bluuebunny/crossref_metadata_2025 huggingface dataset:
Enhancing Reamer Drilling Performance in Deepwater Gulf of Mexico Wells
Authors: Soares Cesar , Armenta Miguel , Panchal Neilkunal
Published: March 2020

Reamers are an integral part of deepwater Gulf of Mexico (GOM) drilling and their performance significantly impacts the economics of well construction. This paper presents a novel programmatic approach to model rate of penetration (ROP) for reamers and improve drilling efficiency. Three field implementations demonstrate value added by the reamer drilling optimization (RDO) methodology.

Facilitated by user interface panels, the RDO workflow consists of surface and downhole drilling data filtering and visualization, detection of rock formation boundaries, frictional torque (FTRQ) and aggressiveness estimation, ROP modeling with analytical equations and machine learning (ML) algorithms [regression, random forests, support vector machines (SVMs), and neural networks], and optimization of drilling parameters. ROP model coefficients and bit and reamer aggressiveness are dependent on lithology and computed from offset well data. Subsequently, when planning a nearby well, bottomhole assembly (BHA) designs are evaluated on the basis of drilling performance and weight and torque distributions between cutting structures to avoid early reamer wear and dysfunctions. Geometric programming establishes optimal drilling parameter roadmaps according to operational limits, downhole tool ratings, rig equipment power constraints, and adequate hole cleaning.

Separate ROP models are trained for reamer-controlled and bit-controlled ROP zones, defined by the proportion of surface weight on bit (WOB) applied at the reamer, in every rock formation. This novel concept enables ROP prediction with the appropriate model for each well segment depending on which cutting structure limits drilling speed. In the first of the three RDO applications with field data from deepwater GOM wells, optimal bit-reamer distances are determined by analyzing reamer weight load in uniform salt sections. Next, ROP modeling for the addition or removal of a reamer from the BHA is used in contrasting well designs to conceivably alleviate a USD 16 million casing inventory surplus. Finally, active optimization constraints are investigated to reveal drilling performance limiters, justifying equipment upgrades for a future deepwater GOM well.

The proposed innovative workflow and methodology apply to any drilling optimization scenario. They benefit the practicing engineer interested in drilling performance optimization by providing insights on how different cutting structure sizes affect ROP behavior and ultimately aiding in the selection of appropriate bit and reamer diameters and optimal operational parameters.
Combined use of apatinib mesylate and vinorelbine versus vinorelbine alone in recurrent or metastatic triple-negative breast cancer: study protocol for a randomized controlled clinical trial
Authors: Wu Shuo , Zhang Liang , Li Huan , Xu Junnan , Jiang Cui , Sun Tao
Published: March 2020

Background: The emergence of new molecular targeted drugs provides new prospects for the treatment of advanced breast cancer; the future therapeutic trend includes chemotherapy combined with molecular targeted therapy. Apatinib mesylate, a novel, small anti-angiogenic agent, highly selectively inhibits the activity of vascular endothelial growth factor receptor-2 tyrosine kinase. Apatinib mesylate also blocks the signaling of vascular endothelial growth factor binding to its receptor, thereby strongly inhibiting tumor angiogenesis and exerting an anti-tumor effect. However, a randomized controlled clinical trial of apatinib combined with vinorelbine for triple-negative breast cancer (TNBC) has not been reported. We will compare the therapeutic effect of vinorelbine alone, or in combination with apatinib mesylate, in patients with recurrent or metastatic TNBC in North China who have received at least two drug treatments, including anthracyclines and taxanes.
Methods/analysis: This study is a triple-blind, randomized, placebo-controlled, parallel-group clinical trial. We plan to include 210 female patients with locally recurrent or metastatic TNBC, admitted at the Liaoning Cancer Hospital & Institute, Northeast China. All enrolled patients will be randomized to oral vinorelbine alone (40 mg, thrice a week [Mondays, Wednesdays, and Fridays] in each 3-week cycle), or in combination with oral apatinib mesylate (500 mg, once daily in each 3-week cycle). Radiographic assessment will be performed every 6 weeks for 36 weeks, and every 9 weeks thereafter. The primary outcome is progression-free survival, and secondary outcomes include overall survival, disease control rate, objective response rate, and incidence of adverse events at grades 3 and 4, as defined by the National Cancer Institute Common Toxicity Criteria Version 4.0. Outcome measures will be evaluated at baseline (< 2 weeks before starting treatment), every 6 weeks during treatment, and at 4 weeks and every 3 months after treatment discontinuation.
Discussion: Based on the data from this trial, we hope to identify a treatment plan that is suitable for female TNBC patients in Northeast China who have been treated with anthracyclines and taxanes.
Trial registration: ClinicalTrials.gov (identifier: NCT03932526). Registered on April 30, 2019.
Association of timed up and go test outcomes with future incidence of cardiovascular disease and mortality in adults aged 66 years: Korean national representative longitudinal study over 5.7 years
Authors: Son Ki Young , Shin Dong Wook , Lee Ji Eun , Kim Sang Hyuck , Yun Jae Moon , Cho Belong
Published: March 2020

