bluuebunny/crossref_metadata_2025 huggingface dataset:
Nexus Among Tourism, Environmental Degradation, Inward FDI and Economic Growth: Fresh Evidence from ASEAN Countries
Authors: Azam Muhammad , Noor Sameena , Nawaz Muhammad Atif
Published: December 2020

This study aims to investigate the linkage among tourism, foreign direct investment, environmental degradation by CO2 emissions and economic growth in five countries from Association of Southeast Asian Nations (ASEAN) over 1995–2017. The outcomes of pooled mean group (PMG) estimator reveal that FDI and international tourism arrivals have a significantly positive influence on economic growth both in the short-run and the long-run. The association between growth and CO2 emissions is found negative and significant. The Granger causality result reveals that there is bidirectional causality between FDI and growth, tourism and growth and FDI and tourism. A unidirectional causal link is found between CO2 emissions and growth, tourism and population and population and CO2 emissions. These findings suggest enhance more inward FDI, control environmental pollution, but also necessary to attract more tourists towards these countries, which in turn, generate revenue and boost up economic growth and development.JEL Classification Codes: F21; O13; O47; Z32
Research on Clinical Characteristics and Prognostic Analysis of Heparin-Induced Thrombocytopenia After Surgery for Acute Type a Aortic Dissection
Authors: Zhou Chu-zhi , Li Yan-zhen , Feng Dong-jie , Fang Yuan , Zha Feng-yan , Wang Erhui , Wei Min-xin , Wen Jun-min
Published: December 2020

PurposeThe present study aimed to explore the clinical characteristics of heparin-induced thrombocytopenia (HIT) after surgery for acute type A aortic dissection and perform a relevant prognostic analysis. MethodsAfter continuous observation and analysis of 204 patients who underwent acute type A aortic dissection, we found that blood platelets decreased significantly after surgery and that these patients can be suspected to suffer HIT based on relevant 4Ts scores. For these suspected HIT patients, a latex particle-enhanced immunoturbidimetric assay was conducted to detect heparin-induced antibodies. Perioperative clinical data of patients in HIT and non-HIT groups were recorded as were blood platelet counts, HIT antibody test results, 4Ts scores, thromboembolic complications, clinical prognosis and outcomes. ResultsIn the present study, 38 suspected HIT patients, 16 HIT patients and 188 non-HIT patients were selected in the clinical setting. Among them, HIT patients were found to have prolonged cardiopulmonary bypass time(223min on average vs. 164min) and delayed aortic cross-clamp time(128min on average vs. 107min), and these differences between HIT patients and non-HIT patients were significant (P<0.05). Additionally, the HIT group required longer operation time and higher dose of heparin, but showing no statistical differences(P>0.05). The transfusions of blood platelets in the HIT group and non-HIT group were 18.7±5.0u and 15.6±7.34 u, respectively.In the HIT group, the mechanic ventilation time and the length of ICU stay were longer comparing the non-HIT group(P<0.05), though no significant differences in total length of stay or In-hospital mortality were observed (P>0.05).The incidence of continuous renal replacement therapy in HIT group was higher than the non-HIT group(P<0.05). Additionally,there were no significant differences in 24-h postoperative drainage or reoperation for bleeding in both group(P>0.05). However, the HIT antibody titer in the HIT group was significantly higher than that in the Suspected HIT group(2.7±1.8U/mL vs. 0.3±0.2U/mL)(P<0.05).Among patients diagnosed with HIT, the incidence of thromboembolism reached 31.5%.For example, two HIT patients newly developed thromboembolism in both lower extremities,and three patients experienced cerebral infarction. ConclusionsAfter surgery for acute type A aortic dissection, HIT patients developed postoperative complications, the duration of ventilatory support and length of ICU stay were extended, and the incidence of thromboembolism increased. HIT antibody detection and risk classification should be implemented for high-risk patients showing early clinical characteristics.
The Diameter of Bronchial Resection Margin is Associated With Postoperative Lung Metastasis and Long-term Survival
Authors: Xiao Zengtuan , Zhang Mengzhe , Wang Xiaofei , Gong Jialin , Liu Zuo , Zhang Zhenfa
Published: December 2020

BackgroundTo investigate the significance of the diameter of bronchial resection margin (DBRM) on the postoperative lung metastasis and long -term survival of patients with primary lung cancer.MethodsWe retrospectively analyzed the data of 1844 patients with primary lung cancer between January 2006 and December 2010 after surgery. Patients were divided into DBRM≤1 cm group (826 patients) and DBRM>1 cm group (1018 patients). Propensity score matching was used to reduce grouping selection bias. Furthermore, we divide the 974 patients who had definite first metastasis site into lung metastasis group (283 patients) and other metastasis group (691 patients), and analyzed related risk factors and prognosis of metastasis. Disease-free survival and overall survival were the study end points.ResultsThe DBRM≤1 cm group had a significantly better prognosis than DBTM>1 cm group (5-year DFS, 36.5% vs 25.7%; P < 0.001; 5-year OS, 45.4% vs 34.1%; P < 0.001). After multivariate survival analysis, DBRM remained the independent favorable effect on DFS (HR, 1.198; 95% CI, 1,071 to 1.340; P = 0.002) and OS (HR, 1.186; 95% CI, 1.060 to1.327; P = 0.003). PSM further confirmed that DBRM≤1 cm group had a better DFS (P = 0.032) and OS (P = 0.026) than the DBRM>1 cm group. It revealed that the DBRM was an independent risk factor for postoperative lung metastasis, and postoperative adjuvant therapy could improve the OS of lung metastases.ConclusionsThe DBRM was an independent risk factor for postoperative lung metastasis and adjuvant therapy could improve long-term survival.
Modified Nuss Operation Using Introducer-Bar Complex for Pectus Excavatum in Adults: A Retrospective Study
Authors: Wang Lei , Liu Juan , Li Yao , Feng Tienan , Cao Beibei , Xiao Haibo , hu fengqing , Li Guoqing
Published: December 2020

