bluuebunny/crossref_metadata_2025 huggingface dataset:
Emergency high ligation in a suspected COVID-19 pediatric patient with incarcerated inguinal hernia: a case report
Authors: Makkadafi Munawir , Fauzi Aditya Rifqi , Praja Amsyar , Athollah Kemala , Marcellus . , Gunadi .
Published: August 2020

Background

SARS-Cov-2 infects not only adults, but also children, including pediatric surgery patients with acute abdomen. Here, we report a pediatric surgery case with incarcerated inguinal hernia and suspected COVID-19.
Case presentation:

A 11-month-old male was brought to our emergency department with the main complaint of recurrent yellowish-green vomiting that was experienced from one day before admission. High fever and shortness of breath were also reported. This patient was also suffering from moderate dehydration. Neither history of contact with a confirmed case of COVID-19 nor traveling from any local transmission area were found. However, a SARS-CoV-2 rapid antibody test revealed a positive result. A lump in the left scrotum that persisted during admission was found. Fluid resuscitation and nasogastric tube placement for decompression was performed. Manual reduction was attempted but failed to reduce the lump. Accordingly, we decided to perform an emergency high ligation using tertiary protection regulations, i.e., full personal protective equipment (PPE) for COVID-19. Intraoperatively, we found a small intestine loop trapped in the scrotum and stuck in the inguinal canal. Postoperatively, the baby was continued to be managed as a patient with COVID-19 while waiting for the real-time reverse transcription polymerase chain reaction (RT-PCR) results.
Conclusions

During the COVID-19 pandemic, surgeons should always be aware of the possibility of cross-transmission from the patient, since children are also susceptible to SARS-CoV-2 infection. When and wherever possible, surgeons should perform the procedure in the quickest and most effective manner to shorten exposure time with patient and anesthetic aerosols as well as using appropriate PPE.
Contribution of ABO-Rhesus/Electrophoresis of hemoglobin methods and Short Tandem Repeats analysis in the determination of paternity in Burkina Faso, West Africa
Authors: Millogo Missa , Soubeiga Serge Theophile , Bazie Bapio Valerie Jean Telesphore , Zohoncon Theodora Mahoukede , Yonli Albert Theophane , Simpore Jacques
Published: August 2020

Background: the establishment of filiation by the current ABO, HLA, MNS, Kells and serum tests, pose a real reliability problem. It is then necessary to combine these methods with or to use high-performance methods such as microsatellite genetic analysis or short tandem repeats. This study aimed to compare the short tandem repeat technique with ABO/Rhesus system in combination with electrophoresis of hemoglobin. Methods: Fourteen (14) contested paternity trios were investigated. Blood samples were collected to determine blood groups using the Beth-Vincent method and the type of hemoglobin by electrophoresis. Blood spots on FTA paper were used for the analysis of 16 STR loci (D8S1179, D21S11, D7S820, CSF1PO, D3S1358, TH01, D13S317, D16S539, D2S1338, D19S433, vWA, TPOX, D18S51, D5S818, FGA, Amel) by capillary electrophoresis on the ABI 31310 Genetic Analyzer. The generated sequences were analyzed with GeneMapper® software version 3.2.1. The data were analyzed to determine the paternity index and the probability of paternity. Results: Of the fourteen (14) trios studied, ten (10) cases were probable inclusion, three (03) cases were exclusion and one (01) case was an undetermined paternity outcome with the ABO-Rhesus/ electrophoresis of hemoglobin system. While the analysis of genetic polymorphisms in DNA gave five (05) inclusions versus nine (09) exclusions of paternity. Of the 10 probable inclusion cases given by the ABO-Rhesus/Electrophoresis of hemoglobin system, only 05 cases (50%) were confirmed for inclusion by Short tandem repeat analysis. Conclusion: The analysis of short tandem repeat with sixteen genetic markers is more reliable in determining paternity than ABO-Rhesus/hemoglobin electrophoresis techniques.
What is the Impact of Sex on Cardiovascular Disease Risk Factors in Patients with Chronic Kidney Diseases in China: A Cross-sectional Study
Authors: Wang Zu-feng , Zhang Nan-hui , Luo Ran , Cheng Yi-chun , Guo Kang-lin , Ge Shuwang , Xu Gang
Published: August 2020

Background: It is controversial about the sex differences in the association of chronic kidney diseases (CKD) and cardiovascular disease (CVD) risk. Thus, we examined CVD risk makers of CKD and non-CKD men and women in China, especially some “non-traditional” ones.Methods: This cross-sectional study used 7999 participants from the China Health and Nutrition Survey in 2009. This study examined the “traditional” risk factors and of CVD, such as lipoprotein cholesterol (LDL-C), total cholesterol (TC) and non-high density lipoprotein cholesterol(non-HDL-C).Also, the “non-traditional” risk factors of CVD were calculated, such as lipoprotein (a)(Lp(a)), white blood cell (WBC) count, visceral adiposity index (VAI) and lipid accumulation product (LAP).Results: Compared with men with CKD, higher levels of TC and LDL-C were observed in women with CKD. Furthermore, compared with men with CKD, the relative difference of WBC count was greater between women with CKD and their non-CKD ones. Meanwhile, the level of LAP and VAI of women with CKD were higher than men with CKD, which indicate the visceral obese. We also observed that the sex by CKD status interactions were statistically significant for TC, LDL-C, non-HDL-C, LAP, VAI and Lp(a) (all p <0.05). After adjusted the covariates, the sex differences effect on CVD risk factors among CKD patients couldn’t be eliminated as well. Conclusions: In CKD situation, women had greater lipid profiles and put on more visceral adiposity than men, which may indicate a higher CVD risk of women with CKD.
Development and Validation of Tongue Diagnostic Parameters-Based Diagnostic Signatures in Coronary Artery Disease Patients with Clopidogrel Resistance after Percutaneous Coronary Intervention
Authors: Liang Bo , Liang Cai-Hong , Lu Jia , Gu Ning
Published: August 2020