Background: The timed up and go test (TUG) is one of the most widely used tests of mobility. We aimed to examine whether the TUG is associated with cardiovascular (CV) events, CV mortality, and all-cause mortality.
Methods: Subjects in the senior cohort database of the Korean National Health Insurance Service (2002–2013) who completed the TUG as part of the National Screening Program for Transitional Ages (NSPTA) during 2007–2008 were identified. An abnormal TUG result was defined as a time ≥10 seconds. Cox proportional hazard models were used to assess the associations between TUG results and CV events, CV mortality, and all-cause mortality.
Results: The mean follow-up period was 5.7 years. Incidence rates of CV events in the normal and abnormal TUG groups were 7.93 and 8.98 per 1,000 person-years, while CV mortality rates were 0.96 and 1.51 per 1,000 person-years, respectively. In a fully adjusted model, we found that abnormal TUG results were not associated with the incidences of CV events and CV mortality. However, abnormal TUG results (≥10 sec) resulted in a 2.9-fold increase in CV mortality in women (adjusted hazard ratio 2.90, 95% confidence interval 1.15 – 7.30). Further, participants lacking certain CV risk factors, such as current cigarette smoking, obesity, or diabetes, had a higher CV mortality rate when TUG results were abnormal.
Conclusions: Abnormal TUG results in subjects aged 66 years were associated with future CV mortality in women and in subjects without obesity, diabetes, or cigarette smoking. In patient with mobility impairment, physicians should consider CV disease risk, especially in women.
Cryptococcal antigenemia and its predictors among HIV infected patients in resource limited settings: a systematic review
Authors: Derbie Awoke , Mekonnen Daniel , Woldeamanuel Yimtubezinash , Abebe Tamrat
Published: March 2020

Background: Cryptococcosis is an opportunistic fungal infection that primarily affects people with advanced HIV/AIDS and is an important cause of morbidity and mortality around the globe. By far the most common presentation of the disease is cryptococcal meningitis (CM), which leads to an estimated 15-20% of all HIV related deaths worldwide, 75% of which are in sub-Saharan Africa. However, to the best of our knowledge there is quite limited reviewed data that on the epidemiology of cryptococcal antigenemia in a large HIV-infected population in resource limited settings.
Methods: Articles published in English irrespective of the time of publication were systematically searched using comprehensive search strings from PubMed/Medline and SCOPUS. In addition, Google Scholar and Google databases were searched manually for grey literature. Two reviewers independently assessed study eligibility, extracted data, and assessed risk of bias. The magnitude of cryptococcal antigenemia and its predictors were presented with descriptive statistics and summary measures. The pooled prevalence of cryptococcal antigenemia was also determined with 95% confidence interval (CI).
Result: Among 2941 potential citations, we have included 22 studies with a total of 8,338 HIV positive individuals. The studies were reported in ten different countries during the year (2007-2018). Most of the articles reported the mean CD4 count of the participants <100 cells/µl. The pooled prevalence of cryptococcal antigenemia at different CD4 count and ART status was at 8% (95%CI: 6-10%) (ranged between 1.7% and 33%). Body mass index (BMI) <18.5kg/m2, CD4 count <100 cells, presenting with headache and male gender were reported by two or more articles as an important predictors of cryptococcal antigenemia.
Conclusions: Implementing a targeted screening of HIV patients with low BMI, CD4 count <100 cells, having headache and males; and treatment for asymptomatic cryptococcal disease should be considered. Additional data is needed to better define the epidemiology of cryptococcal antigenemia and its predictors in resource limited settings in order to design prevention, diagnosis, and treatment strategies.
Transcriptome Ortholog Alignment Sequence Tools (TOAST) for Phylogenomic Dataset Assembly
Authors: Wcisel Dustin J. , Howard J. Thomas , Yoder Jeffrey A. , Dornburg Alex
Published: March 2020

Background Advances in next-generation sequencing technologies have reduced the cost of whole transcriptome analyses, allowing characterization of non-model species at unprecedented levels. The rapid pace of transcriptomic sequencing has driven the public accumulation of a wealth of data for phylogenomic analyses, however lack of tools aimed towards phylogeneticists to efficiently identify orthologous sequences currently hinders effective harnessing of this resource. Results We introduce TOAST, an open source R software package that can utilize the ortholog searches based on the software Benchmarking Universal Single-Copy Orthologs (BUSCO) to assemble multiple sequence alignments of orthologous loci from transcriptomes for any group of organisms. By streamlining search, query, and alignment, TOAST automates the generation of locus and concatenated alignments, and also presents a series of outputs from which users can not only explore missing data patterns across their alignments, but also reassemble alignments based on user-defined acceptable missing data levels for a given research question. Conclusions TOAST provides a comprehensive set of tools for assembly of sequence alignments of orthologs for comparative transcriptomic and phylogenomic studies. This software empowers easy assembly of public and novel sequences for any target database of candidate orthologs, and fills a critically needed niche for tools that enable quantification and testing of the impact of missing data. As open-source software, TOAST is fully customizable for integration into existing or novel custom informatic pipelines for phylogenomic inference.
Clinical Features and Survival of Pregnancy-Associated Breast Cancer: A Retrospective Study of 203 Cases in China
Authors: Han Bo-yue , Li Xiao-guang , Zhao Hai-yun , Hu Xin , Ling Hong
Published: March 2020

