bluuebunny/crossref_metadata_2025 huggingface dataset:
The association between ambient air pollution and scarlet fever in Qingdao, China, 2014-2018: a quantitative analysis
Authors: Hu Xiaowen , Wei Tao , Han Yalin , Jia Jing , Pan Bei , Jiang Fachun , Ni Wei
Published: April 2020

Background: We conducted a distributed lag non-linear time series analysis to quantify the association between air pollution and scarlet fever in Qingdao city during 2014-2018. Methods: A generalized additive Mixed Model (GAMM) combined with a distributed lag non-linear model (DLNM) was applied to quantify the distributed lag effects of air pollutions on scarlet fever, with daily incidence of scarlet fever as the dependent variable and air pollutions as the independent variable adjusted for potential confounders. Results: A total of 6,316 cases of scarlet fever were notified, and there were 376 days occurring air pollution during the study period. Scarlet fever was significantly associated with air pollutions at a lag of 7 days with different RRs of air pollution degrees (1.172, 95%CI: 1.038-1.323 in mild air pollution; 1.374, 95%CI: 1.078-1.749 in moderate air pollution; 1.610, 95%CI: 1.163-2.314 in severe air pollution; 1.887, 95%CI: 1.163-3.061 in most severe air pollution). Conclusions: Our findings show that air pollution is positively associated with scarlet fever in Qingdao, and the risk of scarlet fever could be increased along with the degrees of air pollution. It contributes to developing strategies to prevent and reduce health impact from scarlet fever and other non-vaccine-preventable respiratory infectious diseases in air polluted areas.
Clinical and prognostic role of Vasohibin-1 expression in solid tumors: An evidence from a meta-analysis
Authors: Tian Ye , Miao Chenkui , Ren Xiaohan , Xu Aiming , Zhu Shenhao , Gu Qi , Hou Chao , Qin Chao , Wang Zengjun
Published: April 2020

Background

The role of Vasohibin-1 (VASH1) expression in solid tumors remains controversial. We thus performed this meta-analysis to elucidate the associations between VASH1 expression and the prognosis of solid tumors.
Methods

We searched relevant literature in PubMed, Web of Science and EMBASE. The hazard ratio (HR) or odds ratio (OR) and 95% confidence intervals (CIs) were measured by fixed-effects or random-effects models. Publication bias was assessed using funnel plots and Egger's regression test.
Results

The results showed that VASH1 expression exhibited a significantly decreased overall survival (OS) time (HR = 1.85; 95% Cl = 1.27–2.69) and disease-free survival (DFS) (HR = 1.80; 95% Cl = 1.41–2.29) time. Meanwhile, VASH1 expression was found significantly associated with TNM stage (OR = 1.96; 95% CI = 1.57–2.46), tumor stage (OR = 2.35; 95% CI = 1.88–2.93), lymph node metastasis (OR = 2.02; 95% CI = 1.37–2.98), venous invasion (OR = 1.63; 95% CI = 1.00-2.65), tumor grade (OR = 1.74; 95% CI = 1.13–2.67) and microvessel density (MVD) (OR = 4.30; 95% CI = 2.31–8.03). However, no significant association was found between the VASH1 expression and distant metastasis (OR = 1.81; 95% Cl = 0.74–1.41).
Conclusion

This study demonstrated that VASH1 expression was relevant to more aggressive clinicopathological parameters and might predict inferior DFS and OS in solid tumor patients.
Quantifying the clinical characteristics of coronavirus disease 2019 (COVID-19) of different age segments based on 60 patients
Authors: Weiwei Gao , Xia Zhang , Zhiliang Hu , Yun Chi , shan Zheng Yi , mei Hu Chun , Xiang Yi Yong , Yi Zeng
Published: April 2020

Background: To observe the clinical characteristics of the novel coronavirus pneumonia of different age segments infected with novel coronavirus disease 2019 (COVID-19), to increase awareness of the clinical features of COVID-19, and improve diagnosis and treatment. Methods: By 15 February 2020, 60 patients diagnosed with COVID-19 had been admitted our hospital. We prospectively analyzed the clinical features of different age segments infected with COVID-19, including epidemiological, clinical, laboratory, and radiological characteristics, and treatment, clinical outcomes, and prognosis of this part of patients. Results: We included 29 male and 31 female (median age = 46.18 years old (18–97). Fifty-five (91.7%) patients had a clear epidemiological contact history. The average incubation period is 7.92 days. The most common clinical manifestations are fever (85%) and cough (75). Peripheral white blood cell counts were mostly normal at admission, 7 days, and 14 days, with no difference in patients of different ages. The lymphocyte count was in the normal range on admission, but decreased after 7 days of disease treatment, especially in patients > 65 years old; the lymphocyte count increased again after 14 days. The lymphocyte count in >65-year-old patients was less than that in the <40 and 40–65 years old groups after 7 and 14 days, respectively. At admission, the CD4 T lymphocyte count was within the normal; however, after 14 days the CD4 T lymphocyte count was 723.46 ± 243.82/ml, 640.00 ± 242.30/ml, and 399.88 ± 256.16/ml in the three age segments, respectively. The > 65 years old group had higher levels of lactate dehydrogenase (269.83 ± 73.36 vs. 208.52 ± 35.67 and 243.83 ± 76.66) after 14 days. Imaging revealed more lesions in the 40–65 and > 65 years old groups. The days after the nucleic acid detection turned negative in the three age groups were : 9.19 ± 3.93 (<40), 10.04 ± 4.10 (40–65), and 13.57 ± 2.76 (>65). Conclusion: Patients with COVID-19 pneumonia generally had an epidemiological history. Older patients showed more extensive lesions upon admission, more severe illness, slower recovery of immune function, the longer viral nucleic acid persistence.
Usefulness of ECG to differentiate apical hypertrophic cardiomyopathy from non-ST elevation acute coronary syndrome
Authors: Tao Yirao , Xu Jing , Bako Samira Yerima , Yao Xiaobo , Yang Donghui
Published: April 2020