The authors have withdrawn this preprint due to erroneous posting.
Exercise-therapy and education for individuals one year after anterior cruciate ligament reconstruction: a pilot randomised controlled trial
Authors: Patterson Brooke , Barton Christian , Culvenor Adam , Cooper Randall , Crossley Kay
Published: August 2020

Background: Guided rehabilitation beyond 6-months is rare following anterior cruciate ligament reconstruction (ACLR), despite high prevalence of unacceptable symptoms and quality of life (QoL). We aimed to: i) determine the feasibility of a randomised controlled trial (RCT) evaluating the effectiveness of a physiotherapist-guided lower-limb focussed exercise-therapy intervention for individuals 1-year post-ACLR with persistent symptoms, and ii) estimate the effects of this intervention compared to a trunk-focussed intervention on knee-related QoL.Design: Participant- and assessor-blinded, pilot feasibility RCT.Methods: Participant eligibility criteria: i) 12–15 months post-ACLR; ii) < 87.5/100 on the Knee injury and Osteoarthritis Outcome Score (KOOS) QoL subscale; and one of: a) one-leg rise test < 22 repetitions; b) single-hop < 90% limb symmetry; or c) Anterior Knee Pain Scale < 87/100. Participants were randomised (2:1 ratio) to lower-limb focussed exercise-therapy and individualised education, or trunk-focussed exercise-therapy and standardised education. Both interventions involved eight face-to-face physiotherapy sessions over 16-weeks, to guide allocated exercise-therapy programs. Feasibility was assessed by: i) recruitment (participants/month), ii) retention (< 20% drop-out), iii) physiotherapy attendance, and iv) unsupervised exercise-therapy program adherence (> 80% of 3 sessions/week). Knee-related QoL was evaluated using the KOOS-QoL subscale and ACL-QoL questionnaire, with between-group differences compared to published minimally important difference (MID) scores (KOOS-QoL = 10 points; ACL-QoL = 12 points).Results: 27 participants (3 participants/month; 48% men, 34 ± 12 years) were randomised. Two did not commence treatment, and two were lost to follow-up (16% drop-out). Physiotherapy attendance was > 80% for both groups but reported adherence to the unsupervised program was low (< 55% of prescribed exercises). KOOS-QoL improvement (mean ± SD) in the lower-limb focussed (23 ± 15) and trunk-focussed (16 ± 12) groups resulted in a between-group difference (mean, 95%CI) lower than the MID (7.1, -12.3 to 26.4). ACL-QoL improvement in the lower-limb focussed (20 ± 17) and trunk-focussed (22 ± 13) groups resulted in a between-group difference lower than the MID (-2.5, -18.2 to 13.2).Conclusions: A larger-scale RCT evaluating the effectiveness of a physiotherapist-guided lower-limb focussed program for individuals 1-year after ACLR with persistent symptoms is feasible. This intervention is associated with large within-group knee-related QoL improvements, but may not be superior to a trunk-focussed intervention.Trial Registration: Prospectively registered (ACTRN12616000564459).
The influence of aerobic exercise on conditioned pain modulation and manipulation induced analgesia in people with lateral epicondylalgia: a randomised controlled trial
Authors: Muhsen Ahmad , Moss Penny , Gibson William , Walker Bruce , Jacques Angela , Schug Stephan , Wright Anthony
Published: August 2020

Background: Exercise has been shown to reduce pain sensitivity. It is unclear whether exercise can also potentiate the endogenous analgesia and reduction in pain sensitivity produced by conditioned pain modulation (CPM) and manipulation induced analgesia (MIA).Objectives: To determine whether aerobic exercise potentiates CPM and MIA and to investigate associations between exercise induced analgesia, CPM and MIA.Design: Parallel randomised, controlled trial using computer-generated randomisation to allocate interventions. Methods: A gender-stratified convenience sample included 68 participants with lateral epicondylalgia (LE) from Perth, Western Australia, recruited between October 2017 and June 2018. Participants were allocated to receive either moderate intensity aerobic exercise (control condition, n=34) or high intensity aerobic exercise (active condition, n=34) for 15 minutes on two separate test sessions, with a three-day rest in between. Exercise intensity was determined based on age-related target heart rate (HR) corresponding to 50% and 75% of maximum HR respectively. Following aerobic exercise, participants were immediately assessed for CPM or MIA response, one on each test day, in a random order. A blinded assessor measured pressure pain thresholds (PPT), the main outcome measure, at the elbow and ipsilateral wrist to evaluate CPM and MIA. Data were analysed using linear mixed models, partial correlations, and univariate regression. Results: All participants showed significant increases in PPT at both test sites (p<0.001). The high intensity exercise group demonstrated higher levels of CPM and MIA at both test sites (p<0.001). There were large and positive partial correlations between CPM/MIA and the initial change in PPT following exercise (CPM (r:0.90–0.93, p<0.001)/MIA (r:0.68–0.86, p<0.001)). The change in PPT following aerobic exercise was a significant predictor of both CPM (adjusted R2:92%-95%) and MIA (adjusted R2:73%-93%) response. Conclusion: An acute bout of high intensity aerobic exercise significantly enhanced the analgesic effect of CPM and MIA in people with LE. CPM and MIA may activate similar descending inhibitory mechanisms to mediate their analgesic effects.Trial registration: Prospectively registered with the Australia New Zealand Clinical Trials Registry on 9/02/2017: ACTRN12617000219381, https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=372232
CircPVT1 Promotes Bladder Cancer Progression by Acting as a ceRNA for miR-140-3p to Target TRPS1
Authors: Chi Bao-Jin , Sun Yao , Zhao Jin-tao , Bi Sheng , Wang Shu-Qiu , Huang Liang
Published: August 2020

