bluuebunny/crossref_metadata_2025 huggingface dataset:
Melatonin promotes adventitious root formation in apple by promoting the function of MdWOX11
Authors: Mao Jiangping , Niu Chundong , Li Ke , Chen Shiyue , Tahir Muhammad Mobeen , Han Mingyu , Zhang Dong
Published: September 2020

Background: Melatonin (MT) is important for plant growth and development; however, it is not known whether MT is involved in apple adventitious root (AR) development. In this study, we treated Malus prunifolia (MP) at four different stages of AR development, and analysed the level of the endogenous hormones MT, auxin (IAA), zeatin-riboside (ZR), gibberellins (GA1+3) and abscisic acid (ABA) in all four treatment groups and in the untreated control group. The expression of genes related to MT, IAA biosynthesis, transport and signal transduction, the cell cycle, and root development was quantified by RT-qPCR, and the function of MdWOX11 was analysed in transgenic apple plants.Results: The promotion of AR development by MT was dependent on the stage of AR induction between 0–2 d in apple rootstocks. MT-treatment increased the level of IAA and crosstalk existed between MT and IAA during AR formation. The expression of MdWOX11 was induced by MT treatment and positively regulated AR formation in apple. Furthermore, transgenic lines that overexpressed MdWOX11 lines produced more ARs than ‘GL3’. Phenotypic analysis indicated that MdWOX11 overexpression lines were more sensitive to exogenous MT treatment than ‘GL3’, suggesting that MdWOX11 regulates AR formation in response to MT in apple rootstock.Conclusions: MT promotes AR formation mainly during the AR induction stage by inducing IAA levels and upregulating MdWOX11.
Carbon tetrachloride (CCl4) accelerated development of non-alcoholic fatty liver disease (NAFLD)/steatohepatitis (NASH) in MS-NASH mice fed western diet supplemented with fructose (WDF)
Authors: Zhang Guodong , Wang Xiaoli , Chung Tzu-Yang , Ye Weiwei , Hodge Lauren , Zhang Likun , Chng Keefe , Xiao Yong-Fu , Wang Yixin
Published: September 2020

Background: Multiple murine models of nonalcoholic fatty liver disease/steatohepatitis (NAFLD/NASH) have been established by using obesogenic diets and/or chemical induction. MS-NASH mouse (formally FATZO) is a spontaneously developed dysmetabolic strain that can progress from hepatosteatosis to moderate fibrosis when fed a western diet supplemented with 5% fructose (WDF). This study aimed to use carbon tetrachloride (CCl4) to accelerate and aggravate progression of NAFLD/NASH in MS-NASH mouse. Methods: Male MS-NASH mice at 8 weeks of age were fed WDF for the entire study. Starting at 16 weeks of age, CCl4 was intraperitoneally administered twice weekly at a dose of 0.2 mL/kg for 3 weeks or 0.08 mL/kg for 8 weeks. Obeticholic acid (OCA, 30 mg/kg, QD) was administered in both MS-NASH and C57Bl/6 mice fed WDF and treated with CCl4 (0.08 mL/kg).Results: WDF enhanced obesity and hepatosteatosis, as well as induced moderate fibrosis in MS-NASH mice similar to previous reports. Administration of CCl4 accelerated liver fibrosis with increased bridging and liver hydroxyproline contents, but had no significant impact on liver steatosis and lipid contents. High dose CCl4 caused high mortality and dramatic elevation of ALT and ASL, while low dose CCl4 resulted in a moderate elevation of ALT and AST with low mortality. Compared to C57BI/6 mice with WDF and CCl4 (0.08 mL/kg), MS-NASH mice had more prominent hepatosteatosis and fibrosis. OCA treatment significantly lowered liver triglycerides, steatosis and fibrosis in both MS-NASH and C57Bl/6 mice fed WDF with CCl4 treatment. Conclusions: CCl4 reduced induction time and exacerbated liver fibrosis in MS-NASH mice on WDF, proving a superior NASH model with more prominent liver pathology, which has been used favorably in pharmaceutical industry for testing novel NASH therapeutics.
A pilot study of thiamine and folic acid in hemodialysis patients with cognitive impairment
Authors: Lu Renhua , Fang Yan , Zhou Yijun , Che Miaolin , Shen Jianxiao , Liu Qian , Zhang Haifen , Pan Shuting , Lin Yan , Wang Qin , Mou Shan , Ni Zhaohui , Gu Leyi
Published: September 2020

Background: This study aimed to explore the effectiveness of thiamine and folic acid supplementation on the improvement of the cognitive function in patients with maintenance hemodialysis. Methods: In the present study, we randomly assigned patients undergoing hemodialysis who had the Montreal Cognitive Assessment (MoCA) score lower than 26 to treatment group (n=25, thiamine 90mg/day combined with folic acid 30mg/day) or control group (n=25, nonintervention). All subjects were followed up for 96 weeks. The primary outcome was the improvement of the MoCA score. The secondary outcomes included homocysteine level, survival and safety. Results: Patients in treatment group had an increase of the MoCA score from 21.95±3.81 at baseline to 25.68±1.96 at week 96 (P<0.001, primary outcome), as compared with the MoCA score from 20.69±3.40 to 19.62±3.58 in control group. Thiamine combined with folic acid treatment also resulted in lower level of serum homocysteine in treatment group compare with control group at week 96 (P<0.05, secondary outcome). 3 patients and 9 patients died during follow-up period in treatment and control group respectively (P=0.048). The proportion of adverse events in treatment group was significantly lower than that in control group. Conclusion: Hemodialysis patients with cognitive impairment treated with thiamine and folic acid had a significant improvement in MoCA score. Trial registration: Clinical trial registration number: ChiCTR-IPR-17012210.
Establishment and characterization of a new gastric cancer cell line, XGC-1
Authors: Peng Jigui , Xu Hao , Cai Jianchun
Published: September 2020

