnatal day 12 (P12) in OIR and RAPA groups, respectively. RNV was evaluated using fluorescence angiography and histopathology on P17. Non-perfused areas of retina were analyzed by Image-Pro plus 6.0 software. Retinal expression of cyclin D1 was detected both at mRNA and protein levels.

Results

RAPA treatment significantly decreased RNV, non-perfused areas and number of endothelial cell nuclei breaking through the internal limiting membrane (ILM) in OIR mice. Moreover, RAPA decreased activation of cyclin D1 in retina caused by OIR.

Conclusion

RAPA can inhibit RNV by downregulating the expression of cyclin D1, which indicates its therapeutic potential in treating RNV-related diseases.
Cerebral disorders in the first 7 years of life in children born post-term: a cohort study
Authors: Rolschau Anne Hald , Olesen Annette Wind , Obel Carsten , Olsen Jørn , Wu Chunsen S. , Kofoed Poul-Erik
Published: February 2020

Background

To estimate the association between post-term delivery and risk of physical disabilities, mental disabilities, and seizures during the first 7 years of life.

Methods

Data from 57,884 singleton infants born alive in week 39–45 by mothers included in the Danish National Birth Cohort (1997 to 2004) were analyzed, of these 51,268 were born at term (39–41 + 6) and 6616 post-term (42 + 0–44 + 6). Information on clinical endpoints was obtained from an interview at 18 months of gestational age, from a 7-year questionnaire, and from the Danish National Patient Register.

Logistic regression and Cox regression were used to estimate odds ratios and hazard rate ratios for the outcome obtained from the interview/questionnaire data and from the register-based data, respectively.

Results

We found no statistically significant increased risk of physical disabilities, mental disabilities, and epilepsy among children born post-term, though for most outcomes studied a tendency towards more adverse outcomes was seen. When children born late term (week 41) were compared to children born in week 42 or later the same tendency was found.

Conclusion

Post-term born children had a tendency to an excess risk of neurological disabilities as followed for up to 7 years of age.
Exploring memory function in earthquake trauma survivors with resting-state fMRI and machine learning
Authors: Li Yuchen , Zhu Hongru , Ren Zhengjia , Lui Su , Yuan Minlan , Gong Qiyong , Yuan Cui , Gao Meng , Qiu Changjian , Zhang Wei
Published: February 2020

Background

Traumatized earthquake survivors may develop poor memory function. Resting-state functional magnetic resonance imaging (rs-fMRI) and machine learning techniques may one day aid the clinical assessment of individual psychiatric patients. This study aims to use machine learning with Rs-fMRI from the perspectives of neurophysiology and neuroimaging to explore the association between it and the individual memory function of trauma survivors.

Methods

Rs-fMRI data was acquired for eighty-nine survivors (male (33%), average age (SD):45.18(6.31) years) of Wenchuan earthquakes in 2008 each of whom was screened by experienced psychiatrists based on the clinician-administered post-traumatic stress disorder (PTSD) scale (CAPS), and their memory function scores were determined by the Wechsler Memory Scale-IV (WMS-IV). We explored which memory function scores were significantly associated with CAPS scores. Using simple multiple kernel learning (MKL), Rs-fMRI was used to predict the memory function scores that were associated with CAPS scores. A support vector machine (SVM) was also used to make classifications in trauma survivors with or without PTSD.

Results

Spatial addition (SA), which is defined by spatial working memory function, was negatively correlated with the total CAPS score (r = − 0.22, P = 0.04). The use of simple MKL allowed quantitative association of SA scores with statistically significant accuracy (correlation = 0.28, P = 0.03; mean squared error = 8.36; P = 0.04). The left middle frontal gyrus and the left precuneus contributed the largest proportion to the simple MKL association frame. The SVM could not make a quantitative classification of diagnosis with statistically significant accuracy.

Limitations

The use of the cross-sectional study design after exposure to an earthquake and the leave-one-out cross-validation (LOOCV) increases the risk of overfitting.