Objective: Apical hypertrophic cardiomyopathy (ApHCM) is a phenotypic variant of nonobstructive HCM. ApHCM is characterized by left ventricular hypertrophy involve the distal apex. The electrocardiographic character of ApHCM can mimic non-ST elevation acute coronary syndrome (NSTEACS) which triggers a series of studies and treatments that may be unnecessary. This study aimed to clarify the ECG differences between the two diseases.Methods: Initial electrocardiogram (ECG) recordings of 41 patients with ApHCM and 72 patients with NSTEACS were analyzed retrospectively. We analyzed the voltage of negative T (neg T) wave, R wave and the change of ST-segment in the 12-lead ECGs as well as the number of leads with neg T waves.Results: Across the 12-lead ECGs, the magnitude of R wave significantly differed between ApHCM and NSTEACS in 10 leads excluding leads aVR and V1. ApHCM was associated with a greater maximal amplitude of R wave in lead V5 (3.13±1.08 vs. 1.38±0.73, P=0.000). The magnitude of T wave significantly differed between ApHCM and NSTEACS in 10 leads excluding leads II and V1. ApHCM was associated with a greater maximal amplitude of neg T wave in lead V4 (0.85±0.69 vs. 0.35±0.23, P=0.000). The frequency of giant neg T (1mv or more) wave was higher in ApHCM (36.5% vs. 0%, P=0.000). The magnitude of ST-segment deviation significantly differed between ApHCM and NSTEACS in 10 leads excluding leads aVF and V2. ApHCM was associated with a greater maximal amplitude of ST-segment depression in lead V5 (0.19±0.07 vs. 0.03±0.06, P=0.000). The number of leads with neg T waves also differed between ApHCM and NSTEACS (6.75±1.42 vs. 6.08±1.51, P=0.046). The sum of R wave in lead V5, neg T wave in lead V6 and ST-segment depression in lead V4>2.585 mV identified ApHCM with 90.2% sensibility and 87.5% specificity, representing the highest diagnostic accuracy.Conclusions: Compared with NSTEACS patients, ApHCM patients presented higher R waves and neg T wave voltage as well as a greater ST-segment depression in the 12-lead ECGs.
Upregulated circRNA_100269 suppresses the growth and metastasis of gastric cancer by inactivating PI3K/Akt signaling pathway
Authors: wang zhongli , liu chao
Published: April 2020

Background: The expression of circRNA_100269 in gastric cancer (GC) tissues and cells, together with its regulatory roles on GC cells were investigated. Methods: The levels of circRNA_100269 in GC and matched para-carcinoma tissues, as well as in human GC cell lines and normal gastric epithelial cells were evaluated using RT-qPCR. The models with overexpression or knockdown of circRNA_100269 were generated using lentiviral vectors. Cell viability was examined using MTT assay; cell migration and invasive activity were determined by wound healing and Transwell assay. Cell cycle arrest and apoptosis were assessed; molecules involved in PI3K/Akt signaling, apoptosis and EMT were evaluated using RT-qPCR and immunoblotting. Tumour growth and expression of relevant proteins were examined in circRNA_100269 knockout mice. Results: The results indicated the expression of circRNA_100269 was dramatically decreased in GC samples compared with para-carcinoma tissues (p < 0.05), while the levels of PI3K were notably increased (p < 0.05). Moreover, the level of circRNA_100269 was relevant to histology grade and occurrence of metastasis in GC patients (p < 0.05), where circRNA_100269 and PI3K was inversely correlated (p < 0.05). Additionally, circRNA_100269 was downregulated in GC cells compared with normal gastric epithelial cells. Overexpressed circRNA_100269 remarkably suppressed the proliferation, migration, invasion and EMT of GC cells (p < 0.05), induced cell cycle arrest at G0/G1 phase and promoted cell apoptosis (p < 0.05). In addition, PI3K/Akt signaling was involved in circRNA_100269-mediated proliferation, migration, invasion, EMT and apoptosis in GC cells (p < 0.05). Knockdown of circRNA_100269 also significantly promoted tumor growth in vivo (p < 0.05). Conclusions: the data of the present study suggested that the expression level of circRNA_100269 was decreased in GC tissues and cells. In addition, circRNA_100269 inhibited the progression of GC by suppressing PI3K/Akt signaling. Therefore, circRNA_100269/PI3K/Akt axis may be a potential therapeutic target for GC treatment.
Effectiveness and safety of intravenous unfractionated heparin before fibrinolytic therapy in patients with STEMI: A retrospective observational study
Authors: Fan Jinshan , Mao Xulong , He Guoqiang , Shi Jiachong , Gu Qiang , Lan Jiang
Published: April 2020