BackgroundTo establish a primary human gastric cancer cell line.MethodsFresh gastric cancer tissue samples were separated into a cell suspension, and DMEM/F12 medium containing 10% foetal bovine serum was used for primary culture and subculture. The morphology of the cells was observed under a light microscope, and the cell growth curve was plotted. A soft agar colony formation assay was used to detect the colony formation ability of the cell line. Immunohistochemical methods were used to detect cytokeratin, vimentin and Ki-67, the chromosome G banding method was used to analyse the karyotype of the cells, and the tumourigenic ability of the cells was detected by subcutaneous inoculation of BALB/C nude mice.ResultsWe established a gastric cancer cell line from a 68-year-old male patient. This gastric cancer cell line was named XGC-1 and had a doubling time of approximately 48 h. The cell line displayed strong colony formation ability and tumourigenicity in BALB/C nude mice and had complicated chromosomal abnormalities. When nutrients were insufficient, the cells shed and floated in the medium, but adherent growth was observed in nutrient-rich conditions.ConclusionsThe XGC-1 cell line will be useful for future studies of gastric cancer development, progression, metastasis and therapy.
Clinical Characteristics and Predictors of Mortality in Young Adults with Severe COVID-19
Authors: Lu Yanjiao , Huang Zhenli , Wang Meijia , Tang Kun , Wang Shanshan , Gao Pengfei , Xie Jungang , Wang Tao , Zhao Jinping
Published: September 2020

Background and objective: Little is yet known whether pathogenesis of COVID-19 is different between young and elder patients. Our study aimed to investigate the clinical characteristics and provide predictors of mortality for young adults with severe COVID-19.Methods: A total of 77 young adults with confirmed severe COVID-19 were recruited retrospectively at Tongji Hospital. Clinical characteristics, laboratory findings, treatment and outcomes were obtained from electronic medical records. The prognostic effects of variables were analyzed using logistic regression model.Results: In this retrospective cohort, non-survivors showed higher incidence of dyspnea and co-existing laboratory abnormalities, compared with young survivals in severe COVID-19. Multivariate logistic regression analysis showed that lymphopenia, elevated level of d-dimer, hypersensitive cardiac troponin I (hs-CTnI) and high sensitivity C-reactive protein (hs-CRP) were independent predictors of mortality in young adults with severe COVID-19. Further analysis showed that severely young adults with two or more factors abnormalities above would be more prone to death. The similar predictive effect of above four factors had been observed in all-age patients with severe COVID-19.Conclusion: Lymphopenia, elevated level of d-dimer, hs-CTnI and hs-CRP predicted clinical outcomes of young adults with severe COVID-19.
Hair cortisol-a method to detect chronic cortisol levels in patients with Prader-Willi syndrome
Authors: Shukur Hasanain Hamid , de Rijke Yolanda B , Rossum Elisabeth FC van , Hussain-Alkhateeb Laith , Höybye Charlotte
Published: September 2020

Background: Prader-Willi syndrome (PWS) is a multisymptomatic, rare, genetic, neurodevelopmental disorder in adults mainly characterized by hyperphagia, cognitive dysfunction, behavioral problems and risk of morbid obesity. Although endocrine insufficiencies are common, hypocortisolism is rare and knowledge on long-term cortisol concentrations is lacking. The aim of this study was to evaluate long-term cortisol levels in PWS by measurements of hair cortisol.Methods: Twenty-nine adults with PWS, 15 men and 14 women, median age 29 years, median BMI 27 kg/m2, were included. Scalp hair samples were analyzed for cortisol content using liquid-chromatography tandem-mass spectrometry. In addition, a questionnaire on auxology, medication and stress were included. For comparison, 105 age- and sex-matched participants from the population-based Lifelines Cohort study were included as controls. The mean hair cortisol between the groups were compared and associations between BMI and stress were assessed by a generalized linear regression model.Results: In the PWS group large variations in hair cortisol was seen. Mean hair cortisol was 12.8±25.4 pg/mg compared to 3.8±7.3 pg/mg in controls (p=0.001). The linear regression model similarly showed higher cortisol levels in patients with PWS, which remained consistent after adjusting for BMI and stress (p=0.023). Furthermore, hair cortisol increased with BMI (p=0.012) and reported stress (p=0.014).Conclusion: Long-term cortisol concentrations were higher in patients with PWS compared to controls and increased with BMI and stress, suggesting an adequate cortisol response to chronic stress. Hair cortisol demonstrate promising applications in the context of PWS treatment and disease management.
Interprofessional medication assessment among home care patients: Any impact on functioning? Results from a randomised controlled trial
Authors: Auvinen Kati Johanna , Voutilainen Ari , Jyrkkä Johanna , Lönnroos Eija , Mäntyselkä Pekka
Published: September 2020