Background: Bladder cancer (BC) is one of the most malignancy tumor in the urinary system. Therefore, further studies are needed to revealed the molecular mechanism of BC progression and development. Previous study demonstrated that the deregulation of circRNAs can regulate cell biological functions in tumorigenesis and development. However, the roles of circPVT1 in BC have not yet been revealed. Materials and methods: The expression level of circPVT1, miR-140-3p, and TRPS1 were measured by RT-PCR in BC tissues and cells; dual luciferase reporter and RIP assay showed that circRNA served as a sponge for miRNA, and miRNA could target mRNA. In vitro, effects of overexpression circPVT1 or sh-circPVT1 can regulate BC cells’ proliferation, migration, invasion were detected by CCK-8 assay, wound healing assay, and transwell assay. Results: Our research demonstrated that the expression of circPVT1 was upregulated in BC tissues and cell lines, and increased in metastatic tissues compared to that of non-metastatic tissues. CircPVT1 sponging miR-140-3p to target TRPS1 was revealed by dual luciferase reporter and RIP assay. In addition, the expression level of miR-140-3p was reduced in BC tumor tissues, and TRPS1 was significantly increased in BC tumor tissues. Pearson correlation analysis showed that miR-140-3p with circPVT1 and TRPS1 as compare with miR-140-3p have a moderately negative correlation, and there was a moderately positive correlation between circPVT1 with TRPS1. Further, cytological studies found that circPVT1 enhance BC cells’ proliferation, migration, and invasion by targeting TRPS1 via miR-140-3p. Conclusion: CircPVT1 plays a tumor enhancement role in BC and that can effectively promote cell proliferation, migration, invasion and EMT by targeting the miR-140-3p/TRPS1 axis. CircPVT1 may be a novel potential treatment and diagnosis biomarker in BC.
Biotransformation in Combination of Traditional Medicinal Plants: The Effect of Wickerhamomyces Anomalus on the Antidiabetic Potential and Metabolite Profiling
Authors: Gaur Praveen Kumar , Shanmugam Sadish Kumar
Published: August 2020

The authors have withdrawn this preprint due to erroneous posting.
Genetic characterization of G12P[6] and G12P[8] rotavirus strains in six African countries
Authors: Rakau Kebareng G. , Nyaga Martin M. , Gededzha Maemu P. , Mwenda Jason M. , Mphahlele M. Jeffrey , Seheri L. Mapaseka , Steele Duncan
Published: August 2020

Background: G12 rotaviruses were first observed in sub-Saharan Africa in 2004 and since then have continued to emerge and spread across the continent and are reported as a significant human rotavirus genotype in several African countries, both prior to and after rotavirus vaccine introduction. This study investigated the genetic variability of 15 G12 rotavirus strains with either P[6] or P[8] identified between 2010 and 2014 from Ethiopia, Kenya, Rwanda, Tanzania, Togo and Zambia.Methods: The investigation was carried out by comparing VP7 and partial VP4 sequences of the African G12P[6] and G12P[8] strains with the available GenBank sequences and mapping the recognized neutralization epitopes of these strains.Results: The findings suggested that the VP7 and VP4 genes of the G12 strains circulating in African countries are homologous at the nucleotide and amino acid level, irrespective of country of origin and year of detection, although there was a unique clustering of the Ethiopian strains. The study strains shared a common ancestry with G12 strains circulating globally. Neutralization epitope mapping revealed that rotavirus VP4 P[8] genes associated with G12 had amino acids similar to those reported globally including the vaccines RotaTeq® P[8] and Rotarix®.Conclusions: It is unlikely that widespread vaccine use has driven the molecular evolution and sustainability of G12 strains in Africa. Furthermore, it is too early post vaccine introduction to indicate any effect of vaccine-induced pressure on maintaining the stability of these strains in circulation. Continuous monitoring of rotavirus genotypes is recommended to assess the long-term impact of rotavirus vaccination on the dynamic nature of rotavirus evolution on the continent.
Initial Evidence of Aedes Albopictus (Diptera: Culicidae) Domiciliation in Havana City, Cuba 1995-2018.
Authors: Fernández María del Carmen Marquetti , Castillo Magaly , Peraza Iris , Milian Maricely , Molina Roberto , Leyva Maureen , Bisset Juan A. , Vanlerberghe Veerle
Published: August 2020

Background. Various arboviruses are transmitted to humans by mosquitoes, particularly Aedes aegypti and Aedes albopictus, two invasive and frequently sympatric species. The objective of this study was to evaluate the behavior of Ae. albopictus with regards to houses and association with other mosquitoes in Havana province. Methods. All deposits containing water in the houses and vacant lots of urban and peri urban municipalities of the province Havana were sampled during two periods: the first 1995 – 1999 and the second 2010-2018. Results. Patterns in the presence of Ae. albopictus in the study area were observed: the persistent absence of Ae. albopictus in one municipality; in two municipalities, starting from an absence in the first period to a rapid dispersion in the following period; and a sustained decrease in the dispersion of Ae. albopictus in two other municipalities. The association of Ae. albopictus with other mosquitoes smaller in the peripheral municipalities, although being the ones with the greatest presence of Ae. albopictus. However overall, we found an increase in this association when comparing the period 2010-2018 with the first period since its introduction in Havana. Inside the houses, Ae albopictus was present in 8% (2016) to 21.5% (2013) with an average of 15%, which evidences an initial domiciliation of the species.Conclusions. The results obtained in this work show an initiation of domiciliation of Ae albopictus in the urban area of Havana province. This is important to alert the National Control Program to strengthen the entomological monitoring of Ae. albopictus, and not only Ae. aegypti. The follow up of this domiciliation is important to guide control efforts, knowing its role as a vector of different arboviruses.
Tinnitus in Noise Exposed Workers
Authors: Bai Lu , Yu Jianping , Du Hong , Shen Zhuang , Yang Hongyan
Published: August 2020

