bluuebunny/crossref_metadata_2025 huggingface dataset:
Perceived facilitators and barriers to chronic disease management in primary care networks: a qualitative study
Authors: Foo Chuan De , Surendran Shilpa , Tam Chen Hee , Ho Elaine Qiao Ying , Matchar David Bruce , Car Josip , Koh Gerald Choon Huat
Published: June 2020

Background

The increasing chronic disease burden in developed countries has placed tremendous strain on tertiary healthcare infrastructure and resources. Therefore, there is an urgent need to shift chronic disease management from tertiary to primary care providers to mitigate the increase in demand for chronic care at hospitals. The organization of private general practitioners (GPs) into Primary Care Networks (PCNs) is a pragmatic move by Singapore, a developed and multi-ethnic urban city, to provide private GPs with team-based care capabilities and a platform to track care indicators for better management of chronic patients. As the PCN initiative is still in its embryonic stages, there is a void in research regarding its ability to empower private GPs to manage chronic patients effectively. This qualitative study aims to explore the facilitators and barriers for the management of chronic patients by private GPs in the PCN.
Method:

We conducted 30 semi-structured in-depth interviews with GPs enrolled in a PCN. Qualitative analysis of audio transcripts was performed to extract themes which highlighted the facilitators and barriers faced by PCN in the early stages of its development.
Results

Our results suggest that PCNs facilitated private GPs to more effectively manage chronic patients through 1) provision of ancillary services such as diabetic foot screening, diabetic retinal photography and nurse counselling to permit a “one-stop-shop”, 2) systematic monitoring of process and clinical outcome indicators through a chronic disease registry (CDR) to promote accountability for patients’ health outcomes and 3) funding streams for PCNs to hire additional manpower to oversee operations and to reimburse GPs for extended consultations. Barriers include high administrative load in maintaining the CDR due to the lack of a smart electronic clinic management system and financial gradient faced by patients seeking services from private GPs which incur higher out-of-pocket expenses than public primary healthcare institutions.
Conclusion

PCNs demonstrate great promise in empowering and motivating private GPs to manage chronic patients. However, barriers will need to be addressed to ensure the quality and comprehensiveness of PCNs in managing more chronic patients in the face of an ageing population.
The Impact of Parental Myopia on Myopia in University Students: A Cross-Sectional Study from Shanghai, China
Authors: Li Weiran , Xun Pengcheng , Cui Chang , Zhou Jibo
Published: June 2020

Background: To evaluate the effect of parental myopia on Chinese university students with a high prevalence of myopia in Shanghai.Methods: A cross-sectional study of university students in Shanghai, China. All participants responded to a detailed questionnaire, including questions about age, ethnicity and family history. They underwent a standardized ophthalmological examination, including visual acuity, a slit lamp examination and non-cycloplegic auto-refraction. Generalized linear model was used to identify risk factors for myopia.Results: Of the 11,977 total subjects, 91.55% were myopic (spherical equivalent refraction [SER] ≤ -0.75 D), 20.18% were highly myopic (SER ≤ -6.0 D) and only 6.94% were emmetropic (-0.75 D＜SER ≤ 0.75 D). The mean age of the myopic participants (19.7±2.4) was higher than that of the emmetropic participants (19.3±1.9, p < 0.001). 10391 (91.8%) of Han students were myopic, which exhibited greater myopia than minority students (91.5%, p < 0.001). Among the students from families with two myopic parents, 97.9% had myopia. Only 93.7% of students had myopia where only one parent was myopic, and among the students without myopic parents, 90.7% had myopia (p < 0.001). Female students whose parents were myopic (8.0%) were more likely to have myopia than male students whose parents were myopic (7.5%) (p < 0.001). Students with two myopic parents (mean difference: -2.04, 95% CI: -2.21, -1.86) were at a high risk of myopia compared with students with no myopic parents (p < 0.001).Conclusions: This study showed that the refractive status of children in a population with a high prevalence of myopia was related to the status of parents. Increased severity of parental myopia led to a greater risk of myopia in their children.
Factors Associated with the Type of Cesarean Section and the Risk of Postoperative Complications in Greek Women
Authors: Antoniou Evangelia , Orovou Eirini , Iliadou Maria , Sarella Angeliki , Palaska Ermioni , Sarantaki Antigoni , Iatrakis Georgios , Dagla Maria
Published: June 2020