BackgroundMultimorbidity and polypharmacy are related to the use of potentially inappropriate medicines and negative clinical outcomes including drug-related adverse events and functional declines. Home care clients are a vulnerable patient group often exposed to these risks. The aim of this study was to examine whether an interprofessional medication assessment can influence the functioning of home care patients.MethodsThe FIMA study was a randomised controlled intervention study comparing a general practitioner-led interprofessional medication assessment conducted at the baseline of the study with usual care with a six-month follow-up. We used linear mixed models (LMM) with a random subject effect to detect differences between the usual care and intervention groups in the following outcome measures; Katz index of Activities of Daily Living (ADL), Lawton and Brody scale of Instrumental Activities of Daily Living, Timed up and go-test (TUG), Mini-Mental State Examination, Geriatric Depression Scale and the 3-level version of EQ-5D.ResultsHome care patients (n= 512) had major disease burdens and functional limitations. Regarding TUG times, the LMM detected a one second improvement in the FIMA group and 2.4 seconds worsening in the usual care group. However, the result was not statistically significant. The ADL revealed an interaction across time, treatment and gender (p=0.026). The ADL score decreased in both groups; the decline being the steepest among women in the intervention group.ConclusionsIn general, medication assessments may have limited impact on functioning of older people. Nonetheless, the FIMA intervention may prevent worsening of mobility among older home care patients.Trial registrationThe Interprofessional Medication Assessment for Older Patients, Clinical Trials.gov. NCT02398812. First registration, 26 March 2015. Retrospectively registered. https://www.clinicaltrials.gov/ct2/how/NCT02398812 .
Topical administration of tacrolimus and corticosteroids with concentration gradients is effective in preventing immune rejection in high-risk keratoplasty: a 5-year follow-up study
Authors: Qi Xiaolin , Wang Lichao , Zhang Xiaoyu , Liu Min , Gao Hua
Published: September 2020

BACKGROUND: To evaluate the efficacy of the topical administration of immunosuppressants and corticosteroids with concentration gradients in the management of patients with high-risk keratoplasty.METHODS: One hundred and six patients treated with topical immunosuppressants (50 eyes in the FK506 group and 56 eyes in the CsA group) and corticosteroid eye drops with concentration gradients were enrolled in the study. The rates of rejection episodes, irreversible rejection, graft survival, and related influential factors were evaluated.RESULTS: The mean follow-up period was 48.1±7.9 months (range, 36-60 months). The rates of rejection episodes (P=0.043) and irreversible rejection (P=0.062) were 14.0% and 6.00% in the FK506 group and 37.5% and 7.1% in the CsA group, respectively.Kaplan-Meier survival analysis demonstrated a significantly higher graft survival rate in the FK506 group (81.6%±5.3%, 71.1%±6.3%) compared with that in the CsA group (71.1%±6.3%, 57.5%±7.5%) at 3 and 5 years after surgery (P=0.006). Multivariate logistic regression revealed that poor medication compliance with a preoperative risk score ≥ 3 (P=0.016) and endothelial immune rejection (P=0.033) were risk factors associated with graft survival.CONCLUSIONS: Topical administration of tacrolimus and corticosteroids with concentration gradients is effective in decreasing the incidence of immune rejection in high-risk keratoplasty. Careful instruction of patients on the reasonable use of topical tacrolimus is critical to avoid immune rejection induced by sudden discontinuation of medication.
Quick BSI Score to Identify Bloodstream Infection at the Emergency Department
Authors: Phungoen Pariwat , Lerdprawat Nunchalit , Sawanyawisuth Kittisak , Chotmongkol Verajit , Ienghong Kamonwon , Sumritrin Sumana , Apiratwarakul Korakot
Published: September 2020

Background

Bloodstream infection (BSI) is a common and urgent condition at the emergency department (ED). In order to diagnose BSI, the current guideline fails to mention the juncture at which blood cultures ought to be taken. The decision whether or not to obtain hemoculture is solely based upon clinical judgment and outcomes pertaining to inappropriately ordered blood culture. This study aimed to develop predictive bloodstream infection scoring at the ED employing only clinical factors presented on ED arrival.

Methods

This study was conducted retrospectively at the ED, Khon Kaen University Hospital, Thailand. Inclusion criteria encompassed adult patients suspected of infection defined by blood culture collection presented at the ED with intravenous antibiotics initiated during ED visits. Independent positive predictors for positive blood culture were used to create the Quick Bloodstream Infection score (qBSI score) through logistic regression analysis.

Results

A total of 169578 patients visited the ED during the study period. Of those, 12556 patients (7.40%) were suspected of infection. 8177 cases met the study criteria and were categorized according to positive blood culture results, i.e. bloodstream infection (741 patients; 9.06%). Probability of positive blood culture was calculated via aged over 55 years + moderate to severe CKD + solid organ tumor + (2 x liver disease) + (2 x history of fever with chills) + (2 x body temperature of over 38.3 o C). A score of 1 or over rendered 92.98% sensitivity and negative predictive value of 95.65%.

Conclusions

The qBSI score presented effective sensitivity and negative predictive value amid positive blood culture in patients at the ED suspected of infection. Resultant of employing this score may facilitate in the determining of those exhibiting the need for blood culture at the ED.
Association between sexual violence and unintended pregnancy among adolescent girls and young women in South Africa
Authors: Ajayi Anthony Idowu , Ezegbe Henrietta Chinelo
Published: September 2020

