bluuebunny/crossref_metadata_2025 huggingface dataset:
Accessing health services in India: Experiences of seasonal migrants returning to Nepal.
Authors: Adhikary Pratik , Aryal Nirmal , Dhungana Raja Ram , KC Radheyshyam Krishna , Regmi Pramod Raj , Wickramage Kolitha Prabhash , Duigan Patrick , Inkochasan Montira , Sharma Guna Nidhi , Devkota Bikash , Teijlingen Edwin van , Simkhada Padam
Published: October 2020

Background: Migration to India is a common livelihood strategy for poor people in remote Western Nepal. To date, little research has explored the degree and nature of healthcare access among Nepali migrant workers in India. This study explores the experiences of returnee Nepali migrants with regard to accessing healthcare and the perspectives of stakeholders in the government, support organizations, and health providers working with migrant workers in India.Methods: Six focus group discussions (FGDs) and 12 in-depth interviews with returnee migrants were conducted by trained moderators in six districts in Western Nepal in late 2017. A further 12 stakeholders working in the health and education sector were also interviewed. With the consent of the participants, FGDs and interviews were audio-recorded. They were then transcribed and translated into English and the data were analysed thematically.Results: The interviewed returnee migrants worked in 15 of India’s 29 states, most as daily-wage labourers. Most were from among the lowest castes so called-Dalits. Most migrants had had difficulty accessing healthcare services in India. The major barriers to access were the lack of insurance, low wages, not having an Indian identification card tied to individual biometrics so called: Aadhaar card. Other barriers were unsupportive employers, discrimination at healthcare facilities and limited information about the locations of healthcare services.Conclusions: Nepali migrants experience difficulties in accessing healthcare in India. Partnerships between the Nepali and Indian governments, migrant support organizations and relevant stakeholders such as healthcare providers, government agencies and employers should be strengthened so that this vulnerable population can access the healthcare they are entitled to.
Chromosomal aberration arises during somatic reprogramming to pluripotent stem cells
Authors: Liu Xinyu , Li Conghui , Zheng Kang , Zhao Xiaofeng , Xu Xiaofeng , Yang Aifeng , Yi Min , Tao Huaping , Xie Binghua , Qiu Mengsheng , Yang Junlin
Published: October 2020

Background: Reprogramming somatic cells to induced pluripotent stem cells (iPSCs) has opened new therapeutic possibilities. However, karyotypic abnormalities detected in iPSCs compromised their utility, especially chromosomal aberrations found at early passages raised serious safety concerns. The mechanism underlying the chromosomal abnormality in early-passage iPSCs is not known.Methods: Human dermal fibroblasts (HDFs) were stimulated with KMOS (KLF4, cMYC, OCT4 and SOX2) proteins to enhance their proliferative capacity and many vigorous clones were obtained. Clonal reprogramming was carried out by KMOS mRNAs transfection to confirm the ‘chromosomal mutagenicity’ of reprogramming process. Subculturing was performed to examine karyotypic stability of iPSCs after the re-establishment of stemness. And antioxidant N-acetyl-cysteine (NAC) was added to the culture medium for further confirmming the mutagenicity in the first few days of reprogramming.Results: Chromosomal aberrations were found in a small percentage of newly induced iPS clones by reprogramming transcription factors. Clonal reprogramming ruled out the aberrant chromosomes inherited from rare karyotypically abnormal parental cell subpopulation. More importantly, the antioxidant NAC effectively reduced the occurrence of chromosomal aberrations at the early stage of reprogramming. Once iPS cell lines were established, they restored karyotypic stability in subsequent subculturing.Conclusions: Our results provided the first line of evidence for the ‘chromosomal mutagenicity’ of reprogramming process.
Berberine alters gut microbial function through modulation of bile acids
Authors: Wolf Patricia , Devendran Saravanan , Doden Heidi L. , Ly Lindsey K. , Moore Tyler , Takei Hajime , Nittono Hiroshi , Murai Tsuyoshi , Kurosawa Takao , Chlipala George E. , Green Stefan J. , Kakiyama Genta , Kashyap Purna , McCracken Vance J. , Gaskins H. Rex , Gillevet Patrick M. , Ridlon Jason M.
Published: October 2020