BackgroundShortcoming of traditional Nuss operation on adults is gradually found in the clinical practice. A new kind of introducer-bar complex was introduced. However, there is limited evidence regarding its safety and efficacy. Therefore, a single center, retrospective study was conducted to address this issue.MethodsPatients with pectus excavatum who underwent surgery between January 2015 and June 2017 were consecutively enrolled in this study. In all, 52 patients underwent the modified procedure using the introducer-bar complex (new procedure group), whereas 48 underwent the traditional anti-Nuss procedure (traditional procedure group). Outcomes analysis of balanced baseline was performed to compare the intraoperative and postoperative short-term outcomes.ResultsAll patients in the new procedure group had shorter operation duration (51.54 ± 20.32 vs. 79.45 ± 13.88 min, p = 0.017), postoperative hospitalizations (4.77 ± 1.62 vs. 6.86 ± 2.18 days, p = 0.028), plate removal surgery durations (39.30 ± 8.97 vs. 60.30±10.49 min, p < 0.001), and less blood loss during operation (6.25 ± 4.88 vs. 10.90±5.75ml, p = 0.003) than patients in the traditional procedure group. There was no significant difference in the length of incision, postoperative Haller index, cost, number of steel bars, postoperative surgical outcome and incidence of complications between the two groups.Conclusion﻿Through the main clinical outcome were similar, our data reveals modified procedure has shorter operation time, postoperative hospital stay, operation time for plate removal and less blood loss, which will bring potential clinical benefits to patients.
Variation p.R1045H in MYH7 correlated with hypertrophic cardiomyopathy in a Chinese pedigree
Authors: Zhang Yan , Yiyi Shang , Liu Luo , Ding Xiaoxue , Wu Haiyan , Li Lijiang , Pang Mingjie
Published: December 2020

Objective: Inherited hypertrophic cardiomyopathy (HCM) is s a fatal disease that damages heart function and may cause the heart to stop beating suddenly. The genetic factors play an important role in HCM. Pedigree analysis is a good way to identify the genetic defects that cause disease. Methods: A HCM pedigree was found in Yunnan of China. Whole-exome sequencings were performed for finding the genetic variant of HCM. Another 30 HCM patients and 200 health controls were also used to investigate the frequency of variation by TaqMan-MGB method. Results: The variation NM_000257.4:c.3134G>A (NP_000248.2:p.Arg1045His, rs397516178, short as c.3134G>A) was found to co-segregate with the symptoms of HCM. Meanwhile, the variation was not found in 200 controls. After genotyping the variation in 30 HCM patients, one patient carried the variation and had a family history. Conclusion: Our findings support that this variation may be closely related to the occurrence of the disease. According the ACMG guideline, the c. 3134G>A should be classified as " Likely pathogenic".
Aspiration Biopsy Versus Dilatation and Curettage for Endometrial Hyperplasia Prior to Hysterectomy
Authors: Hwang Woo Yeon , Suh Dong Hoon , Kim Kidong , No Jae Hong , Kim Yong Beom
Published: December 2020

Background: To compare the diagnostic accuracy of aspiration biopsy and dilatation and curettage (D&C) in patients diagnosed with endometrial hyperplasia prior to hysterectomy. Methods: We retrospectively reviewed medical records of 250 patients diagnosed with endometrial hyperplasia by endometrial sampling between July 2003 and March 2020. Endometrial sampling was performed by aspiration biopsy (n=150) or D&C (n=100), followed by hysterectomy within 6 months. Pathological findings of hysterectomy specimens of the two groups were compared to preoperative findings.Results: The overall diagnostic concordance between endometrial sampling specimen including D&C and aspiration biopsy, and hysterectomy specimen was 51.0% (51/100) and 41.3% (62/150), respectively. Patients whose preoperative specimen was obtained by D&C were upgraded less significantly than those who underwent aspiration biopsy (27.6% vs 72.4%; P = 0.008). In particular, significantly fewer patients were upgraded after D&C than after aspiration biopsy in hyperplasia without atypia (28.0% vs 72.0%; P = 0.028) and complex hyperplasia cases (27.9% vs 72.1%; P = 0.049). In addition, when the final pathological upgrade rate to endometrial carcinoma was evaluated between the two methods of endometrial sampling, significantly fewer cases were noted after D&C than after aspiration biopsy (26.8% vs 73.2%; P=0.022).Conclusions: In our study, D&C more accurately reflected the final diagnosis in patients with endometrial hyperplasia than aspiration biopsy based on the histological examination of hysterectomy specimens. When considering the management strategy for women with an endometrial hyperplasia diagnosis obtained by aspiration biopsy, physicians should consider the significant rate of upgraded diseases with this method of endometrial sampling.
Cardiometabolic Multimorbidity and Activity Limitation in Canada: A Cross-Sectional Study of Adults Using the Canadian Longitudinal Study of Aging (CLSA) Data
Authors: Fishbook Brayden N , Siever Jodi , Klassen Tara D , Sakakibara Brodie
Published: December 2020