Background Unintended pregnancy has dire consequences on the health and socioeconomic wellbeing of adolescent girls and young women (AGYW) (aged 15-24 years). While most studies tend to focus on lack of access to contraceptive information and services, and poverty as the main contributing factor to early-unintended pregnancies, the influence of sexual violence has received limited attention. Understanding the link between sexual violence and unintended pregnancy is critical towards developing a multifaceted intervention to reduce unintended pregnancies among AGYW in South Africa, a country with high teenage pregnancy rates. Thus, we estimated the magnitude of unintended pregnancy among AGYW and also examined the effect of sexual violence on unintended pregnancy. Methods Our study adopted a cross-sectional design, and data were obtained from AGYW in a South African university between June and November 2018. A final sample of 451 girls aged 17-24 years, selected using stratified sampling, were included in the analysis. We used adjusted and unadjusted logistic regression analysis to examine the effect of sexual violence on unintended pregnancy. Results The analysis shows that 41.9% of all respondents had experienced an unintended pregnancy, and 25.9% of those unintended pregnancies ended in abortions. Unintended pregnancy was higher among survivors of sexual violence (54.4%) compared to those who never experienced sexual abuse (34.3%). In the multivariable analysis, sexual violence was consistently and robustly associated with increased odds of having an unintended pregnancy (AOR:1.70; 95% CI: 1.08-2.68). Conclusion Our study found a huge magnitude of unintended pregnancy among AGYW. Sexual violence is an important predictor of unintended pregnancy in this age cohort. Thus, addressing unintended pregnancies among AGYW in South Africa requires interventions that not only increase access to contraceptive information and services but also reduce sexual violence and cater for survivors.
Identification, characterization and functional analysis of AGAMOUS subfamily genes associated with floral organs and seed development in Marigold (Tagetes erecta)
Authors: Zhang Chunling , Wei Ludan , Wang Wenjing , Qi Wenquan , Cao Zhe , Li Hang , Bao Manzhu , he yanhong
Published: September 2020

Background: AGAMOUS (AG) subfamily genes regulate the floral organs initiation and development, fruit and seed development. At present, there has been insufficient study of the function of AG subfamily genes in Asteraceae. Marigold (Tagetes erecta) belongs to Asteraceae family whose unique inflorescence structure makes it an important research target for understanding floral organ development in plants. Results: Four AG subfamily genes of marigold were isolated and phylogenetically grouped into class C (TeAG1 and TeAG2) and class D (TeAGL11-1 and TeAGL11-2) genes. Expression profile analysis demonstrated that these four genes were highly expressed in reproductive organs of marigold. Subcellular localization analysis suggested that all these four proteins were located in the nucleus. Protein-protein interactions analysis indicated that class C proteins had a wider interaction manner than class D proteins. Function analysis of ectopic expression in Arabidopsis thaliana revealed that TeAG1 displayed a C function specifying the stamen identity and carpel identity, and that TeAGL11-1 exhibited a D function regulating seed development and petal development. In addition, overexpression of both TeAG1 and TeAGL11-1 leaded to curling rosette leaf and early flowering in Arabidopsis thaliana. Conclusions: This study provides an insight into molecular mechanism of AG subfamily genes in Asteraceae species and technical support for improvement of several floral traits.
Virologic Response of Treatment Experienced HIV-Infected Ugandan Children and Adolescents on NNRTI Based First-Line Regimen, Previously Monitored Without Viral Load
Authors: Ssemambo Phionah Kibalama , Nalubega-Mboowa Mary Gorrethy , Owora Arthur H. , Serunjogi Robert , Kironde Susan Kizito , Nakabuye Sarah , Ssozi Francis , Nannyonga Maria , Musoke Philippa , Barlow-Mosha Linda
Published: September 2020

Background: Many HIV-infected African children gained access to antiretroviral treatment (ART) through expansion of PEPFAR programs since 2004 and introduction of “Test and Treat” WHO guidelines in 2015. As ART access increases and children transition from adolescence to adulthood, treatment failure is inevitable. Viral load (VL) monitoring in Uganda was introduced in 2016 replacing clinical monitoring. However, there’s limited data on the comparative effectiveness of these two strategies among HIV-infected children in resource-limited settings (RLS).Methods: HIV-infected Ugandan children aged 1-12 years from HIV-care programs with >1 year of first-line ART using only immunologic and clinical criteria to monitor response to treatment were screened in 2010. Eligible children were stratified by VL ≤ 400 and >400 copies/ml randomized to clinical and immunological (control) versus clinical, immunological and VL monitoring to determine treatment failure with follow-up at 12, 24, 36, and 48 weeks. Plasma VL was analyzed retrospectively for controls. Mixed-effects logistic regression models were used to compare the prevalence of viral suppression between study arms and identify factors associated with viral suppression. Results: At baseline all children (n=142) were on NNRTI based ART (75% Nevirapine, 25% efavirenz). One third of ART-experienced children had detectable VL at baseline despite high CD4%. Median age was 6 years (interquartile range [IQR]: 5-9) and 43% were female. Overall, the odds of viral suppression were not different between study arms: (arm by week interaction, p=0.63), adjusted odds ratio [aOR]: 1.07; 95%CI: 0.53, 2.17, p=0.57) and did not change over time (aOR: 0 vs 24 week: 1.15; 95% CI: 0.91, 1.46, p=0.24 and 0 vs 48 weeks: 1.26; 95%CI: 0.92, 1.74, p=0.15). Longer duration of a child’s ART exposure was associated with lower odds of viral suppression (aOR: 0.61; 95% CI: 0.42, 0.87, p<.01). Only 13% (9/71) of children with virologic failure were switched to second-line ART, in spite of access to real-time VL.Conclusion: With increasing ART exposure, viral load monitoring is critical for early detection of treatment failure in RLS. Clinicians need to make timely informed decisions to switch failing children to second-line ART. Trial Registration: ClinicalTrials.gov NCT04489953, 28 Jul 2020. Retrospectively registered.
Geometric accuracy of an acrylonitrile butadiene styrene canine tibia model fabricated using fused deposition modelling and the effects of hydrogen peroxide gas plasma sterilisation
Authors: Hsu Chi-Pin , Lin Chen-Si , Fan Chun-Hao , Chiang Nai-Yuan , Tsai Ching-Wen , Chang Chun-Ming , Liu I-Li
Published: September 2020