Background: Pregnancy-associated breast cancer (PABC) is an aggressive disease, and sinceChinese authoritybegan to encourage childbearing in 2015, the incidence of PABC has increased. This study investigated the characteristics and survival of PABC patients. Methods: Patients with PABC who underwent surgery at Fudan University, Shanghai Cancer Center between 2005 and 2018 were enrolled.Data concerning the tumor characteristics, maternal state (whether first or non-first pregnancy ) and survival outcome were recorded. Pearson Chi-square tests were used to compare the characteristics of the tumors, and Kaplan-Meier methods were used to perform the survival analysis. Results: Overall, 203 PABC patients were recruited. Since 2015, 65.5% of non-first pregnant women were diagnosed with breast cancer, it’s 5.7 fold of the incidence of PABC in non-first pregnant women. No significant differences in tumor characteristics were observed between the patients who were in their first pregnancy and those in non-first pregnancy. Among the entire PABC population, luminal B breast cancer accounted for the largest proportion (38.4%), followed by triple-negative breast cancer (TNBC, 30.0%). The distribution of the molecular subtypes of PABC and non-PABC differed (P<0.001) as follows: in the PABC patients, Luminal B 38.4%, Triple negative breast cancer (TNBC) 30.1%, Human Epidermal Growth Factor Receptor 2 (HER-2) overexpression 15.8%, and Luminal A 10.8%; in the non-PABC patients, Luminal A 50.9%, Luminal B 20.1%, TNBC 17.4%, and HER-2 overexpression 8.0%. The 3-year disease free survival (DFS) of all PABC patients was 80.3%. The 3-year DFS of the patients in the first-pregnancy group was 78.4%, and that of the patients in the non-first-pregnancy group was 83.7% (P=0.325). Conclusions: Our study proved that the proportion of women who developed PABC during the second or third pregnancy was extremely high relative to the newborn populations. The patients in the PABC population tended to present more luminal B and TNBC breast cancer than the non-PABC patients.
A cross-sectional study of the relationships between different components of sarcopenia and brachial ankle pulse wave velocity in community-dwelling elderly
Authors: Rong Yu-Dong , Bian Ai-Lin , Hu Hui-Ying , Ma Yue , Zhou Xin-Zi
Published: March 2020

Background
Declination of skeletal muscle mass or sarcopenia is associated with the arterial stiffness. However, but it is unclear whether muscle strength and physical performance; important contributors of sarcopenia are associated with the arterial stiffness. The aim of this study was to investigate the relationship between sarcopenia, the components of sarcopenia and arterial stiffness among elderly population.
Methods
Four hundred and fifty community dwelling elderly participants (266 male, and 184 female, >65 years) were enrolled in this study. Each participant received general medical examinations in Tianjin First Center Hospital. Based on the diagnostic criteria for sarcopenia in older people developed by the Asian Working Group for Sarcopenia (AWGS), 89 participants were separated into the sarcopenia group. The living habits, disease status, general status and laboratory examinations of all participants were collected. The body composition (including appendicular skeletal muscle mass , and visceral fat area (VFA) was measured by bioimpedance analysis. Handgrip strength (HS), usual gait speed (GS), and brachial ankle pulse wave velocity (baPWV) were measured.
Results
Sarcopenia participants had higher baPWV, nutrition risk and lower appendicular skeletal muscle index(ASMI), HS, GS, body mass index(BMI), triacylglycerol(TG), serum albumin(ALB) and creatinine(Cr) than the non-sarcopenia participants; Sarcopenia participants also had higher visceral fat area (VFA)compared to non-sarcopenia participants (p<0.05). ASMI and HS were negatively associated with baPWV (t=-5.807, p=0.000 and t=-3.085, p=0.002), but the relationship between baPWV, and GS was not statistically significant (t=-0.862, p=0.389) by multivariable linear regression. After adjusting for confounders, a multivariate logistic regression analysis revealed that sarcopenia was related to age, BMI, sports and baPWV in community dwelling elderly.
Conclusions
ASMI and HS were negatively associated with baPWV in community dwelling elderly in China; and baPWV was a risk factor of sarcopenia.
Knowledge Level of Cancer Symptoms and Risk Factors in the Gaza Strip: A Cross-sectional Study
Authors: Elshami Mohamedraed , Elshami Alaa , Alshorbassi Nabeela , Alkhatib Mohammed , Ismail Iyad , Abu-Nemer Khitam , Hana Mustafa , Qandeel Ahmed , Abdelwahed Ahmed , Yazji Hamza , Abuamro Hisham , Matar Ghadeer , Alsahhar Ahmed , Abolamzi Ahmed , Baraka Obay , Elblbessy Mahmood , Samra Tahani , Bottcher Bettina
Published: March 2020

Background
In low-income settings, cancer is often diagnosed in advanced stages due to late presentation. Good public awareness of cancer signs and symptoms has a positive impact on the time patients take before they present to healthcare professionals. Therefore, this study examined public knowledge of cancer signs and symptoms as well as risk factors in Gaza.
Methods
This was a cross-sectional study. Participants were recruited from adult visitors (≥18 years) to governmental hospitals covering all five governorates of Gaza, and adolescent students (15 to 17 years) from ten high schools in corresponding locations. An Arabic version of the Cancer Awareness Measure (CAM) was completed in a face-to-face interview. It described demographic data and knowledge of: cancer prevalence, age-related risk, signs and symptoms as well as risk factors both in recall and recognition questions.
Results
Of 3033 participants invited, 2886 completed the CAM (response rate= 95.2%). Adult mean age ± standard deviation (SD) was 33.7±11.7 years and that of adolescents was 16.3±0.8 years. Half of the participants (n=1457, 50.5%) were adolescent (781 females; 53.6%) and 1429 (49.5%) were adult (702 females; 49.1%). About two thirds (n=1885) thought about cancer as unrelated to age. Only 196 participants (6.8%) identified colorectal cancer as the most common cancer among men. Awareness of cancer signs/symptoms was poor to fair, where ‘lump’ was most commonly recognized (n= 2227, 77.2%) and ‘change of bowel habit’ the least (n=670, 23.2%). Only 217 participants (7.5%) had a good level of recognizing risk factors with ‘smoking’ being the most identified and ‘eating less than five portions of fruits and vegetables a day’ the least. There was a higher likelihood for adults to identify most cancer signs/symptoms and risk factors than adolescents, except for recalling ‘unexplained pain’, ‘persistent cough/hoarseness’, ‘non-healing ulcer’, ‘smoking’, and ‘eating less than five portions of fruits and vegetables a day’.
Conclusion
Public awareness of cancer signs/symptoms and risk factors needs to improve to facilitate early presentation and diagnosis in Gaza. Combining the delivery of public campaigns with tailored education to population groups, including the youth, may increase their knowledge and maintain its impact.
Vitamin D status among postmenopausal osteoporotic women: a hospital based cross-sectional study from Northern Sri Lanka.
Authors: Suganthan Navaneethakrishnan , Kumanan Thirunavukarasu , Kesavan Vithegi , Aravinthan Mahalingam , Rajeshkannan Nadarajah
Published: March 2020