Background: Berberine (BBR) is a plant-based nutraceutical that has been used for millennia to treat diarrheal infections and in contemporary medicine to improve patient lipid profiles. Reduction in lipids, particularly cholesterol, is achieved partly through up-regulation of bile acid synthesis and excretion into the gastrointestinal tract (GI). The efficacy of BBR is also thought to be dependent on structural and functional alterations of the gut microbiome. However, knowledge of the effects of BBR on gut microbiome communities is currently lacking. Distinguishing indirect effects of BBR on bacteria through altered bile acid profiles is particularly important in understanding how dietary nutraceuticals alter the microbiome. Results: Germfree mice were colonized with a defined minimal gut bacterial consortium capable of functional bile acid metabolism (Bacteroides vulgatus, Bacteroides uniformis, Parabacteroides distasonis, Bilophila wadsworthia, Clostridium hylemonae, Clostridium hiranonis, Blautia producta; B4PC2). Multi-omics (bile acid metabolomics, 16S rDNA sequencing, cecal metatranscriptomics) were performed in order to provide a simple in vivo model from which to identify network-based correlations between bile acids and bacterial transcripts in the presence and absence of dietary BBR. Significant alterations in network topology and connectivity in function were observed, despite similarity in gut microbial alpha diversity (P = 0.30) and beta-diversity (P = 0.123) between control and BBR treatment. BBR increased cecal bile acid concentrations, (P < 0.05), most notably deoxycholic acid (DCA) (P <0.001). Overall, analysis of transcriptomes and correlation networks indicates both bacterial species-specific responses to BBR, as well as functional commonalities among species, such as up-regulation of Na+/H+ antiporter, cell wall synthesis/repair, carbohydrate metabolism and amino acid metabolism. Bile acid concentrations in the GI tract increased significantly during BBR treatment and developed extensive correlation networks with expressed genes in the B4PC2 community.Conclusions: This work has important implications for interpreting the effects of BBR on structure and function of the complex gut microbiome, which may lead to targeted pharmaceutical interventions aimed to achieve the positive physiological effects previously observed with BBR supplementation.
The correlation of duration of cervical flexion per day with neck disability index scores in office workers: a cross sectional study
Authors: Jinlong Zhang , Yunyun Fang , Lijie Gao , Jian Chen , Cheng Wang , Hongchen He , Qinglu Luo
Published: October 2020

Background: An increasing number of office workers complain of neck pain after extended smart phone use. We conducted this study to examine the correlation between the duration of cervical flexion per day (DCF) during smart phone use and neck disability index scores (NDI ) scores of office workers in China.Methods: In this cohort study, 1791 individuals responded to an on line questionnaire. For our study, we included responses of 498 [27.8%] office workers. Excluded from the study were 1293 [72.9%] individuals including building workers, students, non-office workers, and those who did not complete the questionnaire. Participants completed an online questionnaire survey from May 29, 2019 to April 10, 2020. The NDI was used to evaluate cervical symptoms. Multivariable logistic regression, threshold saturation effect analysis, t-test, and Pearson’s chi-square tests were used to analyze the data. Results: We analyzed questionnaire results of the 498 office workers. The t-test showed no significant differences among the gender groups for age, working age, and NDI scores (P>0.05). Compared with other activities, smart phone use had no positive correlation with NDI scores (P>0.05), while low back pain had a strong correlation with NDI scores (P<0.05). When adjusting for age, working age, and low back pain covariates, DCF had a positive correlation with NDI scores. In addition, DCF had a curve line correlation with NDI-a monotone increasing relationship; the fold point was 6 (P<0.05).Conclusions: DCF had a positive curve line correlation with the NDI suggesting that office workers should limit DCF to a maximum of 6 hours to decrease NDI scores.
Effects of dapagliflozin on serum and urinary uric acid levels in patients with type 2 diabetes: a prospective pilot trial
Authors: Yuan Tao , Liu Shixuan , Dong Yingyue , Fu Yong , Tang Yan , Zhao Wei-Gang
Published: October 2020