Background: Cardiometabolic multimorbidity (CM) is the diagnosis of at least two of: diabetes, stroke, or heart disease. CM is a common pattern of multimorbidity, however, the association between CM and activity limitation remains unknown. The objectives of this study were to 1) estimate the prevalence of activity limitations among Canadians with CM; and 2) quantify the association between CM and activity limitations.Methods: Using data from the Canadian Longitudinal Study on Aging (CLSA), we estimated the prevalence of CM in Canadians aged 45 to 85 (n=51,022). Multinomial logistic regression was used to quantify the association between CM and activity limitation, evaluated using the Older American Resources and Services (OARS) scale.Results: The prevalence of people living with CM and reporting any activity limitation was 27.4%, with the greatest proportion (47.9%) observed in participants living with all three cardiometabolic conditions. The multinomial odds ratio (or relative risk ratio (RRR)) of activity limitation was greatest amongst participants with all three CM conditions (any limitation: RRR = 11.229, 95% CI = 5.803 to 21.726). Of the two disease combinations, those that included stroke had the greatest odds of activity limitation (stroke and diabetes: RRR = 6.546, 95% CI = 4.436 – 9.661; stroke and myocardial infarction: RRR = 7.029, 95% CI = 4.168 – 11.853). Conclusion: Activity limitation is common amongst Canadians living with CM, and those with CM have an increased odds of reporting activity limitation relative to those with no CM conditions. The odds increase in dose-response relationship as one accumulates more CM conditions.
Knockdown of miR-423-5p Simultaneously Upgrades the eNOS and VEGFa Pathways in ADSCs and Improves Erectile Function in Diabetic Rats
Authors: Zhou Jun , Yin Yinghao , Yang Yuan , Peng Dongyi , Wei Jingchao , Tang Yuxin
Published: December 2020

BackgroundTo investigate if inhibition of miR-423-5p in ADSCs alleviates damage to endothelial cells in high glucose conditions and improves erectile function in diabetic rats.MethodsMiR-423-5p was knocked down in adipose derived stem cells (ADSCs). Then, ADSCs, NC-miR-ADSCs, and miR-ADSCs were co-cultured with human umbilical vein endothelial cells (HUVECs). Normal glucose and high glucose media were supplemented. Afterwards, the supernatant and HUVECs were collected for assessment of eNOS and VEGFa expression, cell proliferation, and apoptosis. Fifteen male Sprague-Dawley (SD) rats aged 12 weeks were induced to develop diabetes mellitus by intraperitoneal injection with streptozocin (STZ), and five healthy SD rats were used as normal controls. Eight weeks after developing diabetes, the rats received ADSCs and miR-ADSCs via injection into the corpora cavernosa, whereas normal controls and DM controls were injected with saline. Erectile function and histological assessment of penile tissues were performed eight weeks after injection.ResultsMiR-423-5p was successfully inhibited in ADSCs, and HUVECs co-cultured with ADSCs or miR-ADSCs exhibited higher eNOS and VEGFa protein expression levels compared to DM groups (P<0.05). MiR-ADSCs enhanced HUVEC proliferation compared to the ADSCs and NC-miR-ADSCs in both normal and high glucose conditions (P<0.01). Lower apoptotic rates were observed when HUVECs were co-cultured with miR-ADSCs, compared to ADSCs and NC-miR-ADSCs (P<0.05). The ICP/MAP indicated that erectile function was severely impaired in the DM rats compared with the normal group. Injection of ADSCs and miR-ADSCs improved erectile function (P<0.01) significantly and was associated with the overexpression of eNOS and VEGFa. Masson trichrome stain showed less fibrosis formation in the miR-ADSC group than the DM group.ConclusionsMiR-423-5p knockdown in ADSCs ameliorated high glucose-mediated damage to HUVECs and improved erectile function in DM rats by inducing eNOS and VEGFa overexpression, indicating that miR-423-5p may be a potential target in the treatment of DM erectile dysfunction (DMED).
A Predictive Model of EGFR Mutation Status in Patients with Lung Adenocarcinoma Based on PET/CT Metabolic Indexes and Clinicopathological Variables
Authors: Yang Yanlong , Shi Shuchen , Huang Qianzhun , Zhong Wenzhao , Lin Juntao , Huang Weichao , Li Zizhe , Lan Bin
Published: December 2020

PurposeThe purpose of this study was to create a mathematical model based on the metabolic parameters of PET/CT with clinicopathological characteristics to predict the EGFR mutation status of patients with lung adenocarcinoma.MethodsThis study retrospectively enrolled patients with lung adenocarcinoma who underwent surgical treatment at two centres in China between January 2012 and December 2015. PET/CT metabolic parameters and Classical EGFR mutation status detection by molecular pathology were performed before and after surgery, and we analysed the associations of EGFR mutation status with patient sex, age, smoking history, maximum primary lesion diameter, carcinoembryonic antigen (CEA), neuron-specific enolase (NSE), cytokeratin 19 fragment (CYFRA21-1), TNM stage and histopathological subtype of lung adenocarcinoma.ResultsA total of 310 patients were included, comprising 161 with EGFR mutations (51.9%) and 149 with wild-type EGFR (48.1%). EGFR mutations were more common in females, non-smokers, and those with stage IV disease, a low SUVmax, and ≤35 mm nodules, whereas wild-type EGFR was more common in males, smokers, and those with a solid growth pattern. Multivariate analysis suggested that liver SUVratio, smoking history, tumour size, TNM stage, and solid growth pattern can predict EGFR mutation status, and these factors were used to construct a mathematical model.Conclusion﻿The prediction model constructed in this study based on clinicopathological characteristics and PET/CT parameters might offer a basis by which to predict Classical EGFR status and provide a certain reference value for guiding the use of EGFR-tyrosine kinase inhibitor (EGFR-TKI) treatment in patients with lung adenocarcinoma.
Expression Profiles of VEGF-A, CD31 and GRP78 in Non-Small Cell Lung Cancer.
Authors: Alkeilani Maha , Alqudah Mohammad A. , Almomani Basima A. , Alrjoub Moath M. , Alzoubi Hiba W. , Shhabat Batool A.
Published: December 2020