Background: The benefits and risks of administering intravenous unfractionated heparin (UFH) before fibrinolytic therapy in the treatment of patients with acute ST-segment elevation myocardial infarction (STEMI) remain unclear. This study investigated the effectiveness and safety of intravenous UFH before fibrinolytic therapy in STEMI patients.Methods: A total of 260 STEMI patients were divided into a no-heparin group (n=130) and UFH group (n=130) according to whether they received intravenous UFH before fibrinolytic therapy. The infarction related artery (IRA) patency rate was determined by echocardiography. The primary end point was the clinical patency rate within 120 min after thrombolysis. The safety end point was the occurrence of a severe bleeding event such as gastrointestinal bleeding or stroke. Covariates were balanced by propensity score matching, and the effectiveness of the treatment strategies was compared using a Cox proportional hazard model and subgroup analysis. The safety of intravenous UFH treatment was evaluated using a Cox proportional hazard model.Results: The IRA patency rate was higher in the UFH group than in the no-heparin group. Additionally, UFH as pre-thrombolytic therapy was associated with a significantly lower risk of composite effectiveness outcomes but not a significantly lower risk of composite safety outcomes compared with the no-heparin therapy. Moreover, the 7- and 12-day survival rates were higher in the UFH group than in the no-heparin group. No significant difference in bleeding risk was observed between the two groups.Conclusion: Intravenous UFH administered before fibrinolytic therapy improved the IRA patency rate in STEMI patients with appreciable safety.
Study on the Age of SARS-CoV-2 in Respiratory and Digestive Tract Samples: A Retrospective Study guixian-wu1,dongqin-lv*,susu-He,qian-chen,lin-ling,shaungquan-yan,xiaomai-wu,yongpo-jiang
Authors: Wu Guixian , He Susu , Chen Qian , Ling Lin , Yan Shuangquan , Wu Xiaomai , Jiang Yongpo , Lv Dongqing
Published: April 2020

Background: An acute respiratory disease, caused by a novel coronavirus (SARS-CoV-2, previously known as 2019-nCoV), the coronavirus disease 2019 (COVID-19), has spread throughout China and received worldwide attention. After nearly 2 months efforts by the Chinese government and people from all walks of life, the epidemic in China has gradually been controlled. The awareness of the disease has gradually increased. We have detected the SARS-CoV-2 gene in the patient's sputum, throat swabs and feces, blood and even urine samples, but whether the SARS-CoV-2 RNA is detected in the upper and lower respiratory tracts and the extrapulmonary age is unknown.Methods: We collected data from 146 patients admitted to the Public Health Center of Taizhou Hospital, Zhejiang University, China from January 23, 2020 to March 11, 2020, and confirmed the diagnosis of new-type coronavirus pneumonia by RT-PCR. The final selection was made after screening. For a total of 134 confirmed patients, we collected their clinical data and sputum, nasopharyngeal swabs or throat swabs, fecal nucleic acid test results, and calculated the age of each specimen.Results: A total of 134 confirmed patients were included in the study; of them, 93 were of the common type, and 41 were critically ill. There were no significant differences between males and females, P = 0.853) and their epidemiological history (P = 0.441). The average age of severe patients was 55.85 ± 13.28 years, which was higher than that of common patients at 44.06 ± 12.86 years (P = 0.00). The results showed that the time of SARS-CoV-2 RNA in the upper respiratory tract was 15.1 ± 7.23 days for common patients and 20.56 ± 6.59 days for severe patients, which was longer than that of common patients (P = 0.00). The time of SARS-CoV-2 RNA in the lower respiratory tract was 27.45 ± 10.06 days for common patients and 29.78 ± 10.11 days for severe patients. There was no statistical difference (P = 0.328); SARS-CoV-2 RNA existed in the digestive tract. The time was 22.6 ± 7.69 days for common patients and 27.24 ± 7.86 days for severe patients, which was longer than that of common patients (P = 0.01). SARS-CoV-2 existed for a shorter time in the upper respiratory and digestive tracts than in the lower respiratory tract.CONCLUSION: SARS-CoV-2 is present in the lower respiratory tract for longer than the upper respiratory　and digestive tracts, and there were no statistical differences in the lower respiratory tract between common and severe patients.
Intermittent versus daily dosing of meropenem in haemodialysis patients – A retrospective observational exploratory study
Authors: Ho Vanda , Tay Felecia , Wu Jia En , Lum Lionel , Tambyah Paul
Published: April 2020

BackgroundExtended microbial resistance is very common in patients on haemodialysis, often needing long courses of carbapenems. This results in increased length of stay in hospital and its complications. However, carbapenems can be given intermittently and avoid this problem.We aim to describe the clinical outcomes of intermittent versus daily meropenem in thrice weekly haemodialysed patients.Methods: 125 records were examined retrospectively. Data collected includes patient demographics, clinical interventions such as source control, meropenem dose and regime, and clinical outcomes such as length of hospital stay (LOS), 30-day readmission rates and adverse events.Results: Mean age was 62.6±1.3 years, 56% were male. 65.6% were on haemodialysis secondary to diabetic nephropathy, and 84% were on thrice-weekly regime. Most common bacteria cultured was Klebsiella pneumoniae (14.4%), the most common indication for meropenem was pneumonia (32%) and mainly used for cure (65%). Mean duration of therapy on meropenem was 11.5±1.2 days, 8 patients needed more than 30 days of meropenem. 59.2% did not have intervention for source control.87.2% received daily dosing of meropenem. 6.4% patients received intermittent dosing of meropenem only, 4.8% patients received both types of dosing regimens. Dosing was variable across both arms.LOS of the index admission was shorter for the intermittent arm, 15.5±2.7 days compared to daily arm, 34.7±2.7 days. Though 30-day readmission was higher (50% in the intermittent arm versus 33.1%), total LOS in the year was still lower (49±18.0 days in the intermittent arm versus 53.3±14.9 days). There were few adverse events in both arms.Conclusion: Our study suggests that intermittent dosing of meropenem may be helpful for reducing hospital length of stay. We suggest for randomised controlled trials to prove its safety and efficacy.
Enteral Nutrition Practices in Children with Cancer admitted into a Paediatric Intensive Care Unit and Clinical Outcomes
Authors: Afonso Wanelia , Peres Wilza , Pinho Nivaldo , Martucci Renata , Saraiva Daúbia , Padilha Patricia
Published: April 2020