Background

Tinnitus in noise exposed workers is worse, which seriously affects the normal life and work. Workers with tinnitus often complain that even going to see the doctor is ineffective. They think tinnitus is caused by occupational noise exposure, which makes tinnitus worse. To find the truth the investigation and analysis of tinnitus including reason, treatment and effect and hearing level was proceeded among all noise-exposed workers in railway transportation mechanical manufacturers in Beijing in 2015.
Methods

Cross-section study was conducted. 519 noise-exposed workers were selected as exposed group, 515 non noise-exposed workers were selected as control group. Self-designed questionnaire was used in the way of face-to-face to get subjects’ information including social statistical data, occupational history, past history and living habits.
Results

The incidence of tinnitus was 36.6% among noise-exposed workers, which was significantly higher than that in the control group (χ2 = 40.725, P < 0.05). Meanwhile the incidence of seeing the doctor was 15.8%. The incidence of tinnitus was significantly different in different subgroups of exposed group (χ2 = 6.072, P < 0.05). There was no significant difference between using earphones and tinnitus (P > 0.05). In the exposed group the incidence of hearing abnormal in workers with tinnitus was significantly higher than those without tinnitus (χ2 = 18.570, P < 0.05).
Conclusions

Right knowledge, attitude and practice (KAP) would be helpful for workers with tinnitus. Occupational health education and supervision of noise-exposed workers should be further strengthened in this industry. Personal protection should be enhanced so as to improve occupational health.
Treatment Outcomes of Retinal Vein Occlusion in Clinical Practice in Nepal
Authors: BHANDARI SANJEEB , Poudel Manish , Paudyal Indira , Joshi Pratibha Lama , Shrestha Chunu , Paudyal Govinda , Pradhan Eli
Published: August 2020

Background: This study evaluated the treatment outcomes of retinal vein occlusion (RVO) in a routine clinical practice in Nepal. Methods: This was a retrospective analysis of observational data of patients with RVO who attended the retina clinic of the Tilganga Institute of Ophthalmology from 1 November 2017 to 31 October 2018. The main outcome was the mean change in visual acuity (VA) at 12 months from the start of treatment. Other outcomes of interest were the mean change in central subfield thickness (CST) and the number of treatments over 12 months. Results: A total of 99 eyes (of 99 patients) with RVO (60 - branch RVO [BRVO] and 39 - central RVO [CRVO] were available for the analysis. Eyes with CRVO had worse VA and CST at baseline. Eyes in both groups were similar for age, associated factors for RVO, duration of vision loss and the presence of ischemia at baseline. The mean (95% Confidence Interval [CI]) VA change at 12 months for BRVO was -0.35 (-0.46, -0.23) logMAR (p < 0.001) from a mean (SD) of 0.75 (0.42) logMAR at baseline with 63% achieving VA < 0.3 logMAR while for CRVO it was -0.35 (-0.46, -0.23) logMAR (p = 0.19) from 1.13 (0.61) logMAR at baseline and VA < 0.3 logMAR in 36%. The mean (95% CI) change in CST over 12 months was -114 (-189, -40) µm (p = 0.003) from a mean (SD) of 423 (151) µm at baseline for BRVO and -184(-276, -91) µm (p < 0.001) from 519 (213) µm for CRVO. Patients in both groups received a median of 2 bevacizumab injections over 12 months. Around 37% eyes were lost before 12 months’ observation. The mean VA and CST trajectory in these eyes at their last visit was similar to those that completed 12 months. Conclusion: The outcomes of RVO are inferior and the number of treatments over the 12 months fewer than those of clinical trials and other reports from routine clinical practice. Future studies to identify the barriers for undertreatment in our practice are warranted to improve the treatment outcomes.
Prevalence and correlates of multiple non-communicable diseases risk factors among adults in Sudan: Results of the first national STEPS survey in 2016
Authors: Pengpid Supa , Peltzer Karl
Published: August 2020

Background

Non-communicable diseases (NCDs) are on the rise in low- and middle-income countries. The aim of this study was to assess the prevalence and correlates of multiple NCD risk factors among adults in Sudan.
Methods

Cross-sectional nationally representative data were analysed from 7,722 18–69 year-old individuals (median age = 36 years) that took part in the “2016 Sudan STEPS survey.”
Results