BackgroundAngiogenesis is mandatory for tumor growth and progression. The modest response to the anti-angiogenic therapies in non-small cell lung cancer reflects the presence of confounding molecular factors. The aims of this study were to investigate the expression levels of VEGF-A, CD31 and GRP78 and test for significant correlations between them.MethodsParaffin-embedded NSCLC tissue samples (71 adenocarcinoma and 23 squamous cell carcinoma) were retrospectively collected from 94 patients who underwent surgical resection between 2008 and 2015; and did not receive chemotherapy or radiotherapy prior to surgery. The expressions of VEGF-A, CD31 and GRP78 were determined by immunohistochemistry. ResultsHigh expression levels of VEGF-A, CD31 and GRP78 were observed in 15, 36 and 74 cases, respectively. Adenocarcinomas expressed higher levels of the aforementioned proteins as compared with squamous cell carcinomas (p-value < 0.05). Moreover, a statistically significant association was found between VEGF-A and CD31 expression levels (p-value = 0.006).ConclusionsOur study was the first to investigate the associations between GRP78 and the angiogenesis markers CD31 and VEGF-A in NSCLC patients. High GRP78 expression was revealed in the majority of the investigated samples. Nevertheless, no relationship was found between GRP78 and VEGF-A or CD31 which could be attributed to small sample size. On the other hand, the positive association between VEGF-A and CD31 expression levels suggests that VEGF-A may cooperate with CD31 to promote angiogenesis in NSCLC.
Rho-associated Protein Kinase 2 Confers Epileptogenesis through the Activation of Astroglial Stat3 Pathway
Authors: Song Li-jia , Zhang Hua , Jin Jun-gong , Wang Chao , Qu Xiao-Peng , Jiang Xue , Gao Li , Li Gang , Wang Da-li , Shen Liang-liang , liu bei
Published: December 2020

Patients with temporal lobe epilepsy (TLE) are prone to tolerance to antiepileptic drugs. Based on the perspective of molecular targets for drug resistance, it is necessary to explore effective drug resistant genes and signaling pathways for the treatment of TLE. We performed gene expression profiles in hippocampus of patients with drug-resistant TLE and identified ROCK2 as one of the 20 most significantly increased genes in hippocampus. In vitro and in vivo experiments were performed to identify the potential role of ROCK2 in epileptogenesis. In addition, the activity of Stat3 pathway was tested in hippocampal tissues and primary cultured astrocytes. The expression levels of ROCK2 in the hippocampus of TLE patients were significantly increased compared with the control group, which was due to the hypomethylation of ROCK2 promoter. Fasudil, a specific Rho-kinase inhibitor, alleviated epileptic seizures in the pilocarpine rat model of TLE. Furthermore, ROCK2 activated the Stat3 pathway in pilocarpine-treated epilepsy rats, and the spearman correlation method confirmed that ROCK2 is associated with Stat3 activation in TLE patients. In addition, ROCK2 was predominantly expressed in astrocytes during epileptogenesis, and induced epileptogenesis by activating astrocyte cell cycle progression via Stat3 pathway. The overexpressed ROCK2 plays an important role in the pathogenesis of drug-resistant epilepsy. ROCK2 accelerates astrocytes cell cycle progression via the activation of Stat3 pathway likely provides the key to explaining the process of epileptogenesis.
Numerical simulation and experimental verification of laser multi-section welding
Authors: Liu Jia , Jiang Tao , Shi Yan , Zhu Hongyin , Dai Yuchi
Published: December 2020

Aiming at the problems of large welding deformation and spatter in resistance spot welding of traditional lube oil cooler plate, a new welding method: laser multi-section welding is proposed. The major processes here involved were a finite element model of pulsed laser lap welding established using SYSWELD simulation software, and the laser welding process of different welding methods. Study the influence of different welding methods on welding quality, Optimize the parameters of average power and duty cycle according to the comparative analysis of experimental results and numerical simulation Experimental results indicate: When the new 6-sections welding method is adopted, the resulting welded joint has the most uniform heat input, the largest welding fusion area, the tensile properties of the welded joints were significantly improved, however, there are still pores. By changing the duty cycle, air holes can be effectively eliminated to further improve the quality of the joint.
Association of Vitamin D Supplementation in Cardiorespiratory Fitness and Muscle Strength in Adult Twins: A Randomized Controlled Trial
Authors: Pires Jeane , Borges Michelle Vasconcelos de Oliveira , Soares Aline Alves , Sousa Elys Costa de , Costa José Ronaldo Ribeiro da , Silva Weberthon Alessanderson Costa , Sousa Magnus Vinícius Bezerra de , Dantas Paulo Moreira Silva , Silbiger Vivian Nogueira , Luchessi André Ducati
Published: December 2020