Background: Three-dimensional (3D) printing techniques have been used to produce anatomical models and surgical guiding instruments in orthopaedic surgery. The geometric accuracy of the 3D printed replica may affect surgical planning. This study assessed the geometric accuracy of an acrylonitrile butadiene styrene (ABS) canine tibia model printed using fused deposition modelling (FDM) and evaluated its morphological change after hydrogen peroxide (H 2 O 2 ) gas plasma sterilisation. The tibias of six canine cadavers underwent computed tomography for 3D reconstruction. Tibia models were fabricated from ABS on a 3D printer through FDM. Reverse-engineering technology was used to compare morphological errors (root mean square; RMS) between the 3D-FDM models and virtual models segmented from original tibia images (3D-CT) and between the models sterilised with H 2 O 2 gas plasma (3D-GAS) and 3D-FDM models o n tibia surface and in cross-sections at: 5%, 15%, 25%, 50%, 75%, 85%, and 95% of the tibia length. Results: The RMS mean ± standard deviation and average positive and negative deviation values for all specimens in E FDM-CT (3D-FDM vs. 3D-CT) were significantly higher than those in E GAS-FDM (3D-GAS vs. 3D-FDM; P < 0.0001). Mean RMS values for E FDM-CT at 5% bone length (proximal tibia) were significantly higher than those at the other six cross-sections ( P < 0.0001). Mean RMS differences for E GAS-FDM at all seven cross-sections were nonsignificant. Conclusions: The tibia models fabricated on an FDM printer had high geometric accuracy with a low RMS value. The surface deviation in E FDM-CT indicated that larger errors occurred during manufacturing than during sterilisation. Therefore, the model may be used for surgical rehearsal and further clinically relevant applications in bone surgery.
The relationship between ambient temperature and FPG: a series of cross-sectional studies in Guangdong Province, China
Authors: Luo Jiali , He Guanhao , Xu Yanjun , Chen Zihui , Xu Xiaojun , Peng Jiewen , Chen Shaowei , Hu Jianxiong , Ji Guiyuan , Liu Tao , Zeng Weilin , Li Xing , Xiao Jianpeng , Guo Lingchuan , Ma Wenjun
Published: September 2020

Background

There existed evidence that the prevalence and glycemic control rate of type 2 diabetes mellitus (T2DM) have seasonal variation. The present study aimed to examine the associations between ambient temperature exposure and FPG among different groups (total, non-T2DM, old T2DM and new T2DM groups) and calculate temperature adjusted prevalence and glycemic control rate of T2DM.

Methods

Four cross-sectional health surveys with 26,350 respondents were conducted in Guangdong Province from 2007 to 2015. Multistage cluster sampling was used to recruit study participants. Generalized additive model was employed to evaluate the associations between daily mean temperature and FPG among different groups. The prevalence and glycemic control rate of T2DM were calculated based on the exposure-response association between temperature and FPG.

Results

The exposure-response curves of temperature and FPG were downward parabola in total, non-T2DM and old-T2DM groups, while it was “U”-shaped without statistically significant for new T2DM cases. When temperature decreased from 30°C to 4°C, the FPG significantly increased 0.59 (95%CI: 0.49, 0.68) mmol/L, 0.47 (95%CI: 0.43, 0.52) mmol/L and 1.59 (95%CI: 0.59, 2.59) mmol/L in total, non-T2DM and old-T2DM groups, respectively. When the ambient temperature increased from 5°C to 30°C, the prevalence of T2DM slowly decreased from 10.03% to 9.39%, and the glycemic control rate of T2DM greatly increased from 31.9% to 58.5%.

Conclusion

The prevalence and glycemic control rate of T2DM are associated with ambient temperature, which suggests temperature should be considered and adjusted when estimating T2DM prevalence and developing clinical management of T2DM.
Short- and long-term outcomes of laparoscopic surgery for colorectal cancer in the elderly aged over 80 years old versus non-elderly: a retrospective cohort study
Authors: Ueda Yoshitake , Shiraishi Norio , Kawasaki Takahide , Akagi Tomonori , Ninomiya Shigeo , Shiroshita Hidefumi , Etoh Tsuyoshi , Inomata Masafumi
Published: September 2020

Background

Recently, colorectal cancer has increased in elderly patients worldwide, with laparoscopic colorectal surgery increasing in elderly patients with colorectal cancer. However, whether laparoscopic colorectal surgery is an optimal procedure for colorectal cancer in the elderly remains unclear. This study aimed to verify safety and curability of laparoscopic colorectal surgery in elderly patients ≥80 years old.

Methods

Patients undergoing curative colorectal surgery from 2006 to 2014 were enrolled and classified into the laparoscopic surgery in elderly patients aged ≥80 years (LAC-E) group, open surgery in elderly patients (OC-E) group, and laparoscopic surgery in non-elderly patients (LAC-NE) group. Short- and long-term outcomes were compared between these groups.

Results

The LAC-E, OC-E, and LAC-NE groups comprised 85, 25, and 358 patients, respectively. Intraoperative blood loss and incidence of postoperative complications were significantly lower in the LAC-E versus OC-E group (97 vs. 440 mL, p<.01 and 14% vs. 32%, p<.05, respectively). Long-term outcomes were not different between these two groups. Operation time was significantly shorter in the LAC-E versus LAC-NE group (249 vs. 288 min, p<.01). Intraoperative blood loss and postoperative complications were similar between the groups. Although the 5-year overall survival rate in the LAC-E group was lower than that in the LAC-NE group (64% vs. 80%, p<.01), there was no difference in 5-year disease-specific survival between the groups.

