bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of real-world free cervical cancer screening for eligible women in Beijing China, 2008-2018
Authors: Jie Shen , Yan Zhang , Lili Gao , Yue Zhang , Lili Han
Published: June 2020

Background: Cervical cancer is a very common gynecological malignancy. The incidence of cervical cancer in Beijing increased rapidly, the local government launched free cervical cancer screening in 2008 as a pilot, and then the program covered all register eligible women in 16 districts since 2009. Our study assessed the free screening program in Beijing from 2008 to 2018. Methods: Analyzed the data of all women aged 35-64 years old who received free cervical cancer screening in Beijing from January 2008 to December 2018. Results: Since 2008, Beijing has conducted five cycles of cervical cancer screening among 35-64 years old women. During the period, target population has adjusted and service management kept on improved. Totally 2,624,129 person times have received the services. The average detection rate of abnormal cervical cytology was 2.3%, the rate of colposcopy referral was 1.8%, and the rate of abnormal colposcopy result was 63.5%. The detection rate of CIN2+ and cervical cancer was 208.5 / 100,000, of which 5228 cases of CIN 2+ were detected, the detection rate of 199.2 / 100,000; 244 cases of cervical cancer were detected and the rate was 9.3 / 100,000. Conclusions: Free cervical cancer screening can effectively serve the grassroots women, improve women's health awareness, and realize the early detection and early treatment of cervical cancer. The coverage of the screening population and the screening strategies need to be further explored to achieve the goal of decreasing cervical cancer incidence and mortality in the future.
In Vivo Expression of Reprogramming Factor OCT4 Ameliorates Myelination Deficits and Induces Striatal Neuroprotection in Huntington’s Disease
Authors: Yu Ji Hea , Nam Bae-Geun , Kim MinGi , Seo Jung Hwa , Cho Sung-Rae
Published: June 2020

Background: White matter atrophy has been shown to precede the massive loss of striatal GABAergic neurons in Huntington’s disease (HD). The HD-induced white matter atrophy is associated with motor deficits. In vivo reprogramming toward a plastic state has emerged as a new approach for treating neurological diseases. Particularly, octamer-binding transcription factor 4 (OCT4) can induce myelin repair and functional recovery. This study investigated the effects of in situ expression of reprogramming factor OCT4 on behavioral performances, neural stem cell (NSC) niche activation in the subventricular zone (SVZ) and induction of cell fate specific to the changed microenvironment of HD. Methods: R6/2 mice, a transgenic mouse model of HD, randomly received adeno-associated virus serotype 9 (AAV9)-OCT4, AAV9-Null, or phosphate-buffered saline in both lateral ventricles at 4 weeks of age. To evaluate the behavioral improvement, rotarod test and grip strength test were performed at regular intervals. To investigate the expression of oligodendrocyte progenitor cell (OPC)-related genes, real-time quantitative reverse transcription PCR (qRT-PCR) and immunohistochemistry were performed. Next, we assessed the amelioration of myelination deficits via transmission electron microscope (TEM) and magnetic resonance imaging (MRI) at 13 weeks of age. Finally, we confimed striatal neuroprotecion by qRT-PCR and confocal microscopy.Results: The AAV9-OCT4 group displayed significantly improved rotarod performance and grip strength compared to the control groups. Following AAV9-OCT4 treatment, the number of newly generated NSCs and OPCs was significantly increased in the SVZ, and the expression of OPC-related genes such as NG2, Olig2, PDGFRα, Wnt3 and myelin regulatory factor (MYRF), and glial cell-derived neuroprotective factor (GDNF) was significantly increased. Further, the amelioration of myelination deficits in the corpus callosum was observed through TEM and MRI, and striatal DARPP32+ GABAergic neurons significantly increased in the AAV9-OCT4 group.
Composing High-level Stream Processing Pipelines
Authors: Mahapatra Tanmaya
Published: June 2020

The growing number of Internet of Things (IoT) devices provide a massive pool of sensing data. However, turning data into actionable insights is not a trivial task, especially in the context of IoT, where application development itself is complex. The process entails working with heterogeneous devices via various communication protocols to co-ordinate and fetch datasets, followed by a series of data transformations. Graphical mashup tools, based on the principles of flow-based programming paradigm, operating at a higher-level of abstraction are in widespread use to support rapid prototyping of IoT applications. Nevertheless, the current state-of-the-art mashup tools suffer from several architectural limitations which prevent composing in-flow data analytics pipelines. In response to this, the paper contributes by (i) designing novel flow-based programming concepts based on the actor model to support data analytics pipelines in mashup tools, prototyping the ideas in a new mashup tool called aFlux and providing a detailed comparison with the existing state-of-the-art and (ii) enabling easy prototyping of streaming applications in mashup tools by abstracting the behavioural configurations of stream processing via graphical flows and validating the ease as well as the effectiveness of composing stream processing pipelines from an end-user perspective in a traffic simulation scenario.
CHR: An Integrated Software Tool for chilling requirements
Authors: Chen Chen , Xu Wanyu , Gou Ningning , Bai Lasu , Wang Lin , Wuyun Tana
Published: June 2020

Background

Bud dormancy in deciduous fruit trees enables plants to survive cold weather. The buds adopt dormant state and resume growth after satisfying the chilling requirements. Chilling requirements play a key role in flowering time. So far, several chilling models, including ≤ 7.2 °C model, the 0–7.2 °C model, Utah model, and Dynamic Model, have been developed; however, it is still time-consuming to determine the chilling requirements employing any model. This calls for efficient tools that can analyze data.
Results