The prevalence of individual NCD risk factors was 94.6% inadequate fruit and vegetable intake, followed by hypertension (31.6%), general overweight/obesity (28.0%), low physical activity (21.3%), current tobacco use (15.7%), raised total cholesterol (13.6%), diabetes (5.9%), and heavy episodic drinking (1.7%). In all, 34.2% had 0–1 NCD risk factor, 33.5% 2 risk factors, and 32.4% 3 or more NCD risk factors. In adjusted ordinal logistic regression analysis, compared to individuals 18–34 years old, persons 50–69 years old were 3.52 times (AOR: 3.52, 95% CI: 2.88–4.31) more likely to have multiple NCD risk factors. Men were 21% (AOR: 1.21, 95% CI: 1.00-1.46) more likely than women to have multiple NCD risk factors. Individuals residing in urban areas were 86% (AOR: 1.86, 95% CI: 1.49–2.32) more likely than individuals residing in rural areas to have multiple NCD risk factors, and compared to persons never married, married participants and persons separated, divorced or widowed persons were 51% (AOR: 1.51, 95% CI: 1.22–1.87) and 74% (AOR: 1.74, 95% CI: 1.22–2.47), respectively, more likely to have multiple NCD risk factors. Compared to persons with less than 500 pounds household income, persons with over 2000 pounds household income were 75% (AOR: 1.75, 95% CI: 1.28–2.38) more likely to have multiple NCD risk factors. Compared to women who cannot read or write, women who had more than primary education were 38% (AOR: 1.38, 95% CI: 1.06–1.80) more likely to have multiple NCD risk factors. Compared to men who were self-employed, engaged in non-paid work, were students or unemployed (able to work), government employees, non-government employees, retired or unemployed (unable to work) had a significantly higher odds of having multiple NCD risk factors.
Conclusion

Almost one in three participants had three or more NCD risk factors and several associated variables were identified that can facilitate in designing intervention programmes.
Protocol for an economic evaluation and budget impact assessment of a randomised, stepped-wedge controlled trial for practice change support to increase routine provision of antenatal care for maternal alcohol consumption
Authors: Reeves Penny , Szewczyk Zoe , Kingsland Melanie , Doherty Emma , Elliott Elizabeth , Dunlop Adrian , Searles Andrew , Wiggers John
Published: August 2020

Background
Antenatal clinical practice guidelines recommend routine assessment of women’s alcohol consumption during pregnancy. The delivery of advice and referral when necessary are also recommended. However, evidence suggests there are barriers to the uptake of best-care guidelines. Effective, cost-effective and affordable implementation strategies are needed to ensure the intended benefit of guidelines are realized through addressing identified barriers. This paper describes the protocol for evaluating the efficiency and affordability of a practice change intervention compared to usual practice in an implementation trial.
Methods
The effectiveness of the intervention will be evaluated in a stepped-wedge randomised controlled implementation trial, conducted in an Australian setting. An economic evaluation will be conducted alongside the trial to assess intervention efficiency. Budget impact assessment will be conducted to assess affordability. The prospective trial-based economic evaluation will identify, measure and value key resource and outcome impacts arising from the multi-strategy practice change intervention compared with usual practice. The evaluation will comprise: (i) a cost-consequence analyses, where a score card approach will be used to show the costs and benefits given the multiple primary outcomes included in the trial; and (ii) a cost effectiveness analyses, where the primary outcome will be incremental cost per percent increase in participants reporting receipt of antenatal care for maternal alcohol consumption consistent with guideline recommendations. Intervention affordability will be evaluated using budget impact assessment and will estimate the financial implications of adoption and diffusion of this implementation strategy from the perspective of relevant fund-holders. Results will be extrapolated to estimate the cost and cost-effectiveness of rolling out the model of care.
Discussion
Uptake of clinical guidelines requires practice change support. It is hypothesized that the implementation strategy, if found to be effective, will also be cost-effective, affordable and scalable. This protocol describes the economic evaluation that will address these hypotheses.
GDF15 Promotes Corneal Neovascularization and Retinoblastoma Cell Progression via AKT/ERK Signal Pathway
Authors: Zheng Wen , Cheng Shi-liang , Li Chun-guang , Yu Miao , Li Meng , Liu Xin-feng , Li Fang-fang
Published: August 2020

Objective: We performed this study to investigate the role of growth differentiation factor 15 (GDF15) in corneal neovascularization and retinoblastoma cell progression and the potential mechanisms.Methods: Human retinal endothelial cell (HREC) and retinoblastoma cell line (Y79, RB116 and WERI-Rb1) were treated with recombinant human (rhGDF15, 50 ng/mL) and transfected with small interfering RNA, si-GDF15. Cell migration and proliferation were detected by Scratch assay and CCK8 assay. We performed flow cytometry to measure apoptosis. Tube formation assay for in vitro angiogenesis measurement was used. RT-PCR and western blot were applied to detect the angiogenesis-related factors expression and the level of p-AKT(Ser473), p-AKT(Thr308), AKT, p-ERK1/2(Thr202/Tyr204), and ERK1/2. Tumor growth curve was used after subcutaneous injection of Y79 cells in nude mice and rhsi-GDF15 injection into the tail vein during 21 days.Results: In retinoblastoma cell, rhGDF15 promoted Y79, RB116 and WERI-Rb1 cell migration and suppressed the level of apoptosis. The knock-down of GDF15 significantly inhibited cell migration and promoted apoptosis. In HREC, rhGDF15 increased the tube formation, the level of HIF-1α and SDF, and cell migration, compared with control group, and si-GDF15 played the opposite role. The level of p-AKT(Ser473), p-AKT(Thr308), AKT, p-ERK1/2(Thr202/Tyr204), and ERK1/2 were increased by rhGDF15 in both HREC and retinoblastoma cell lines, contrary to the results of GDF15 knock-down.Conclusion: The downregulation of GDF15 can inhibit corneal angiogenesis and the migration of retinoblastoma cells and promote their apoptosis, which could be dependent on the AKT/ERK pathway.
Effect of dobutamine on intrinsic myocardial function and myocardial apoptosis in septic rats with myocardial dysfunction
Authors: Tang Xiang-Xu , Xu Ya-Qian , Dai Xiao-Meng , Xing Yun , Yang Duo-Meng , Huang Qing-Yang , Li Hong-Mei , Lv Xiu-Xiu , Wang Yi-Yang , Lu Da-Xiang , Wang Hua-Dong
Published: August 2020