Conclusion

Laparoscopic colorectal surgery is technically and oncologically safe for colorectal cancer in the elderly as well as the non-elderly and can be an optimal procedure for colorectal cancer in the elderly.
The impact of eHealth group interventions on the mental, behavioural, and physical health of adults: A systematic review protocol
Authors: Currie Cheryl L , Larouche Richard , Voss M. L. , Higa Erin K. , Spiwak Rae , Scott David , Tallow Treena
Published: September 2020

Background: COVID-19 has resulted in an increased demand for mental health services globally. There is emerging evidence for the efficacy for group eHealth interventions that support population-based mental health and wellbeing, but a systematic review is lacking. The primary objective of this systematic review is to summarize the evidence for eHealth group counselling and coaching programs for adults. A second objective is to assess, within studies selected for our primary objective, the impact of programs that encourage PA on outcomes compared to those that do not.Methods and Design: Randomized controlled trials that assess the impact of eHealth group counselling or coaching programs on mental health, health behaviour, or physical health conditions or concerns among community dwelling adults will be searched in MEDLINE, PsycInfo, CINHAL, and the Central Register of Controlled Trials. The review will be structured using PRISMA guidelines. Studies will be synthesized using the Cochrane Handbook and Synthesis Without Meta-Analysis (SWiM) reporting guideline. Quality will be evaluated using GRADE. Risk of bias will be assessed using the Cochrane Risk of Bias tool with higher quality studies prioritized when drawing conclusions. The role of sex and gender will be considered as well as possible gender biases at all stages of the review.Discussion: This review will examine the effectiveness of eHealth counselling and coaching programs delivered to adults in a group format. Findings will inform the decisions of governments, communities, and health care organizations responding to the COVID-19 pandemic in Canada. Systematic review registration: The protocol has been registered at the International Prospective Register of Systematic Reviews (PROSPERO: CRD42020187551).
Psychological distress among infectious disease physicians during the response to the COVID-19 outbreak in the Republic of Korea
Authors: Park Se Yoon , Kim Bongyoung , Jung Dong Sik , Jung Sook In , Oh Won Sup , Kim Shin-Woo , Peck Kyong Ran , Chang Hyun-Ha
Published: September 2020

Background
This study aimed to investigate psychological distress among infectious disease (ID) physicians during the coronavirus disease (COVID-19) outbreak in the Republic of Korea.
Methods
Using an online-based survey link sent via text message and email, we conducted a survey from April 21 to 25, 2020, targeting all ID physicians currently working in ID (n = 265). The questionnaire was based on the Maslach Burnout Inventory-Human Services Survey and the Depression, Anxiety, and Stress Scales, and information was collected on factors protecting against psychological distress and difficulties in relation to COVID-19.
Results
Of 265 ID physicians, 115 (43.3%) responded, showing burnout (97, 90.4%), depression (20, 17.4%), anxiety (23, 20.0%), and stress (5, 4.3%). There were no differences in terms of distress between ID physicians who were directly involved in the care of patients with COVID-19 or not. Greater than 50% of physicians valued their work and felt recognized by others, whereas < 10% indicated that sufficient human and financial support and private time had been provided during the outbreak. The most challenging issues concerned a lack of human resources for COVID-19 treatment or infection control, a shortage of personal protective equipment or airborne infection isolation rooms, pressure for research, and lack of guidelines for COVID-19 management.
Conclusions
During the COVID-19 outbreak in the ROK, most respondents reported psychological distress. Preparing strategies for infectious disease outbreaks that support ID physicians is essential.
Preliminary study of the toxicity and radioprotective effects of zymosan in vitro and in vivo
Authors: Zhang Yue-zhi , Ge Shu-jing , Leng Qing-zhen , Ma Jian-jun , Liu Hanchen
Published: September 2020

Background: This study aimed to confirm the cytotoxicity of zymosan in AHH-1 cells and HIECs and to determine the treatment time and dose of zymosan at which it exerts radioprotective effects.Methods: AHH-1 cells and HIECs were administered 0, 20, 40, 80 or 160 μg/mL zymosan. The CCK-8 assay and flow cytometry were used to evaluate cell viability and apoptosis 24 h, 48 h, and 72 h after administration. Furthermore, 12 h before irradiation, the cells were treated with 0, 5, 10, or 20 μg/mL zymosan and then irradiated with 4 Gy X-rays. Cell viability and apoptosis were measured by the CCK-8 assay and flow cytometry at 24 h. In addition, the protective effect of zymosan against radiation in vitro was compared to that of 20 μg/mL LPS as a positive control. In vivo, weight, the spleen index and the thymus index were measured to evaluate the toxicity of 0, 5, 10, 20 and 10 mg/kg zymosan. In addition, rats were treated with 0, 2, 4, 8 or 10 mg/kg zymosan and then irradiated with 7 Gy X-rays. The survival rate, spleen index and thymus index were evaluated. The protective effect of zymosan against radiation in vivo was compared to that of 10 mg/kg LPS a positive control. Results: The viability and apoptosis of cells treated with different doses of zymosan for different treatment times were not different from those of control cells (p<0.05). Furthermore, cell viability and apoptosis were clearly improved after zymosan preadministration (p<0.05). The radioprotective effect of zymosan was dose-dependent. In addition, the viability of cells pretreated with zymosan was higher than that of cells pretreated with LPS, and the apoptosis rate of zymosan-treated cells was lower than that of cells pretreated with LPS (p<0.05). In vivo, weight, the spleen index and the thymus index were significantly decreased by zymosan at a concentration of 20 mg/kg (p<0.05). Further experiments showed that the concentration at which zymosan exerted radioprotective effects was 10 mg/kg. The radioprotective effect of zymosan was better than that of LPS pretreatment (p<0.05). Conclusion: Zymosan is nontoxic to cells and exerts a better radioprotective effect than LPS.
The Role of Postprandial Very-Low-Density Lipoprotein ­in the Development of Atrial Remodeling in Metabolic Syndrome
Authors: Lee Hsiang-Chun , Shin Shyi-Jang , Huang Jih-Kai , Lin Ming-Yen , Lin Yu-Hsun , Ke Liang-Yin , Jiang He-Jiun , Tsai Wei-Chung , Chao Min-Fang , Lin Yi-Hsiung
Published: September 2020