Background: We aimed to evaluate the effects of short-term therapy with dapagliflozin on serum uric acid (SUA) and urinary uric acid (UUA) levels in patients with type 2 diabetes.Methods: In this prospective pilot trial, 8 patients with type 2 diabetes mellitus were assigned to the treatment group with dapagliflozin 10 mg once daily for one week, and 7 subjects with normal glucose tolerance were recruited into the control group. Data of anthropometric measurements, SUA, 24-hour UUA, fractional excretion of UA (FEUA), serum lipid parameters and 3-hour oral glucose tolerance test (OGTT) were collected in both treatment and control groups; all examinations were repeated after treatment. The area under the curve of glucose (AUCGlu) was calculated to reflect the general glucose levels, while insulin resistance and islet β-cell function were reflected by indexes calculated according to the data obtained from the OGTT.Results: The weight and serum lipid parameters showed no differences before and after treatment with dapagliflozin for one week. We found SUA levels decreased from 347.75 ± 7.75 μmol/L before treatment to 273.25 ± 43.18 μmol/L after treatment, with a statistically significant difference (P=0.001) and was accompanied by a significant increase in FEUA from 0.009 to 0.029 (P=0.035); there was a linear correlation between SUA and FEUA levels. Glucose control, insulin sensitivity and islet β-cell function were improved to a certain extent. We also found a positive correlation between the decrease in glucose levels and the improvement in islet β-cell function.Conclusions: The SUA-lowering effect of dapagliflozin could be driven by increasing UA excretion within one week of treatment, and a certain degree of improvement in glucose levels and islet β-cell function were observed. Trial registration: ClinicalTrials.gov identifier, NCT04014192. Registered 12 July 2019, https://www.clinicaltrials.gov/ct2/show/NCT04014192?term=NCT04014192&draw=2&rank=1. Yes.
Seroprevalences of classical swine fever virus and porcine reproductive and respiratory syndrome virus in pigs in Hunan Province, China
Authors: Yu Haoyang , Zhang Luhua , Cai Yunfeng , Peng Tao , Liu Lei , Wang Naidong , Wang Guiping , Deng Zhibang , Zhan Yang
Published: October 2020

Background: Classical swine fever (CSF) and porcine reproductive and respiratory syndrome (PRRS) are responsible for major economic losses and represent a threat to the swine industry worldwide. Routine surveillance serology for CSF and PRRS will be critical to maintain the health status of sow farms in Hunan Province, which is one of the top pig production provinces in China.The objective of our study was to investigate the seroprevalence of CSF virus (CSFV) and PRRS virus (PRRSV) in Hunan Province from 2017 to 2019 using ELISA. The cohort pig serum samples were collected from vaccinated and unvaccinated sow farms in eight cities in Hunan Province. Results: CSFV and PRRSV seropositivity showed significant differences among parts of Hunan Province in China. Interestingly, our findings show that the level of CSFV antibody in piglet sera decreases gradually with increasing piglet age, whereas PRRSV-specific antibodies may appear in various growth stages in unvaccinated animals. Meanwhile, the average rate of CSFV antibody seropositivity was 82.2%, while the rate of PRRSV antibody seropositivity was slightly higher (84.4%) in the immunized group.Conclusions: The results from this study suggest that a serological investigation of these two major infectious diseases (CSF and PRRS) among pigs at various growth stages will provide a basis for the further development of more effective prevention and control measures.
Lactobacillus fermentum CQPC07 attenuates obesity, inflammation and dyslipidemia by modulating the antioxidant capacity and lipid metabolism in high-fat diet induced obese mice
Authors: Wu Ya , Li Xueya , Tan Fang , Zhou Xianrong , Mu Jianfei , Zhao Xin
Published: October 2020

