bluuebunny/crossref_metadata_2025 huggingface dataset:
R-MPV Followed by High-dose Chemotherapy With Thiotepa-based and Autologous Stem Cell Transplantation for Newly Diagnosed Primary Central Nervous System Lymphoma: A Single-center Experience
Authors: Lee Ji Yun , Paik Jin Ho , Suh Koung Jin , Kim Ji-Won , Kim Se Hyun , Kim Jin Won , Kim Yu Jung , Lee Keun-Wook , Kim Jee Hyun , Bang Soo-Mee , Lee Jong-Seok , Lee Jeong-Ok
Published: October 2020

BackgroundHigh-dose chemotherapy followed by autologous stem-cell transplantation (HDC–ASCT) as a consolidation treatment is a promising approach in eligible patients with newly diagnosed primary central nervous system lymphoma (PCNSL). This study sought to assess the safety and efficacy of initial methotrexate-based chemotherapy followed by consolidation HDC-ASCT with a thiotepa-based conditioning regimen in patients with newly diagnosed PCNSL. MethodsIn this retrospective analysis, 22 patients with newly diagnosed PCNSL received chemotherapy with rituximab, methotrexate, procarbazine, and vincristine (R-MPV). Those who showed a complete or partial response subsequently received consolidation HDC-ASCT with a thiotepa-based conditioning regimen and no radiotherapy. ResultsCharacteristics of the PCNSL patients included a median age of 57 years (range: 49–67 years), Eastern Cooperative Oncology Group performance status of grade 2 or more in 9.1%, elevated lactate dehydrogenase level in 26.3%, and involvement of multiple lesions in 72.1%. About 82% of patients received six cycles of induction chemotherapy, which was well-tolerated with excellent disease control. The rate of confirmed/or unconfirmed complete response increased from 45.5% in the interim to 81.8% before HDC-ASCT. With a median follow-up of 19.6 months (range: 7.5–56.5 months), the 2-year progression-free survival and overall survival estimates were 84% and 88%, respectively. There were no treatment-related deaths. Grade 3 toxicity was recorded in 90.9% after HDC-ASCT, and the most common grade 3 adverse event was febrile neutropenia without sepsis. ConclusionsThe discussed treatment approach appears feasible in patients with newly diagnosed PCNSL, yielding encouraging results.
Ultrahigh water permeation with high multivalent metal ions rejection rate through graphene oxide membranes
Authors: Dai Fangfang , Zhou Feng , Chen Junlang , Liang Shanshan , Chen Liang , Fang Haiping
Published: October 2020

Graphene oxide (GO) membranes show exceptional molecular permeation properties and have gained tremendous attention in the area of wastewater treatment. However, they still suffer from some limitations, such as low water permeance when the ion rejection rate is at a satisfactory level and unstable performance. Here, we develop a sort of GO membrane that exhibits ultrahigh water permeance up to 75.2 L m−2 h−1 bar−1 while still maintaining a high rejection rate of 99.9% for multivalent metal ions. Importantly, of all state-of-the-art nanofiltration membranes, this is the most permeable membrane with a satisfactory level of rejection rate for multivalent ions. Furthermore, the GO membrane has outstanding stability over long-time operation. Our work provides a simple way to fabricate GO membranes with outstanding water purification performance.
Spinon Fermi surface spin liquid in a triangular lattice antiferromagnet NaYbSe2
Authors: Dai Peng-Ling , Zhang Gaoning , Xie Yaofeng , Duan Chunruo , Gao Yonghao , Zhu Zihao , Feng Erxi , Huang Chien-Lung , Cao Huibo , Podlesnyak A. , Granroth Garrett , Everett S. , Neuefeind Joerg , Voneshen David , Wang Shun , Tan Guotai , Morosan Emilia , Wang Xia , Shu Lei , Chen Gang , Guo Yanfeng , Lu Xingye , Dai Pengcheng
Published: October 2020

Triangular lattice of rare-earth ions with interacting effective spin-1/2 local moments is an ideal platform to explore the physics of quantum spin liquids (QSLs) in the presence of strong spin-orbit coupling, crystal electric ﬁelds, and geometrical frustration. The Yb delafossites, NaYbCh2 (Ch=O, S, Se) with Yb ions forming a perfect triangular lattice, have been suggested to be candidates for QSLs. Previous thermodynamics, nuclear magnetic resonance, and powder sample neutron scattering measurements on NaYbCh2 have supported the suggestion of the QSL ground states. The key signature of a QSL, the spin excitation continuum, arising from the spin quantum number fractionalization, has not been observed. Here we perform both elastic and inelastic neutron scattering measurements as well as detailed thermodynamic measurements on high-quality single crystalline NaYbSe2 samples to conﬁrm the absence of long-range magnetic order down to 40 mK, and further reveal a clear signature of magnetic excitation continuum extending from 0.1 to 2.5 meV. By comparing the structure of our magnetic excitation spectra with the theoretical expectation from the spinon continuum, we conclude that the ground state of NaYbSe2 is a QSL with a spinon Fermi surface.
Tumor Mutation Burden: A Predictive Biomarker for Gastric Cancer Immunotherapy
Authors: Xiang Renshen , Fu Tao
Published: October 2020