Background: Although vitamin D is related to cardiorespiratory fitness and muscle strength, there is no evidence in the literature about the genetic influence of the response to the increase in body vitamin D. Therefore, we evaluate the effect of longitudinal supplementation of vitamin D on parameters of physical fitness in monozygotic twins.Methods: In total, 74 participants were included, with a mean age of 25 years, divided into two groups, one group received supplementation with cholecalciferol for 60 days and the other group did not. Cardiorespiratory fitness and muscle strength were measured before and after supplementation, through maximal treadmill tests and dynamometry, respectively. Wilcoxon tests were used to compare intra-group results and the Mann-Whitney test to examine intergroup differences.Results: There was an increase in the serum concentration of vitamin D in participants who ingested the supplementation. Cardiorespiratory fitness improved after supplementation through increases in the values of maximum oxygen consumption of 28% (P <0.001). Muscle strength in right hand grip significantly increased in participants who received the supplement to 33.0 (P = 0.007).Conclusion: 60 days of cholecalciferol supplementation improved cardiorespiratory fitness and upper limb muscle strength.Trial registration: RBR-3qy2f2. Registered 28 March 2016, http://www.ensaiosclinicos.gov.br/rg/RBR-3qy2f2/2
Feasibility of Using Common Data Model for Orthopedic Research: Analysis of Risk Factors for Periprosthetic Joint Infection after Total Joint Arthroplasty
Authors: Chae Young Ju , Shin Jin Ho , Jung Sung Jae , Gong Hyun Sik
Published: December 2020

Background: Common data model (CDM) is a standardized data structure defined to efficiently use different sources in hospitals. A study using the CDM is scarce for orthopedic outcome researches due to the complexity of variables. We aimed to test the feasibility of applying CDM in the orthopedic field and analyzed risk factors for periprosthetic joint infection (PJI) after total joint arthroplasty (TJA) using CDM.Methods: We undertook a retrospective cohort study of all primary and revision hip and knee TJAs at our institution from January 2003 to October 2017. We identified potential risk factors for PJI after TJAs in the literatures, which included preoperative demographic/social factors, previous medical history, intraoperative factors, laboratory results and others. The data sourced from EMR was extracted, transformed, and loaded into CDM.Results: Variables such as demographic/social factors, medical history and laboratory results could be converted into CDM, but the other known risk factors could not. In total, 12,320 primary hip and knee TJAs and 120 revision arthroplasties were identified. Among them, 34 revisions were done because of PJI. Risk factors of PJI were hypertension and urinary tract infection after total hip arthroplasty, and age (70-79 years), male sex, anemia, steroid use, and urinary tract infection after total knee arthroplasty. Conclusions: This study demonstrates that orthopedic outcome researches using CDM is feasible although data converting to CDM was possible for limited factors. Further data transforming technologies need to be developed to analyze more factors relevant to orthopedic area, such as intraoperative factors and imaging findings.
Resilience and Health-Related Quality of Life in Patients with Pulmonary Diseases Receiving Ambulatory Oxygen Therapy
Authors: Isokääntä Siiri , Honkalampi Kirsi , Kokki Hannu , Sintonen Harri , Kokki Merja
Published: December 2020

PURPOSE: Pulmonary diseases affect health-related quality of life (HRQoL), but there are few data on patients’ adaptation to a serious illness. This study assessed resilience and its associations with HRQoL, life satisfaction, anxiety and depression in patients with pulmonary diseases receiving ambulatory oxygen therapy.METHODS: In this prospective cohort study, we enrolled 43 patients with pulmonary diseases receiving ambulatory oxygen therapy. The patients completed the following questionnaires at baseline and after one and three months; the Resilience Scale-25, the Life Satisfaction Scale-4, the 15D instrument of HRQoL, the Hospital Anxiety and Depression Scale (HADS) and the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST 2.0). To compare HRQoL, we recruited age- and gender-matched controls from the general population (n=3574). The primary outcome was the proportion of patients with low resilience.RESULTS: Almost half (41-49%) of the patients had low resilience, which was correlated with low HRQoL, low levels of life satisfaction and higher levels of anxiety and depression. Patients had very low HRQoL compared to controls (p<0.001). Dissatisfaction with life increased during the follow-up (p=0.004), but only a few patients had anxiety. Patient satisfaction with assistive technology was high; the mean QUEST 2.0 score (scale 1-5) was 4.00 at baseline, 3.92 at one month and 3.83 at three months (p=0.797).CONCLUSIONS: Resilience was low in half of the patients and was inversely correlated with HRQoL and life satisfaction and positively correlated with anxiety and depression.TRIAL REGISTRATION: ClinicalTrials.gov Protocol Record 507A023. Registered 17 September 2020 - Retrospectively registered, https://clinicaltrials.gov/ct2/results?cond=&term=NCT04554225&cntry=&state=&city=&dist=
Near-Infrared Intraoperative Imaging of Pelvic Autonomic Nerves:Clinical Trial
Authors: Jin Hao , Lu Ligong , Cui Min
Published: December 2020