In this study, we developed novel software Chilling and Heat Requirement (CHR), by flexibly integrating data conversions, model selection, calculations, statistical analysis, and plotting.
Conclusion

CHR is a tool for chilling requirements estimation, which will be very useful to researchers. It is very simple, easy, and user-friendly.
The Surgical Treatment of Non-Metastatic Melanoma in a Multicenter Registry: A Retrospective Cohort Quality Improvement Study to Reduce the Morbidity Rates
Authors: Fiore Paolo Del , Mocellin Simone , Rastrelli Marco , Damiani Giovanni Battista , Tropea Saveria , Russano Francesco , Spina Romina , Sommariva Antonio , Buja Alessandra , Collodetto Alessandra , Ferrazzi Beatrice , Vecchiato Antonella , Cavallin Francesco , Rossi Carlo Riccardo
Published: June 2020

Background: Reproducible, high-quality surgery is a key point in the management of cancer patients. Quality indicators for surgical treatment of melanoma has been presented with benchmarks but data on morbidity are still limited. This study presents the quality indicators on morbidity after surgical treatment for non-metastatic skin melanoma in an Italian registry.Methods: Data were extracted from the Central National Melanoma Registry (CNMR) promoted by the Italian Melanoma Intergroup (IMI). All surgical procedures (WE, SNLB or LFND) for non-metastatic skin melanoma between January 2011 and February 2017 were evaluated for inclusion in the study. Only centers with adequate completeness of information (>80%) were included in the study. Short-term complications (wound infection, dehiscence, skin graft failure and seroma) were investigated.Results: Wound infection rate was 1.1% (0.4% to 2.7%) in WE, 1.3% (0.7% to 2.5%) in SLNB and 4.1% (2.1% to 8.0%) in LFND. Wound dehiscence rate was 2.0% (0.8% to 5.1%) in WE, 0.9% (0.2% to 3.0%) in SLNB and 2.8% (0.9% to 8.6%) in LFND. Seroma rate was 4.2% (1.5% to 11.1%) in SLNB and 15.1% (4.6% to 39.9%) in LFND. Unreliable information was found on skin graft failure.Conclusions: Our findings contribute to available literature in setting up the recommended standards for melanoma centers, thus improving the quality of surgery offered to patients. A consensus on the core issues around surgical morbidity is needed to provide practical guidance on morbidity prevention and management.
Unmet contraceptives needs among Female Sex Workers (FSWs) in semi urban Blantyre, Malawi
Authors: Twizelimana Donatien , Muula Adamson S
Published: June 2020

Introduction:Research has paid limited attention to understanding factors that are associated with unmet contraceptives needs among female sex workers (FSWs). In order to fill this knowledge gap we estimated the prevalence of unmet contraceptives needs and examined factors that were associated with unmet contraceptives needs among FSWs in semi urban Blantyre, Malawi.MethodsWe used systematic sampling to recruit 290 FSWs in semi urban Blantyre between February and March 2019. In this cross sectional study, we used questionnaire interviews to collect quantitative data. We calculated the mean and standard deviation for continuous variables and proportions for categorical variables to describe the data. Logistic regression analysis was used to investigate the association between unmet needs (the outcome variable) and explanatory variables such as: having a steady partner, fear of contraceptives’ side effects and having a history of sexual transmitted infections.ResultsOut of the 290 study participants 102 (35.2%) reported unmet needs for contraceptives. The following factors were significantly associated with unmet contraceptives needs in multivariate analysis: FSWs’ history of physical and sexual violence by clients [OR 3.38, 95% CI (1.10, 10.43)], p < 0.03, participants with a steady partner [OR 3.28, 95% CI (1.89, 5.68)], p < 0.001, and participants who feared side effects of contraceptives [OR 2.99, 95% CI (1.73, 5.20)], p < 0.001.ConclusionThere is need to improve awareness of contraceptives among FSWs in semi urban Blantyre. Sexual and Reproductive Health services (SRH) should address barriers to contraceptives use such as sexual transmitted infections, clients’ violence, fear and misinformation on contraceptives. There is also a need to improve the knowledge, attitudes, and counseling skills of health providers in order to address unmet contraceptives needs among FSWS.
Factors influencing early initiation of breastfeeding among mothers in Rajshahi district, Bangladesh
Authors: Ayesha Ummay , M Abu Sayed Md. Al , Islam Md. Nurul , Hossain Md. Ripter , Tasmia Samme Amena , Hossain Md. Golam
Published: June 2020

Background

Early initiation of breastfeeding (EIBF) is referred as providing the breast milk to the newborn within one hour of birth which ensures that the infant receives the colostrum. The aim of this study was to identify the risk factors associated with early initiation of breastfeeding among mothers in Rajshahi district, Bangladesh.
Methods

The data was collected from mothers living in Rajshahi district who had at least one child aged 6–24 months from January to March, 2019. The EIBF was measured by a question to mother, “did you provide your breast milk to your infant within one hour after delivered? Frequency distribution, Chi-square and multivariable binary logistic regression model were utilized in this study for getting prevalence and influential factors of EIBF.
Results

This study revealed that the prevalence of EIBF was 88.4%. Logistic model provided that place of delivery, family monthly income, husbands’ education level, mothers’ nutritional status, mothers’ age, husbands’ occupation, getting pregnancy with planning, mothers taking advice regarding the benefit of breastfeeding during their pregnancy were the influential factors of EIBF among mothers in Rajshahi district, Bangladesh.
Conclusions