Background Cesarean Section was historically performed to save the lives of mothers and infants. Ηowever, in the past decades, a significant increase in Cesarean Section rates have been observed in Greece and worldwide. The purpose of this research was to investigate the contributing factors to the increase in the Cesarean Section rate (emergency and elective) and postoperative complications.Methods A total of births in 6 months (August 2019- February 2020) at the University Hospital of Larisa in Greece was collected. The performed analysis included the available socio-demographic and medical information in the medical records and a socio-demographic and medical questionnaire for women with cesarean deliveries. We also analyzed the importance of the variables in cesarean deliveries compared to vaginal deliveries and postoperative complications.Results Out of the total number of the included 633 births, the vaginal delivery rate was 42% (n = 268), and the cesarean delivery rate was 58% (n = 365); Elective Cesarean Section was performed in 36% (n = 230) of the Cesarean Section cases and Emergency Cesarean Section in 22% (n = 135). Women with a previous Cesarean Section and women with in vitro fertilization showed higher percentages for Elective Cesarean Section (46%) compared to women who underwent an Emergency Cesarean Section for the same reasons (42.2%). Besides, a higher percentage of Emergency Cesarean Sections was observed in women living in urban centers (OR = 4.044, p = 0.002) and those diagnosed with stress disorders (OR = 7.048, p = 0.004). Furthermore, Cesarean Section complications were more common among women having undergone Emergency Cesarean Section (OR = 10.357, p < 0.001).Conclusion The overall high rates of Cesarean Section in Greece demonstrate the lack of national strategies and prevention mechanisms from iatrogenic interventions and lack of promoting good midwifery practices. More specifically, a decrease in iatrogenic factors leading to the primary Cesarean Section will decrease Cesarean Section rates in Greece.
Characterization of Poplar Growth-Regulating Factors and Analysis of Their Function in Leaf Size Control
Authors: Wang Jinnan , Zhou Houjun , Zhao Yanqiu , Sun Pengbo , Tang Fang , Song Xueqin , Lu Mengzhu
Published: June 2020

Background: Growth-regulating factors (GRFs) are plant-specific transcription factors that control organ size. Nineteen GRF genes were identified in the Populus trichocarpa genome and one was reported to control leaf size by regulating cell expansion. In this study, we further characterize the roles of the other poplar GRFs in leaf size control in a similar manner. Results: The 19 poplar GRF genes were clustered into six groups according to their phylogenetic relationship with Arabidopsis GRFs. Bioinformatic analysis, degradome, and transient transcription assays showed that 18 poplar GRFs were regulated by miR396, with GRF12b the only exception. The functions of PagGRF6b (Pag, Populus alba × P. glandulosa), PagGRF7a, PagGRF12a, and PagGRF12b, representing three different groups, were investigated and the results show that they have different roles in leaf size control. PagGRF6b has no function, while PagGRF7a functions as a negative regulator of leaf size by regulating cell expansion. By contrast, PagGRF12a and PagGRF12b function as positive regulators of leaf size control by regulating both cell proliferation and expansion, primarily cell proliferation. Conclusions: The diversity of poplar GRFs in leaf size control may facilitate the specific, coordinated regulation of poplar leaf development through fine adjustment of cell proliferation and expansion.
Subtle decline in cardiac mechanics is correlated with albuminuria in asymptomatic normotensive patients with type 2 diabetes mellitus: a two-dimensional strain echocardiography study
Authors: Raafat Sameh Samir , Nazmy Nour Eldin M. , Bastawy Islam M. , Abdellatif Yasser A.
Published: June 2020

Background: Type 2 diabetes mellitus (T2DM) insidiously affects the myocardium with subsequent cardiomyopathy, it also pathologically involves the microvascular bed of the kidney reflected by albuminuria. This study aimed to investigate the relation between albuminuria and subclinical left ventricular (LV) systolic dysfunction in asymptomatic normotensive patients with T2DM assessed by two-dimensional (2D) speckle tracking echocardiography.Methods and results Sixty normotensive patients with T2DM, within 5 years of initial diagnosis, receiving conventional oral antidiabetic medications were included and subdivided into 2 subgroups, each including thirty patients according to the presence of albuminuria, together with thirty healthy control subjects all underwent full echocardiographic examination including left ventricular (LV) regional and global longitudinal strain (GLS) measurements. Laboratory tests including serum creatinine, glycated hemoglobin (HbA1C) and albumin creatinine ratio (ACR) were withdrawn for the three groups. There was a significant reduction in average peak systolic LV global longitudinal strain (GLS) in patients with T2DM when compared to control group (-16.18 ± 2.78% versus -18.13 ± 2.86%, P<0.001), however there was no significant difference in average peak systolic LV GLS between both diabetic subgroups (-15.57 ± 2.77% in subgroup with albuminuria versus -16.79 ± 2.70% in subgroup without albuminuria, p=0.077). Moreover, there was a significant correlation between ACR and reduction of GLS in patients with T2DM and albuminuria (r =0.38, P=0.003). However, this correlation was absent in patients with T2DM without albuminuria (r=0.107, P=0.573). Conclusion: Patients with type 2 diabetes mellitus (T2DM) have subclinical LV systolic dysfunction despite normal ejection fraction through reduction of average peak systolic LV GLS that is correlated with albumin creatinine ratio in patients with T2DM and albuminuria.
Process evaluation of an evidence-based weight loss program for low-income, mid-life women implemented in local health departments: Application of the RE-AIM framework
Authors: Norwood Arnita F. , Linnan Laura , Ammerman Alice S. , Cai Jianwen , Ward Dianne S. , Samuel-Hodge Carmen D.
Published: June 2020