Background: Few studies have focused on the underlying relationship between the prognosis of tumor mutation burden (TMB) and immune cell infiltration in gastric cancer (GC). This study aims to explore the relationship among TMB and various components in tumor microenvironment (TME). Methods: The transcription profiles and somatic mutation data of 375 tumor and 32 normal samples were obtained from TCGA. The specific mutation information was summarized and visualized with waterfall chart, then number of TMB per million bases of each GC sample was calculated. Immune/stromal scores and tumor purity were calculated by the ‘ESTIMATE’ package, and the fractions of 22 immune cells in each sample were evaluated by CIBERSORT algorithm. Finally, Lass regression analysis was utilized to generate a prognostic scoring signature with TCGA cohort as the training set, while GES84437 cohort as the validation set. Results: Higher TMB indicated favorable overall survival (OS, P = 0.043)，better disease specific survival (P = 0.029), and longer progression free interval (P = 0.004). TMB was positively correlated with MSI and tumor purity, while negatively associated with immune/stromal scores. Moreover, TMBhigh group has lower T cells CD4 memory resting (P < 0.001) and T cells regulatory (P < 0.001), and more T cells CD4 memory activated (P < 0.001) and T cells follicular helper (P = 0.009). More importanly, the infiltration of dendritic cells activated predicted a worse OS, while T cells CD4 memory activated and T cells follicular helper meant a better OS. Finally, a nomogram combined TMB-related signature with clinicopathologic variables can successfully predict the OS with high accuracy and efficiency.Conclusion: TMB can effectively reveal the immune infiltration status in TME of GC, and might serve as a prognostic classifier for individualized treatment of clinical decision-making.
Molecular Characterization of Cytidine Monophospho-N-Acetylneuraminic Acid Hydroxylase (CMAH) Gene and Frequency of Blood Types in Stray Cats of İzmir, Turkey
Authors: Can Hüseyin , Alak Sedef Erkunt , Köseoğlu Ahmet Efe , Şahar Umut , Bostanbaş Berna , Baydarlı Serdar , Döşkaya Mert , ÜN Cemal
Published: October 2020

Cytidine monophospho-n-acetylneuraminic acid hydroxylase (CMAH) gene associated with blood groups in cats encodes CMAH enzyme that converts Neu5Ac to Neu5Gc. Although variations in CMAH gene of pedigree cats have been revealed, the presence/lack of them in non-pedigree stray cats is unknown. Therefore, the present study aimed to investigate the variations in CMAH gene and the quantity of Neu5Ac and Neu5Gc on erythrocytes of non-pedigree stray cats (n:12) living in İzmir, Turkey. Meanwhile, these 12 cats were typed using the mitochondrial DNA control region. Also, the frequency of blood types was determined in 76 stray cats including 12 cats that were used for CMAH and Neu5A/Neu5Gc analysis. In total, 14 SNPs were detected in 5’UTR as well as in exon 2, 4, 9, 10, 11 and 12 of CMAH gene. Among these SNPs, -495C>T in 5’UTR was detected for the first time as heterozygous in type A and AB cats, and homozygous and heterozygous in type B cats. The remaining 13 that have been detected in previous studies were also found as homozygous or heterozygous. Homozygous form (T/T) of the -495C>T polymorphism was found among only type B cats. Among the polymorphisms previously determined in the literature, homozygous form of the -371C>T polymorphism was found among only type B cats whereas heterozygous form (A/C) of the 327A>C polymorphism was detected in only type AB cats. Both Neu5Gc and Neu5Ac were detected in type A and AB cats. In type B cats, only Neu5Ac was detected. Among two type AB cats, the level of Neu5Ac was found higher in cat carrying heterozygous form (T/C) of 1392T>C. Mitotypes A, A6, D, E and 1 were detected among stray cats analysed for the characterisation of CMAH gene. The prevalence of type B cats (67.1%) was higher than others. As a result, the presence of a new SNP as well as previous SNPs indicates that more variations can be found in stray cats with a more comprehensive study in the future. Also, the high prevalence of type B cats demonstrates the high risk of neonatal isoerythrolysis among stray cats living in İzmir, Turkey.
Design and Evaluation of the I-SCAN Faculty POCUS Program
Authors: Janjigian Michael , Dembitzer Anne , Srisarajivakul-Kl Caroline , Hardower Khemraj , Cooke Deborah , Zabar Sondra , Sauthoff Harald
Published: October 2020

IntroductionPoint-of-care ultrasound (POCUS) is becoming widely adopted with increasing accessibility of courses. Little is known about the optimal design of the introductory course or longitudinal training programs that are critical to success.AimTo evaluate the effectiveness of a comprehensive hospitalist POCUS training programSettingFour hospitals at an academic medical center.Program DescriptionThe program consisted of a 2-day introductory course and a longitudinal phase comprising clinical POCUS practice, clip uploading with online feedback, hands-on teaching, and monthly ultrasound conferences. Assessments were performed immediately before and after the 2-day course and after one year.Program EvaluationKnowledge increased from baseline to post 2-day (median score 58% and 85%, respectively, p<0.001) and decreased slightly at one year (median score 81%, p=0.012). After the 2-day introductory course, the median score for hands-on image acquisition skills, the principal metric of learner success, was 75%. After one year, scores were similar (median score 74%). Confidence increased from baseline to post 2-day (1.5 to 3.1 on a 4 point Likert scale from Not at all confident (1) to Very confident (4), p<0.001), and remained unchanged after one year (2.73). Course elements correlating with a passing score on the final hands-on test included number of clip uploads (r=0.85, p,0.001), attendance at hands-on sessions (r=0.7, p=0.001), and attendance at monthly conferences (r=0.50, p=0.03).DiscussionThe I-ScaN POCUS training program increased hospitalist knowledge, skill and confidence with maintained skill and confidence after one year. Uploading clips and attending hands-on teaching sessions were most correlative with learner success.
Increasing uptake of colon cancer screening in a medically underserved population with the addition of blood-based testing
Authors: Ioannou Stephanie , Sutherland Kyle , Sussman Daniel A. , Deshpande Amar R.
Published: October 2020