Background

Dobutamine (DOB) has been recommended as the first-line inotrope for septic patients with low cardiac output, but its long-term impact on intrinsic myocardial dysfunction during sepsis remains unclear. This study investigated the long-term effect of DOB on intrinsic myocardial function and cardiomyocyte apoptosis in sepsis.
Methods

Male Sprague-Dawley rats were randomly divided into sham and cecal ligation and puncture (CLP) groups. The intrinsic myocardial function and other organ functions were measured at different time points, the inflammatory response and serum biomarkers of myocardial injury were also determined. In separate experiments, the effect of DOB (5 or 10 µg/kg) treatment on survival, intrinsic myocardial function, serum and myocardial cytokines and myocardial apoptosis were measured in septic rats.
Results

The mortality rate of septic rats was 70% on day 10 after CLP. At 6 h after CLP, the left ventricular ± dP/dt were significantly depressed, serum tumor necrosis factor (TNF) –α level, cardiac TNF-α, intercellular adhesion molecule and vascular cell adhesion molecule-1 (VCAM-1) mRNA, and VCAM-1 protein levels were increased, but not serum cTnI, N-terminal pro-brain natriuretic peptide (NT-proBNP), heart-type fatty acid-binding protein (H-FABP), creatinine and urea nitrogen concentrations as well as lung wet-dry weight ratios in CLP group compared with those in sham group. At 9 h after CLP, serum alanine aminotransferase and aspartate aminotransferase activities were higher in CLP rats than controls. At 6 h after CLP, treatment with DOB did not affect the left ventricular ± dP/dt, the levels of TNF-α, interleukin (IL) − 1β and IL-6 in the serum and myocardium as well as cardiomyocyte apoptosis at 20 h after CLP. However, administration of 10.0 µg/kg DOB at 6 h after CLP significantly increased serum IL-10 level and improved survival in septic rats.
Conclusions

The intrinsic myocardial depression occurs earlier than hepatic and renal dysfunction in severe sepsis and serum cTnI, NT-proBNP and H-FABP are not suitable as an early biomarker for this kind of cardiac dysfunction. For septic rats, DOB treatment in the presence of intrinsic myocardial dysfunction neither improves myocardial function nor attenuates myocardial inflammation and cardiomyocyte apoptosis at the later stage of sepsis.
Analysis of battle and non-battle traumatic renal injuries: a 6-year experience in a conflict zone in Afghanistan
Authors: Zabkowski Tomasz , Brzozowski Robert
Published: August 2020

Renal trauma occurs in 1-5% of all trauma cases [1]. The kidney is considered the most commonly injured genitourinary organ, with a male to female ratio of 3:1 [2]. Gunshot wounds are the most common causes of penetrating injuries and have the tendency to become more severe and less predictable than blunt trauma. Bullets cause destruction of the parenchyma and are often associated with multiorgan injuries [3]. Penetrating injury contributes to direct disruption of the parenchyma, collecting system, or vascular pedicle tissues.
Bony Stress and Its Association With Intervertebral Disc Degeneration in the Lumbar Spine: a Review of Clinical and Basic Science Studies
Authors: Chepurin Daniel , Chamoli Uphar , Diwan Ashish D.
Published: August 2020

BackgroundMultiple components of the lumbar spine interact during the normal and pathological function. Bony stress in the lumbar spine is recognised as a factor in the development of pars defects and stress fractures, but its relationship with intervertebral disc (IVD) degeneration is not well understood. Therefore, a translational review encompassing basic science and clinical evidence was conducted to examine the relationship between bony stress in the lumbar spine and IVD degeneration.MethodsOnline databases Scopus, PubMed and MEDLINE via OVID were searched for relevant studies published between January 1980 – February 2020, using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines. Two authors independently analysed the data, noting study characteristics and bias.ResultsThirty-two articles were included in the review: eight human studies, nine finite element analysis studies, three in-vivo biomechanical testing studies, and twelve in-vitro biomechanical testing studies. Of the 32 articles, 19 supported, four rejected and nine made no conclusion on the hypothesis that there is a positive associative relationship between IVD degeneration and bony stress. However, not enough evidence was available to confirm or reject a causal relationship.ConclusionMost studies suggest that the prevalence of IVD degeneration increases with the presence of bony stress, but whether a causal relationship exists is unclear. The literature recommends early diagnosis and clinical suspicion of IVD degeneration and bony stress. Longitudinal studies are required to explore causal relationships between IVD degeneration bony stress.
Pattern of Inpatients Acute Poisonings in Birjand City, East of Iran
Authors: Naseri Kobra , Kiani Zahra , Sajadi Zakieh Sadat , Mehrpour Omid , Sadeghi Mahmood
Published: August 2020