Background and Aim: Delays in both the prescription of, as well as interruptions in the administration of ENT, have been widely investigated. The most common reasons for damage in the nutritional impairment in children in a PICU are the presence of gastrointestinal disorders, together with medical and nursing procedures. This study aims to describe enteral nutrition practices in children with cancer and to evaluate the factors related to clinical outcomes, hospitalisation time (HT) and mechanical ventilation time (MVT), in a Paediatric Intensive Care Unit (PICU) of an Oncological Treatment Centre in Rio de Janeiro, Brazil.Method: It is a retrospective longitudinal study, with children that were admitted into the PICU during 2013. Those children who had been diagnosed with a malignancy, aged 1 to 18 years, HT > 72 h, as well as with the use of enteral nutrition therapy (ENT) during their hospitalisation in the PICU, were included in the study. The controlled variables were severity, age, caloric deficiencies, cumulative proteins, gastrointestinal symptoms and the early initiation of ENT. The odds ratios between the exposure factors were estimated with a confidence interval (CI) of 95% and a significance level of p < 0.05. Results: The study selected 54 patients; the median age was 8.02 (2.35–12.79) years. The cumulative deficiencies of calories and proteins were 21.5 (14.0–29.6) kcal / kg / day and 0.60 (0.33–0.97) g / kg / day, respectively. Diarrhoea and younger age and the cumulative caloric deficiencies were HT predictors. Abdominal distention and younger age were associated with a higher MVT. Conclusions: Changes in the gastrointestinal tract, with evaluation of the cumulative caloric deficiencies in critically ill children with cancer, should be monitored more continuously, as well as with the impact of these variables on the HT and MVT outcomes.
Latent Tuberculosis Infection Prevalence and Characteristics in the HIV disease population in Two Major Medical Centers in Tegucigalpa, Honduras
Authors: Castro-Lainez Mirams T , Varela-Martinez Cecilia , Rivera Rebeca , Diaz-Romero Jose A , Solorzano-Flores Leticia N , Howell Alan , Sierra-Hoffman Miguel , Stevens Mark L , Palou-Garcia Elsa , Deliz Rafael J
Published: April 2020

Background

In Honduras, thirteen percent of patients with tuberculosis are coinfected with HIV, but the prevalence of latent tuberculosis infection among people with HIV infection is unknown. The goal of this study is to determine the prevalence and characteristics of latent tuberculosis infection among HIV diagnosed patients.
Methods

A cross-sectional study was conducted from June 2015 to December 2015 in two major clinical centers in Tegucigalpa, Honduras. This study used an adapted questionnaire-based clinical algorithm from the World Health Organization, procedures described by the Pan American Health Organization, and the Honduran National Norms for Tuberculosis Control included in the supplement material. There were two hundred ten individuals interviewed. Laboratory testing included tuberculin skin testing with absolute CD4 counts.
Results

There was a statistically significant higher risk of latent tuberculosis infection with HIV disease in the subgroups with a lower level of education (p = 0.002) and prior history of tuberculosis (p < 0.001).
Conclusion

The prevalence of latent tuberculosis infection is lower than in high-prevalence regions in different countries. The tuberculin skin test continues to identify patients with latent tuberculosis with HIV disease and intervene with concurrent antiretroviral therapy and tuberculosis chemoprophylaxis. A low education level is probably related to low socioeconomic status and access to healthcare. The findings of this study represent an opportunity to reach underserved areas, test the HIV population with the tuberculin skin test, and administer chemoprophylaxis.
Arthroplasty versus internal fixation for intertrochanteric fractures in the elderly: A meta-analysis
Authors: Yu Kexiao , Lu Weizhong , Xiao Qiuke , Wan Ruijie , Dong Lujue , Dai Zhenyu
Published: April 2020

Background

Surgical treatment is the first choice for intertrochanteric fractures in the elderly as it allows early rehabilitation and functional recovery. Recently, more and more surgeons prefer arthroplasty instead of internal fixation in the treatment of senile intertrochanteric fractures. However, there is conflicting evidence as to which is the best surgical treatment for them. In this article, we performed a systematic review and meta-analysis to compare the clinical effectiveness of internal fixation (IF) and arthroplasty (AR) for intertrochanteric fractures in the elderly.
Methods

The online databases of PubMed, Cochrane Database, and Web of Science were searched to include studies conducted from 01/01/2000 to 11/30/2018 in English using keywords to identify articles relevant to this study. All studies had to have evaluated the treatment of patients with intertrochanteric fractures in the elderly(≥ 60 years of age). The quality of the trials was assessed and meta-analyses were conducted using the Cochrane Collaboration’s RevMan 5.3 version.
Results

A total of 14 studies involving a total of 1588 patients were suitable for inclusion in this meta-analysis. There was no significant difference between the IF and AR groups for postoperative complications-related general condition (OR = 1.24; 95% CI = 0.90, 1.70; P = 0.19), hospital stay (SMD = 0.16; 95% CI= -0.5, 0.82; P = 0.64), and Harris hip score (SMD= -0.12; 95% CI= -0.79, 0.54; P = 0.71). AR group had a significantly lower rate of complications-related operation (OR = 2.21; 95% CI = 1.41, 3.45; P = 0.0005) and reoperation (OR = 2.74; 95% CI = 1.57, 4.76; P = 0.0004). However, compared with AR group, IF group could reduce the blood loss (OR=-4.08; 95% CI=-4.58, -3.59; P < 0.00001), transfusion requirement (SMD= -0.67; 95% CI= -1.08, -0.26; P = 0.001), operation time (SMD= -0.80; 95% CI= -1.47, -0.12; P < 0.00001), and have a lower rate of mortality within 1-year (OR = 0.67; 95% CI = 0.52, 0.86; P = 0.002).
Conclusion