Adherence to colorectal cancer screening is suboptimal, particularly in medically underserved populations. We report here on our assessment of the impact of offering a blood-based screening test on screening rates in a health fair setting. Patients attending student-run health fairs who met colon cancer screening guideline eligibility criteria received a recommendation to attend that screening station. Patients were offered recommended accepted screening methods, and if they declined they were offered blood-based testing. Screening rates, test outcomes, and the rate of follow up completion of colonoscopy were measured and compared with historic screening outcomes. Of 1401 screening eligible patients, 640 (45.7%) attended the colon cancer screening station, of whom 460 were eligible for assessment. Amongst these, none selected colonoscopy, 30 (6.5%) selected FIT, and 430 (93.5%) selected blood-based testing. Only 2 patients returned the FIT. For the blood test, 88 were positive, and 20 of these received a follow up colonoscopy. Based on this assessment, blood-based testing is an effective method to increase screening rates in medically underserved populations, though efforts to further improve access to follow up colonoscopy are necessary.
Comparative Transcriptomics Provides Insight Into Rind Color Polymorphism in Watermelon
Authors: Liu Dongming , Yang Huihui , Sun Dongling , Zhang Minjuan , Dou Junling , Yang Sen , Zhu Huayu , Hu Jianbin , Sun Shouru , Yang Luming
Published: October 2020

BackgroundAs an important agronomic trait affecting breeding and consumption choice, rind color of watermelon [Citrullus lanatus (Thunb.) Matsum. and Nakai] receives considerable attention from breeders. Although rind color occupies an important place in watermelon breeding work, the underlying molecular mechanism governing this complex trait has still not been determined. ResultsIn the present study, chlorophyll and carotenoid contents were hypothesized to be the main factors determining rind color. Clearly different structures and numbers of chloroplasts and grana lamellae were found among materials with different rind colors. To study the genes involved in the coloration process of the yellow, dark green, light green, and light green-gray rinds, 84,516 unigenes were obtained from the rind transcriptome. Through DEGs screening and pathway analysis of chlorophyll and carotenoid mechanism, the genes with abnormal expression levels were identified. Then, the nucleotide sequences and expression levels of the putative genes responsible for different rind colors were studied.ConclusionsThis study provides a comprehensive insight on the factors affecting rind coloration and investigated expression levels of the critical genes concerning pigment metabolism in watermelon. These results would help to analyze the molecular mechanisms of rind coloration regulation and development of the related organelles.
Genome wide analysis of kinesin gene family in Citrullus lanatus reveals an essential role in early fruit development
Authors: Tian Shujuan , Jiang Jiao , Xu Guo-qi , Wang Tan , Liu Qiyan , Chen Xiner , Liu Man , Yuan Li
Published: October 2020

BackgroundKinesin (KIN) as a motor protein is a versatile nano-machine and involved in diverse essential processes in plant growth and development. However, the kinesin gene family has not been identified in watermelon, a valued and nutritious fruit, and yet their functions has not been characterized. Especially, their involvement in early fruit development, which directly determines the size, shape, yield and quality of the watermelon fruit, remains unclear.ResultsIn this study, we performed a whole-genome search and comprehensive analysis in C. lanatus. In total, 48 kinesins were identified and categorized into 10 kinesin subfamilies groups based on phylogenetic analysis. Their uneven distribution on 11 chromosomes was revealed by chromosomal distribution analysis. Conserved motif analysis showed that the ATP-binding motif of kinesins was conserved within all subfamilies, but not the microtubule-binding motif. 10 segmental duplication pairs genes were detected by the syntenic and phylogenetic approaches, which explains the expansion of the kinesin gene family in C. lanatus genome. Moreover, 5 ClKINs genes are specifically and abundantly expressed in early fruit developmental stages according to comprehensive expression profile analysis, indicating their critical regulatory roles during early fruit development. Our current data also demonstrated that the majority of kinesin genes were responsive to plant hormones, implying their involvement in the signaling pathways of plant hormones.ConclusionsThis study is the first comprehensive analysis of the kinesin gene family in watermelon, which establishes a foundation for further functional investigation of C. lanatus kinesin genes and provides novel insights into their biological functions. In addition, these results will provide a useful resource for further selecting an artificial regulator of fruit development in C. lanatus.
Analysis of Mental Health Status and Influencing Factors of Overseas Chinese in Laos
Authors: Li Yanfang , Tao Qin , Zhou Xiaoyu , Zhang Kan
Published: October 2020

Background: To provide a reference for foreign aid workers by identifying the mental health status of Overseas Chinese resident in Laos and the influencing factors. Methods :Convenience sampling method was used to select the 414 Overseas Chinese in Laos from April 10 to May 10 in 2020. The mental health status was assessed by using PHQ-9 and GAD-7 scales, and the influencing factors were analyzed. Results :The prevalence of anxiety and depression among overseas Chinese in Laos was 28.5% and 36.2%. Factors influencing anxiety and depression included family members' attitudes towards their departure abroad, financial aid subsidies, living standards in Laos, and Laotian food. Conclusion :Degrees of anxiety and depressive were varying among Overseas Chinese in Laos. Depression was highly correlated with anxiety, and the influencing factors of anxiety and depression were different. Foreign aid workers should pay attention to the mental health of the Overseas Chinese in Laos and the influencing factors.
Causes of Preterm and Low Birth Weight Neonatal Mortality in a Rural Community in Kenya: Evidence From Verbal and Social Autopsy
Authors: Olack Beatrice , Santos Nicole , Inziani Mary , Moshi Vincent , Oyoo Polycarp , Nalwa Grace , Ouma Linet , Otare Christopher , Walker Dilys , Otieno Phelgona Apondi
Published: October 2020