This study identified several modifiable influential factors of EIBF. The customs, culture and other characteristics are almost same across the country in Bangladesh. These factors could be considered to increase the rate of EIBF among mothers in Bangladesh.
Botulinum Neurotoxin A Prevents the Development of Nitroglycerin-Induced Chronic Migraine via Inhibition of CGRP and NLRP3 Inflammasomes in Mice
Authors: Zhu Ting , Niu Jing-Qi , Su Cun-Jin , Chen Jia-Wei , Zhang Yan-Lin , Luo Wei-Feng , Liu Tong
Published: June 2020

Background This study was designed to examine the therapeutic effects of Botulinum neurotoxin A (BoNT/A) on chronic migraine and to explore the potential mechanisms by using a mouse model of chronic migraine, which was established by repeated intraperitoneal (i.p.) injection with nitroglycerin (NTG).Methods NTG-induced basal and evoked mechanical hypersensitivity were evaluated using the von Frey filament test. Before the first injection of NTG, a single facial injection of BoNT/A was administered in the supraorbital region to explore its preventive effects on the development of chronic migraine in mice. The expression of calcitonin gene-related peptide (CGRP) and synaptosomal-associated protein25 (SNAP25) in the trigeminal ganglia (TG) and the trigeminal nucleus caudalis (TNC) were detected by Western blotting and immunostaining. Results Repeated administration of NTG resulted in basal and evoked mechanical hypersensitivity in mice. Single facial BoNT/A injection prevented the development of NTG-induced mechanical hypersensitivity in mice. Western blotting results revealed that peripheral BoNT/A injection decreased the NTG-induced upregulation of expression of CGRP and SNAP25 in the TGs and NOD-, LRR- and pyrin domain-containing protein 3 (NLRP3) inflammasomes in the TNC. Immunostaining results revealed peripheral BoNT/A injection also decreased the NTG-induced upregulation of CGRP expression in the TNC.Conclusions Thus, these results indicate that single facial injection of BoNT/A may be a preventive treatment of chronic migraine, possible due to the inhibitory effect of BoNT/A on the expression of CGRP and SNAP25 in the TGs and NLRP3 inflammasomes in the TNC.
Effectiveness and Long-term Outcomes of Different Crossing Strategies for the Endovascular Treatment of Complex Iliac Artery Chronic Total Occlusions
Authors: Zhang Huan , Li Xiangtao , Niu Luyuan , Feng Yaping , Luo Xiaoyun , Zhang Changming , Zhang Fuxian
Published: June 2020

Purpose

To explore the optimal crossing approach (antegrade versus retrograde) for iliac artery chronic total occlusions (CTOs) and to examine the long-term outcomes.

Materials and Methods

We performed a study on 107 patients (116 iliac occlusive lesions, mean age 64.0±11.1, 88 men) who underwent an iliac CTO endovascular intervention attempted with the use of both crossing strategies but were managed with one final crossing approach between August 2012 and August 2018. Baseline data, procedural characteristics, and outcomes were described. A Cox proportional hazard model and Kaplan-Meier method were developed to assess the differences in the two crossing approaches in terms of the 1-year and 5-year primary patency rates, TLR (target lesion revascularization) and MALEs (major adverse limb events).

Results

CIA (common iliac artery) lesions were more likely to be crossed successfully in the retrograde direction (6.8% for antegrade vs. 20.9% for retrograde, p=0.005), while lesions in the CIA/EIA (external iliac artery) were more prone to be crossed successfully in the antegrade direction (58.9% for antegrade vs. 39.5% for retrograde, p=0.016). Considering EIA lesions, there were no significant differences in the crossing approach between the two groups. The two crossing approaches were associated with similar estimates of 1- and 5-year primary patency, TLR and MALE rates.

Conclusion

The antegrade approach was associated with a higher rate of successful crossing in CIA/EIA CTO lesions, while the CIA-only CTOs were more likely to be crossed successfully with the retrograde approach.
Comparison of Symptomatic Spondylolysis in Young Soccer and Baseball Players
Authors: Yokoe Takuji , Tajima Takuya , Sugimura Hiroshi , Kubo Shinichirou , Nozaki Shotarou , Yamaguchi Nami , Morita Yudai , Chosa Etsuo
Published: June 2020

Background: Spondylolysis is a main cause of low back pain (LBP) in young athletes. There are few studies analyzing the difference of spondylolysis among young athletes with different sports activity. The purpose of this study was to compare the clinical factors and distribution of the lesions of spondylolysis on magnetic resonance imaging (MRI) scans in young soccer and baseball players with symptomatic spondylolysis.Methods: The medical records of 178 young athletes aged 7 to 18 years old who underwent MRI to evaluate the cause of LBP between 2017 to 2019 were retrospectively reviewed to identify patients with spondylolysis. Of the young athletes with symptomatic spondylolysis, clinical factors and MRI findings in soccer and baseball players were retrospectively evaluated. The clinical factors were age, sex, interval from onset of LBP to MRI, and side of the dominant leg in the sports field. MRI findings included number, lumbar level, and side of the lesions. Results: A total of 21 soccer players (mean age, 15.2 ± 1.4 years) and 38 baseball players (mean age, 15.1 ± 1.7 years) with symptomatic spondylolysis were enrolled. All patients were male. No significant differences were noted in age and the interval from onset of LBP to MRI between the groups. Soccer players had greater numbers of multiple (p = 0.005) and bilateral (p = 0.004) lesions than baseball players. The dominant side of the hand for pitching or batting was correlated with the contralateral-side lesions in baseball players (p = 0.01).Conclusions: The distribution of the lesions of spondylolysis differed in young soccer and baseball players. Pitching or batting with the dominant-side hand would be associated with contralateral-side lesions in baseball players. Sports-specific movements and the side of the dominant leg should be considered when treating young athletes with symptomatic spondylolysis.
Survival of multiple nail gun injuries to the head, lung, and heart: A case report
Authors: Wang Suo-Hsien , Chen Mao-Yu , Huang Tzu-Yen , Chang Che-Chia , Chien Chih-Ying
Published: June 2020