Background: Fundamental to successfully translating evidence-based interventions to real life settings with diverse populations is achieving fidelity to the intervention within the given public health setting. Health departments may be key in addressing the obesity epidemic given their unique position to deliver obesity prevention services in community settings. We developed the Weight-Wise II Program from four evidenced-based interventions for implementation in local health departments. For this study, we conducted a process evaluation of the implementation of the Weight-Wise II Program, an intensive evidence-based behavioral weight loss program for low-income, mid-life women. Methods: The Weight-Wise II Program, a 16-week group-based weight loss program, was implemented in six local health departments. The RE-AIM framework (reach, effectiveness, adoption, implementation, and maintenance) served as a guide to conduct a comprehensive process evaluation. Process data were collected and analyzed using quantitative and qualitative methods. Results: The Weight-Wise II Program reached low-income and mid-life women, a high-risk population, and was effective in achieving modest weight loss. Attendance and self-monitoring were positively associated with weight loss. Interventionists delivered the program as intended and it was well received by participants. Planned adaptations enhanced program implementation by being responsive to participant and health department needs. Despite implementation by health department staff, the program was not routinely maintained three years post-intervention. Conclusion: Evidence-based weight loss interventions can be successfully implemented in local health departments. RE-AIM is a useful framework for systematically evaluating the process of implementation and impact of a behavioral weight loss intervention offered in public health settings. The addition of complementary implementation frameworks may help in identification of contextual factors influencing subsequent maintenance of evidence-based interventions in public health settings. Trial registration: ClinicalTrials.gov Identifier: NCT01141348. Registered 9 June 2010 – Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT01141348 Contributions to the literature The Weight-Wise II Program is an evidence-based weight loss intervention translated for implementation in local health departments serving a diverse low-income population. This study provides an approach and tools for comprehensively monitoring and evaluating evidenced-based programs implemented in public health settings. The study findings address gaps in the literature by providing guidance on program adaptations while maintaining fidelity including organizational contexts, participant engagement, and sustainability.
Air sampling for detection of infectious laryngotracheitis (ILT) in commercial poultry flocks.
Authors: Brown Lauren , Premaratna Dilhani , Segal Yonatan , Beddoe Travis
Published: June 2020

Objective Infectious laryngotracheitis (ILT) is an acute and highly contagious viral respiratory disease of poultry, caused by gallid herpesvirus 1 (ILTV), which causes significant economic losses. Due to recent outbreaks of ILT in Australia, it has been proposed that ILT could be transmitted between poultry sheds by the wind; however, there has never been direct detection of gallid herpesvirus 1 from air samples. We aimed to optimize a sampling system for recovery and detection of airborne gallid herpesvirus 1 in poultry sheds. Results Poultry farms with a known clinical outbreaks of ILT were used as a test case for detection of airborne gallid herpesvirus 1. Using a liquid cyclonic impinging device, it was found that recovery and detection of airborne gallid herpesvirus 1 was possible in alkaline PEG buffer. Additional sampling was performed at different heights to determine the presence of ILTV in the air. In farm 3, all three air samples at both heights were positive for ILVT while at farm 2 only one sample at 45cm was positive. We envisaged in the future air sampling will be able to detect and track potential transmission of gallid herpesvirus 1 both inside and outside of the poultry shed.
Transcriptomic Analysis at Organ and Time Scale Reveals Gene Regulatory Networks Controlling the Sulfate Starvation Response of Solanum Lycopersicum.
Authors: Canales Javier , Uribe Felipe , Henríquez-Valencia Carlos , Lovazzano Carlos , Medina Joaquín , Vidal Elena A.
Published: June 2020

Background: Sulfur (S) is a major component of biological molecules and thus an essential element for plants. Although the biochemistry and metabolism of sulfate is well understood, little is known about the regulatory mechanisms underlying plant responses to sulfate deprivation, especially in crop plants such as tomato (Solanum lycopersicum). In this work we analyzed the impact of sulfate starvation on the transcriptome of tomato plants to identify regulatory networks and key transcriptional regulators at a temporal and organ scale. Results: Sulfate starvation reduces the growth of roots and leaves which is accompanied by major changes in the organ transcriptome, with the response being temporally earlier in roots than leaves. Comparative analysis showed that a major part of the Arabidopsis and tomato transcriptomic response to sulfate starvation is conserved between these plants and allowed for the identification of processes specifically regulated in tomato, including the control of internal phosphate levels. Integrative gene network analysis uncovered key transcription factors controlling the temporal expression of genes involved in sulfate assimilation, as well as cell cycle, cell division and photosynthesis during sulfate starvation in tomato roots and leaves. Interestingly, one of these transcription factors presents a high identity with SLIM1, a central component of the sulfate starvation response in Arabidopsis. Conclusions: Together, our results provide the first comprehensive catalog of sulfate-responsive genes in tomato, as well as novel regulatory targets for future functional analyses in tomato and other crops.
WITHDRAWN: Greater Adherence to Dietary Guidelines Reduces the Risk of Cardiovascular Diseases in Chinese Patients with Type 2 Diabetes Mellitus: A Case-Control Study
Authors: Wu Shang-Ling , Ye Yan-Bin , Peng Long-Yun , Chen Yu-Ming , Zhuo Shu-Yu , Li Yan-bing , Lu Wei , Chen Pei-Yan , Mai Hai-Yan , Fang Shi , Sui Yi , Ruan Pei-Shan
Published: June 2020