BackgroundUnder-five mortality in Kenya has declined over the past two decades. However, the reduction in the neonatal mortality rate has remained stagnant. In a country with weak civil registration and vital statistics systems, there is an evident gap in documentation of mortality and its causes among low birth weight (LBW) and preterm neonates. We aimed to establish causes of neonatal LBW and preterm mortality in Migori County, among participants of the PTBI-K (Preterm Birth Initiative-Kenya) study.MethodsThis was a cross sectional study whereby Verbal and social autopsy (VASA) interviews were conducted with caregivers of deceased LBW and preterm neonates delivered within selected 17 health facilities in Migori County, Kenya. The probable cause of death was assigned using the WHO International Classification of Diseases (ICD-10). ResultsBetween January 2017 to December 2018, 3175 babies were born preterm or LBW, and 162 (5.1%) died in the first 28 days of life in 17 participating health facilities in the PTBI-K project. VASA was conducted among 88 (53.7%) neonatal deaths. Almost half (38, 43.2%) of the deaths occurred within the first 24 hours of life. Birth asphyxia (45.5%), neonatal sepsis (26.1%), respiratory distress syndrome (12.5%) and hypothermia (11.0%) were the leading causes of death. In the early neonatal period, majority (54.3%) of the neonates succumbed to asphyxia while in the late neonatal period majority (66.7%) succumbed to sepsis. Delay in seeking medical care was reported for 4 (5.8%) of the neonatal deaths. ConclusionDeaths among LBW and preterm neonates occur early in life due to preventable causes. This calls for enhanced intrapartum and immediate postpartum care interventions targeting asphyxia, sepsis, respiratory distress syndrome and hypothermia.
Risk Factors for Workplace Encounters with Weapons by Hospital Employees
Authors: Blando James , Paul Chalsie , Szklo-Coxe Mariana
Published: October 2020

Background:Healthcare workers are at a high risk of experiencing workplace violence and associated injuries, and the presence of weapons in a healthcare setting increases the potential severity of injuries and consequences of violence. The specific aim of this study was to determine which organizational factors were associated with frequent weapons confiscation in a healthcare facility and to identify potential effective interventions. This study investigated the hypothesis that hospital-related factors impact the frequency of weapons confiscation.Methods:A cross-sectional survey was administered on-line to hospital security directors and assessed the associations of organizational factors with the frequency of weapons confiscation.Results: It was found that hospitals with metal detectors were more than 5 times as likely to frequently confiscate weapons, suggesting this intervention is effective. It was also found that hospitals with psychiatric units were more likely to have frequent confiscation of weapons, likely due to the standard procedure of searching patients before admission to the psychiatric unit. Several factors thought to be potentially related, such as perception of risk and state violent crime rates, were not associated with weapons confiscation risk. Conclusion: This data suggests that searching patients and using metal detectors are important tools in the prevention of weapons entering a healthcare setting. This reduction would likely enhance safety and reduce injury from workplace violence.
Common Mental Disorders in Mothers of Children Attending Out-patient Malnutrition Clinics in Rural North-western Nigeria: A Cross-sectional Study
Authors: Abdullahi Aminu Taura , Farouk Zubaida Ladan , Imam Abdulazeez
Published: October 2020

BackgroundChildren with uncomplicated severe acute malnutrition are managed routinely within out-patient malnutrition treatment programs. These programs do not offer maternal mental health support services, despite maternal mental health playing a significant role in the nutritional status of children. Additionally, the burden of maternal Common Mental Disorders (CMDs) is poorly described among mothers of children attending these programs. This study thus determined the burden and risk factors for maternal CMDs among children attending out-patient malnutrition clinics in rural North-western Nigeria.MethodsWe conducted a cross-sectional study among 204 mothers of children with severe acute malnutrition who attending eight out-patient malnutrition clinics in Jigawa, North-western Nigeria. We used the World Health Organization Self-Reporting Questionnaire-20 (WHO SRQ-20) screening tool, a recognised and validated proxy measure for CMDs to identify mothers with CMDs. The prevalence of maternal CMDs was determined by identifying the proportion of mothers with SRQ scores of ≥8. Risk factors for CMD were determined using multivariable logistic regression. ResultsMaternal CMD prevalence in children attending these facilities was high at 40.7%. Non-receipt of oral polio vaccine (OPV) (AOR 6.23, 95%CI 1.85 to 20.92) increased the odds for CMD. While spousal age above 40 (AOR 0.95, 95%CI 0.90 to 0.99) and long years spent married (AOR 0.92, 95%CI 0.85 to 0.98) decreased the odds for CMD. ConclusionsOur findings indicate maternal CMD burden is high in out-patient malnutrition clinics in North-western Nigeria. Maternal mental health services would need to be integrated into the community management of acute malnutrition programs to provide more holistic care, and possibly improve long-term outcomes after discharge from these programs
Associations Between COVID-19-Related Changes to Pregnant Women’s Work-Plans and Prenatal Depression
Authors: Sherin Margaret , Gildner Theresa E. , Thayer Zaneta M.
Published: October 2020