Background: Negatively charged very-low-density lipoprotein (VLDL-χ) in metabolic syndrome (MetS) patients exerts cytotoxic effects on endothelial cells and atrial myocytes. Atrial cardiomyopathy, manifested by atrial remodeling with a dilated diameter, contributes to atrial fibrillation pathogenesis and predicts atrial fibrillation development. The correlation of VLDL-χ with atrial remodeling is unknown. This study investigated the association between VLDL-χ and the remodeling of left atrium.Methods: Consecutively, 87 MetS and 80 non-MetS individuals between 23 and 74 years old (50.6% men) without overt cardiovascular diseases were included in the prospective cohort study. Blood samples were collected while fasting and postprandially (at 0.5, 1, 2, and 4 hours after a unified meal). VLDL was isolated by ultracentrifugation; the percentile concentration of VLDL-χ (%) was determined by ultra-performance liquid chromatography. The correlations of left atrial diameter (LAD) with variables including VLDL-χ, LDL-C, HDL-C, triglycerides, glucose, and blood pressure, were analyzed by multiple linear regression models. A hierarchicallinear model was conducted to test the independencies of each variable’s correlation with LAD.Results: The mean LAD was 3.4 ± 0.5 cm in non-MetS subjects and 3.9 ± 0.5 cm in MetS patients (P< 0.01). None of the fasting lipid profiles were associated with LAD. VLDL-χ, BMI, waist circumference, hip circumference, and blood pressure were positively correlated with LAD (all P<0.05) after adjustment for age and sex. Significant interactions between VLDL-χ and blood pressure, waist circumference, and hipcircumference were observed. When adjusted for obesity- and blood pressure-related variables, 2-hour postprandial VLDL-χ (mean 1.30 ± 0.61%) showed a positive correlation with LAD in MetS patients. Each 1% VLDL-χ increase was estimated to increase LAD by 0.23 cm.Conclusions: Postprandial VLDL-χ is associated with atrial remodeling particularly in the MetS group. VLDL-χ is a novel biomarker and may be a therapeutic target for atrial cardiomyopathy in MetS patients.Trial registration: ISRCTN 69295295. Retrospectively registered 9 June 2020.
Impact of racism and discrimination on the physical and mental health outcomes among Aboriginal and Torres Strait Islander peoples living in Australia: a protocol for a scoping review
Authors: Kairuz Camila A , Casanelia Lisa M , Bennett-Brook Keziah , Coombes Julieann , Yadav Uday Narayan
Published: September 2020

Background Racism is increasingly recognised internationally as a key factor contributing to health disparities. A comprehensive body of strong research from international authors has reported negative associations between racism and health outcomes. In Australia, although the literature is more limited, available findings follow global trends. Australia has an identified health gap between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians, and despite efforts to bridge this gap, health inequities continue to exist. This scoping review aims to assess, analyse and synthesise the relationship between racism and discrimination on the physical and mental health of Aboriginal and Torres Strait Islander peoples living in Australia.Method This is the study protocol for a scoping review. A systematic search will be conducted using five electronic databases: PubMed, CINAHL, Embase, Web of Science and the Australia’s National Institute for Aboriginal and Torres Strait Islander Health Research. The database search will include studies published between 2000 and 2020. Reference lists of the included articles will be searched. Outcome measures will include physical and mental health components including chronic conditions, depression and anxiety, psychological distress, social and emotional difficulties, suicide and health-related outcomes such as wellbeing and life satisfaction. Duplications will be removed, and titles and abstracts will be reviewed to select studies. Full-text screening of preselected studies will be performed by four reviewers independently, to select studies according to inclusion criteria. Included studies will be appraised for quality using appropriate tools tailored for each study design. Data will be extracted, and study findings and characteristics synthesised in a narrative summary. Discussion Our scoping review will synthesise the evidence on the impacts of racism and discrimination in relation to the physical and mental health of Aboriginal and Torres Strait Islander peoples living in Australia. These findings could guide future health interventions by addressing the exposure of racism and racial discrimination in order to reduce health disparity. It is anticipated the findings to be of interest to policymakers, researchers, Aboriginal and Torres Strait Islander communities and community health organisations and other stakeholders interested in optimising public health interventions for and in partnership with Aboriginal and Strait Torres Islander communities of Australia. Scoping review registration The protocol for this review has been registered on the International prospective register of systematic reviews (PROSPERO). The registration ID is CRD42020186193.
The apoptotic effect of polysaccharides with specific molecular weight extracted from Inonotus obliquus on HT-29 colon cancer cells
Authors: Han Xue , Zhao Sainan , Wang Yu , Sun Jialei , Chen Shiwei
Published: September 2020