Background:

Most nail gun injuries occur at the extremities due to working accidents. Injuries to the brain or thorax are relatively rare, and cases with both injuries are even rarer. Initial evaluation, resuscitation and surgical planning can be challenging.
Case presentation:

Here, we present a case with nail gun injuries to the brain, lung, and heart by suicide attempt. The patient presented to the emergency department under shock. After resuscitation and surgical intervention, he was discharged without significant morbidity.
Conclusions:

Multiple nail gun injuries, especially those to vital organs such as the brain, lung, and heart, can be challenging to emergency physicians and surgeons. Imaging tools, treatment strategies, and possible complications are discussed in this article to provide optimized outcomes in such situations.
Low Vitamin D Levels are Associated with Vascular Endothelial Dysfunction in Patients with Type 2 Diabetes: A Retrospective Study
Authors: Tanaka Kenichi , Okada Yosuke , Hajime Maiko , Tanaka Yoshiya
Published: June 2020

Background: The aim of this study was to determine the association between serum 25-hydroxyvitamin D (25(OH)D) levels and vascular endothelial function in patients with type 2 diabetes (T2D).Methods: This retrospective study included 113 T2D patients who were admitted for in-hospital diabetes educational program and underwent measurements of serum 25(OH)D levels and reactive hyperemia index (RHI). The primary endpoint was the association between serum 25(OH)D levels and RHI in T2D patients.Results: Serum 25(OH)D levels correlated significantly with RHI in T2D patients (r=0.285, p=0.002). Receiver operating characteristic (ROC) curve analysis showed that serum 25(OH)D level of 16.5 ng/mL is the optimal cut-off level for predicting vascular endothelial dysfunction (RHI<1.67), with a sensitivity of 68.5%, specificity of 67.9%, and area under the ROC curve (AUC) of 0.668 (95% confidence interval [CI]: 0.566–0.770, p=0.002). The mean RHI was significantly lower (1.70±0.54) in patients with low 25(OH)D levels (n=56, 25(OH)D levels <16.5 ng/mL) than that (1.99±0.58 vs.; p<0.001) of patients with high 25(OH)D levels (n=57, 25(OH)D level >16.5 ng/mL). The proportion of patients with RHI<1.67 was also higher in the low 25(OH)D group than in the high 25(OH)D group (38% vs. 18%; p<0.001). Multivariate logistic regression analysis identified serum 25(OH)D levels <16.5 ng/mL was associated with increased odds of RHI <1.67 (odds ratio 4.598, 95% CI 1.961–10.783, p <0.001).Conclusions: The results demonstrated the association of serum 25(OH)D levels with endothelial function in T2D patients and identified serum 25(OH)D level of <16.5 ng/mL as a predictor of vascular endothelial dysfunction. Serum 25(OH)D level is a potentially useful marker of vascular endothelial dysfunction in T2D patients.
Analyses of Local Control of Pulmonary Oligometastases after Stereotactic Body Radiotherapy and Impact of Local Control on Survival
Authors: Yamamoto Takaya , Niibe Yuzuru , Aoki Masahiko , Shintani Takashi , Yamada Kazunari , Kobayashi Mitsuru , Yamashita Hideomi , Ozaki Masatoki , Manabe Yoshihiko , Onishi Hiroshi , Yahara Katsuya , Nishikawa Atsushi , Katsui Kuniaki , Oh Ryoong-Jin , Terahara Atsuro , Jingu Keiichi
Published: June 2020

Background
Successful local therapy for oligometastases may lead to longer survival. The purpose of this multicenter retrospective study was to investigate the effectiveness of stereotactic body radiotherapy (SBRT) for pulmonary oligometastases and to investigate affecting factors for local control (LC).
Methods
The inclusion criteria was that SBRT for pulmonary oligometastases was the number of metastases was limited to 1 to 5, the primary lesion and other extrathoracic metastases were controlled before SBRT, and the biological effective dose (BED10) of SBRT was 75 Gy or more. The Cox proportional hazards model was used for analyses.
Results
Data for 1378 patients with 1547 tumors from 68 institutions were analyzed. The median follow-up period was 24.2 months. One-year, 3-year and 5-year LC rates were 92.1%, 81.3% and 78.6%, respectively, and 1-year, 3-year and 5-year overall survival rates were 90.1%, 60.3% and 45.5%, respectively. Multivariate analysis for LC showed that increased maximum tumor diameter (p = 0.011), type A dose calculation algorithm (p = 0.005), shorter overall treatment time of SBRT (p = 0.035) and colorectal primary origin (p < 0.001 excluding esophagus origin) were significantly associated with lower LC rate. In survival analysis, local failure (p < 0.001), poorer performance status (1 vs. 0, p = 0.013; 2–3 vs. 0, p < 0.001), esophageal primary origin (vs. colorectal origin, p = 0.038), squamous cell carcinoma pathology of the primary lesion (vs. adenocarcinoma, p = 0.006) and increased maximum tumor diameter (p < 0.001) showed significant relationship with shorter survival.
Conclusions
LC of pulmonary oligometastases by SBRT showed a significant survival benefit compared to patients with local failure. Some important factors for achieving higher LC were revealed.
Numerical Simulation Study on Strain Rate Effect of Fiber Reinforced Composites
Authors: Ye Hui , Liu Chang , Zhu Yanrong
Published: June 2020