Background The evidence regarding the impact of the healthy eating index on the risk of cardiovascular events among patients with type 2 diabetes mellitus (T2DM) is limited. Objectives To examine the associations of adherence to the Chinese and American dietary guidelines regarding subsequent risk of developing cardiovascular disease (CVD) among Chinese individuals with T2DM. Methods This 1:1 matched case-control study included 419 enrolled pairs hospital-based CVD cases and T2DM controls who were matched by age and gender, in Guangdong province, China. A structured questionnaire and a 97-item food-frequency questionnaire was used to collect general information and dietary intake information. Diet quality scores were calculated according to the Chinese Healthy Eating Index (CHEI) and the Healthy Eating Index-2015 (HEI-2015). Results After adjustment for various confounding factors, the higher diet quality scores on the CHEI and HEI-2015 showed a significant association with a lower risk of CVD. The odds ratios (95% confidence interval) per 5-score increment were 0.73 (0.67, 0.79) in the CHEI and 0.63 (0.55, 0.72) in the HEI-2015, respectively. In stratified analyses, the protective associations remained significant in the subgroups of gender, smoking status, tea-drinking, hypertension state, dyslipidemia state, BMI, and T2DM duration, but not among the drinkers in CHEI. Conclusion Greater adherence to the most recent Chinese or American dietary guidelines may protect against CVD incidents among Chinese patients with T2DM. These data further provide novel evidence that supports the extensive beneﬁts of adopting a healthy dietary pattern in reducing the subsequent burden of CVD complications in patients with T2DM.
Talking with Children About Cancer: A Content Analysis of Text in Children's Picture Books
Authors: Yamaji Noyuri , Sawaguchi Megumi , Ota Erika
Published: June 2020

Background
To tell children that they are diagnosed with cancer is challenging for any healthcare professional and family. Pictures books are one of the communication tools for talking with children about severe diseases. However, little research is available about the contents and appropriateness of picture books about cancer for children.
Methods
This study aimed to examine the contents of children's picture books about cancer and explore the advantages and disadvantages of using picture books to communicate with children about cancer. We searched the picture books about cancer written for children aged under ten years old on the Amazon.com Web site on 5 July 2019 and hand-searched on the cancer-related institutes' Web site. We extracted the texts of relevant picture books and conducted a contents analysis of them. Two researchers independently coded the patterns and contents and calculated the agreement between the codings of two researchers using Cohen's kappa coefficient.
Results
We identified 2,555 picture books and included 30 of them. We identified three main contents, (a) cancer-related knowledge, (b) impacts of cancer, and (c) dealing with cancer. Cancer-related knowledge refers to the information about what is going on and what children have to do. Impacts of cancer refer to the impact of having a child with cancer. Dealing with cancer relates to the actions to reduce or minimize stressful events that had been described. These contents were written with simple words and illustrations. Some of them included the essential contents, which might be misunderstood by children.
Conclusions
Picture books use plain language with illustrations and might be helpful for children to understand about cancer. However, as these books do not include all contents, it is necessary to select and use multiple books depending on the content which is wanted to tell the child. Moreover, there was no picture book which was developed based on children's information needs and validated. Further research should evaluate the impacts of these books as a communication tool when talking with children diagnosed with cancer.
COVID-19 prevalence estimation by random sampling in the population - Optimal sample pooling under varying assumptions about true prevalence
Authors: Brynildsrud Ola
Published: June 2020

Background
The number of confirmed COVID-19 cases divided by population size is used as a coarse measurement for the burden of disease in a population. However, this fraction depends heavily on the sampling intensity and the various test criteria used in different jurisdictions, and many sources indicate that a large fraction of cases tend to go undetected.
Methods
Estimates of the true prevalence of COVID-19 in a population can be made by random sampling. Here I use simulations to explore confidence intervals of prevalence estimates under different sampling strategies, exploring optimal sample sizes and degrees of sample pooling at a range of true prevalence levels.
Results
Sample pooling can greatly reduce the total number of tests required for prevalence estimation. In low-prevalence populations, it is theoretically possible to pool hundreds of samples with only marginal loss of precision. Even when the true prevalence is as high as 10% it can be appropriate to pool up to 15 samples, although this comes with the cost of not knowing which patients were positive. Sample pooling can be particularly beneficial when the test has imperfect specificity can provide more accurate estimates of the prevalence than an equal number of individual-level tests.
Conclusion
Sample pooling should be considered in COVID-19 prevalence estimation efforts.
Long noncoding RNA TSLNC8 Enhances Pancreatic Cancer Aggressiveness by Regulating CTNNB1 Expression via Association with HuR
Authors: Chai Wei , Liu Ruhai , Li Fengshan , Zhang Zhiquan , Lei Bao
Published: June 2020

Background
Pancreatic cancer (PC) is one of the most lethal malignancies worldwide. Tumor suppressor long noncoding RNA on chromosome 8p12 (TSLNC8) is a newly identified long noncoding RNA (lncRNA) and play an important role in human cancers. However, the function and molecular mechanism of TSLNC8 in PC progression remains to be elucidated.
Methods
qRT-PCR was performed to examine the expression pattern of TSLNC8 in PC tissues and cell lines. Overexpression and knockdown experiments were conducted to detect the function of TSLNC8 in PC. The interaction between TSLNC8 and HuR was tested by RNA immunoprecipitation assay.
Results
Our results showed a significant increase of TSLNC8 expression in PC tissues and cell lines. Upregulation of TSLNC8 expression in PC tissues was closely correlated with TNM stage, distant and lymph node metastasis, and poor prognosis of PC patients. Functional experiments demonstrated that TSLNC8 promoted PC cells proliferation and invasion in vitro, and enhanced PC growth and metastasis in vivo. Mechanistically, TSLNC8 associated with HuR, promoted the binding of HuR with CTNNB1 mRNA and increased the stability of CTNNB1 mRNA, thus activating WNT/β-catenin signaling pathway.
Conclusion
Our present study revealed that oncogenic lncRNA TSLNC8 positively regulate PC growth and metastasis via HuR-mediated mRNA stability of CTNNB1, extending the understanding of PC pathogenesis regulated by lncRNAs.
The effect of Wogonoside on the expression of pulmonary fibrosis factor in Mycoplasma pneumoniae pneumonia
Authors: Wang Huihui , Wang Xiaoxi , Yang Zhimin , Xu Huixing , Wang Xin , Tang Guixin , Meng Yanli , Wang Weiming
Published: June 2020