Conclusion

Spontaneous brain activity of the left middle frontal gyrus and the left precuneus acquired by rs-fMRI may be a brain mechanism of visual working memory that is related to PTSD symptoms. Machine learning may be a useful tool in the identification of brain mechanisms of memory impairment in trauma survivors.
Metagenomic next-generation sequencing for mixed pulmonary infection diagnosis
Authors: Wang Jiahui , Han Yelei , Feng Jing
Published: February 2020

Background

Metagenomic next-generation sequencing (mNGS) is emerging as a promising technique for pathogens detection. However, reports on the application of mNGS in mixed pulmonary infection remain scarce.

Methods

From July 2018 to March 2019, 55 cases were enrolled in this retrospective analysis. Cases were classified into mixed pulmonary infection (36 [65.5%]) and non-mixed pulmonary infection (19 [34.5%]) according to primary diagnoses. The performances of mNGS and conventional test on mixed pulmonary infection diagnosis and pathogen identification were compared.

Results

The sensitivity of mNGS in mixed pulmonary infection diagnosis was much higher than that of conventional test (97.2% vs 13.9%; P < 0.01), but the specificity was the opposite (63.2% vs 94.7%; P = 0.07). The positive predictive value of mNGS was 83.3% (95% CI, 68.0–92.5%), and the negative predictive value was 92.3% (95% CI, 62.1–99.6%). A total of 5 (9.1%) cases were identified as mixed pulmonary infection by both conventional tests and mNGS, however, the pathogens identification results were consistent between these two methods in only 1 (1.8%) case. In summary, the pathogens detected by mNGS in 3 (5.5%) cases were consistent with those by conventional test, and only 1 (1.8%) case was mixed pulmonary infection. According to our data, mNGS had a broader spectrum for pathogen detection than conventional tests. In particular, application of mNGS improved the diagnosis of pulmonary fungal infections. Within the 55 cases, mNGS detected and identified fungi in 31 (56.4%) cases, of which only 10 (18.2%) cases were positive for the same fungi by conventional test. The most common pathogen detected by mNGS was Human cytomegalovirus in our study, which was identified in 19 (34.5%) cases of mixed pulmonary infection. Human cytomegalovirus and Pneumocystis jirovecii, which were detected in 7 (12.7%) cases, were the most common co-pathogens in the group of mixed pulmonary infection.

Conclusions

mNGS is a promising technique to detect co-pathogens in mixed pulmonary infection, with potential benefits in speed and sensitivity.

Trial registration

(retrospectively registered): ChiCTR1900023727. Registrated 9 JUNE 2019.
Novel biomarker genes which distinguish between smokers and chronic obstructive pulmonary disease patients with machine learning approach
Authors: Matsumura Kazushi , Ito Shigeaki
Published: February 2020

Background

Chronic obstructive pulmonary disease (COPD) is combination of progressive lung diseases. The diagnosis of COPD is generally based on the pulmonary function testing, however, difficulties underlie in prognosis of smokers or early stage of COPD patients due to the complexity and heterogeneity of the pathogenesis. Computational analyses of omics technologies are expected as one of the solutions to resolve such complexities.

Methods

We obtained transcriptomic data by in vitro testing with exposures of human bronchial epithelial cells to the inducers for early events of COPD to identify the potential descriptive marker genes. With the identified genes, the machine learning technique was employed with the publicly available transcriptome data obtained from the lung specimens of COPD and non-COPD patients to develop the model that can reflect the risk continuum across smoking and COPD.

Results

The expression levels of 15 genes were commonly altered among in vitro tissues exposed to known inducible factors for earlier events of COPD (exposure to cigarette smoke, DNA damage, oxidative stress, and inflammation), and 10 of these genes and their corresponding proteins have not previously reported as COPD biomarkers. Although these genes were able to predict each group with 65% accuracy, the accuracy with which they were able to discriminate COPD subjects from smokers was only 29%.