AR is associated with less rates of complications-related operation and reoperation but has an increased risk of blood loss, transfusion, operation time and mortality within 1-year. Our findings demonstrated that AR does not have significant advantages over IF for intertrochanteric fractures in the elderly.
Transcutaneous auricular vagal nerve stimulation inhibits P2X7R expression in limbic brain regions and reverses depression-like behavior in Zucker diabetic fatty rats
Authors: Yu Yutian , He Xun , Wang Yu , Zhang Jinling , Tang Chunzhi , Rong Peijing
Published: April 2020

Background

Previous studies confirmed that Zucker diabetic fatty rats (ZDF, fa/fa) develop type 2 diabetes (T2D) with depression-like behavior innately, and transcutaneous auricular vagal nerve stimulation (taVNS) was found to have anti-diabetic and anti-depressive effect in ZDF rats. However, there is still a lack of molecular-biological evidence that ZDF rats are a good rodent model of depression, and how does taVNS take the anti-depressive effect to the ZDF rats. P2 × 7R, a purinergic receptor most-related to inflammation and depression, is found to be elevated in depressed brains and is gradually considered as a potential therapeutic target for depression.
Methods

We deployed taVNS and transcutaneous none vagal nerve stimulation (tnVNS) to ZDF rats. We applied forced swimming test (FST) to evaluate to the depression-like behavior of the rats. We used Western blot to test the P2 × 7R expression in the hypothalamus, amygdala, hippocampus, prefrontal cortex, and cingulate cortex of the rats. Furthermore, we used immunohistochemical staining to colocalize the P2 × 7R expressing cells in the ZDF rats’ brains.
Results

We found that compared with their lean littermates (ZL rats), naïve ZDF rats developed depression-like behavior innately with elevated P2 × 7R expression in their limbic brain regions (hypothalamus, amygdala, hippocampus, prefrontal cortex, and cingulate cortex); and taVNS but not tnVNS inhibited the P2 × 7R expression in their limbic brain regions and reversed the depression-like behavior. Moreover, P2 × 7R was found majorly expressing in astrocytes and microglia of ZDF rats.
Conclusions

ZDF rats are a good rodent model of depression, and taVNS plays an anti-depressive effect in ZDF rats by inhibiting glial P2 × 7R expression in their limbic brain regions.
Applying Random Forest Model Algorithm to GFR estimation
Authors: Liu Peijia , Yang Dong , Li Shaomin , Chong Yutian , Li Ming , Hu Wentao , Wang Bohan , Liu Xiang , Liu Xun
Published: April 2020

Background

The utilization of estimating-GFR equations is critical for kidney disease in the clinic. However, the performance of the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation has not improved substantially in the past eight years. Here we hypothesized that random forest regression(RF) method could go beyond revised linear regression, which is used to build the CKD-EPI equation
Methods

1732 participants were enrolled in this study totally (1333 in development data set from Tianhe District and 399 in external data set Luogang District). Recursive feature elimination (RFE) is applied to the development data to select important variables and build random forest models. Then same variables were used to develop the estimated GFR equation with linear regression as a comparison. The performances of these equations are measured by bias, 30% accuracy, precision and root mean square error(RMSE).
Results

Of all the variables, creatinine, cystatin C, weight, body mass index (BMI), age, uric acid(UA), blood urea nitrogen(BUN), hematocrit(HCT) and apolipoprotein B(APOB) were selected by RFE method. The results revealed that the overall performance of random forest regression models ascended the revised regression models based on the same variables. In the 9-variable model, RF model was better than revised linear regression in term of bias, precision ,30%accuracy and RMSE(0.78 vs 2.98, 16.90 vs 23.62, 0.84 vs 0.80, 16.88 vs 18.70, all P < 0.01 ). In the 4-variable model, random forest regression model showed an improvement in precision and RMSE compared with revised regression model. (20.82 vs 25.25, P < 0.01, 19.08 vs 20.60, P < 0.001). Bias and 30%accurancy were preferable, but the results were not statistically significant (0.34 vs 2.07, P = 0.10, 0.8 vs 0.78, P = 0.19, respectively).
Conclusions

The performances of random forest regression models are better than revised linear regression models when it comes to GFR estimation.
Analysis of BRCA1 large genomic rearrangements to identify individuals at risk of breast cancer
Authors: García-Magallanes Noemí , Martínez-Camberos Alejandra Paola , Leal-León Emir Adolfo , Picos-Cárdenas Verónica Judith , Romo-Martínez Enrique Johathan , Luque-Ortega Fred , García-Alvarez Edith Eunice , Barbosa-Jasso María del Pilar , Contreras-Gutierrez José Alfredo , Meraz Eliakym Arámbula
Published: April 2020

Background. Breast cancer (BC) is a malignant neoplasm in which genetic and environmental aspects contribute to its development. In many cases, pathogenic mutations in BRCA1 are caused by large genomic rearrangements such as copy number variations, a mechanism of gene inactivation that increases the risk of BC. Therefore, identifying women at high risk of BC through genetic testing is of great importance. This study aimed to identify large BRCA1 rearrangements in patients with early-onset or family history of BC. Methods. Peripheral blood from patients with (n= 38) and without (n= 30) BC was analyzed using the multiplex ligation-dependent probe amplification assay to detect large genomic rearrangements in BRCA1. Results. One patient with sporadic BC showed an ambiguous deletion in exon 12 of the BRCA1 gene. To validate this result, full sequencing of this region was performed. The mutation detected by MLPA resulted in a false positive, showing that large genomic rearrangements in BRCA1 were absent in all subjects. Moreover, in this same patient, we detected the presence of c.4308T>C (rs1060915) polymorphism. Conclusions. In our patients with BC, large genomic rearrangements in BRCA1 are held unaccountable for the development of the disease. We identified the presence of single nucleotide polymorphism, c.4308T>C (rs1060915), in a patient with sporadic BC.
Cadmium uptake, translocation, and redistribution affect Cd accumulation in grain of common wheat (Triticum aestivum L.) cultivars
Authors: Cheng Yiran , Zhang Xu , Wang Sha , Xiao Xue , Zeng Jian , Kang Houyang , Fan Xing , Sha Lina , Zhang Haiqin , Zhou Yonghong , Wang Yi
Published: April 2020