Background: Information on the pattern of acute poisonings in Birjand hospitals is limited. This study aimed to address this knowledge gap by examining the admissions in a poisoning center in Birjand. Methods: Medical records of a main poisoning center in Birjand were reviewed for poisoned patients admitted to hospital from September 2017 to August 2018.Results: During the study period 897 cases of acute poisoning were evaluated. Patients’ age ranged from 11 to 97 years, with a high rate of poisonings between 15 and 25 years. A slight female predominance in poisoning cases was observed. Most cases of poisonings occurred in spring, and the common route of exposure was oral (90.7%). High incidence of poisoning occurred in married couples, uneducated patients, and residents of urban areas. Patients with a previous medical history experienced addiction and psychiatric disorders. Intentional poisoning accounted for 49.5% of acute poisoning cases referred to the hospital in the current study. The main groups of toxicants were pharmaceutical products (45.8%), chemicals (13.3%), and narcotics (9.4%). The mean of hospital stay was 2.8±3.0 days, and the final treatment outcome was 66.0% complete recovery. The mortality rate was 0.8%, and most cases of death were due to pesticides poisoning.Conclusions: Acute poisoning, particularly intentional poisoning, is common in Iran. Due to the high rate of deliberate poisonings, especially in young adults and students, monitoring drugs and distribution and exceptional attention to mental health should be seriously taken into consideration by national health authorities for the prevention of suicide attempts.
Clusters of Responders and Predictive Factors for Response to Supplementation With Boswellia, Turmeric, and Red Algae Extracts in Painful Knee Osteoarthritis: A Prospective Observational Study Using an Arsenal of Patient Centred-measures
Authors: Ait-Abdellah Samira , Gal Caroline , Leblanc Anne , Trouvin Anne-Priscille , Perrot Serge
Published: August 2020

Background: Knee osteoarthritis (KOA) is a common, painful condition. This open-label, observational, longitudinal study evaluated the use of a fixed combination of boswellia, turmeric, and red algae extracts in patients with painful KOA. Given the growing interest in patient-centred care in osteoarthritis, effects were assessed by an arsenal of patient-reported outcome measures (PROMs): Patient Acceptable Symptom Scale (PASS), Minimal Clinically Important Improvement (MCII), Patient Global Impression of Change (PGIC), and Lequesne algofunctional index (LAFI). Patients also completed a list of 17 items on pain quality.Methods: Patients with painful unilateral or bilateral KOA were included. They had to take 1-4 capsules per day of a dietary supplement containing boswellia, turmeric, and red algae extracts (Cartimotil Fort®, PiLeJe Laboratoire, Paris, France) for 90 days. Patients completed PROMs on Days 0 (baseline), 10, 20, 30, 60, and/or 90. Results: From March 2017 to March 2019, 118 patients [female: 69.5%; age: 62.9 (9.5) years, mean (SD); BMI: 26.4 (4.0) kg/m²; DN4 <4: 90.7%] were included in the study and took at least one capsule. Mean (SD) follow-up duration was 100.7 (54.9) days. Pain relief was maximal on Day 90: 64.5% of patients were responders (positive PASS); 68.8% and 58.4% had MCII and PGIC scores indicating positive effect (score ≥3) or global improvement (score ≥5); 73.3% (versus 47.5% at baseline) were mildly/moderately disabled (LAFI score <8); 55.2% had meaningful decrease (-30%) in pain intensity (VAS), 35.1% (versus 59.2% at baseline) took analgesics as supplementary treatment. Median time to first PASS change was 34 days. Pain intensity (VAS) as well as two pain characteristics (i.e., “Stabbing pain” and “Widespread pain”) were independent factors associated with non-response on Day 30. Four clusters of responders were isolated according to pain characteristics, with one cluster exhibiting a higher responder rate. Treatment compliance and safety were satisfactory.Conclusions: This study showed that the fixed combination of boswellia, turmeric, and red algae extracts improved KOA patients. Further studies are needed to confirm the observations. Beyond these results, this study showed the importance of PROs and specific pain qualitative descriptors for accurate evaluation of dietary supplement approaches in painful conditions. Trial registration details: ClinicalTrials.gov, NCT02977936. Registered 30 November 2016, https://clinicaltrials.gov/ct2/show/NCT02977936
Association of STAT3 Gene polymorphism with noise-induced hearing loss(NIHL) in the Chinese population
Authors: Gao Dengfeng , Wang Boshen , Sun Dawei , Wang Ning , Guo Jiadi , Zhang Suhao , Zhu Baoli
Published: August 2020

Objectives: NIHL is a disease with irreversible damage caused by multi-factor interaction, and the STAT3 is an essential protein with signal transduction and transcription functions. This study is aimed to explore the effect of STAT3 polymorphism on individual susceptibility to NIHL individuals, and to further examine the interaction between lifestyles and NIHL in the dominant model .Methods: This study was designed a case-control study and included 609 NIHL cases and 611 healthy hearing controls from the Jiangsu province of China. By collecting the lifestyle and demographic information of the study participants, genotyping the collected blood samples, and performing Real-time Quantitative PCR (qRT-PCR) to analyze and investigate the potential association between STAT3 SNPs and NIHL.Results: Statistical analysis results show that individuals carrying the C allele of rs1053023 and rs1053005 were more likely to develop NIHL than individuals carrying the T allele (OR = 1.367, 95% CI = 1.148-1.628, P = 0.0001 and OR = 1.37, 95% CI = 1.147-1.636, P = 0.001). In the dominant model (TC/CC genotype and TT genotype), stratified analysis of lifestyle, we found that people who smoke regularly are more likely to suffer from NIHL than non-smokers or occasional smokers. Besides, the expression of STAT3 was higher in NIHL cases by real-time quantitative PCR.Conclusion: Gene polymorphisms, rs1053023 and rs1053005, from STAT3, are associated with NIHL and C alleles of rs1053023 and rs1053005 within STAT3 may become biomarkers for workers exposed to noise.
Effect of Corneal Refractive Surgery on Accommodative and Binocular Dysfunctions Among Civilian Pilots in Southwest China
Authors: Wu Ye , Zhang Zhen , Liao Meng , Li Qi , Tang XueLin , Liu Longqian
Published: August 2020