Backgroud: Obesity is an epidemic disease in the world, the treatment and prevention of obesity methods have gained great attention. Lactobacillus is the main member of probiotics, and the physiological activity of it is specific to different strains. This study systematically explored the anti-obesity effect and possible mechanism of Lactobacillus fermentum CQPC07 (LF-CQPC07), which was isolated from pickled vegetables.Results: LF-CQPC07 effectively controlled the weight gain of mice caused by a high-fat diet. The results of pathological sections indicated that LF-CQPC07 alleviated hepatocyte damage and fat accumulation in adipocytes. The detection of biochemical indictors revealed that LF-CQPC07 decreased the levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG), and increased the level of high-density lipoprotein cholesterol (HDL-C). Additionally, LF-CQPC07 caused the decrease in the amounts of inflammatory cytokines interleukin (IL)-1β, tumor necrosis factor-α (TNF-α), IL-6, and interferon-γ (IFN-γ), and the increase in the amounts of the anti-inflammatory cytokines IL-10 and IL-4. LF-CQPC07 also decreased the amounts of alanine aminotransferase (ALT), aspartate transaminase (AST), and alkaline phosphatase (ALP). Confirmed by qPCR, LF-CQPC07 enhanced the mRNA expression of catalase (CAT), gamma glutamylcysteine synthetase 1 (GSH1), copper/zinc superoxide dismutase (SOD1), manganese superoxide dismutase (SOD2), and glutathione peroxidase (GSH-Px). It also increased the mRNA expression levels of carnitine palmitoyltransferase 1 (CPT1), peroxisome proliferator-activated receptor alpha (PPAR-α), lipoprotein lipase (LPL), and cholesterol 7 alpha hydroxylase (CYP7A1), and decreased that of PPAR-γ and CCAAT/enhances binding protein alpha (C/EBP-α) in the liver of mice.Conclusion: this research confirmed that LF-CQPC07 is capable of ameliorating obesity, improving hyperlipemia, and alleviating chronic low-grade inflammation and liver injury accompanied with obesity. Its mechanism may be the regulation of antioxidant capacity and lipid metabolism. Therefore, LF-CQPC07 has enormous potential to serve as a potential probiotic for the prevention or treatment of obesity.
The Morphology of Patella changed significantly after Soft Tissue Correction for children with Recurrent Patella Dislocation
Authors: Niu Jinghui , Qi Qi , Hao Kuo , Lin Wei , Piao Kang , Wang Fei
Published: October 2020

Background: Although morphological improvement of femoral trochlea has been investigated in children with patellar dislocation after surgery, whether the patellar shape changed under the same condition is still unknown. The purpose of the study was to investigate the changes of patella morphology in transverse plane following surgical correction of recurrent patella dislocation in children.Methods: A total of 22 patients with a mean age of 9.9 years (7 to 12) were included. All had unilateral recurrent patella dislocation. The knees with recurrent patellar dislocation were treated with medial patellar retinaculum plasty and defined as the affected side. The contralateral knees with no symptom of patellar instability were considered as the unaffected side. All patients were treated between October 2014 and August 2018. Axial CT (Computed Tomography) scans were undertaken in all patients to assess the patella morphological characteristics on a particular axial image preoperatively and at the final follow-up.Results: There were not significant differences about patellar transverse diameter, thickness and Wiberg angle between affected side and unaffected side before surgery and at the last follow-up respectively ( The mean follow-up period: 28.0 ± 3.3 months). However, before surgery, the Wiberg-index in the affected side (0.74 ± 0.06) was significantly different from that in the unaffected side (0.64 ± 0.04). At the last follow-up, the Wiberg-index in the affected side (0.67 ± 0.05) and the unaffected side (0.65 ± 0.04) were not significantly different. Also, in the affected side, the Wiberg-index at the last follow-up was significantly lower than that before surgery (P < 0.05). The Wiberg-index in the unaffected side was not significantly different before surgery and at the last follow-up. Conclusion: The patella morphology can change significantly after surgical procedures in children with patellar recurrent dislocation whose epiphysis is not closed.
Early incidence of deep venous thrombosis and its early marker after knee arthroscopy: A retrospective study with routinely applied ultrasonography
Authors: Shu Lei , Ni Qubo , Chen Biao , He Hangyuan , Chen Liaobin , Yang Xu
Published: October 2020