Background Vitamin D deficiency is common among post-menopausal women and it is important to treat vitamin D deficiency to prevent falls and fractures in patients with osteoporosis. Few studies examined the prevalence of vitamin D deficiency in general population of Sri Lanka but no studies to date done among post-menopausal women with osteoporosis. This is the first study of such kind conducted to evaluate the serum vitamin D levels and factors related to Vitamin D deficiency among postmenopausal women.Methodology Hospital based Cross -sectional study was conducted at the Endocrine Unit, Teaching Hospital from January to December 2018.During the study period 105 postmenopausal women registered for DEXA scan with Endocrine Unit were recruited to the study. Data collection was done by investigators and blood sample was taken from each participant by registered nursing officers and sample was analysed by using immunohistochemistry assays. Serum Vitamin D levels were categorized and data analysis was done using SPSS 26.Results Mean age of 105 postmenopausal women was 67.7 with minimum 33 and maximum 84 years. Mean Vitamin D levels were 27.5(range11.7-52.5ng/ml). Vitamin D levels were adequate in only 36.2% (95%CI: 27.4-45.7) of women, 44% had insufficient levels and deficiency was present in 19% (95%CI: 12.4-27.4) of participants. Among the 105 women 20% were vegetarian and 53% of them consuming milk on average 3 days per week, 76.2% consuming fish on average 2 days per week, 64.8% consuming egg on average 1 day per week. Furthermore seventy five participants (71.4%) reported adequate level of sun exposure (>30minutes).Commonly reported vitamin deficiency symptoms includes paraesthesia (57.1%),bone pain (55.2%), easy fatigability (54.3%), malaise (51.4%), muscle cramps (43.8%) and proximal myopathy (40.0%).Among 71(66.7%) completed bone density assessment,38% (27.3-49.7) of them showed osteoporosis range. Vertebral Z score showed a significant correlation with vitamin D level(r-0.252, P-0.034).Conclusion Prevalence of vitamin D deficiency is relatively high among the post-menopausal women with a provisional diagnosis of osteoporosis. It is essential to correct vitamin D deficiency with supplementation when initiating treatment for osteoporosis. So vitamin D testing is desirable in decision making to treat or not to treat.
Identifying no-harm incidents in home healthcare: a cohort study using trigger tool methodology
Authors: Lindblad Marléne , Unbeck Maria , Nilsson Lena , Schildmeijer Kristina , Ekstedt Mirjam
Published: March 2020

Background Patient safety in home healthcare is largely unexplored. No-harm incidents may give valuable information about risk areas and system failures as a source for proactive patient safety work. We hypothesized that it would be feasible to retrospectively identify no-harm incidents and thus aimed to explore the cumulative incidence, preventability, types, and potential contributing causes of no-harm incidents that affected adult patients admitted to home Healthcare. Methods A structured retrospective record review using a trigger tool designed for home healthcare. A random sample of 600 home healthcare records from ten different organizations across Sweden was reviewed. Results In the study, 40,735 days were reviewed. In all, 313 no-harm incidents affected 177 (29.5%) patients; of these, 198 (63.2%) no-harm incidents, in 127 (21.2%) patients, were considered preventable. The most common no-harm incident types were “fall without harm,” “deficiencies in medication management,” and “moderate pain.” The type “deficiencies in medication management” was deemed to have a preventability rate twice as high as those of “fall without harm” and “moderate pain.” The most common potential contributing cause was “deficiencies in nursing care and treatment, i.e., delayed, erroneous, omitted or incomplete treatment or care.” Conclusion This study suggests that it is feasible to identify no-harm incidents and potential contributing causes such as omission of care using record review with a trigger tool adapted to the context. No-harm incidents and potential contributing causes are valuable sources of knowledge for improving patient safety, as they highlight system failures and indicate risks before an adverse event reach the patient.
Build a Bioinformatics Analysis Platform and Apply it to Routine Analysis of Microbial Genomics and Comparative Genomics
Authors: Liu Hualin , Xin Bingyue , Zheng Jinshui , Zhong Hao , Yu Yun , Peng Donghai , Sun Ming
Published: March 2020