Purpose: To identify whether COVID-19-related changes to how long pregnant women planned to work in pregnancy were associated with depression.Methods: An online convenience sample of pregnant women in the U.S. were recruited in April-May 2020 (N = 1,970) through social media and dissemination to U.S.-based maternal health contacts. We used multivariate logistic regression to evaluate whether COVID-19-related changes to pregnant women’s work-plans were associated with clinically-significant prenatal depression (Edinburgh Postnatal Depression Survey score >=15), adjusting for covariates.Results: Of the 1,600 eligible participants without missing data, 29.6% of participants (N = 473) reported that they experienced a COVID-19-related work-plan change, while 22.1% (N = 350) of participants had a clinically-significant EPDS score. Women were more likely to report a work-plan change if they were younger (t(1598) = 2.90, p<0.004), had a lower household income (𝛘2(2) = 29.63, p<0.001), were less educated (𝛘2(2) = 27.48, p<0.001), were farther along in pregnancy (t(1598) = -4.96, p<0.001), and worked outside the home during COVID-19 (𝛘2(2) = 59.27, p<0.001). Both COVID-19-related work-plan changes (OR = 1.74 , 95% CI 1.34 – 2.25, p < 0.001) and uncertainty about the nature of these changes (OR = 2.70, 95% CI 1.22 – 5.96, p = 0.014) were associated with significantly higher odds of a clinically-significant depression score.Conclusion: Pregnant women who experienced a work-plan change or who were uncertain about how COVID-19 would impact their work-plans were significantly more likely to experience depression, suggesting a need for universal access to prenatal depression screening and paid maternity leave.
Uncommon Giant Corneal Keloid: A Case Report and Literature Review
Authors: Li Shang , Jiang Lei , Xu Xiaolin , Yang Ke , Jie Ying
Published: October 2020

Background: Corneal keloid is a rare kind of clinical disease. Surgery is the only treatment in the end, but the literature reports vary. This is a case study of the diagnostic and treatment course for a patient with giant corneal keloid.Case presentation: A 36-year-old young man was admitted to the hospital because of a large mass on the surface of the left cornea. A slit lamp examination revealed that the lesion covered the entire cornea and protruded from the surface of the eyeball, so that the left eyelid could not be closed normally. B-scan of the eye showed that the internal structure of the left eye was normal. The mass was surgically removed and send for pathological examination, and then the ocular surface reconstruction was taken by deep anterior lamellar keratoplasty. Histopathologic study showed irregular epithelium, the absence of Bowman’s layer and hyperplastic collagen fibers, which are consistent with the diagnosis of corneal keloid. Immunohistochemical revealed positive staining for vimentin in lesion subject and smooth muscle actin (SMA) in vascular wall. The corneal graft remained clear 4 months after surgery and the patient was satisfied with the visual outcome. A final diagnosis of giant corneal keloid was reached.Conclusion: Corneal keloid should be suspected in cases of enlarging white glistening corneal nodule after trauma. Deep anterior lamellar keratoplasty is one of the effective surgical option for corneal keloids.
Bleeding Risk Stratification in Coronary Artery Surgery the Should-Not-Bleed Score
Authors: Petricevic Mirna , Petricevic Mate , Pasalic Marijan , Cepulic Branka Golubic , Raos Mirela , Vasicek Vesna , Goerlinger Klaus , Rotim Kresimir , Gašparović Hrvoje , Bojan Biocina
Published: October 2020

BackgroundCardiac surgery has an estimated 20% of the total blood transfusions. Of those, 11% were utilized in patients undergoing coronary artery bypass grafting (CABG) with documented wide variability in transfusion rate (7.8% to 92.8%). To address the issue of unnecessary transfusions within CABG population, we developed the model to predict the patients at low risk of bleeding who should not be transfused. Herein we present our “SHOULD-NOT-BLEED-SCORE” application developed for Windows® software platform and based on our previous research.MethodsThis study aimed to develop the user-friendly application that stratifies the patients with respect to bleeding risk. The statistical model we used in our previous research was focused on detection of CABG patients at low risk of bleeding. The rationale behind such an approach was to identify among CABG patients subgroup at low risk of bleeding. By identifying patients at low risk of bleeding we can define the subgroup of patients who should not be transfused. We developed the Windows platform application based on risk modelling we previously calculated on 1426 patients undergoing elective CABG from January 2010 to January 2018.ResultsThe SHOULD-NOT-BLEED-SCORE risk score is developed for Windows software platform. The mathematical model based on multivariate analysis was used for app development. The variables that entered the scoring system were: Age; Body Mass Index; Chronic Renal Failure; Preoperative Clopidogrel Exposure; Preoperative Red Blood Cells Count; Preoperative Fibrinogen Level; Preoperative Multiplate ASPI test (AUC). The SHOULD-NOT-BLEED-SCORE identifies/predicts patients without excessive bleeding with the strong discriminatory performance (ROC analysis AUC 72.3%, p<0.001).ConclusionThe SHOULD-NOT-BLEED risk scoring application may be useful in preoperative risk screening process. The clinical and economic burden associated with unnecessary transfusions may be adequately addressed by preoperative scoring system detecting patients at low risk of bleeding who should not be transfused.
Epidemiology of Influenza Virus Reinfection: A Retrospective Analysis of a Nine-year Influenza Surveillance Data
Authors: Wang Jing , Jiang Lina , Xu Yunan , He Weitao , Zhang Chao , Bi Fuyin , Tan Yi , Ning Chuanyi
Published: October 2020