BACKGROUND

Mycoplasma pneumoniae pneumonia (MPP) is an acute respiratory infectious pneumonia with pulmonary interstitial fibrosis. TGF-β1 is well accepted as the central mediator for fibrosis which promotes the formation of tissue fibrosis factor. Qinbaiqingfei pellet (Qinbai) has already been approved as the first effective new traditional Chinese medicine which can delay activities of Mycoplasma pneumoniae (M.pneumoniae) and protect lung epithelial cells in clinical trials. However, the mechanism of Qinbai inhibiting the expression of TGF-β1 is still unclear.
METHODS

The Chinese herbs in Qinbai were screened by surface plasmon resonance (SPR) and it was deteimined that Scutellaria baicalensis extracts in Qinbai showed the best binding with TGF-β1. Then the active ingredient whicn can be bound with TGF-β1 protein in the solution of Qinbai and Scutellaria baicalensis was isolated and analyzed by UPLC-Q-TOF-MS, which proved the active ingredient was Wogonoside. The affinity constant of Wogonoside and TGF-β1 protein was measured by SPR affinity analysis. A549 cells infected with M.pneumoniae were intervened by Wogonoside, and then the expression of TGF-β1 and Smad3 in A549 cells were analyzed by PCR and western blotting.
RESULTS

The results showed the bound effect of Scutellaria baicalensis and TGF-β1 was effective. The active ingredients which can be bound with TGF-β1 in the solution of Scutellaria baicalensis and Qinbai were obtained and analyzed to investigate the mechanism of Qinbai inhibiting the expression of TGF-β1. UPLC-Q-TOF-MS results showed that the active ingredients was Wogonoside. SPR affinity analysis showed that the affinity constant was 21.71 µM. Pharmacological experiments revealed that Wogonoside strongly inhibited the expression of TGF-β1 and Smad3 in A549 cells infected by M.pneumoniae.
CONCLUSION

Wogonoside in Qinbai can be bound with TGF-β1 and down-regulate the expression of lung fibrosis factors TGF-β1 and Smad3. The finding may improve our understanding the molecular mechanism of Qinbai mediating MPP and provide new sights into the future pharmacological investigation of Qinbai.
Relevant factors for early liver transplantation after Kasai portoenterostomy
Authors: Ge Liang , Zhan Jianghua , Gao Wei , Zhao Shengqiao , Xu Xiaodan , Dou Ran
Published: June 2020

Background
To explore the relevant factors for early liver transplantation (LT) after Kasai portoenterostomy (KP).
Methods
Retrospective analysis was performed for 200 children with biliary atresia, who underwent LT with hepatic failure after KP. According to the interval between KP and LT, they were divided into three groups: G1 (≤6-month), G2 (6-month ~ 2-year) and G3 (> 2-year). Gender, age of Kasai portoenterostomy, jaundice-clearance, cholangitis after KP and liver function indexes before LT were compared among the three groups.
Results
The proportion of patients with age of KP (≤90-day) in G1 was lower than that in G3 (P = 0.003). Jaundice-clearance occurred in 6 (7.6%), 26(28.6%) and 26 (86.7%) patients after KP in G1, G2 and G3 respectively (P < 0.001). There were statistical differences in the incidence of early cholangitis, late cholangitis and repeated cholangitis among the three groups (P = 0.035, < 0.001 and 0.022). The native liver survival (NLS) rate of children at operation age > 90-day was lower than that of children at operation age ≤ 90-day (P = 0.002). The NLS rate of the children with jaundice-clearance after KP was significantly better than that of the children without jaundice-clearance (P < 0.001). The NSL rate of the children with early cholangitis after operation was lower than that in children without early cholangitis (P = 0.026). The NLS rate of patients of G2 and G3 with cholangitis after KP was lower than that in children without cholangitis (P = 0.017). Multiple logistic regression analysis showed uncleared jaundice after KP was a risk factor for the NSL survival time in patients.
Conclusion
The age of KP (> 90-day), jaundice-unclear and early cholangitis could reduce the NLS time after KP, which were related to early liver transplantation. Jaundice-unclear was a risk factor for early liver transplantation.
The Ibr-7 Derivative of Ibrutinib Exhibits Radiosensitivity in Pancreatic Cancer Cells via Targeting EGFR
Authors: Tan Biqin , Zhang Bo , Yan Youyou , Li Qingyu , Wang Fei , Lin Nengming
Published: June 2020