Genomics and comparative genomics have been increasingly used as routine methods for general microbiological researches. However, it is usually necessary to call several tools or even write some scripts to complete some simple analysis, which is complicated for most biological researchers. To simplify the operation process, especially for the convenience of microbiologists in the analysis, here we have developed PGCGAP, a comprehensive, malleable and easily-installed prokaryotic genomics and comparative genomics analysis pipeline, which implements genome assembly, gene prediction and annotation, average nucleotide identity (ANI) calculation, phylogenetic analysis, COG annotation, pan-genome analysis, inference of orthologous gene groups, variants calling and annotation and screening for antimicrobial and virulence genes. Although we have tried our best to simplify the installation and usage of PGCGAP, it may be difficult for non-bioinformatician users to master it. So, a protocol was created to help microbiologists without any experience in bioinformatics to establish their own bioinformatics platform and perform routine analysis. This protocol shows how to choose equipment, to install a Linux subsystem on a laptop with windows 10 system, to install PGCGAP and perform all analysis with an example dataset. The protocol requires a basic understanding of Linux, so an additional web page was written to help uninitiated users learn Linux and whole-genome sequencing (https://github.com/liaochenlanruo/pgcgap/wiki/Learning-bioinformatics or http://bcam.hzau.edu.cn/linuxwgs.php).
A Mutant Vesicular Stomatitis Virus with Reduced Cytotoxicity and Enhanced Anterograde Trans-synaptic Efficiency
Authors: Lin Kunzhang , Zhong Xin , Ying Min , Li Lei , Tao Sijue , Zhu Xutao , He Xiaobin , Xu Fuqiang
Published: March 2020

Understanding the connecting structure of brain network is the basis to reveal the principle of the brain function and elucidate the mechanism of brain diseases. Trans-synaptic tracing with neurotropic viruses has become one of the most effective technologies to dissect the neural circuits. Although the retrograde trans-synaptic tracing for analyzing the input neural networks with recombinant rabies and pseudorabies virus has been broadly applied in neuroscience, viral tools for analyzing the output neural networks are still lacking. The recombinant vesicular stomatitis virus (VSV) has been used for the mapping of synaptic outputs. However, several drawbacks, including high neurotoxicity and rapid lethality in experimental animals, hinder its application in long-term studies of the structure and function of neural networks. To overcome these limitations, we generated a recombinant VSV with replication-related N gene mutation, VSV-NR7A, and examined its cytotoxicity and efficiency of trans-synaptic spreading. We found that by comparison with the wild-type tracer of VSV, the NR7A mutation endowed the virus lower rate of propagation and cytotoxicity in vitro, as well as significantly reduced neural inflammatory responses in vivo and much longer animal survival when it was injected into the nucleus of the mice brain. Besides, the spreading of the attenuated VSV was delayed when injected into the VTA. Importantly, with the reduced toxicity and extended animal survival, the number of brain regions that was trans-synaptically labeled by the mutant VSV was more than that of the wild-type VSV. These results indicated that the VSV-NR7A, could be a promising anterograde tracer that enables researchers to explore more downstream connections of a given brain region, and observe the anatomical structure and the function of the downstream circuits over a longer time window. Our work could provide an improved tool for structural and functional studies of neurocircuit.
Genomic Characterization of an Emerging Enterobacteriaceae Species: the First Case of Co-infection With a Typical Pathogen in a Human Patient
Authors: Zhang Zhao , Li Daixi , shi xing , Zhai Yao , Guo Yatao , Zheng Yali , Zhao Lili , He Yukun , Chen Yusheng , Wang Zhanwei , Su Jianrong , Kang Yu , Gao Zhancheng
Published: March 2020

Background Opportunistic pathogens are important for clinical practice as they often cause antibiotic-resistant infections. However, little is documented for many emerging opportunistic pathogens and their biological characteristics. Here, we isolated a novel species strain of extended-spectrum β-lactamase-producing Enterobacteriaceae from a patient of with a biliary tract infection. And we explored the biological and genomic characteristics of this strain to provide new evidence and detailed information for opportunistic pathogens about the co-infection they may cause. Results The isolate grows grew very slowly but confers conferred strong protection for the co-infected cephalosporin-sensitive Klebsiella pneumonia pneumoniae . As the initial laboratory testing failed to identify the taxonomy of the strain, great perplexity was caused in the etiological diagnosis , and anti-infection treatment for the patient. Rigorous sequencing efforts achieved the complete genome sequence of the isolate which we designated as AF18. AF18 is phylogenetically close to a few strains respectively isolated from soil, clinical sewage, and patients, forming a novel species together, while the taxonomic nomenclature of which is still under discussion. And this is the first report of human infection of this novel species. Like As its relatives, AF18 harbors many genes related to cell mobility, various genes adaptive to both natural wild environment and animal host, tens of over 30 mobile genetic mobile elements, and a plasmid bearing bla CTX-M-3 gene, indicating its ability to disseminate antimicrobial - resistant genes from the natural environment to patients. Transcriptome sequencing identified two sRNAs that critically regulate the growth rate of AF18 , which could serve as targets for novel antimicrobial strategies. Conclusions Our findings imply that AF18 and its species are not only infection-relevant but also potential disseminators of antibiotic resistance genes i n transferring antibiotic determinants , which highlights the need for continuous monitoring for this novel species and efforts to develop controlling treatment strategies.
Depreciation analysis and filter model review
Authors: abidi monem
Published: March 2020

Deciding to invest in oneself is not a direct and simple action. It is as complicated as it took a good time to besiege the factors influencing this investment process. In this respect, many approaches have emerged, sometimes contradictory, and complementary in other cases. The introduction of depreciation raises the challenge to pinpoint the problem, which remains so far fierce to any domestication. This paper presents a model that takes into account these different lines (such as the average level of aptitude of the entire population, the degree of homogeneity of skills within the same type of diploma). It turns out that the market value of a diploma tends to zero if the dispersion of skills is equal to productivity multiplied by the average aptitude of this level. A new conception of investment in education is thus formed, in which the price awarded to diplomas depends largely on the ability, whatever the average, or in terms of variance, stopping their investment in training at the same level.
Recombinant Adenovirus Expressing Vesicular Stomatitis Virus G Proteins induce both humoral and cell-medicated immune responses in Mice and Goats
Authors: Xue Xiaojuan , Yu Zhaorong , Jin Hongyan , Liang Lin , Li Jiayang , Li Xiaolu , Wang Yong , Cui Shangjin , Li Gang
Published: March 2020