Background: The pelvic autonomic nerves control and regulate anorectal and urogenital function. The dysfunction of pelvic autonomic nerves lead to disorders of anorectum, bladder and male sex organs. Thus the intraoperative identification of pelvic autonomic nerves could be crucial in complications prevention and diseases treatment. Our clinical trial aims at estimating the effectiveness and validity of intraoperative indocyanine green fluorescence imaging in pelvic autonomic nerves identification.Methods: Intraoperative fluorescence imaging using indocyanine green was performed in 10 patients and the feasibility was determined. From February 2019 to June 2019, the 10 patients undergoing laparoscopic colorectectomy was administrated 4.5 mg/Kg indocyanine green 24 hours before surgery. The near-infrared fluorescence imaging was conducted during surgery. A novel white light and near-infrared dual-channel laparoscopic equipment was applied. For each patient, signal background ratio values for pelvic autonomic nerves were recorded and analyzed.Results: We confirmed the best dose and timing of indocyanine green administration was 4.5 mg/Kg and 24 hours before surgery. Using the dual laparoscopic equipment, we could observe the splanchnic plexus, inferior mesenteric artery plexus, and sacral plexus successfully with a high signal background ratio value of 3.18 (standard deviation: 0.48). Conclusion: Pelvic autonomic nerves could be observed using indocyanine green fluorescence imaging during surgery. The novel method may replace the current visual identification method and become the standard clinical practice.
Impact of Exogenous Applications of Salicylic Acid on the Tolerance to Drought Stress in Pepper (Capsicum Annuum L.) Plants
Authors: khazaei zahra , Estaji Asghar
Published: December 2020

Background: Drought is also one of the most widespread abiotic stresses that adversely effects the growth and development of plants. To investigate the effect of salicylic acid and drought stress on several physiological and chemical reactions in sweet pepper plants, the experiment was achieved as a factorial based on a completely randomized design in greenhouse. Drought stress levels were non-stress conditions (irrigation with field capacity), moderate stress (30% field capacity irrigation) and intense water stress (60% field capacity irrigation) and three concentrations of salicylic acid included 0 (as control), 0.5 and 1 mM were sprayed on the plant in three to four leaf stages. Results: The results showed that drought decreased fresh and dry weight of shoots and roots, leaf relative water content (RWC), fruit diameter and length, the index including chlorophyll and leaf area and increased electrical conductivity (EC), antioxidant activity, total phenolic content, ascorbate, polyphenol oxidase (PPO) and ascorbate peroxidase (APX) activity. After application of foliar salicylic acid, all of the above parameters, except the electrical conductivity content, increased. Conclusions: From the results of this experiment it is concluded that salicylic acid provides a better tolerance for drought stress in pepper plant through its influence on vegetative, biochemical and physiological characteristics.
Hyperactive cytokine T-cell response is associated with immunosenescence in severe acute COVID-19 infection 
Authors: Arcanjo Angélica , Logullo Jorgete , Leite Paulo Emílio Corrêa , Menezes Camilla Cristie Barreto , Freire-de-Lima Celio Geraldo , Granjeiro José Mauro , Barroso Shana Priscila Coutinho , Conceição-Silva Fátima , Savino Wilson , Morrot Alexandre
Published: December 2020

COVID-19 is a disease caused by the novel SARS-CoV-2 coronavirus, originally classified as a severe acute respiratory syndrome coronavirus (SARS-CoV). The most severe cases of COVID-19 can progress to severe pneumonia with respiratory failure, septicemia, multiple organ failure and death. The severity of the disease is aggravated by the deregulation of the immune system causing an excessive initial inflammation including the cytokine storm, compring interleukins characteristic of the T-dependent adaptive response. In the present study we show that severe patients have high levels of T helper type-1 and type-2 cytokines, as well as VGEF. Furthermore, our show abnormal cytokine levels upon T-cell mitogen stimulation, in a non-polarized response profile. This response is not specific, given that the stimulus with the heterologous tuberculin antigen was able to induce high levels of cytokines compared to healthy controls, including the vascular endothelial growth factor VEGF, which promotes neoangiogenesis in physiological and pathophysiological conditions, caused by tissue hypoxia, and involved in a clonal exhaustion program in T cells. This can be decisive given our findings demonstrating for the first time a significantly increased frequency of late-differentiated CD8+ T cells characterized by critically shortened telomeres with particular phenotype (CD57+CD28-) in severe acute COVID-19 infection. These findings reveal that severe COVID-19 is associated with senescence of T cells, especially within the CD8+ T cell compartment and points to possible mechanisms of loss of clonal repertoire and susceptibility to recurrences of COVID-19 symptoms, due to viral relapse and reinfection events.
Beauveria bassiana ERL836 and JEF-007 with similar virulence show different gene expression when interacting with cuticles of western flower thrips, Frankniella occidentalis
Authors: Kim Sihyeon , Kim Jong Cheol , Lee Se Jin , Lee Mi rong , Park So Eun , Li Dongwei , Baek Sehyeon , Shin Tae Young , Kim Jae Su
Published: December 2020

Background: Insect-killing fungal species, Beauveria bassiana, is as an environment-friendly pest management tool, and many isolates are on the track of industrialization. However, some of B. bassiana isolates show similar morphology and virulence against insect pests, and so it is hard to differentiate them. Herein we used two patented isolates, ERL836 and JEF-007, and investigated their virulence against western flower thrips, Frankliniella occidentalis, and further analyzed genome structures and transcriptional responses when interacting with cuticles of thrips to see possible differences on the initial step of fungal infection.Results: The two isolates showed no significant differences in fungal growth, conidial production, and virulence against thrips, and they were structurally similar in genome. But, in transcription level, ERL836 appeared to infect thrips easily, while JEF-007 appeared to have more difficulty. In the GO analysis of ERL836 DEGs (differentially expressed genes), the number of up-regulated genes was much larger than that of down-regulated genes, when compared to JEF-007 DEGs (more genes down-regulated). Interestingly, in the enrichment analysis using shared DEGs between two infecting isolates, plasma membrane-mediated transporter activity and fatty acid degradation pathway including cytochrome P450 were more active in infecting ERL836.Conclusion: The two B. bassiana isolates had similar morphology and virulence as well as genome structure, but in transcription level they differently interacted with the cuticle of western flower thrips. This comparative approach using shared DEG analysis could be easily applied to characterize the difference of the two B. bassiana isolates, JEF-007 and ERL836.
Age and pain score before gastrointestinal endoscopies in children are predictors for post procedure pain.
Authors: Galai Tut , Yerushalmy-Feler Anat , Heller Nathan P. , Ben-Tov Amir , Weintraub Yael , Amir Achiya , Moran-Lev Hadar , Zac Lilach , Cohen Shlomi
Published: December 2020