In order to study the effect of strain rate effect on the simulation precision of fiber reinforced composites, the dynamic enhancement factor (DIF) was introduced to modify the modulus and strength of the composite, and the modified Hashin failure criterion was used to establish a three-dimensional progressive damage constitutive model of composite materials which could consider the strain rate effect. The model is embedded into the Abaqus software by VUMAT subroutine, and the simulation of the projectile penetrating the fiberglass reinforced composite laminates is carried out. The simulation results are compared with the experimental results and the constitutive model simulation results without considering the strain rate effect. The results show that the constitutive model with strain rate established in this paper can accurately simulate the process of projectile penetrating the laminates. Compared with the simulation results without strain rate, the accuracy is increased in the model with strain rate, respectively by 14.1% at the penetration speed of 1.8 m/s and by 22.7% at 3 m/s. The errors, between the simulation results of without strain rate and that of the experiments, are increased with the increase of penetration speed, and increase from 28.7% of 1.8 m/s to 36.9% of 3 m/s. The simulation error of constitutive model with strain rate is relatively stable.
NFATc2-dependent epigenetic upregulation of CXCL14 is involved in the development of neuropathic pain induced by paclitaxel
Authors: Liu Meng , Zhang Su-Bo , Luo Yu-Xuan , Yang Yan-Ling , Zhang Xiang-Zhong , Li Bo , Meng Yan , Chen Yuan-Jie , Guo Rui-Xian , Xiong Yuan-Chang , Xin Wen-Jun , Li Dai
Published: June 2020

Background: The major dose-limiting toxicity of paclitaxel, one of the most commonly used drugs to treat solid tumor, is painful neuropathy. However, the molecular mechanisms underlying paclitaxel-induced painful neuropathy are largely unclarified. Methods: Paw withdrawal threshold was measured in the rats following intraperitoneal injection of paclitaxel. The qPCR, western blotting, protein or chromatin immunoprecipitation, ChIP-seq identification of NFATc2 binding sites, microarray analysis were performed to explore the molecular mechanism. Results: We found that paclitaxel treatment increased the expression of NFATc2 in the spinal dorsal horn, and knockdown of NFATc2 with NFATc2 siRNA significantly attenuated the mechanical allodynia induced by paclitaxel. Further binding site analysis utilizing ChIP-seq assay combining with gene expression profile revealed a shift of NFATc2 binding site closer to TSS of target genes in dorsal horn after paclitaxel treatment. We further found that NFATc2 occupancy directly upregulated the chemokine CXCL14 expression in dorsal horn, which was mediated by enhanced interaction between NFATc2 and p300 and consequently increased acetylation of histone H4 in CXCL14 promoter region. Also, knockdown of CXCL14 in dorsal horn significantly attenuated mechanical allodynia induced by paclitaxel. Conclusion: These results suggested that enhanced interaction between p300 and NFATc2 mediated the epigenetic upregulation of CXCL14 in the spinal dorsal horn, which contributed to the chemotherapeutic paclitaxel-induced chronic pain.
Successful use of anakinra in a patient with COVID-19- associated pericarditis
Authors: Karadeniz Hazan , Yamak Betül Ayça , Özger Hasan Selçuk , Sezenöz Burak , Tufan Abdurrahman , Emmi Giacomo
Published: June 2020

Since its recognition in December 2019 as a cause of pneumonia, SARS-CoV-2 infection has rapidly spread globally, causing a pandemic. Although it is an infectious disease, several distinct manifestations have been described in the setting of COVID-19, which result from the immune perturbations caused by this new Coronavirus. The heart is frequently involved in COVID-19 and is associated with severe outcomes. Pericarditis is rarely reported in COVID-19 patients and no reports on its treatment and outcome are available so far. Herein, we present a 33-year-old man with COVID-19-related pericarditis (COVID-19-RP) who was unresponsive to colchicine and nonsteroidal anti-inflammatory drugs, but was successfully treated with the IL-1R antagonist anakinra.
​Analysis of the Iranian maternal mortality surveillance system and providing system improvement strategies: Study protocol for strategy formulation
Authors: Beigi Marjan , Sadatmahalleh Shahideh Jahanian , Changizi Nasrin , Mohammadi Eesa , Kazemi Ashraf
Published: June 2020

Background
The implementation of the maternal mortality surveillance system in Iran has significantly reduced the incidence of maternal mortality. However, the pattern of the causes of the mortalities, which has remained constant over the years, are still concerning. This study aimed to explain the experiences of the actors of the Iranian maternal mortality surveillance and provide strategies for improving this system.
Methods
This research is a qualitative study to develop strategies, that will be conducted in two phases. In the first phase, purposive sampling will be performed, and the data will be collected based on the experiences of the Iranian maternal mortality surveillance system actors in Iran's Ministry of Health and the selected universities (Shiraz, Isfahan, Tehran, Zahedan, Alborz, Shahrekord) through semi-structured interviews. Moreover, during this phase, some part of the data will be collected through random participation of the researcher in some maternal mortality committees of the selected universities. In order to carry out the second phase, a panel of experts will be set up to discuss the best strategies for improving the Iranian maternal mortality surveillance by considering the above results.
Discussion
The analysis of maternal mortality surveillance system needs to evaluate the experiences of the actors who are the policymakers of this system and can be effective in identifying its challenges. This analysis and formulation of the subsequent strategies can lead to maternal health indicators remaining within the range of international standards or even beyond those standards in Iranian universities and countries with similar surveillance system.
Risk Factors for the Critical Illness in SARS-CoV-2 Infection: a Multicenter Retrospective Cohort Study
Authors: Cheng Sijing , Wu Dingfeng , Li Jie , Zou Yifeng , Wan Yunle , Shen Lihan , Zhu Lixin , Shi Mang , Hou Linlin , Xu Tao , Jiao Na , Li Yichen , Huang Yibo , Tang Zhipeng , Xu Mingwei , Jiang Shusong , Li Maokun , Yan Guangjun , Lan Ping , Zhu Ruixin
Published: June 2020