Background: With a human type 5 replication-defective adenovirus expression vector, we constructed the three recombinant adenoviruses (rAd) and expressed the Vesicular Stomatitis Virus (VSV) Indiana serotype glycoprotein (VSV-IN-G), VSV New Jersey serotype glycoprotein (VSV-NJ-G), and the G fusion protein [two serotypes G (VSV-IN-G-NJ-G)]. Three rAds were named rAd-IN, rAd-NJ, and rAd-IN-NJ. The three rAds were inoculated into AAV-293 cells, and the AAV-293 cells were serially propagated to 20 generations until the virus titers were stable, then TCID50 was determined. In direct immunofluorescence and western blot were used for detecting the expression of the target proteins and lymphocyte proliferation test was used for immune cell numbers. Results: The results showed that G proteins we expressed with good reactogenicity. The rAds were used to subcutaneously inoculate mice three times with 2-week intervals, and goats two times with 3-week intervals, respectively. On 0, 2, 4, and 6 weeks of post-inoculation for the mice and 0, 3, 6, 9, and 12 weeks for goats, their sera were collected and NT antibodies were determined. The results showed that the rAds could induce the production of VSV antibodies in the mice, and VSV NT antibodies in the goats. The antibody levels were 1:16 to 1: 32 in mice, and 1:32 to 1: 64 in the goats. The rAds induced strong immune lymphocyte proliferations in mice and goats, which was significantly higher than those of the negative control groups. Conclusion: The three rAds expressed VSV-G proteins at high levels, and induced humoral and cellular immune responses in both mice and goats, which laid a foundation for further studies of the recombinant adenovirus vaccines expressing VSV glycoprotein.
Molecular confirmation of hemothropic mycoplasmas (hemoplasmas) in domestic cats (Felis catus) in Romania
Authors: Imre Mirela , Văduva Cristina , Dărăbuș Gheorghe , Morariu Sorin , Herman Viorel , Suici Tijana , Lait Philippa , Imre Kálmán
Published: March 2020

Background: The hemotropic mycoplasmas (hemoplasmas) of the genus Mycoplasma are recognized as important bacteria that parasitize red blood cells, causing hemolytic anemia in many mammalian species, including cats. No information is available concerning the presence of feline hemoplasma infections in cats in Romania. Thus, the objective of the present study was to provide data on the occurrence and molecular characterization of hemothropic mycoplasmas in client owned cats in Romania. Methods : Blood samples from 51 unhealthy cats, originating from Timişoara Municipality, Romania, were screened for the presence of hemoplasmas using conventional polymerase chain reaction (PCR) targeting the 16S rRNA gene and sequencing assays. Results: Molecular analysis revealed 11 (21.6%) positive samples, consisting of 8 (72.7%) Candidatus Mycoplasma haemominutum and 3 (27.3%) Mycoplasma haemofelis confirmed positives. Candidatus Mycoplasma turicensis was not detected, and no co-infections were registered. No significant associations ( p > 0 . 05) were found between the hemoplasma infection status and age, gender, breed, presence of ectoparasites, FeLV/FIV positivity of cats or the sampling season. However, outdoor access was positively associated ( p =0.049) with infection and could be considered a risk factor (OR=4.1) in acquiring feline hemotropic mycoplasmas. Conclusions : The findings support the emergence of feline hemoplasma infections in previously uninvestigated territories of Europe, providing useful information for small animal practitioners. To our knowledge, the present survey is the first reported molecular evidence of feline hemoplasma infections in Romania.
Major Leg Wound Complications between the Proximal and Distal Segments of Saphenous Veins Harvested by No-Touch Technique in Coronary Artery Bypass Graft Surgery: study protocol for a single-center randomized within-subject controlled clinical trial
Authors: Tian Meice , Hu Shengshou , Wang Xianqiang , Li Sidong , Wang Liqing
Published: March 2020

Background : The No-Touch saphenous vein harvesting technique has been proved to reduce vein graft occlusion after coronary artery bypass graft surgery. However, the optimum segment of the saphenous vein for this technique is still undetermined. Previous studies implicated lower occlusion of proximal segments of saphenous veins compared to distal segments, but with concern of higher leg wound complications. No randomized trials have been carried out accordingly. This pilot study is a single-center randomized within-subject-controlled tria l, comparing the leg wound complications of proximal segments of saphenous veins harvested by No-Touch versus distal segments. Methods : The study is planning intending to enroll 100 coronary artery bypass graft surgery patients from our institution, with each patient requiring two vein grafts with or without cardiopulmonary bypass. Both proximal and distal segments of saphenous veins will be harvested by No-Touch technique from ipsilateral legs. The proximal vein segments will be randomized to the left or right coronary territory for bypassing. The primary endpoint is major leg wound complications at 6 days postoperatively. Secondary endpoints include major leg wound complications during 3-month follow-up and graft vessel occlusion at 3 months and 1 year. Clinical events include major adverse cardiac or cerebrovascular events and recurrence of angina Discussion : This is the first study assessing the safety and effectiveness between different segments of No-Touch saphenous veins for coronary artery bypass graft surgery, and will help to establish preliminary evidence for decision making of precise vein graft conduit choice. Trial registration : ClinicalTrials.gov: NCT04284956
Tumor resection reduced circulating tumor cell dissemination
Authors: Zeng Chong , Zhang Xiaoli , Yao Jie
Published: March 2020