BackgroundEpidemiological characteristics profile of the reinfection of the influenza virus has not been well described. MethodsOur study estimated the reinfection rate using nine-year influenza surveillance data and further examined the characteristics associated with the reinfection. ResultsA total of 53,605.6 person-months and the median time of 8.7 months were observed for reinfection. The cumulative reinfection incidence was 2% at 6 months, 4% at 12 months, 5% at 24 months, and 7% after 59 months. Living in the rural area (HR=1.37 [95% CI 1.29-1.45]), and age ≤6 years (HR=11.43 [95% CI 9.47-13.80]) were independent risk factors associated with influenza reinfection. ConclusionsOur findings indicate that the reinfection of the influenza virus in Guangxi independently and positively associated with the rural area and younger age. The unusually high frequency of reinfection points to a need for further prospective longitudinal studies to better investigate sufficient impact on the development of broadly protective or universal vaccines.
Effects of Soil and Water Conservation Measures on Selected Soil Physicochemical Properties: The Case of Ejersa Lafo District, Central Highlands of Ethiopia.
Authors: Mammo Siraj , Tolesa Adugna , Bohnett Eve
Published: October 2020

BackgroundLand degradation in the form of soil erosion and fertility depletion is the major environmental problem in Ethiopia. However to curb this problem, Soil and Water conservation (SWC) measures are commonly practiced in many rural parts of Ethiopia. This study was conducted to assess the effects of SWC measures on selected soil quality indicators in Ejersa Lafo District. For this study two peasant associations (kebeles) were selected from the district based on the severity of soil erosion and information on SWC practices. A total of 12 composite soil samples from soil 0 to 20cm depth from two sub watersheds with SWC and without SWC practices at Jamjam laga batu and Koriso Odo guba from three landscape positions (upper slope, middle slope, and bottom) were collected. All the soil samples were analyzed following the standard and recommended procedures in Ambo University chemistry laboratory and subjected to ANOVA using the SPSS computer program. ResultMost of the selected soil physicochemical properties were affected by watershed management intervention. Comparing the two farmlands, the highest bulky density of 1.37gcm-3 was observed from unconserved farmland. The results of the study also showed higher values of Soil electrical conductivity (EC), Total nitrogen (TN), Cation exchange capacity (CEC), Soil Organic matter (SOM), Organic Carbon, Available Phosphorus (Av. P) and Available Potassium (Av. K) in conserved land and those all significantly varied between farm plots. On the other hand, Sandy, pH, SOM, TN, Av. P and Av. K values were significantly affected (p<0.05) by slope and all increased from upper (>30%), middle (15-30%) and lower (8-15%). ConclusionThe contribution of watershed management intervention to improve soil physicochemical properties is significant in the study area as it improved some of the selected soil physicochemical properties of soil. Furthermore, efforts are required to enhance community adoption towards soil and water conservation. Additionally, further research has to be carried out on socio-economic aspects and impacts of the intervention on crop productivity for better understanding of the sustainable use of the land and to make a comprehensive conclusion.
Cognitive Reserve Proxies, Alzheimer Pathologies, and Cognition
Authors: Ko Kang , Yi Dahyun , Byun Min Soo , Lee Jun Ho , Jeon So Yeon , Kim Woo Jin , Byeon Gihwan , Sung Kiyoung , Han Dongkyun , Lee Young Hwa , Joung Haejung , Jung Gijung , Lee Jun-Young , Kim Heejung , Kim Yu Kyeong , Kang Koung Mi , Sohn Chul-Ho , Lee Dong Young
Published: October 2020

BackgroundLimited information is available regarding which of the commonly used cognitive reserve (CR) proxies are more appropriate to precisely reflect moderation effect for the relationship between a specific Alzheimer’s disease (AD) pathology and cognitive decline. We examined the moderating effects of the frequently used four CR proxies [i.e., education, premorbid intelligence quotient (pIQ), occupational complexity (OC), and lifetime cognitive activity (LCA)] on the relationships between various in vivo AD pathologies and cognitive decline. MethodsThis study included 361 older adults (268 cognitively unimpaired, 52 mild cognitive impairment with beta-amyloid (Aβ) deposition, 41 AD dementia with Aβ deposition). All participants underwent multi-modal brain imaging including [11C] Pittsburgh Compound B positron emission tomography (PET), [18F] Fluorodeoxyglucose-PET, and magnetic resonance imaging to measure AD pathologies as well as comprehensive clinical and neuropsychological assessments. Information on education, pIQ estimated with an adult reading test, OC, and LCA was obtained. The Consortium to Establish a Registry for Alzheimer's Disease neuropsychological battery total score (CERAD-TS) was used as the cognitive measure. We used linear regression model predicting cognition to examine the interactions of each CR proxy and each AD pathology.ResultsAmong the CR proxies, only education significantly moderated the relationship between Aβ deposition and CERAD-TS. Education, pIQ, and LCA, but not OC, showed moderating effect on the relationship between AD-signature cerebral hypometabolism and CERAD-TS. In contrast, only OC had a significant moderating effect on the relationship between cortical atrophy of the AD-signature regions and CERAD-TS. ConclusionsThe present findings suggest that the proposed CR proxies have different moderating effects on the relationships between specific AD pathologies and cognitive decline. To investigate CR or related issues, it is necessary to select a proper CR proxy considering the target brain pathology.
Dual RNAseq highlights the kinetics of skin microbiome and fish host responsiveness to bacterial infection
Authors: Luyer Jeremy Le , Schull Quentin , Auffret Pauline , Lopez Pierre , Crusot Margaux , Belliard Corinne , Basset Câline , Carradec Quentin , Poulain Julie , Planes Serge , Saulnier Denis
Published: October 2020