BackgroundPrior studies reported that 5~32% COVID-19 patients were critically ill, a situation that poses great challenge for the management of the patients and ICU resources. We aim to identify independent risk factors to serve as prediction markers for critical illness of SARS-CoV-2 infection. Methods Fifty-two critical and 200 non-critical SARS-CoV-2 nucleic acid positive patients hospitalized in 15 hospitals outside Wuhan from January 19 to March 6, 2020 were enrolled in this study. Multivariable logistic regression and LASSO logistic regression were performed to identify independent risk factors for critical illness.ResultsAge older than 60 years, dyspnea, respiratory rate > 24 breaths per min, leukocytosis >9.5 X109/L, neutrophilia >6.3 X109/L, lymphopenia <1.1 X109/L, neutrophil-to-lymphocyte ratio >3.53, fibrinogen >4g/L, d-dimer >0.55 µg/mL, blood urea nitrogen >7.1 mM, elevated aspartate transaminase, elevated alanine aminotransferase, total bilirubin >21 µM, and Sequential Organ Failure Assessment (SOFA) score ≥2 were identified as risk factors for critical illness. LASSO logistic regression identified the best combination of risk factors as SOFA score, age, dyspnea, and leukocytosis. The Area Under the Receiver-Operator Curve values for the risk factors in predicting critical illness were 0.921 for SOFA score, 0.776 for age, 0.764 for dyspnea, 0.658 for leukocytosis, and 0.960 for the combination of the four risk factors.ConclusionsOur findings advocate the use of risk factors SOFA score ≥2, age >60, dyspnea and leukocytosis >9.5 X109/L on admission, alone or in combination, to determine the optimal management of the patients and health care resources.
Comparative Effects Between High-intensity Atorvastatin and Rosuvastatin on New Onset Diabetes Mellitus and Cardiovascular Outcome
Authors: Choi Jah Yeon , Choi Byoung Geol , Park Yoonjee , Kang Dong Oh , Jang Won Young , Kim Woohyeun , Na Jin Oh , Kim Jin Won , Kim Eung Ju , Rha Seung-Woon , Park Chang Gyu , Seo Hong Seog , Jeong Myung Ho , Chae Sung-Chull , Seong In-Whan , Yoon Chang-Hwan , Cha Kwang Soo , Oh Seok Kyu , Choi Cheol Ung
Published: June 2020

Background: High-intensity statin is typically used in patients with acute myocardial infarction (AMI) for secondary prevention; however, concern regarding its association with diabetes mellitus has been consistent. We investigated and compared the impact of high-intensity atorvastatin on new-onset diabetes mellitus (NODM) and cardiovascular outcomes with that of high-intensity rosuvastatin for a 3-year follow-up period. Methods: Data from the Korea Acute Myocardial Infarction Registry were collected from November 2011 to October 2015, and 13,104 AMI patients were enrolled from major cardiovascular centers. Among them, 2,221 patients without diabetes who had been administered with high-intensity atorvastatin (40–80 mg) and rosuvastatin (20 mg) were investigated. The atorvastatin and rosuvastatin groups were compared and evaluated for the incidence of NODM and major adverse cardiac event (MACE) including total death, myocardial infarction, and revascularization cases in the following 3 years.Results: Baseline characteristics were comparable between two groups. Event-free survival rate of NODM and MACE was not significantly different between the atorvastatin and rosuvastatin groups (92.5% vs. 90.8%, respectively; Log-rank P-value = 0.550). The event-free survival rate of MACE was also not significantly different between atorvastatin and rosuvastatin groups (89.0% vs. 89.6%, respectively; Log rank p-value = 0.662). Multivariable Cox analysis revealed that the statin type was not a prognostic factor in the development of NODM and MACE. Conclusions: Administering high-intensity atorvastatin and rosuvastatin in AMI patients produced comparable effects on NODM and clinical outcome, suggesting their clinical equivalence in secondary prevention.
Habitually Late Bedtime is Associated With Elevated Serum Uric Acid and Monosodium Urate Monohydrate Deposition in Patients With Gout: A Case Control Study
Authors: Chen Xiaoting , Chen Lihui , Liu Fengjing , Chen Si , Han Ying , Hu Zhumeng , Chen Haibing
Published: June 2020

Background: In this study, we observed whether habitually late bedtime affects serum uric acid levels and monosodium urate monohydrate deposition in joints and tendons in patients with gout.Methods: This study included 195 patients with gout, who had been divided into two groups based on their bedtime (early or late) and compared serum uric acid levels between the groups. The study also compared ultrasounds of joints and tendons between groups, including the metatarsal-phalangeal joints, knee joints, and tendons of the lower limbs. A multivariate logistic regression was used to analyse the risk factors of monosodium urate monohydrate deposition.Results: Compared to patients with an early bedtime, those with a late bedtime had higher urate levels and a significantly higher proportion of double contour signs, tophi, and bone erosion in metatarsal-phalangeal joints (p < 0.05). Late-bedtime patients also had higher proportions of synovial hypertrophy and double contour signs in knee joints (p < 0.05), and a higher incidence of tophi in the quadriceps tendon (6.4%), compared to early-bedtime patients (2.5%; p < 0.05). Late bedtime was associated with monosodium urate monohydrate deposition. Conclusions: Patients with gout who had a late bedtime exhibited elevated urate levels, enhanced monosodium urate monohydrate deposition, and greater gout-related joint damage, compared to patients with an early bedtime.
Unimproved water, sanitation, and hygiene (WASH) and common childhood illness in Myanmar: evidence from a nationally representative survey
Authors: Naz Lubna , Ghimire Umesh
Published: June 2020