Background: Gastrointestinal endoscopy may be associated with pain and anxiety. Predictors for high pain scores after endoscopies in children are not known. The aim of our study was to identify risk factors for prolonged recovery and higher pain scores after gastrointestinal endoscopy in children. Methods: All the children that were electively admitted for gastrointestinal endoscopies were included. We retrospectively collected demographic, clinical and endoscopic data as well as information on the recovery process. A numerical rating scale and the Faces, Legs, Activity, Cry, and Consolability Scale were used for pain scoring. Results: During the study period (01/2016-10/2016), 284 children (median age 10.7 years, interquartile range 6.7-14.8) were recruited. In a univariate analysis, older age, higher pre-procedure pain scores, longer procedure durations, higher number of biopsies and longer recovery duration were associated with higher post-procedure pain scores. In a multivariate analysis higher pain scores before the procedure (OR 12.42, 95% CI 3.67-42, P < 0.001) and older age (OR 1.016, 95% CI 1.007-1.025, P < 0.001) were associated with higher pain scores after the procedure. Children with a higher pain score before the procedure also had a longer recovery period (OR 5.28, 95% CI (1.93‐14.49), P = 0.001).Conclusion: Older age and higher pain score before the procedure were identified as predictors for higher pain score after pediatric gastrointestinal endoscopies. Children with these risk factors should be identified before the procedure in order to personalize their post-procedure management.
Classification and morphology of middle mesial canals of mandibular first molars in a Southern Chinese subpopulation: a cone-beam computed tomographic study
Authors: Yang Yeqing , Wu Buling , Zeng Junkai , Chen Ming
Published: December 2020

Background: Cone-beam computed tomography (CBCT) was employed to study the morphology and curvature of middle mesial canals (MMCs) of mandibular first molars (MFMs).Methods: CBCT scanning was performed on MFMs of 1100 patients. Patients' images that met the inclusion criteria were divided into group A (<40 years old) and group B (≥40 years old) for further study. The images were used to study the incidence of MMCs at different ages, measure the curvature of MMCs in the mesiodistal and buccolingual directions using the Schneider method, and observe the anatomical morphology of the mesial root canal system. All statistical analyses were performed by using SPSS 21.0 software. Quantitative data were presented as mean ± standard deviation. Student’s t-test was used to calculate the statistical significance. P<0.05 was considered statistically significant.Results: In 875 patients, 1750 MFM images met the inclusion criteria. Among these cases, 158 MFMs contained an MMC, yielding an incidence rate of 9.03%. The incidence rate of MMCs was 11.22% in group A and 6.61% in group B, and this difference was statistically significant (P<0.05). The curvature in the mesiodistal direction was 29.39±8.53º in group A and 26.06±8.50º in group B, and this difference was also significant (P<0.05). The curved regions in groups A and B were often located in the middle 1/3 of canal. No significant difference in the distance between MMC orifices and mesiobuccal canal orifices or mesiolingual canal orifices was noted (P>0.05). The most common mesial root canal morphological type was type II (3-2) (53.80%). Conclusion: The incidence of MMCs in MFMs declined as age increased. The canal systems of MMCs were varied and complex, mainly exhibiting an obvious mesiodistal curve. CBCT is an outstanding method to help guide root canal therapy.
Escherichia coli Nissle 1917 secreting functional interleukin 2 targets tumours and enhances the immune response to suppress tumours
Authors: Lu Binghua , Yang Huijun , Liu Fei , Sun Yunjun , He Haocheng , Ding Xuezhi , Hu Shengbiao , xia liqiu
Published: December 2020

Escherichia coli Nissle 1917 (EcN) is non-pathogenic probiotic bacteria. Previous studies have indicated that EcN can accumulate and proliferate selectively in solid tumours in BALB/c mouse models. In this study, EcN was engineered to express human interleukin 2 (hIL-2), which is known to enhance immune responses to tumours by activating a variety of immune cells. IL-2 expressed by EcN was proven to activate PBMCs in vitro. Compared to control EcN, intraperitoneally injected EcN expressing hIL-2 (EcN(hIL-2)) was selectively distributed in the tumour microenvironment and inhibited the growth of CT26 tumours in a tumour-bearing mouse model. Antitumour activity was achieved without toxicity to key normal organs and tissues, such as liver, spleen and kidneys. The antitumour mechanism was associated with the infiltration of inflammatory cells, such as T cells, neutrophils and macrophages. These findings provide evidence that the combination of tumour-targeting EcN bacteria and delivery of the immunostimulatory factor IL-2 can be exploited as a promising tumour immunotherapy.
Responsiveness of human bronchial fibroblasts and epithelial cells from asthmatic and non-asthmatic donors to the transforming growth factor-β1 in epithelial-mesenchymal trophic unit model
Authors: Paw Milena , Wnuk Dawid , Jakieła Bogdan , Bochenek Grażyna , Sładek Krzysztof , Madeja Zbigniew , Michalik Marta
Published: December 2020