Background: Tenacibaculum maritimum is a fish pathogen known for causing serious damage to a broad range of wild and farmed marine fish populations worldwide. The recently sequenced genome of T. maritimum strain NCIMB 2154 T provided unprecedented information on the possible molecular mechanisms involved in the virulence of this species. However, little is known about the dynamic of infection in vivo, and information is lacking on both the intrinsic host response (gene expression) and its associated microbiome community. Here, we applied complementary omic approaches, including dual RNAseq and 16S rRNA gene metabarcoding sequencing using Nanopore and short-read Illumina technologies to unravel the host–pathogen interplay in an experimental infection system using the tropical fish Platax orbicularis as model. Results: We showed that the T. maritimum transcriptomic landscape during infection is characterised by an enhancement of antibiotic catalytic and glucan catalytic functions but a decrease in the sulfate assimilation process, compared with in vitro cultures. The fish host concurrently displays a large panel of immune effectors, notably involving innate response and triggering acute inflammatory response. In addition, our results suggest that fish activate an adaptive immune response visible through the stimulation of T-helper cells, Th17, with congruent reduction of Th2 and T-regulatory cells. Fish were, however, largely sensitive to infection, and less than 25% survived after 96 hpi. These surviving fish showed no evidence of stress (cortisol levels) or significant difference in microbiome diversity compared with controls at the same sampling time. The presence of Tenacibaculum in resistant fish skin and the total absence of any skin lesions suggest that these fish did not escape contact with the pathogen, but rather that they prevented pathogen entry. In these individuals, we detected up-regulation of specific immune-related genes differentiating resistant individuals from controls at 96 hpi, which suggests a possible genomic basis of resistance, although no genetic variation in coding regions were found. Conclusions: Here we focus in detail on the interplay between common fish pathogens and host immune response during experimental infection. We further highlight key actors of defence response, pathogenicity and possible genomic bases of fish resistance to T. maritimum .
Robotic Versus Laparoscopic Gastrectomy for Gastric Cancer: A Systematic Review and Meta-Analysis
Authors: Ma Jianglei , Li Xiaoyao , Zhao Shifu , Zhang Ruifu , Yang Dejun
Published: October 2020

Background To date, robotic surgery has been widely used worldwide. We conducted a systematic review and meta-analysis to evaluate short- and long-term outcomes of robotic gastrectomy (RG) in gastric cancer patients to determine whether RG can replace laparoscopic gastrectomy (LG).Methods Pubmed, Cochrane Library, WanFang, China National Knowledge Infrastructure (CNKI) and VIP databases were comprehensively searched for studies published before May 2020 that compared RG with LG. Next, two independent reviewers conducted literature screening and data extraction. The quality of the literature was assessed using the Newcastle-Ottawa Scale (NOS),and the data analyzed using the Review Manager 5.3 software. Random effects or fixed effects models were applied according to heterogeneity.Results A total of 19 studies including 7275 patients were included in the meta-analyses, of which 4598 patients were in the LG group and 2677 in the RG group. Compared with LG,RG was associated with longer operative time (WMD=−32.96 min; 95% CI:-42.08~-23.84, P<0.00001),less blood loss (WMD=28.66 ml; 95% CI: 18.59~38.73, P<0.00001),and shorter time to first flatus (WMD=0.16days; 95%CI:0.06~0.27, P=0.003).There was no significant difference between RG and LG in terms of the hospital stay (WMD=0.23days, 95 % CI:-0.53~0.98, P=0.56),overall postoperative complication (OR=1.07, 95 % CI:0.91~1.25, P=0.43),mortality (OR=0.67, 95% CI=0.24~1.90, P=0.45),the number of harvested lymph nodes (WMD=-0.96, 95% CI:-2.12~0.20, P=0.10),proximal resection margin (WMD=-0.10 cm,95% CI:-0.29~0.09, P=0.30),and distal resection margin (WMD=0.15cm,95% CI:-0.21~0.52, P=0.41).No significant differences were found between the two treatments in overall survival(OS) (HR=0.95, 95% CI:0.76~1.18; P=0.64), recurrence-free survival(RFS) (HR=0.91, 95% CI:0.69~1.21;P=0.53), and recurrence rate (OR=0.90, 95% CI:0.67~1.21; P=0.50). Conclusions The results of this study suggested that RG is as acceptable as LG in terms of short-term and long-term outcomes. RG can be performed as effectively and safely as LG. Moreover, more randomized controlled trials comparing the two techniques with rigorous study designs are still essential to evaluate the value of the robotic surgery for gastric cancer.
Radiomics Nomograms for Predicting Different Patterns of Distant Metastases After Definitive Chemoradiotherapy for Locally Advanced Non-Small-Cell Lung Cancer
Authors: Tong Xin , Chen Xia , Chen Yicong , Qiu Qingtao , Sun Xiaorong , Xing Ligang
Published: October 2020