Background

Inadequate Water, Hygiene and Sanitation (WASH) is one of the major risk factors of common childhood illness - namely, diarrhea, cough, fever, and acute respiratory infection, in many Southeast Asian countries. This study aims to analyze the relationship between WASH-related indicators and common childhood illnesses; cough, fever and diarrhea among under-five children in Myanmar.
Methods

The data of 4,815 under-fives was extracted from the first Myanmar Demographic and Health Survey 2015-16. Chi-square test was used to determine association between WASH and sociodemographic variables and each common childhood illness. The bivariate logistic regression was used to obtain the unadjusted odds of cough, fever, and diarrhea for each wash indicator, i.e., Unimproved toilet, access to unsafe water, and unsafe feces disposal. Further multivariate regression was employed and adjusted odd ratios were obtained of each common childhood illness after accounting for all wash indicators.
Results

Among under-five children, 16.2% suffered from cough, 16% suffered from fever, and 10.4% from diarrhea. Unimproved toilet facility was associated with cough (Adjusted Odds Ratio (AOR) 1.15, 95% CI:0.86, 1.22), and fever (AOR 1.03, 95% CI:0.86,1.23) among children. Children from households practicing unimproved child feces disposal had 21%, 18%, and 52% higher odds of experiencing cough (95% CI:1.12, 1.31), fever (95% CI: 0.99,1.29), and diarrhea (95% CI:1.21, 1.68), respectively. A combination of unimproved water, toilet and child feces disposal facilities was associated with cough (AOR 1.34, 95% CI:1.03, 1.73), fever (AOR 1.12, 95% CI:0.86, 1.19) and diarrhea (AOR 1.18, 95% CI:0.95, 1.29).
Conclusion

Inadequate improved WASH significantly contributed to common childhood illnesses among children in Myanmar. Findings suggest that WASH interventions should be targeted to the poor and rural areas where the prevalence of both childhood illnesses and unimproved WASH facilities were reportedly high.
Long-term observation and sequencing analysis of SKPs-derived corneal endothelial cell-like cells for treating corneal endothelial dysfunction
Authors: Shen Lin , Sun Peng , Du Liqun , Zhu Jing , Ju Chengqun , Guo Hui , Pang Kunpeng , Wu Xinyi
Published: June 2020

Background
Corneal endothelial dysfunction is a principal cause of visual deficiency. Corneal transplantation is the most effective treatment for corneal endothelial dysfunction. However, a severe shortage of available donor corneas remains a global challenge. Previously, we acquired corneal endothelial cell-like cells (CEC-like cells) derived from skin-derived precursors (SKPs). CEC-like cells exerted excellent therapeutic effect in rabbit and monkey corneal endothelial dysfunction models.
Method:
We prolonged the observation in the monkey experiment for 2 years. Further transcriptome sequencing was also carried out on HCEC, CEC-like cells before transplantation and after transplantation.
Results
We confirmed that the monkey cornea remained transparent and the CEC-like cells could adapt to the microenvironment after transplantation. The gene expression pattern of CEC-like cells was similar to HCEC and changed slightly after transplantation.
Conclusions
This study presented a brand-new insight into CEC-like cells and further provided a promising prospect of cell-based therapy for corneal endothelial dysfunction. The renewable cell source, novel derivation method and simple treatment strategy may be clinically applied in regenerative medicine in the future.
Dynamic Changes of Lipid Profile in Severe Hypertriglyceridemia-Induced Acute Pancreatitis Patients Under Double Filtration Plasmapheresis: A Retrospective Observational Study
Authors: Zheng Huijun , Wang Donghai , Wang Xiaoling , Lin Yongjun , Lu Zhihua , Chen Yueliang , Feng Guo , Yang Na
Published: June 2020

Background: In this study, we aimed to investigate the dynamic changes of lipid profile under double filtration plasmapheresis (DFPP) in severe hypertriglyceridemia-induced acute pancreatitis (sHTGP) patients and ascertain whether these changes were associated with the prognosis of the disease.Methods: This retrospective study was conducted at a tertiary critical care center in China. We included sHTGP patients who were admitted within 72h after AP onset. All the sHTGP patients received DFPP within 24h after admission. Lipid profile changes was measured in 47 patients with sHTGP on admission, consecutive 4 days after DFPP and at discharge. According to the TG levels in the first day after DFPP, we divided patients into two group: non-target (TG>5.6mmol/L) and target group (TG ≤5.6mmol/L). Propensity score matching was used to investigate association between TG-lowering effect and the prognosis. Linear regression analysis on four models was used to determine the relationship between other lipid parameters and the outcome.Results: Except for low density lipoprotein, all the parameters of lipid profile at disease onset showed significant difference from their normal levels. The median serum triglyceride (TG) level of the sHTGP patients was 42.9 mmol/L on admission. In the first day after DFPP, serum TG, cholesterol (TC) and very low density lipoprotein decreased significantly, and the high-density lipoprotein (HDL) as well as apoprotein A1 increased meanwhile. TG continued to fall for the following three days and the other indicators held steady. After propensity score matching, the hospitalization duration was significantly lower in the target group (14.5 [13.0, 16.0] vs 8.0 [6.0, 15.3], P=0.035). Linear regression analysis revealed that the levels of HDL were negatively associated with the duration of hospitalization in three adjusted models.Conclusion: There was distinct fluctuation of the lipid profile upon the burst of sHTGP and the parameters changed significantly in the first day after DFPP. Among these parameters, HDL may serve as a biomarker for disease prognosis in patients with sHTGP. Moreover, reaching the TG-lowering target of 5.6mmol/L may shorten hospitalization duration.
Cancer stem cell marker-positive tumour nests in intrahepatic cholangiocarcinoma are related to epithelial type CD1a-positive dendritic cell infiltration and to high Sox9 expression
Authors: Utsunomiya Aya , Ohe Rintaro , Kabasawa Takanobu , Aung Naing Ye , Urano Yuka , Tamazawa Nobuyuki , Kitaoka Takumi , Suzuki Kazushi , Kawamura Ichiro , Kimura Wataru , Yamakawa Mitsunori
Published: June 2020