Furthermore, logistic regression enabled the conversion of gene expression levels to a numerical index, which we named the “potential risk factor (PRF)” index. The highest significant index value was recorded in COPD subjects (0.56 at the median), followed by smokers (0.30) and non-smokers (0.02). In vitro tissues exposed to cigarette smoke displayed dose-dependent increases of PRF, suggesting its utility for prospective risk estimation of tobacco products.

Conclusions

Our experimental-based transcriptomic analysis identified novel genes associated with COPD, and the 15 genes could distinguish smokers and COPD subjects from non-smokers via machine-learning classification with remarkable accuracy. We also suggested a PRF index that can quantitatively reflect the risk continuum across smoking and COPD pathogenesis, and we believe it will provide an improved understanding of smoking effects and new insights into COPD.
Clinical effect evaluation and correlation between preoperative imaging parameters and clinical effect of endoscopic Transforaminal decompression for lumbar spinal stenosis
Authors: Li Lijun , Chang Feng , Hai Yong , Yang Jincai , Xu Cheng , Yuan Jie , Sun Jiuqiang , Wang Qinghua , Ding Shengqiang , Yang Xiaowen
Published: February 2020

Background

The objective of this study was to evaluate the clinical effect and correlation between preoperative imaging parameters and the clinical effect of endoscopic transforaminal decompression for lumbar spinal stenosis.

Methods

In this prospective study, 87 patients from Shanxi Province People’s Hospital met the criteria for lumbar spinal stenosis and were recruited from June 2014 to January 2016. These patients underwent endoscopic transforaminal decompression. The clinical symptoms were evaluated by VAS, ODI, and claudication at 3 and 6 months after surgery. The overall clinical efficacy was evaluated using the MacNab score. Yellow ligament thickness and area of the dural sac were examined by MRI. Bony vertebral canal area, real spinal canal area, nerve root canal bony area, nerve root canal real area, distance between the articular joints, and vertebral canal sagittal diameter were examined by CT. The soft tissue invasion ratio of the vertebral canal and the invasion ratio of the nerve root canal were calculated. Correlations between imaging parameters and age, sex, and clinical efficacy were examined.

Results

The MacNab scores were excellent in 47% of cases, good in 34%, generally good in 8%, and poor in 11%. VAS, ODI, and claudication were significantly improved compared with the preoperative values (P < 0.01). A significant difference was observed between the 71–81 year age group and the other age groups (P < 0.05). There were good correlations between clinical efficacy and vertebral canal sagittal diameter, distance between the articular joints, soft tissue invasion ratio of the vertebral canal, and invasion ratio of the nerve root canal.

Conclusion

Treatment of lumbar spinal stenosis by endoscopic transforaminal decompression can achieve good clinical results. This operation is less effective in patients older than 71 years of age. There were positive correlations between clinical efficacy and the vertebral canal sagittal diameter, the articular joints, soft tissue invasion ratio of the vertebral canal, and invasion ratio of the nerve root canal.
Laparoscopic spleen-preserving distal pancreatectomy for a solid-cystic intraabdominal desmoid tumor at a gastro-pancreatic lesion: a case report
Authors: Sugimachi Keishi , Iguchi Tomohiro , Ohta Mitsuhiko , Mano Yohei , Hisano Terumasa , Yokoyama Ryohei , Taguchi Kenichi , Ikebe Masahiko , Morita Masaru , Toh Yasushi
Published: February 2020

Background

We report a case of an intraabdominal desmoid tumor that occurred at a gastro-pancreatic lesion with spontaneous cystic features, and present the successful laparoscopic resection of the tumor.

Case presentation

A 20-mm retroperitoneal cystic mass with a solid component was found adjacent to the stomach and pancreatic body in a 52-year-old woman with no history of familial adenomatous polyposis. Laparoscopic spleen-preserving distal pancreatectomy with wedge resection of the stomach was performed, and complete resection was achieved without intraoperative and postoperative complications. Histopathological examination by immunohistochemistry enabled diagnosis of a desmoid tumor that had originated from the stomach and invaded the pancreatic parenchyma with a spontaneous cystic change. We herein report an extremely rare case of an intraabdominal desmoid tumor with a spontaneous cystic change.