Background

To study the cadmium (Cd) accumulation in wheat grain, we evaluated the grain Cd concentrations of 46 common wheat cultivars grown at two sites in Sichuan, China and selected five different grain Cd accumulators (a high-Cd accumulator ZM18, four low-Cd accumulators YM51, YM53, SM969 and CM104) to explore the physiological processes of Cd accumulation in the grain of wheat grown under varying degrees of Cd stress.
Results

Our results showed that the Cd concentration in grain differed among genotypes. Under low-Cd stress, the grain Cd concentration was correlated with the Cd translocation factor (TF) of roots to grain and all the Cd redistribution factors (RFs). Compared with the ZM18, the cultivars YM53 and SM969 accumulated less Cd in the grain due to low Cd redistribution from lower stems and older leaves to grain. The low-Cd accumulators YM51 and CM104 were due to low Cd transport from roots to grain, and low Cd redistribution from glumes, flag leaves, lower stems, and older leaves to grain. Under high-Cd stress, the ZM18, YM53, and SM969 accumulated significantly more Cd in the grain, root and other tissues than did YM51 and CM104. Correlation analyses showed that the grain Cd concentration of wheat under high Cd stress was positively correlated with the Cd concentration in each tissue and the TFs of roots to grains, rachis, internode 1 and flag leaves.
Conclusions

Cd translocation directly from roots to grain and Cd redistribution from shoots to grain determines the Cd accumulation in grain of wheat cultivars under low-Cd stress. Cd uptake by root and then synchronously transported to new shoots determined the differences of Cd accumulation in the grain of wheat cultivars under high Cd stress.
Hypertension management based on general practice care in Shanghai, China
Authors: Luo Xiaoli , Huang Yimin , Zheng Yongtao , Wang Lichao , Li Jue , Zhang Lijuan
Published: April 2020

Background

Hypertension is one of the major public health problems in China. General practice (GP)-based disease management programs including hypertension have been widely disseminated in communities of Shanghai since 2010. This study was to evaluate the effectiveness on GP-management profile among patients with hypertension in urban communities of Shanghai, China.
Methods

A retrospective, community-based study using a primary care database from 2015 to 2017 was performed. The annual effective management of hypertension (≥ 4 times follow-up per year), blood pressure (BP) control rates, drug interventions, comorbidities burden were analyzed, respectively. Logistic regression analysis was used to determine the association between factors and uncontrolled BP.
Results

From 2015 to 2017, the effective management rate increased from 83.6–95.1%. Among them, drug treatment rates and BP control rates displayed a growing trend (P༜0.001), reached 94.1% and 80.6% in 2017, respectively. The medication of antihypertensive drugs was dominated by calcium channel blocker (CCB) and angiotensin receptor blocker (ARB) categories. Of the 8105 patients registered in 2015, 31.0% cases developed new comorbidities in the following two-years. Totally, comorbidities were present in 46.9% patients in 2017. Age, body mass index, combined medication, history of stroke and kidney damage were independently related to uncontrolled BP.
Conclusions

Although the rate of treatment and control of hypertension were higher in Shanghai than average of country in a community population, the comorbidities accompanied by hypertension was still far from being satisfactory. Future efforts to promote GP and optimize management strategies are needed to improve the current status.
Early Drop in Systolic Blood Pressure and Worsening Renal Function in Elderly Patients With Acute Heart Failure: How Does the Heart Rate Interact?
Authors: Takeuchi Makoto , Nagai Michiaki , Dote Keigo , Kato Masaya , Oda Noboru , Kunita Eiji , Kagawa Eisuke , Yamane Aya , Kobayashi Yusuke , Shiota Haruko , Osawa Ayano , Kobatake Hiroshi
Published: April 2020

Background: Regardless of patients' baseline renal function, worsening renal function (WRF) during hospitalization is associated with poor outcomes. In individuals with acute heart failure (AHF), one predictor of WRF is an early drop in systolic blood pressure (SBP). Few studies have investigated WRF in elderly AHF patients or the influence of these patients' at-admission heart rate (HR) on the relationship between an early SBP drop SBP and the AHF. Methods: We measured the SBP and HR of 245 elderly AHF inpatients (82.9±6.0 years old, females 50.6%) at admission and another six times over the next 48 hr. We defined 'WRF' as a serum creatinine increase ≥0.3 mg/dL by Day 5 post-admission. We calculated the 'early SBP drop' as the difference between the admission SBP value and the lowest value during the first 48 hr of hospitalization. Results: There were significant differences between the 36 patients with WRF and the 209 patients without WRF: early SBP drop (51.3 vs. 32.5 mmHg, p<0.01) and at-admission HR (79.3 vs. 89.6 bpm, p<0.05), respectively. In the multiple logistic regression analysis adjusted for the confounders, early SBP drop (OR: 1.003, 95%CI: 1.003–1.03, p<0.04) and HR at-admission (OR: 0.98, 95%CI: 0.96–0.99, p<0.01) were significantly associated with WRF. No significant association was shown for the interaction term of early SBP drop ´ at-admission HR with WRF (p=0.3). Conclusions: In these elderly AHF patients, exaggerated early SBP drop and lower at-admission HR were significant independent predictors of WRF, and these factors were additively associated with WRF.
Supporting Australian Clinical Learners in a Collaborative Clusters Education Model: A Mixed Methods Study
Authors: de Mortel Thea van , Armit Lyn , Shanahan Brenton , Needham Judith , Brown Candy , Grafton Eileen , Havell Michelle , Henderson Amanda , Grealish Laurie
Published: April 2020