Background

It is yet a mystery whether dendritic cells (DCs) contact cancer stem cells (CSCs) and uptake CSC antigens in intrahepatic cholangiocarcinoma (ICC). The aim of this study was to examine the histological relationship between tumour cells expressing CSC markers and DCs infiltrating ICC. In addition, clinicopathological factors, including progression-free survival (PFS) and overall survival (OS), were compared between cases with many and few CSC marker-positive cells.
Materials and methods

Resected tissue sections of 22 cases with ICC were used for immunostaining to detect DC infiltration into ICC tumour nests positive for CD1a, DC-SIGN, DEC205, DC-LAMP, and CD123 and to detect ICC tumour cells positive for CSC markers such as CD44v9, EpCAM, and Sox9. The relationship between the number of CSC marker-positive cells and ICC clinicopathological factors was examined by Kaplan-Meier method and univariate and multivariate analyses using the Cox proportional hazards model.
Results

CD1a+ immature DCs infiltrated ICC tumour nests significantly more than the other types of DCs. Furthermore, they were frequently localized within CD44v9− and EpCAMhigh ICC tumour nests. According to Kaplan-Meier method, PFS and OS were longer in the Sox9high group than in the Sox9low group, and according to both univariate and multivariate analyses, Sox9 expression was an independent factor.
Conclusion

The present study first demonstrated that CD1a+ immature DCs frequently infiltrated CD44v9− and EpCAMhigh ICC tumour nests, suggesting the possibility of cell-to-cell contact between epithelial type immature DCs and CSCs in ICC. Furthermore, it was suggested that Sox9 expression in ICC may be a prognostic factor.
Novel Intelligent Method for Fault Diagnosis of Steam Turbine Based on T-SNE and XGBoost
Authors: Wang Xizhe , Zhang Lijun
Published: June 2020

For fault failures of a steam turbine occur frequently and cause huge losses, it is important to identify the fault category. A steam turbine clustering fault diagnosis method based on t-distribution stochastic neighborhood embedding (t-SNE) and extreme gradient boosting (XGBoost) is proposed. Firstly, the t-SNE algorithm is used to map high-dimensional data to low-dimensional space, and data clustering is performed in low-dimensional space. Combined with the fault records of the power plant, the fault data and health data of the clustering result are distinguished. Then, the imbalance problem in the data is processed by the synthetic minority over-sampling technique (SMOTE) algorithm to obtain the steam turbine characteristic data set with fault labels. Finally, we used the XGBoost to solve this multiclassification problem. In the experiment, the method achieved the best performance with an overall accuracy of 97% and early warning at least two hours in advance. The experimental results show that this method can effectively evaluate the state and make fault warning for power plant equipment.
Phenotypic Sexual Dimorphism in Response to Dietary Fat Manipulation in C57BL/6J Mice
Authors: Casimiro Isabel , Stull Natalie D. , Tersey Sarah A. , Mirmira Raghavendra
Published: June 2020

Background:Obesity and the metabolic syndrome are increasingly prevalent in society and their complications and response to treatment exhibit sexual dimorphism. Mouse models of high fat diet-induced obesity are commonly used for both mechanistic and therapeutic studies of metabolic disease and diabetes. However, the inclusion of female mammals in obesity research has not been a common practice, and has resulted in a paucity of data regarding the effect of sex on metabolic parameters and its applicability to humans. Methods:Here we analyzed male and female C57BL/6J mice beginning at 4 weeks of age that were placed on a low-fat diet (LFD, 10% calories from fat), a Western Diet (WD, 45% calories from fat), or a high fat diet (HFD, 60% calories from fat). Assessments of body composition, glucose homeostasis, insulin production, and energy metabolism, as well as histological analyses of pancreata were performed. Results:Both male and female C57BL/6J mice had similar increases in total percent body weight gain with both WD and HFD compared to LFD, however, male mice gained weight earlier upon HFD or WD feeding compared to female mice. Male mice exhibited a decrease in both food consumption and activity with either WD or HFD compared to LFD, whereas female mice did not exhibit any differences in food intake and minimal changes in locomotor activity on any diet. Glucose tolerance tests performed at 4, 12 and 20 weeks of dietary intervention revealed impaired glucose tolerance that was worse in male mice compared to females. Furthermore, male mice exhibited an increase in pancreatic β cell area as well as reduced insulin sensitivity after HFD feeding compared to WD or LFD, whereas female mice did not. Conclusions:Male and female C57BL/6J mice exhibited strikingly different responses in weight, food consumption, locomotor activity, and β cell adaptation upon dietary manipulation, with the latter exhibiting less striking phenotypic changes. We conclude that the nature of these responses emphasizes the need to contextualize studies of obesity pathophysiology and treatment with respect to sex.