Background: Radiotherapy is one of the main therapeutic methods for pancreatic cancer, but radiation resistance limits the clinical application. As a result, novel therapeutic agents to improve the radiosensitivity is urgent. This study aimed to investigate the effect of Ibr-7 (the derivative of ibrutinib) on radiosensitivity of human pancreatic cancer cells.Methods: The effect of Ibr-7 on pancreatic cancer cell’s proliferation were detected by CCK-8 assay. Radiosensitivity was assessed by clonogenic formation assay. Cell cycle, cell apoptosis were analyzed by flow cytometry. DNA damage was detected by immunofluorescence analysis. The expression of p-EGFR, EGFR were determined by western blot.Results: Ibr-7 showed anti-proliferative effect in PANC-1 and Capan2 cells in a dose- and time-dependent manner. Ibr-7 (2 µmol/L) enhanced the effect of radiation in PANC-1 and Capan2 cells. Further findings showed that this combination enhanced G2/M phase arrest and increased cell apoptosis. Additional molecular mechanism studies revealed that the expression of p-EGFR was decreased by Ibr-7 alone or combined with radiation. Overexpression of EGFR reversed the cell apoptosis induced by Ibr-7 combined with radiation. Moreover, the expression of γ-H2AX was significantly decreased in Ibr-7 combined with radiation group.Conclusions: Our study indicated that the potential application of Ibr-7 as a highly effective radiosensitizer for the treatment of pancreatic cancer cells.
Identification of Chondroitin Polymerizing Factor (CHPF) as Tumor Promotor in Cholangiocarcinoma through Regulating Cell Proliferation, Cell Apoptosis and Cell Migration
Authors: Duan Xiaohui , Yang Jianhui , Jiang Bo , Duan Wenbin , Wei Rongguang , Zhang Hui , Mao Xianhai
Published: June 2020

Background: Cholangiocarcinoma (CCA) is a variety of biliary epithelial tumors involving intrahepatic, perihilar and distal bile duct. It is the most common malignant bile duct tumor in the liver and the second most common primary liver cancer, whose molecular mechanism not fully understood. Specifically, the relationship between CCA and chondroitin polymerizing factor (CHPF) is still not clear.Methods: In this study, detection of clinical specimens was performed to preliminarily study the role of CHPF in cholangiocarcinoma. Cholangiocarcinoma cells with CHPF knockdown were constructed for in vitro study, which was also used in the construction of mice xenograft model for investigating the role of CHPF in the development of cholangiocarcinoma.Results: The results demonstrated that CHPF was significantly upregulated in cholangiocarcinoma tissues compared with normal tissues. High expression of CHPF was correlated with more advanced tumor grade. Moreover, knockdown of CHPF significantly inhibited cell proliferation, cell migration, promoted cell apoptosis and arrest cell cycle in G2 phase in vitro, as well as suppressed tumor growth in vivo.Conclusions: In conclusion, CHPF was identified as a tumor promotor in the development and metastasis of cholangiocarcinoma, which may provide a novel therapeutic target for the targeted therapy against cholangiocarcinoma.
Prevalence and Impact of Fibrinolytic Dysregulation in Patients with Acute Coronary Syndromes
Authors: Wan Huaibin , Wu Zhihao , Lie Zhenbang , Li Daqiang , Su Shaohui
Published: June 2020

Background：Dual antiplatelet therapy can reduce coronary thrombosis and improve the prognosis in patients with acute coronary syndrome (ACS). However, there was limited prognostic information about fibrinolytic dysregulation in patients with ACS. This study is aimed to evaluated the prevalence and impact of fibrinolytic dysregulation in patients with acute coronary syndrome (ACS).Methods：We retrospectively analyzed coagulation and fibrinolysis related indexes of ACS in hospitalized adults with rapid thrombelastography between May 2016 and December 2018. All of the follow-up visits were ended by December 2019. The primary outcome was the occurrence of major adverse cardiovascular events (MACEs), which included unstable angina pectoris, non-fatal myocardial infarction, non-fatal cerebral infarction, heart failure and all-cause death. Results：338 patients were finally included with an average age of 62.5 ± 12.8 years old, 273 (80.5%) were males, 137(40.5%) patients were with STEMI. Fibrinolysis shutdown and hyperfibrinolysis were observed among 163 (48.2%) and 76(22.5%) patients, respectively. During a total of 603.2 person·years of follow-up period, 77 MACEs occurred (22.8%). Multivariate Cox regression analysis indicated that age [HR: 1.031 95% CI: 1.007-1.056, P = 0.012] and LY30 [HR: 1.097, 95% CI: 1.013-1.188, P = 0.023] were independently correlated with the occurrence of MACEs. The hazard ratios pertaining to MACEs in patients with LY30＜0.8% and ＞3.0% compared with those in the physiologic range(LY30: 0.8-3.0%) were 2.275 [HR: 2.275, 95% CI: 1.241-1.241, P = 0.003] and 1.196 [HR: 1.196, 95% CI: 0.679-2.109,P=0.535], respectively.Conclusions: Fibrinolytic dysregulation is very common in selected patients with ACS, and hyperfibrinolysis (HF) (LY30 >3%) is associated with poor outcomes in patients with ACS
Climatic change and its relationship with human society in northern Japan since the mid-Holocene - Quantitative reconstruction of atmospheric and sea surface temperature -
Authors: Kawahata Hodaka , Hatta Yoshiki , Kajita Hiroto , Ota Yuki , Akihiro Yoshida , Nishina Kenji , Aono Tomoya , Habu Junko
Published: June 2020