Background: Nursing student numbers have risen in response to projected registered nurse shortfalls, increasing numbers of new graduates requiring transitional support and pressure on clinical placements. A Collaborative Clusters Education Model, in which Entry to Practice facilitators coach ward-based registered nurses to support students’ and new graduates’ learning, may address placement capacity. The research aim was to evaluate the acceptability of the Collaborative Clusters Education Model to stakeholders by examining their perceptions of the facilitators and barriers to the model in its implementation. Methods: A convergent mixed methods evaluation approach was adopted. The study took place in a large Australian health service in south-east Queensland. Participants included Bachelor of Nursing students, Entry to Practice facilitators, ward-based registered nurses, academics and new graduates. A mixed methods design was used. Elements included an online survey of nursing students, and interviews with new graduates, Entry to Practice facilitators, ward-based registered nurses, and academics. Descriptive statistics were calculated on quantitative data. Thematic analysis was conducted on qualitative data. Results: Participants included 134 nursing students, five new graduates, seven Entry to Practice facilitators, four registered nurses, and three nurse academics. Students rated facilitators’ effectiveness highly (4.43/5±0.75), although this finding is tempered by a low response rate (13.5%). For learners, the model provided access to learning experiences, although preferences for sources of support differed between students and new graduates, and further clarification of responsibilities was required. For other stakeholders, three themes emerged: students’ and new graduates’ integration into the workplace can promote learning; tensions arise in new ways to approach performance assessment; and aligning expectations requires high levels of communication. Conclusions: This evaluation found that acceptability was good but at risk from limited clarity around roles and responsibilities. Further research into this model is recommended.
Prevalence and risk factors of perceived stress on COVID-19 among health care providers in Dilla Town Health institutions, Southern Ethiopia: A cross-sectional study
Authors: Chekole Yigrem Ali , Yimer Solomon , Mekuriaw Birhanie , Mekonnen Semagn
Published: April 2020

Background: The Coronavirus belongs to large groups of viruses that cause serious health problems including the mental health of the society particularly the health care providers. Understanding the mental health response after a public health emergency might help health care providers and communities to prepare for a population's response to a disaster.Objective: This study aimed to assess the magnitude of perceived stress and risk factors of coronaviruses disease 2019 among healthcare providers in Dilla, Southern Ethiopia 2020.Methods: This cross-sectional study was conducted among 244 samples selected with systematic random sampling technique. Data collection was carried out with validated perceived stress scale adapted from the World health organization. Data were coded and entered into Epi-info Version 7 and was exported and analyzed with SPSS version 20. Crude and adjusted OR were analyzed using logistic regression and the level of significance of association was determined at P-value <0.05.Result: The magnitude of perceived stress of coronavirus disease 2019 among participants was 126 (51.6%). Being at the age range of 25-31 years (AOR=2.5, 95%CI, 1.07, 5.90), nurse professionals (AOR= 7.8, 95%CI 2.15, 27.98) and pharmacist professionals (AOR=4.15, 95%CI, 1.01, 17.06) were variables found to have a strongly statistically significant association with perceived stress of Coronaviruses disease.Conclusion: this indicates that early prevention, early identification and intervention of perceived stress of coronaviruses disease among healthcare providers. Particularly, more stress for the frontline healthcare worker nurses, pharmacists and age ranges of 25-31 years.
Early childhood Group-A streptococcal infections and basal ganglia antibodies in adult ADHD: A preliminary study
Authors: Oliva Francesco , Girolamo Giulia di , Malandrone Francesca , Iaia Noemi , Biasi Fiorella , Maina Giuseppe
Published: April 2020

Background: To explore the relationship between adult Attention Deficit/ Hyperactivity Disorder (ADHD) and recurrent group A streptococcus (GAS) infections during early childhood.Method: Childhood history of recurrent GAS infections and a blood sample were collected in a sample of DSM-IV adult ADHD outpatients. The anti-streptolysin O (ASO), anti-deoxyribonuclease B (anti-DNase B), and anti-basal ganglia antibodies (ABGA) titers were determined in patient plasma by enzyme-linked immunosorbent assay (ELISA). Titers positivity was evaluated following manufacturer's specifications. Absolute titers were also collected as continuous variables.Results: Fourteen out of 22 (63.6%) have had recurrent infections in childhood (i.e., seven, 31.8%, have had tonsillitis or adenoiditis and seven, 31.8%, have had different GAS related infections). Eighteen patients (81.9%) were positive for anti-DNase B, five (22.7%) for ASO, and 4 (18.2%) were positive for both of them. Five participants (22.7%) were ABGA positive, whereas only two (9.1%) were positive for all three antibodies.Conclusions: ADHD patients might be more prone to GAS infections during childhood and seem to have an increased risk for GAS-related autoimmunity in adulthood. Both infections and ensuing acquired autoimmunity could influence the neurodevelopmental process, by contributing, at least in part, to the ADHD pathogenesis.
Melatonin and Vitamin C Attenuate Cassava Diet-Induced Alteration in Thyroid Function
Authors: Alagbonsi Abdullateef , Maliki Oloruntobi Oluwasegun , Ibitoye Comfort Moyinolowa , Olayaki Luqman Aribidesi
Published: April 2020

Background

Cyanide is present in cassava and is well known to cause adverse effects on the male reproductive functions. This study evaluated the effect of melatonin and/or vitamin C on body weight, thyroid function and reproductive parameters in male Wistar rats treated with cyanide-enriched cassava-diet (CD), and their possible mechanisms of actions.
Methods

Forty-five (45) animals were divided into 9 groups (n = 5 each) that received the following treatments for 28 days. Groups I-III received normal saline (control), melatonin (15 mg/kg), and vitamin C (100 mg/kg) only. Groups IV-VI received 40% CD, while groups V and VI were additionally treated with melatonin only and melatonin and vitamin C respectively. Groups VII-IX received 80% CD, but groups VIII and IX were additionally treated with melatonin only and melatonin and vitamin C respectively.
Results