Background: The asthma-related airway wall remodeling is associated i.a. with a damage of bronchial epithelium and subepithelial fibrosis. Functional interactions between human bronchial epithelial cells and human bronchial fibroblasts are known as the epithelial-mesenchymal trophic unit (EMTU) and are necessary for a proper functioning of lung tissue. However, a high concentration of the transforming growth factor-β1 (TGF-β1) in the asthmatic bronchi drives the structural disintegrity of epithelium with the epithelial-to-mesenchymal transition (EMT) of the bronchial epithelial cells, and of subepithelial fibrosis with the fibroblast-to-myofibroblast transition (FMT) of the bronchial fibroblasts. Since previous reports indicate different intrinsic properties of the human bronchial epithelial cells and human bronchial fibroblasts which affect their EMT/FMT potential beetween cells derived from asthmatic and non-asthmatic patients, cultured separatelly in vitro, we were interested to see whether corresponding effects could be obtained in a co-culture of the bronchial epithelial cells and bronchial fibroblasts. In this study, we investigate the effects of the TGF-β1 on the EMT markers of the bronchial epithelial cells cultured in the air-liquid-interface and effectiveness of FMT in the bronchial fibroblast populations in the EMTU models. Results: Our results show that the asthmatic co-cultures are more sensitive to the TGF-β1 than the non-asthmatic ones, which is associated with a higher potential of the asthmatic bronchial cells for a profibrotic response, analogously to be observed in “2D” cultures. They also indicate a noticeable impact of human bronchial epithelial cells on the TGF-β1-induced FMT, stronger in the asthmatic bronchial fibroblast populations in comparison to the non-asthmatic ones. Moreover, our results show the protective effects of fibroblasts on the structure of the TGF-β1–exposed mucociliary differentiated bronchial epithelial cells and their EMT potential.Conclusions: Our data are the first to demonstrate a protective effect of the human bronchial fibroblasts on the properties of the human bronchial epithelial cells, which suggests that intrinsic properties of not only epithelium but also subepithelial fibroblasts affect a proper condition and function of the EMTU in both normal and asthmatic individuals.
Surgical excision of complex lipoma from the foot: a case report 
Authors: Uddin Akram , Flanagan George , Reilly Ian
Published: December 2020

Background: Soft tissue malignant tumours of the foot and ankle are rare. Diagnostic imaging and interventional biopsy are vital to establish the nature and grading of a suspicious tumour prior to surgical intervention. The purpose of the study is to provide an account on how a symptomatic mass to the plantar aspect of the foot warranted a referral to a sarcoma centre, highlighting the importance of having urgent access to diagnostic imaging and a pathway to refer suspected cases to specialist centres.Method: A single patient with a symptomatic soft tissue tumour of the plantar foot was referred from our service to the regional sarcoma centre. It was considered to be benign and therefore open surgical resection was performed under local anaesthesia by our team, and the lesion sent for histopathological examination.Results: Histopathological analysis identified the excised mass as a lipoma to show no atypia or necrosis and mature adipose tissue with fibrous bands. At 2 years postoperatively there was no recurrence and the patient presented an asymptomatic foot. Favourable patient reported outcomes measures were observed.Conclusion: United Kingdom (UK) Guidelines suggest that all soft tissue masses of suspicious nature, greater than 50mm, deep seated irrespective of size, or fast growing should be referred to a sarcoma unit prior to surgical management. European guidance identifies a threshold of 15mm for a mass in the foot. Patients presenting with red flag symptoms irrespective of size of mass should be referred to a sarcoma centre. Advanced imaging and multidisciplinary input to enable appropriate surgical planning is recommended for these soft tissue tumours that present to the foot and ankle surgeon. Level of evidence: V case study.
REPRESENTATION OF ROMA IN LITHUANIAN ONLINE MEDIA: 15MIN.LT AND LRYTAS.LT CASE STUDIES
Authors: Sutkutė Rūta
Published: December 2020

This study focuses on how Roma communities are represented in the Lithuanian online media. The aim is to answer the question of how news about the Roma is embedded in the broader practices of neoliberalism and racist discourses. Representation of the Roma in the media is inseparable from constructivism, power and influence. Roma communities have little opportunity to make their voices heard in society, i.e., their voice is not heard or represented in the media. Political representation of the Roma is particularly important due to the weak opportunities to participate in the formulation and decision-making of certain political decisions, both in the national and international context. It is assumed, that the negative and even stereotypical portrayal of the Roma in the media encourages a negative public attitude towards this ethnic group and has an impact on the (in)successful integration of the Roma into society. The aim of the research is to find out how Roma are represented on the online news portals 15min.lt and Lrytas.lt and to reveal how stereotypes are formed in relation with this national minority. The following tasks are used to reveal the aim of the work: to present the history of the Roma and the problems of their identity, to analyze the concept of Romaphobia, to present the theory of social constructivism and the role of the media in shaping social reality; to perform a qualitative analysis of the content of the news portals 15min.lt and Lrytas.lt: comparing how Roma perceptions are formed on these news portals and how different groups of actors contribute to constructing and maintaining stereotypes in the media/society. The qualitative analysis of the content revealed that the information, provided in the media, aims to portray the Roma as a threat to public security and to the local population, who experience socio-economic exclusion, who have different values and are reluctant to integrate. However, Roma are not given the right to self-representation because the unilateral narrative of the event dominates and the audience for which the report is addressed is too homogeneous. Manifestations of Romaphobia are observed in the news portals' discourse. It can be assumed, that this creates a negative value orientation for readers, as Roma is perceived as an “undesirable” ethnic group in Lithuania. However, the Roma themselves do not have effective means to make heard their “voice” and participate in public life in order to challenge the dominant negative images