Background: To (1) investigate the early incidence of deep venous thrombosis (DVT) after knee arthroscopy at a single institution and (2) determine the early marker for DVT in these patients.Methods: The records of patients who underwent knee arthroscopy in our department between January 2018 and October 2019 were reviewed. Ultrasonography was performed for each patient at 24h preoperative and 72h postoperative. The low-molecular-weight-heparin (LMWH) was routinely used as thromboprophylaxis on the first day postoperative after 1st January 2019. Preoperative and perioperative data were collected with respect to demographic data, medical history, medications, and surgical and anesthesia data. Chi-square test or Student t test was used to preliminarily screen out suspected risk factors. Then, multiple logistic regression analysis was utilized to further determine the risk factors of DVT after knee arthroscopy.Results: During the study period, 272 patients were reviewed. Among these patients, 21 cases of DVT occurred, resulting in an incidence of 7.7%, two (0.74%) of which were identified as symptomatic thrombosis. The incidence of DVT in the anticoagulant group was 7.9%, and 7.4% in the non-anticoagulant group, respectively. The use of low molecular weight heparin postoperative did not reduce the incidence of DVT after knee arthroscopy. An increased D-dimer level could be an early marker for an elevated risk of postoperative DVT. No association between different arthroscopic procedures and thrombotic events. And the tourniquet time are not related risk factor.Conclusions: In this study, the early incidence of DVT after knee arthroscopy was 7.7%. Symptomatic DVT was rare and occurred infrequently. The incidence of DVT within three days could not be reduced by using LMWH, and a high D-dimer level was an early marker for DVT after knee arthroscopy.
Recognition of high-risk HPV E6 oncoproteins by 14-3-3 proteins studied by interactomics and crystallography
Authors: Gógl Gergő , Tugaeva Kristina , Eberling Pascal , Kostmann Camille , Trave Gilles , Sluchanko Nikolai
Published: October 2020

In tumors induced by high-risk mucosal human papillomaviruses (hrm-HPVs), HPV E6 oncoproteins inhibit apoptotic processes and sustain cell proliferation. E6 from all hrm-HPVs harbor a C-terminal short PDZ domain-binding motif (PBM), whose phosphorylation down-regulates PDZ binding but triggers E6 binding to 14-3-3 proteins. Here we classify PBMs of E6 proteins depending on their principle ability to be phosphorylated and subsequently acquire a 14-3-3-binding motif III consensus, (pS/pT)XX-COOH. Systematic competitive fluorescence polarization measurements show that the PBMs from four selected E6 oncoproteins bind all seven human 14-3-3 isoforms with distinct, wide-ranging affinities, obeying remarkable trends assigned to 14-3-3 isoform specificity and small E6 sequence variations. We crystallized the hrm-HPV18 E6 PBM bound to 14-3-3ζ, revealing a 14-3-3-motif III complex at 1.9 Å resolution. Using fluorescence polarization and crystallography, we also demonstrate that fusicoccin, a molecule that reinforces many known 14-3-3 complexes, destabilizes the 14-3-3-E6 interaction, indicating the druggability of that complex.
Increasing levels of Parasutterella in the gut microbiome correlate with improving Low-Density Lipoprotein levels in healthy adults consuming resistant potato starch during a randomised trial
Authors: Bush Jason Russell , Alfa Michelle J
Published: October 2020