Melatonin and/or vitamin C supplement increased body weight in CD-treated rats. The sperm count (but not other semen parameters) was increased by CD and melatonin, while combination of melatonin and vitamin C in CD-treated rats increased all semen parameters. Neither CD alone nor its co-administration with melatonin and /or vitamin C affected plasma luteinising hormone (LH) and testosterone. The 40% CD and 80% CD increased triiodothyronine (T3), but the increase by the former was abolished by melatonin alone while the increase by the latter was neither affected by melatonin alone nor its combination with vitamin C. Moreover, the 40% CD and 80% CD increased thyroxine (T4), but was neither affected by melatonin alone or its combination with vitamin C. The levels of thyroid stimulating hormone (TSH) were not different across all treatment groups. Both 40% CD and 80% CD increased the thiocyanate level, which was ameliorated by melatonin but abolished by combination of melatonin and vitamin C. Both 40% CD and 80% CD decreased the total antioxidant capacity (TAC) level, which was abolished by melatonin.
Conclusion

In conclusion, this study suggests that CD increases weight gain, thyroid hormone and oxidative stress, which were attenuated by anti-oxidants melatonin and vitamin C.
Parental monitoring and adolescent health risk behaviors: A comparative analysis of nine Southeast Asian countries
Authors: Vo Thang
Published: April 2020

Background: Strong parental monitoring is thought to protect adolescents from engaging in health risk behaviors. However, differing levels of economic development and regulatory systems suggest that findings from Western countries may not generalize to Southeast Asia. This study analyzed the relationship between parental monitoring and health risk behaviors among adolescents in nine Southeast Asian countries.Methods: Cross-sectional data for 52,803 adolescents (aged 11–18 years; 51.4% female) were obtained from the World Health Organization’s Global School-Based Student Health Survey. Data collected between 2007 and 2015 was available for Indonesia, Myanmar, Thailand, The Philippines, Malaysia, Vietnam, Brunei, Timor-Leste, and Laos. Univariate and multivariate logistic regression analyses were conducted to assess the relationships between parental monitoring, sexual risk behaviors, and substance use. Age, gender, country differences in sexual risk behaviors, and substance use were also examined.Results: The results revealed that adolescents who reported regular parental monitoring had a lower probability of engaging in sexual risk behaviors and substance use. Using alcohol, prohibited substances, and tobacco was significantly associated with engaging in sexual risk behaviors. Males and older participants were more likely than females and younger participants to report all forms of health risk behavior. Significant differences existed in risk behavior between countries, with participants in Timor-Leste the most likely to engage in most forms of health risk behavior.Conclusion: We considered the results in the context of the economic and regulatory environments in each country. In developing countries, particularly those with relatively strong economic growth and relaxed drug and alcohol regulations, parental monitoring, and other factors such as culture, education, and the health system play a crucial role in protecting adolescents from risky behaviors.
An Inconvenient Relationship of Hemoglobin A1c Level with Endothelial Function in Type 2 Diabetes
Authors: Yamaji Takayuki , Harada Takahiro , Hashimoto Yu , Takaeko Yuji , Kajikawa Masato , Han Yiming , Maruhashi Tatsuya , Kishimoto Shinji , Kihara Yasuki , Hida Eisuke , Chayama Kazuaki , Goto Chikara , yusoff Farina Mohamad , Nakashima Ayumu , Higashi Yukihito
Published: April 2020

Background Diabetes is associated with endothelial dysfunction. However, there is little information on the relationship between hemoglobin A1c (HbA1c) level and endothelial function. This study evaluated the relationship between HbA1c level and flow-mediated vasodilation (FMD).Methods We measured FMD in 1215 patients with type 2 diabetes including 349 patients not taking antidiabetic drugs and 866 patients taking antidiabetic drugs. The patients were divided into four groups based on HbA1c levels: <48 mmol/mol, 48–52 mmol/mol, 53–63 mmol/mol, and ≥ 64 mmol/mol. (< 6.5%, 6.5–6.9%, 7.0-7.9%, ≥ 8.0%)Results An inverted U-shaped pattern of association between HbA1c level and FMD was observed at the peak of HbA1c of about 53 mmol/mol (7%). FMD was significantly smaller in the HbA1c < 48 mmol/mol (6.5%) group than in the HbA1c 48–52 mmol/mol (6.5–6.9%) group and HbA1c 53–63 mmol/mol (7.0-7.9%) group (p < 0.001 and p < 0.001), and FMD values were similar in the HbA1c < 48 mmol/mol (6.5%) group and HbA1c ≥ 64 mmol/mol (8.0%) group. There were no significant differences in nitroglycerine-induced vasodilation (NID) values among the four groups. After adjustments for confounding factors, FMD was significantly smaller in the HbA1c < 48 mmol/mol (6.5%) group than in the HbA1c 48–52 mmol/mol (6.5–6.9%) and HbA1c 53–63 mmol/mol (7.0-7.9%) group (p = 0.002 and p = 0.04). In patients not taking antidiabetic drugs, FMD was also significantly smaller in the HbA1c < 48 mmol/mol (6.5%) group than in the HbA1c 48–52 mmol/mol (6.5–6.9%) group and HbA1c 53–63 mmol/mol (7.0-7.9%) group (p < 0.001 and p = 0.02), and there were no significant differences in NID values among the four groups.Conclusions These findings suggest that a low HbA1c level of < 48 mmol/mol (6.5%) is associated with endothelial dysfunction. An HbA1c level of 48–52 mmol/mol (6.5–6.9%) may be appropriate for maintenance of endothelial function.