Conclusion

Regardless of its rarity, desmoid tumor should be included in the preoperative differential diagnosis of a cystic intraabdominal mass, and laparoscopic function-preserving surgery may be an optimal treatment option.
Comparison of silicone versus polyurethane ureteral stents: a prospective controlled study
Authors: Gadzhiev Nariman , Gorelov Dmitry , Malkhasyan Vigen , Akopyan Gagik , Harchelava Revaz , Mazurenko Denis , Kosmala Christina , Okhunov Zhamshid , Petrov Sergei
Published: February 2020

Background

Approximately 80% of patients with indwelling ureteral stents experience stent related symptoms (SRS). We believe SRS can be reduced through altering the composition of ureteral stents to a less firm material. Therefore, we aim to compare modern silicone and polyurethane ureteral stents in terms of SRS intensity and safety.

Methods

From June 2018 to October 2018, patients from two distinct clinical centers were prospectively enrolled in the study and stratified (non-randomly) into either control group A, patients who received polyurethane stents (Rüsch, Teleflex), or experimental group B, patients who received silicone stents (Cook Medical). Each participant completed a survey 1 h after stent insertion, in the middle of the stent dwelling period, and before stent removal or ureteroscopy noting body pain and overactive bladder via the visual analog scale pain (VASP) and overactive bladder (OAB) awareness tool, respectively. Additionally, successfulness of stent placement, hematuria, number of unplanned visits, and stent encrustation rates were assessed within each group.

Results

A total of 50 patients participated in the study, control group A consisted of 20 patients and experimental group B consisted of 30 patients. Participants in group B, silicone ureteral stents, demonstrated significantly lower mean values of VASP 2 weeks prior to stent removal and promptly before stent removal (p = 0.023 and p = 0.014, respectively). No other comparisons between the two groups were statistically significant.

Conclusions

Compared to polyurethane ureteral stents, silicone ureteral stents are associated with lower body pain intensity assessed by VASP 2 weeks before stent removal and at the time of stent removal.

Trial registration

Current Controlled Trials NCT04000178. Retrospectively registered on June 26, 2019.
Efficacy of dapoxetine treatment in Chinese patients with premature ejaculation and possible factors affecting efficacy in the real-world practice
Authors: Peng Jing , Fang Dong , Li Huixi , Tang Yuan , Yuan Yiming , Cui Wanshou , Gao Bing , Li Hongjun , Zhang Zhichao
Published: February 2020

Background

The treatment effect of dapoxetine in real-world practice is not well established. This study was to investigate the factors influencing efficacy of dapoxetine for the treatment of Premature ejaculation (PE) in the real-world setting.

Methods

Altogether 154 patients were followed up between Jan 2015 and Dec 2015. The clinical global impression of change (CGIC), premature ejaculation profile (PEP), the estimated intravaginal ejaculation latency time (eIELT) and estimated number of intravaginal thrusts before ejaculation (NITBE) were collected. The clinical characteristics of patients with CGIC = 0 and CGIC≥1 were compared.

Results

After 4 weeks treatment, an obvious improvement compared with the baseline was found regarding mean eIELT (2.4 ± 1.6 min vs 1.0 ± 0.7 min, P < 0.001) and mean NITBE (85.9 ± 61.9 times vs 37.4 ± 28.6 times, P < 0.001). The proportion of patients with a self-evaluation of at least “slightly better” and were categorized into “CGIC≥1” group was 70.1%. There were significant differences between patients in the “CGIC = 0” and “CGIC≥1” groups regarding mean NITBE (P = 0.010) and PEDT (P = 0.009) score at baseline. The adverse effects were acceptable.

Conclusion

Dapoxetine was well-tolerated and improved the sexual satisfaction of patients with PE. The severity of PE based on PEDT and NITBE suggest that there could be an effectiveness change with dapoxetine use in real-world practice.