Background: Prebiotics, defined as a substrate that is selectively utilized by host microorganisms conferring a health benefit, present a potential option to optimize gut microbiome health. Elucidating the relationship between specific intestinal bacteria, prebiotic intake, and the health of the host remains a primary microbiome research goal.Objective: To assess the correlations between gut microbiota, serum health parameters, and prebiotic consumption in healthy adults.Methods: We performed ad hoc exploratory analysis of changes in abundance of genera in the gut microbiome of 75 participants from a randomized, placebo-controlled clinical trial that evaluated the effects of resistant potato starch (RPS; MSPrebiotic®, N = 38) intervention versus a fully digestible placebo (N = 37) for which primary and secondary outcomes have previously been published. Pearson correlation analysis was used to identify relationships between health parameters (ie. blood glucose and lipids) and populations of gut bacteria.Results: Abundance of Parasutterella (phylum Proteobacteria) tended to increase in the gut microbiome of individuals consuming RPS and those increases in Parasutterella were correlated with reductions in low-density lipoprotein (LDL) levels in participants consuming RPS but not placebo. Segregating RPS-consuming individuals whose LDL levels decreased (ie “Responders”) from those who did not (ie. “Non-Responders”) revealed that LDL Responders had significantly higher levels of Parasutterella both at baseline and after 12 weeks of consuming RPS.Conclusion: Our analyses suggest that RPS may help improve LDL levels depending upon the levels of Parasutterella in an individual’s gut microbiome.Trial Registration: This study protocol was reviewed and approved by Health Canada (Submission #188517; “Notice of Authorization” dated 06/05/13) and registered as NCT01977183 (10/11/13) listed on NIH website: ClinicalTrials.gov. Data generated in this study have been submitted to NCBI (http://www.ncbi.nlm.nih.gov/bioproject/381931).Funding: MSP Starch Products Inc.
A pilot randomized controlled trial of a tailored smoking cessation program for people living with HIV in the Washington, D.C. metropolitan area
Authors: Kierstead Elexis C. , Harvey Emily , Sanchez Denisse , Horn Kimberly , Abroms Lorien C. , Spielberg Freya , Stanton Cassandra A. , Debnam Charles , Cohn Amy , Gray Tiffany , Magnus Manya , Patel Minal , Niaura Raymond , Elf Jessica L.
Published: October 2020

ObjectiveMorbidity and mortality from smoking-related diseases among people living with HIV (PLWH) in the U.S. surpasses that due to HIV itself. Conventional smoking cessation treatments have not demonstrated strong efficacy among PLWH. We conducted a pilot randomized controlled trial (RCT) to evaluate a tailored smoking cessation intervention based on the minority stress model. We compared standard of care counseling (SOC) to a tailored intervention (TI) including one face-to-face counseling session incorporating cognitive behavioral therapy to build resilience, and 30 days of 2-way text messaging.ResultsThe primary outcome was smoking cessation. Secondary outcomes included cigarettes per day (CPD), exhaled carbon monoxide (CO), and cessation self-efficacy. A total of 25 participants were enrolled (TI:11, SOC:14), and 2 were lost to follow up. There were no significant differences in quit rates between study groups. However, there was a significantly greater decrease in CPD in the TI versus SOC (13.5 vs. 0.0, p-value:0.036). Additionally, self-efficacy increased in both groups (TI p-value:0.012, SOC p-value:0.049) and CO decreased in both groups (TI p-value:<0.001, SOC p-value:0.0488). This intervention shows promise to support smoking cessation among PLWH. A larger study is needed to fully evaluate the efficacy of this approach.Trial RegistrationRetrospectively registered (10/20/2020) NCT04594109
Inhibition of SIRT6 potentiates the anti-tumor effect of doxorubicin through suppression of the DNA damage repair pathway in osteosarcoma
Authors: Zhang Zhongkai , Ha Sang Hoon , Moon Young Jae , Hussein Usama Khamis , Song Yiping , Kim Kyoung Min , Park See-Hyoung , Park Ho Sung , Park Byung-Hyun , Ahn Ae-Ri , Lee Sang-A , Ahn Su Jin , Kim Jung Ryul , Jang Kyu Yun
Published: October 2020