For the prediction for future climate, it is required to enhance our understanding of the Holocene climatic change. By estimating paleo-temperature, we attempted to examine the relationship between climatic changes and human activities in northern Japan. The alkenone SSTs showed a variation of 8.7 °C (14.5 °C to 23.2 °C). Jomon people living around Funka Bay were more dependent on marine products than in Honshu due to cooler climatic conditions. There are two Hypsithermal environments at Funka Bay around 4.6 cal. kyr BP and 1.2 cal. kyr BP. Sea levels for the last 7 kyrs have been controlled mainly by local/regional tectonic vertical movement. Therefore, the highstand never always corresponded to Hypsithermal environments. More than one driving forcing, rather than one, may control climatic/environmental change. The 4.2ka event in northern Japan could be characterized by cooling by a few degrees by the combination of reduced ESAM and El Niño mode. Another notable cooling event occurred in 1.0-0.8 cal. kyr BP due to the La Niña condition and reduced solar activities, which means that the Japanese archipelago never experienced Medieval Warm Event: instead, there was a Medieval Cold Event in Japan. The Okhotsk culture in Hokkaido prospered only under the Hypsithermal condition during the 5 th - 9 th centuries and subsequently it declined and was incorporated into the Satsumon culture under the cooler environmental conditions. For the Yayoi-era (2.9 cal. kyr BP-) and the following periods, our results are consistent with the previous results from Hiroshima Bay, western Japan, that cold periods (6 th - 7 th century BC, 3 rd century BC, 6 th century AD, 10 th -12 h century AD and 16 th century AD) coincided with major shifts in social systems in Japan.
Surgical management of ulnar styloid fractures: comparison of fixation with anchor suture and tension band wire
Authors: Chen Alvin Chao-Yu , Lin Yi-Hsuan , Weng Chun-Jui , Cheng Chun-Ying
Published: June 2020

Background Limited reference is available regarding surgical management in symptomatic ulnar styloid fractures with small bony avulsion. The study goal is to report the surgical outcomes using anchor suture fixation with comparison to traditional tension band wire fixation.Methods We retrospectively reviewed the medical records in patients who underwent surgical repair for unilateral ulnar styloid fractures with distal radioulnar instability between 2004 and 2017. A total of 31 patients were enrolled including two kinds of fixation methods. Anchor suture fixation plus distal radioulnar joint pinning was performed in ten patients with tiny avulsion bony fragments (group A); tension band wire fixation was performed in 21 patients with big styloid fracture fragments (group B). Patient characteristics and 2-year treatment outcomes were compared between two groups based on Mayo Modified Wrist Score (MMWS), Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH), visual analog scale (VAS) and surgical complication. Descriptive statistics were used for calculation of key variables; a p-value of < 0.05 was considered statistically significant.Results Based on Gaulke classification, there were five subtypes in group A and three subtypes in group B. Incidence of concomitant distal radius fractures was significantly higher in group B; other patient characteristics including age, sex, injury side, and time to surgery showed no significant difference. Outcome assessment regarding MMWS, QuickDASH and VAS was comparable between two groups. Bone-related complications including nonunion, DRUJ subluxation and styloid resorption were analyzed; the difference was not significant. Incidence of implant-related complications including migration and secondary removal surgery was significantly higher in group B (p = 0.021).Conclusion Surgical fixation in symptomatic ulnar styloid fractures yields comparable treatment outcomes in both fracture patterns. Implant-related complication with secondary removal surgery is more common in tension band wire group. Anchor suture fixation is a feasible option for tiny styloid avulsion fragments with limited surgical complication.
Probiotics Ameliorate Pioglitazone-associated Bone Loss in Diabetic Rats
Authors: Gholami Ahmad , Dabbaghmanesh Mohammad Hossein , Ghasemi Younes , Talezadeh Pedram , Koohpeyma Farhad , Montazeri-Najafabady Nima
Published: June 2020

Background: Pioglitazone as a PPAR-g agonist are used for management of type 2 diabetes mellitus. Nevertheless, evidence showed that the therapeutic modulation of PPARg activity using Pioglitazone may be linked with bone mass reduction and fracture risk in type 2 diabetes mellitus patients. The objective of the current research was to inspect the preventive role of some types of probiotic strains including (Lactobacillus acidophilus, Lactobacillus reuteri, Lactobacillus casei, Bifidiobacterum longum and Bacillus coagulans) against pioglitazone-induced bone loss.Methods: Streptozotocin (60 mg/kg) was administered for diabetes induction. Diabetic rats were fed orally with pioglitazone (300 mg/kg) and probiotics (1×109 CFU/ml/day) alone and in combination of both for 4 weeks. Dual energy X-ray absorptiometry (DEXA) were used to asses BMD, BMC and area of the femur, spine and tibia at the experiment termination. Serum glucose, serum calcium, alkaline phosphatase, phosphorus, BUN, Creatinine, and urine calcium were also analyzed. Results: Administration of pioglitazone and probiotics alone and in combination significantly improved elevated blood glucose. Pioglitazone treatment significantly increased urinary calcium and BUN, and decreased ALP and creatinine. Co-treatment of probiotics with pioglitazone significantly decreased urinary calcium, creatinine and ALP. Pioglitazone showed detrimental effects on femur-BMD whereas treatment with probiotics remarkably ameliorated these effects. Among the tested probiotics Bifidiobacterum longum displayed the best protective effects on pioglitazone-induced bone loss in diabetic rats.Conclusion:This study suggests probiotic supplementation in diabetic patients on pioglitazone regime could be considering as a good strategy to ameliorate bone loss induced by pioglitazone.
FusAtNet: Dual Attention based SpectroSpatial Multimodal Fusion Network for Hyperspectral and LiDAR Classification
Authors: Mohla Satyam , Pande Shivam , Banerjee Biplab , Chaudhuri Subhasis
Published: June 2020