Background: To analyze whether corneal refractive surgery (CRS) is associated with the distribution of different accommodative dysfunctions (ADs) and binocular dysfunctions (BDs) in civilian pilots. A further aim was to analyze the percentages and visual symptoms associated with ADs and/or BDs in this population.Methods: One hundred and eight civilian pilots who underwent CRS from January 2001 to July 2012 (age range: 23-35 years) and 99 emmetropic civilian pilots (age range: 23-35 years) were included in this study. Visual symptoms, refractive status, accommodative and binocular tests of each subject were performed.Results: No significant difference was observed between the CRS and emmetropic groups in the overall prevalence of ADs and BDs (15.7% and 15.2% in the CRS and emmetropic groups, respectively; P=0.185). ADs were present in 4.63% and 3.03% of the CRS and emmetropic group, respectively. BDs were observed in 11.1% and 12.1% of the CRS and emmetropic group, respectively, yielding no significant differences between the groups in the prevalence of ADs or BDs (AD: P=0.094; BD: P=0.105). Pilots with ADs and/or BDs had significantly more visual symptoms than pilots with normal binocular vision (p < 0.001). Conclusions: CRS for civilian pilots with low-moderate myopia might not impact binocular functions. ADs and/or BDs commonly occur in both emmetropia pilots and pilots who undergo CRS, and pilots with ADs and/or BDs are associated with increased symptoms. This study confirms the importance of a full assessment of binocular visual functions in detecting and remedying these dysfunctions in this specific population.Trial registration number: ChiCTR1900027235 (date: 6 Nov 2019) Available at www.medresman.org
Visualization of the Meridian Courses by the Mineral Pulse Light Stimuli
Authors: cha yongchol , choe hyok , oh songjin , cha zinhwa , dong zhang
Published: August 2020

Background; The infrared thermographic technology was used to visualize the meridian course, "energetic paths" at the human body surface from 1980s. However, the study failed as acupuncture, moxa and Laser needle stimulus. Objectives; The purpose of this study is to visualize the meridian course by mineral pulse light stimulator, new acupoints stimulus method. Methods; Any acupoints at arms (PC6) and legs (SP6, SP4, KI3) were stimulated by the mineral pulse light stimulator during 15 ~ 30 minutes. Results; When any acupoints at arms and legs were stimulated by the mineral pulse light stimulator, the meridian-like high thermal lines were induced along the connective classic meridians after 3 minutes usually. The rising temperature is average 1.85 ± 0.52℃ (P < 0.001). Inducing rate of MLHTL is 80.3% (male 80.0%, female 3.0%) and reappearance rate 100%. Conclusions; The meridian-like high thermal lines are induced along the meridian course at the classic meridian figure, so that the meridians course as "energetic paths", were visualized by mineral pulse light stimulator, new acupoints stimulus method first on the world. Everyone can induce MLHTL by MPL stimulator (Version 1.0), so that can see it anytime from now on.
Ultra-fast self-gelling powder mediate robust wet adhesion to promote healing of gastrointestinal perforations
Authors: Peng Xin , Xia Xianfeng , Xu Xiayi , Yang Xuefeng , Yang Boguang , Zhao Pengchao , Yuan Weihao , Chiu Philip , Bian Liming
Published: August 2020

Achieving strong adhesion of bioadhesives on wet tissues remains a challenge and an acute clinical need due to the interfering interfacial water and lack of adhesive–tissue interactions. Herein we report a self-gelling and adhesive polyethyleneimine and polyacrylic acid (PEI/PAA) powder, which can absorb interfacial water to rapidly form a physically crosslinked hydrogel in situ within two seconds due to strong physical interactions between the polymers. Furthermore, the physically crosslinked polymers can diffuse into the substrate polymeric network to enhance wet adhesion on various tissues. Superficial deposition of PEI/PAA powder can effectively seal damaged porcine stomach and intestine despite excessive mechanical challenges. We further demonstrate the use of PEI/PAA powder as sealants to enhance the treatment outcomes of gastric perforation in a rat model. Owing to their strong wet adhesion, excellent cytocompatibility, adaptability to fit complex target sites, and easy synthesis, we believe that the PEI/PAA powder are promising bioadhesives with a wide array of biomedical applications.
Comparisons of Simulation Results between Passive and Active FSI Models for Left Ventricle in Hypertrophic Obstructive Cardiomyopathy
Authors: Huang Xueying , Deng Long , Zuo Heng , Yang Chun , Song Yunhu , Lesperance Mary , Tang Dalin
Published: August 2020

Background. Patient-specific active Fluid-Structure Interactions (FSI) model is a useful approach to non-invasively investigate the hemodynamics in the heart. However, it takes a lot of effort to obtain the proper external force boundary conditions for active models, which heavily restrained the time-sensitive clinical applications for active computational models. Methods. The simulation results of 12 passive FSI models based on 6 patients’ pre-operative and post-operative CT images were compared with corresponding active models to investigate the differences in hemodynamics and cardiac mechanics between these models. Results. It was found that there was no significant difference in shear stress and pressure difference on mitral valve leaflet (MVL) between passive and active models, but a significant difference was found in wall stress on the inner boundary of left ventricle (Endocardium). It was also found that flow shear stress and pressure difference on the MVL were significantly decreased after successful surgery in both active and passive models. Conclusion. Our results suggested that the passive models may provide good approximated hemodynamic results at 5% RR interval, which is crucial for analyzing the initiation of systolic anterior motion (SAM). Comparing to active models, the passive models decrease the complexity of the modeling construction and the difficulty of convergence significantly. Therefore, with proper boundary conditions and sufficient clinical data, the passive computational model may be a good substitution model for the active model to perform hemodynamic analysis for left ventricle to investigate the mechanisms of the initiation of SAM.