Background: Recently, natural products, particularly Inonotus obliquus (I. obliquus), have attracted lots of attention due to their effective anticancer effects with relatively low toxicity. Results: I. obliquus polysaccharides (IOP) with different molecular weights were obtained by filtering the aqueous extract through fractional membrane. IOP60b (10 kDa ≤ molecular weight ≤ 30 kDa) with the highest yield and inhibition ratio of HT-29 cancer cells was chosen to evaluate the apoptotic effect on HT-29 cancer cells. After treated with different concentrations of IOP60b, morphological changes including cell shrinkage and nuclear condensation and DNA fragmentation of HT-29 cancer cells were observed. In addition, the proportions of cells in early apoptosis and late apoptosis were significantly (p<0.05) increased in a dose-dependent manner. To further explore the underlying mechanism, RT-PCR and Western blotting were employed. Results indicated that both Bcl-2 family and Caspase family were involved in the regulation process of apoptosis and IOP60b induced cellular apoptosis via upregulation of Bax/Bcl-2 ratio and activation of Caspase-3.Conclusion: These data suggested that IOP60b could be a potential candidate for the clinical prevention and treatment of colorectal cancer.
Who indicates Caesarean section in Romania? A cross-sectional survey in tertiary level maternity on childbirth patients and doctors' profiles 
Authors: Simionescu Anca Angela , Horobet Alexandra , Marin Erika , Belascu Lucian
Published: September 2020

Background. Cesarean section (C-section) rate in Romania is the second-highest in the European Union (44.1% in 2017), and the number of C-sections performed in the country has increased in the past decades. Given how common C-section is now, it is important to gain insight into the practice and perceptions of patients and doctors in countries with high C-section rates. The objectives are 1) to compare the preferred modes of birth among women; 2) to draw a profile of patients and doctors in whose case the actual birth method is different from the preferred method; and 3) to analyze the way Romanian women want to give birth. Methods. We conduct a statistical analysis based on an observational, analytical, and cross-sectional survey on 117 singleton pregnant women more than 36 weeks in spontaneous labor in tertiary level maternity in Romania. Various statistical tests have been used to indicate statistical significance. Results. We calculate an increase of almost 58% in actual childbirth mode against preferred childbirth by C-sections, rather difficult to justify based only on medical emergencies. There are 22 patients with non-concordant C-section indications between preferred and actual mode of birth, 7 of them (31.8%) preferred natural birth and 15 (68.2%) preferred C-section. The profiles of patients with concordant and non-concordant delivery modes are different and indicate a statistically significant difference between the preference for delivery and actual birth method. Patients who preferred vaginal birth, but gave birth by C-section, are mature and more educated women, in the middle to high-income category, mostly attended by consultant doctors and specialists. Doctors’ profiles show that specialists and consultants attend the largest share of non-concordant births, while residents and young senior doctors attend mostly vaginal births. Conclusions. We emphasize health system particularities in Romania as triggers of high C-section rates that favor women’s preferences against C-section medical indication. Improving patients’ confidence in the health care system, built on competence and fitted hierarchical team position may lead to choosing the optimal way of birth for childbirth safety and pain control.
Epidemiological and clinical features of imported and local patients with coronavirus disease 2019 (COVID-19) in Hainan, China
Authors: Wu Biao , Lei Zi-Ying , Wu Kun-Liang , He Jian-Rong , Cao Hui-Juan , Fu Juan , Chen Feng , Chen Yuan , Chen Bao , Zhou Xiao-Li , Huang Tao , Wu Tao , Du Yong-Guo , Chen Suo-Xian , Xiao Fu-Rong , Gao Zhi-Liang , He Jing , Lin Feng , Lin Bingliang
Published: September 2020

Background: Hainan Island, which is a popular tourist destination, received many imported cases of Coronavirus disease 2019 (COVID-19) but successfully contained the epidemic within one month. We described the epidemiological and clinical characteristics of COVID-19 in Hainan and compared these features between imported and local cases to provide information for other international epidemic areas.Methods: We included 91 patients (56 imported and 35 local cases) from two designated hospitals for COVID-19 in Haikou, China, from January 20 to February 19, 2020. Data on the demographic, epidemiological, clinical and laboratory characteristics were extracted from medical records. Patients were followed until April 21, 2020, and the levels of antibodies at the follow-ups were also analyzed.Results: Of the 91 patients, 78 (85.7%) patients were diagnosed within the first three weeks after the first case was identified (Day 1: Jan 22, 2020), while the number of local cases started to increase during the third week. No new cases occurred after Day 29. Fever and cough were two main clinical manifestations. In total, 15 (16.5%) patients were severe, 14 (15.4%) had complicated infections, nine (9.9%) were admitted to the ICU, and three died. The median duration of viral shedding in feces was longer than that in nasopharyngeal swabs (19 days vs 16 days, P=0.007). Compared with local cases, imported cases were older and had a higher incidence of fever and concurrent infections. There was no difference in outcomes between the two groups. IgG was positive in 92.8% patients (77/83) in the follow-up at week 2 after discharge, while 88.4% patients (38/43) had a reduction in IgG levels in the follow-up at week 4 after discharge, and the median level was lower than that in the follow-up at week 2 (10.95 S/CO vs 15.02 S/CO, P<0.001).Conclusion: Imported cases were more severe than local cases but had similar prognoses. The level of IgG antibodies declined from week 6 to week 8 after onset. The short epidemic period in Hainan suggests that the epidemic could be quickly brought under control if proper timely measures were taken.