Background: Cancer is a major public health problem worldwide. Whether to perform tumor resection or non-resection remains controversial face different types. Circulating tumor cells (CTCs) which are classified into three subpopulations epithelial (E-CTC), mesenchymal (M-CTC), and epithelial mesenchymal (E/M-CTC) based on expression of specificity biomarker.Methods: We identified CTCs using CanPatrol CTC enrichment technique from peripheral blood samples of 930 patients with tumor resection or non-resection. Patients were divided into two groups: Resection (n=615) and Non-resection (n=315). The relationship between tumor resection and count of CTCs were studied by using correlation analysis.Results: The mean patient age was 57.52 years (range, 17–87 years). Univariate analysis tumor resection could significantly reduce the number of total CTC cells (hazard ratio，HR, 0.92, 95% confidence interval, CI= 0.903-0.937; P < 0.001), the E-CTC cells (HR, 0.889, 95% CI= 0.837-0.944; P < 0.001), the M-CTC cells (HR, 0.799, 95% CI= 0.735-0.869; P < 0.001), and the E/M-CTC cells (HR, 0.908, 95% CI= 0.888-0.928; P < 0.001).Furthermore, correlation analysis between total CTC and E-CTC, M-CTC, and E/M-CTC, the pearson correlation coefficient was 0.467, 0.458, and 0.963, respectively.Conclusions: In conclusion，the tumor resection can reduce the number of CTCs in peripheral blood.
Percutaneous vertebroplasty for Kummell’s disease: Short-term analysis of therapeutic effects and outcome predictors
Authors: Li Yibing , Gao Wenjie , Wang Xiaodong , Hao Dingjun
Published: March 2020

Background: To retrospectively investigate the short-term therapeutic effect of percutaneous vertebroplasty (PVP) for Kummell’s disease using a variable angle needle and to analyze the possible outcome predictors.Methods: Twenty-seven patients were included in this study. Medical records were evaluated. The following factors were analyzed on imaging data: location of lesion, the percentage of bone marrow edema, patterns of cement spreading, and post-procedural kyphosis correction. Visual analogue score (VAS) was used to analyze the clinical effect, and the improvement rate was calculated. Statistical analyses were conducted to evaluate the relationship between those factors and therapeutic outcomes using Fisher’s exact test, Chi-squared test, and Student’s unpaired t-test.Results: The effectiveness rate was 70.4% at 1 week, 74.1% after 1 month, and 63.0% after 3 months. Six months and one year after procedures, the effective rate remained steady at 70.4%. Post-procedural kyphosis correction ≥8° was a risk factor for inferior pain relief. An area of edema over 40% was a prognostic factor for superior pain relief at the first follow-up point. Cement morphology was a positive predictor for better pain relief at 1 month follow-up.Conclusions: Compared to the therapeutic effects of PVP on fresh osteoporotic vertebral compression fractures (OVCF), percutaneous vertebroplasty for Kummell’s disease was effective in only 63% to 74.1% of the patients at different follow-up points. Overemphasized kyphotic correction (over 8 degrees) was associated with poor outcomes. Areas of edema over 40% and cement morphology of mixed type were positive prognostic factors in the early stage.
IgG4-related aortitis/periaortitis and periarteritis: a distinct spectrum of IgG4-related disease
Authors: Peng Linyi , Zhang Panpan , Li Jieqiong , Liu Zheng , Lu Hui , Zhu Liang , Wang Xiaorong , Teng Fei , Li Xuemei , Guo Huifang , Fei Yunyun , Zhang Wen , Zhao Yan , Zeng Xiaofeng , Zhang Fengchun
Published: March 2020

Background: Large vessels could be involved in IgG4-related disease(IgG4-RD).This study aimed to clarify the clinical features and evaluate the treatment efficacy for IgG4-RD with aortitis/periaortitis and periarteritis (PAO/PA). Methods: This study enrolled 587 IgG4-RD patients in a prospective cohort with a follow-up time for more than 6 months. The distribution of IgG4-related PAO/PA was classified into four types: type 1, thoracic aorta; type 2a, abdominal aorta; type 2b, abdominal aorta and iliac artery; type 2c, iliac artery; type 3, thoracic and abdominal aorta; type 4, other arteries. Patient’s demographic data, clinical characteristics, laboratory parameters, and treatment efficacy were analyzed. Results: Of 587 IgG4-RD patients, 89(15.2%) had PAO/PA. The average age was 58.3±11.1 years, with male predominance (85.4%). Vessels affected were as follows: abdominal aorta (83.1%), iliac artery (70.8%), thoracic aorta (13.5%) and other vessels (13.5%). The most prevalent distribution type of IgG4-related PAO/PA was type 2b, with 74 (83.1%) patients, followed by type 2a, type 2c, type 3, and type 1. 55 (61.8%) PAO/PA patients had hydronephrosis, with renal insufficiency occurred in 43 (48.3%), and 31 (34.8%) PAO/PA patients had D-J stent drainage due to severe ureteral obstruction. After treatment with glucocorticoid and immunosuppressants, 82% patients achieved a remission with shrinking of perivascular mass. Conclusions: IgG4-RD with PAO/PA was distinct from non-PAO/PA in demographic features, organs involvement distribution, inflammatory markers, serum IgG4 and IgE. The most common affected vessel was abdominal aorta, and most patients responded well with treatment.
The Role of Series Cholecystectomy in High Risk Acute Cholecystitis Patients Who Underwent Gallbladder Drainage
Authors: Wang Chi-Chih , Tseng Ming-Hseng , Lin Chun-Che , Wu Sheng-Wen , Yang Tzu-Wei , Sung Wen-Wei , Wang Yao-Tung , Lee Hsiang-Lin , Shiu Bei-Hao , Tsai Ming-Chang
Published: March 2020