With recent advances in sensing, multimodal data is becoming easily available for various applications, especially in remote sensing (RS), where many data types like multispectral imagery (MSI), hyperspectral imagery (HSI), LiDAR etc. are available. Effective fusion of these multisource datasets is becoming important, for these multimodality features have been shown to generate highly accurate land-cover maps. However, fusion in the context of RS is non-trivial considering the redundancy involved in the data and the large domain differences among multiple modalities. In addition, the feature extraction modules for different modalities hardly interact among themselves, which further limits their semantic relatedness. As a remedy, we propose a feature fusion and extraction framework, namely FusAtNet, for collective land-cover classification of HSIs and LiDAR data in this paper. The proposed framework effectively utilizses HSI modality to generate an attention map using "self-attention" mechanism that highlights its own spectral features. Similarly, a "cross-attention" approach is simultaneously used to harness the LiDAR derived attention map that accentuates the spatial features of HSI. These attentive spectral and spatial representations are then explored further along with the original data to obtain modality-specific feature embeddings. The modality oriented joint spectro-spatial information thus obtained, is subsequently utilized to carry out the land-cover classification task. Experimental evaluations on three HSI-LiDAR datasets show that the proposed method achieves the state-of-the-art classification performance, including on the largest HSI-LiDAR dataset available, University of Houston (Data Fusion Contest - 2013), opening new avenues in multimodal feature fusion for classification.
Normative Beliefs and Values Shape Mother’s Care Seeking Behaviours for Skilled Birth Attendance (Sba) During Birthing in Africa: A Scoping Review Protocol
Authors: Jacobs Choolwe , Hyder Adnan
Published: June 2020

Background: Skilled birth attendance (SBA) during delivery has been associated with improved maternal health outcome. However, low utilisation of SBA during childbirth has continued in many developing countries including Zambia. An understanding of the beliefs and values and how mothers are influenced by relational normative motivations is critical in understanding some “hidden” barriers and facilitators to utilisation of SBA in health facilities.Methods: A scoping review of normative beliefs and values shaping care seeking behaviours for Skilled Birth Attendance by mothers in Africa will be conducted. Google scholar, PubMed, EBSCOhost, SCOPUS, Embase and WEB of Science will be searched for articles that meet the eligibility criteria. The primary search will include peer-reviewed articles. Further searches will be made on Research gate, including grey literature from university websites for dissertations and theses. We will also search reference lists for relevant articles and studies. Keyword searches will be used to identify articles. Two independent reviewers will begin screening for eligible titles, abstracts and full articles with a third reviewer to help resolve any disputes. During title and abstract screening, duplicates will be removed. Study selection will conform to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines, and the Mixed Method Appraisal Tool will determine the quality of included studies. Content analysis will be used to present the narrative Discussion: Understanding how individual mother’s health seeking behaviours for SBA and those close to them are influenced by their beliefs and values is critical to informing health systems on the possible “hidden” barriers and facilitators to utilisation of SBA in public health facilities. The review will complement evidence base on normative beliefs and values shaping care seeking behaviours for Skilled Birth Attendance by mothers in Africa.
Contrasting Cumulative Risk and Multiple Individual Risk Models of the Relationship Between Adverse Childhood Experiences (ACEs) and Adult Health Outcomes
Authors: LaNoue Marianna , George Brandon J , Helitzer Deborah L , Keith Scott W
Published: June 2020

Background
A majority of the documented relationships between adverse childhood experiences (ACEs) and adult health outcomes are based in cross-sectional self-reported datasources such as the CDC’s Behavioral Risk Factor Surveillance System survey. Despite using the same or similar questions, there is a great deal of inconsistency in the operationalization of self-reported childhood adversity for use as a predictor variable. A cumulative risk model, resulting in a cumulative numeric ‘ACE Score’, is normative but there are differences in the way the ACE Score is calculated and used in statistical models. Alternative conceptual models are rarely used, even though predictor characterization directly impacts interpretations about the effects of adversity on outcomes. We investigated differences in model fit and performance between the cumulative ACE Score and a ‘multiple individual risk’ model that enters individual ACE events individually into prediction models.
Methods
We merged the 2011–2012 BRFSS data (N = 56,640) and analyzed 3 self-report outcomes. We compared model fit metrics and used Vuong’s test for model selection to arrive at a best fit model.
Results
The multiple individual risk model was a better fit than the categorical ACE Score for the ‘lifetime history of depression’ outcome. For the outcomes of obesity and cardiac disease, the cumulative risk and multiple individual risks models were of comparable fit, but yield very different inferences.
Conclusions
Additional information-rich inferences about ACE-health relationships can be obtained from including a multiple individual risk modeling strategy, either in addition to or in place of a cumulative risk ACE Score.