Background: To develop and validate radiomics-based nomograms for predicting different patterns of distant metastases (DMs), including oligometastases and polymetastases, after definitive chemoradiotherapy (CRT) for locally advanced non-small-cell lung cancer (LA-NSCLC).Methods: In all, 139 LA-NSCLC patients treated with definitive CRT between January 2014 and December 2017 were analyzed retrospectively. Computed tomography (CT) radiomics features were quantitatively extracted by 3D Slicer software. The least absolute shrinkage and selection operator (LASSO) Cox regression model was applied for date dimension reduction, feature selection and radiomics signature development. Univariate and multivariate Cox regression analyses were utilized to identify independent predictors of DMs. Finally, a nomogram that incorporates both the radiomics signature and independent clinical risk factors was developed and assessed according to the Harrell concordance index (C-index), calibration curve and clinical usefulness.Results: With a median follow-up of 20.6 months, DMs were detected by follow-up imaging in 47 patients (26 patients had oligometastatic disease). For those who experienced DM, the first metastases were most common in the lung (32.1%), followed by the brain (20.7%), and bone (15.1%). The median time to DMs was 13.5 months. Twelve radiomics features were found to be predictive for DMs. Multivariate Cox proportional hazards testing revealed that histology subtype and overall stage were independent clinical risk factors for DMs (p-value < 0.05). The radiomics nomogram combining the selected radiomics signature, histology subtype and overall stage predicted DMs better than either the radiomics signature or clinical factors alone (p-value < 0.001). The model showed good discrimination and good calibration. Furthermore, the radiomics signature consisting of nine selected features was significantly associated with oligometastases (p-value < 0.001). The radiomics-based nomogram showed strong discrimination ability for the prediction of oligometastatic disease. The C-index was 0.800 (95% CI= 0.710 to 0.890) for the primary cohort, and 0.828 (95% CI= 0.686 to 0.970) for the validation cohort.Conclusion: The above-described radiomics nomograms can precisely predict DM and the oligometastatic state in patients with LA-NSCLC, which may constitute a useful clinical tool to guide subsequent personalized treatments.
Structural decomposition analysis with disaggregate factors within the Leontief inverse
Authors: Muradov Kirill
Published: October 2020

A trivial case in input-output structural decomposition analysis is a decomposition of a product of variables, or factors, where one factor is an inverse -- typically Leontief inverse -- of a sum of other factors. There may be dozens and hundreds of such factors that describe the changes in subsets of technical coefficients. The existing literature offers ambiguous guidance in this case. The solution that is consistent with the index number theory may be virtually infeasible. The simplified ad hoc solutions require the researcher to make arbitrary choices, lead to biased estimates and do not ensure the consistency-in-aggregation of factors. This paper reviews the ad hoc solutions to the said problem and describes a numerical test to identify the best-performing solution. It is found that calculating the average of the two polar decomposition forms for each factor is superior to other approximations in terms of minimising the errors.
Combined Topical and Systemic Administration with human adipose-derived mesenchymal stem cells (hADSC) and hADSC-derived exosomes markedly promoted cutaneous wound healing and regeneration
Authors: Zhou Yang , Zhao Bo , Zhang Liao Xing , Lu Jun Yi , Lu Tao Shou , Cheng Jian , Fu Yu , Lin Lin , Zhang Yan Ning , Li Xin Pei , Zhang Jing , Zhang Jun
Published: October 2020

Background: Cutaneous wound healing and regeneration has become a recognized health challenge in the world, which causes severe damage to the mental and physical health of patients. Human Adipose-derived mesenchymal stem cells (hADSC) play an essential role in wound healing via their paracrine function. Exosomes secreted by hADSC may contribute to this progress. In this study, we investigated the potential clinical application roles of hADSC and hADSC-derived exosomes (hADSC-Exo) in cutaneous wound healing. Methods: hADSC-Exo was isolated from human hADSC by ultracentrifugation. Mice were subjected to a full-thickness skin biopsy experiment and treated with either control vehicle or hADSC or hADSC-Exo by smearing administration (sm) or subcutaneous administration (sc) or intravenous administration (iv). The efficacy of hADSC and hADSC-Exo on wound healing was evaluated by measuring wound closure rates, histological analysis. Results: Combined application of local hADSC-Exo smearing and hADSC/hADSC-Exo intravenous administration offered the additional benefit of promoting wound healing, accelerating re-epithelialization, reducing scar widths, and enhancing angiogenesis and collagen synthesis. Either topical application of hADSC-Exo or systemic administration with hADSC/hADSC-Exo appeared more effective in stimulating cell proliferation, inhibiting cell apoptosis and inflammation, promoting skin elasticity and barrier integrity, with increased genes expression of PCNA, VEGF, collagen III, Filaggrin, Loricrin, and AQP3, with decreased genes expression of TNF-alpha. Conclusion: Our findings suggest that the combined administration of hADSC/hADSC-Exo can facilitate cutaneous wound healing and reduce scar formation. These data provide the first evidence for the feasibility of smearing of hADSC-Exo as a cell-free therapy in treating cutaneous wounds, and the potential clinical value of combined administration of hADSC/hADSC-Exo.
Clinical impact of respiratory syncytial virus infection on children hospitalized for pertussis
Authors: Zhang Ruimu , Deng Jikui
Published: October 2020

Background: Although Respiratory syncytial virus (RSV) is one of the common pathogens in children with pertussis and viral coinfection, the clinical impact of RSV infection on pertussis remains unclear. We compared clinical characteristics and sought differences between infants with single Bordetella pertussis (B. pertussis) infection and those with RSV coinfection.Methods: We enrolled 80 patients with pertussis who were hospitalized in Shenzhen Children’s Hospital from January 2017 to December 2019. Respiratory tract samples were tested for B. pertussis with real-time polymerase chain reaction and respiratory viruses with immunofluorescence assay. Clinical data were obtained from hospital records and collected using a structured questionnaire.Results: Thirty-seven of 80 patients had B. pertussis infection alone (pertussis group) and 43 had RSV-pertussis coinfection (coinfection group). No significant differences were found with regard to sex, body weight, preterm birth history, pertussis vaccination, symptoms, presence of pneumonia, or lymphocyte count between the 2 groups. Patients with RSV coinfection were older; received more β-lactam antibiotic treatment; had higher rates of wheezes and rales on chest auscultation, a higher rate of readmission, and a longer hospital stay.Conclusions: RSV coinfection increases β-lactam antibiotic use, readmission rate, and hospital stay in children hospitalized for pertussis. RSV infection should be suspected when wheezes or rales are present on auscultation of the chest in these patients. Early detection of RSV may avoid unnecessary antibiotic use.