Background Cholecystectomy (CCY) is the only definitive therapy for acute cholecystitis. We conducted this study to evaluate which patients may not benefit from further CCY after percutaneous transhepatic gallbladder drainage (PTGBD) has been performed in acute cholecystitis patients.Methods Acute cholecystitis patients with PTGBD treatment were selected from one million random samples from the National Health Insurance Research Database obtained between January 2004 and December 2010. Recurrent biliary events (RBEs), RBE-related medical costs, RBE-related mortality rate and an RBE-free survival curve were compared in patients who accepted CCY within 2 months and patients without CCY within 2 months after the index admission.Results 365 acute cholecystitis patients underwent PTGBD at the index admission. A total of 190 patients underwent further CCY within 2 months after the index admission. The other 175 patients did not accept further CCY within 2 months after the index admission. RBE-free survival was significantly better in the CCY within 2 months group (60% vs. 42%, p<0.001). The RBE-free survival of the CCY within 2 months group was similar to that of the no CCY within 2 months group in patients ≥ 80 years old and patients with a Charlson Comorbidity Index (CCI) score ≥ 9.Conclusion We confirmed CCY after PTGBD reduced RBEs, RBE-related medical expenses, and the RBE-related mortality rate in patients with acute cholecystitis. In patients who accepted PTGBD, the RBE and survival benefits of CCY within 2 months became insignificant in patients ≥ 80 years old or with a CCI score ≥ 9.
CT Imaging Changes of Corona Virus Disease 2019 (COVID-19): A multi-center study in Southwest China
Authors: Li Xiaoming , Zeng Wenbing , Li Xiang , Chen Haonan , Shi Linping , Li Xinghui , Xiang Hongnian , Cao Yang , Chen Hui , Liu Chen , Wang Jian
Published: March 2020

Background: Since the first case of a coronavirus disease 2019 (COVID-19) infection pneumonia was detected in Wuhan, China, a series of confirmed cases of the COVID-19 were found in Southwest China. The aim of this study was to describe the imaging manifestations of hospitalized patients with confirmed COVID-19 infection in southwest China. Methods: In this retrospective study, data were collected from 131 patients with confirmed coronavirus disease 2019 (COVID-19) from 3 Chinese hospitals. Their common clinical manifestations, as well as characteristics and evolvement features of chest CT images, were analyzed. Results: A total of 100 (76%) patients had a history of close contact with people living in Wuhan , Hubei. The clinical manifestations of COVID-19 included cough, fever. Most of the lesions identified in chest CT images were multiple lesions of bilateral lungs, lesions were more localized in the peripheral lung, 109 (83%) patients had more than two lobes involved, 20 (15%) patients presented with patchy ground glass opacities, patchy ground glass opacities and consolidation of lesions co-existing in 61 (47%) cases. Complications such as pleural thickening, hydrothorax, pericardial effusion, and enlarged mediastinal lymph nodes were detected but only in rare cases. For the follow-up chest CT examinations (91 cases), We found 66 (73%) cases changed very quickly, with an average of 3.5 days, 25 cases (27%) presented absorbed lesions, progression was observed in 41 cases (46%), 25 (27%) cases showed no significant changes. Conclusion: Chest CT plays an important role in diagnosing COVID-19. The imaging pattern of multifocal peripheral ground glass or mixed consolidation is highly suspicious of COVID-19, that can quickly change over a short period of time.
BIRC7 and STC2 expression are associated with tumorigenesis and poor outcome in extrahepatic cholangiocarcinoma
Authors: Li Jiequn , Yang Zhulin , Huang Shengfu , Li Daiqiang
Published: March 2020

Background: Extrahepatic cholangiocarcinoma (EHCC) is a highly aggressive epithelial malignancy and has a poor prognosis for the insensitivity to therapies and difficulty in detection. Novel targets and biomarkers are urgently needed to develop for functional, diagnostic and prognostic application on EHCC.Methods: Immunohistochemical staining technique using the EnVision antibody complex was performed on the samples obtained from 100 EHCC，30 peritumoral extrahepatic biliary tract (EHBT), 10 EHBT adenomas and 15 normal EHBT tissues.Results: The positive rates of BIRC7 and STC2 expression in tissues obtained from peritumoral EHBT, EHBT adenomas and normal EHBT were significantly lower than those in EHCC tissues. BIRC7 and STC2 proteins were expressed at significantly higher levels in patients with lymph node metastasis, invasion of adjacent tissues, and higher TNM stage (III and/or IV) and unable to undergo resection (biopsy only). Kaplan-Meier survival curves indicated that significantly decreased overall survival rate in patients with positive-BIRC7 or positive-STC2 expression compared with patients of negative-BIRC7 or negative-STC2 expression, respectively. Cox-proportional regression analysis demonstrated that positive-BIRC7 and positive-STC2 expression, along with poor differentiation of EHCC, tumor size >3cm, lymph node metastasis, invasion of adjacent tissues and unable to undergo resection are independent prognostic factors of EHCC patients.Conclusions：The levels of BIRC7 and STC2 expression were correlated with clinicopathological characteristics of EHCC, and positive expression of BIRC7 and STC2 are associated with progression and poor clinical outcomes of EHCC. BIRC7 and STC2 might be a potential biomarker for EHCC diagnosis and prognosis.