Background: SIRT6 has diverse roles in cells, and the role of SIRT6 in tumorigenesis is controversial. Considering the role of SIRT6 as an inducer of DNA damage repair, it might be involved in resistance to anti-cancer therapy. Methods: We evaluated the prognostic significance of SIRT6 in 37 osteosarcomas and investigated the therapeutic efficacy of SIRT6 on the anticancer effects of doxorubicin, olaparib, and ATM inhibitor. Results: Immunohistochemical expression of SIRT6 was significantly associated with shorter overall survival and relapse-free survival of osteosarcoma patients, especially in patients who received adjuvant chemotherapy. In U2OS and KHOS/NP osteosarcoma cells, knock-down of SIRT6 significantly potentiated apoptotic effects of doxorubicin and SIRT6 overexpression induced resistance to doxorubicin. Moreover, SIRT6 induced the DNA damage repair pathway and SIRT6-mediated resistance to doxorubicin was attenuated by blocking the DNA damage repair pathway with olaparib and ATM inhibitor. Conclusions: This study suggests that suppression of SIRT6 in combination with doxorubicin might be an effective modality in the treatment of osteosarcoma patients, especially for osteosarcomas with shorter survival with high expression of SIRT6.
Comparison of lumbar endoscopic unilateral laminotomy bilateral decompression and minimally invasive surgery transforaminal lumbar interbody fusion for one-level lumbar spinal stenosis
Authors: Hua Wenbin , Wang Bingjin , Ke Wencan , Wu Xinghuo , Zhang Yukun , Li Shuai , Yang Shuhua , Yang Cao
Published: October 2020

Background: The aim of the present study is to compare the clinical outcomes and postoperative complications of lumbar endoscopic unilateral laminotomy bilateral decompression (LE-ULBD) and minimally invasive surgery transforaminal lumbar interbody fusion (MIS-TLIF) to treat one-level lumbar spinal stenosis (LSS) without degenerative spondylolisthesis or deformity.Methods: A retrospective analysis of 112 consecutive patients of one-level LSS undergoing either LE-ULBD or MIS-TLIF was performed. Patient demographics, operation time, estimated blood loss, time to ambulation, length of hospitalization, intraoperative and postoperative complications were recorded. The visual analog scale (VAS) score for leg and back pain, the Oswestry Disability Index (ODI) score, and the Macnab criteria were used to evaluate the clinical outcomes. The healthcare cost was also recorded.Results: The operation time, estimated blood loss, time to ambulation and length of hospitalization of LE-ULBD group were shorter than MIS-TLIF group. The postoperative mean VAS and ODI scores decreased significantly in both groups. According to the modified Macnab criteria, the outcomes rated as excellent/good rate were 90.6% and 93.8% in the two groups. The mean VAS scores, ODI scores and outcomes of the modified Macnab criteria of both groups were of no significant difference. The healthcare cost of LE-ULBD group was lower than MIS-TLIF group. Two cases of intraoperative epineurium injury were observed in the LE-ULBD group. One case of cauda equina injury was observed in the LE-ULBD group. No nerve injury, dural injury or cauda equina syndrome was observed in MIS-TLIF group. However, one case with transient urinary retention, one case with pleural effusion, one case with incision infection and one case with implant dislodgement were observed in MIS-TLIF group.Conclusions: Both LE-ULBD and MIS-TLIF are safe and effective to treat one-level LSS without degenerative spondylolisthesis or deformity. LE-ULBD is a more minimally invasive option and of less economic burden compared with MIS-TLIF. Decompression plus instrumented fusion may be not necessary for one-level LSS without degenerative spondylolisthesis or deformity.
Acute skeletal muscle wasting and dysfunction predict physical disability at hospital discharge in patients with critical illness
Authors: Mayer Kirby P. , Bastin Melissa L. Thompson , Montgomery-Yates Ashley A. , Pastva Amy M. , Dupont-Versteegden Esther E. , Parry Selina M. , Morris Peter E
Published: October 2020

Background: Patients surviving critical illness develop muscle weakness and impairments in physical function, however, the relationship between early skeletal muscle alterations and physical function at hospital discharge remains unclear. The primary purpose of this study was to determine if changes in muscle size, strength and power assessed in the intensive care unit (ICU) predict physical function at hospital discharge. Methods: Study design is a single-center, prospective, observational study in patients admitted to the medicine or cardiothoracic ICU with diagnosis of sepsis or acute respiratory failure. Rectus femoris (RF) and tibialis anterior (TA) muscle ultrasound images were obtained day one of ICU admission, repeated serially and assessed for muscle cross-sectional area (CSA), layer thickness (mT), and echointensity (EI). Muscle strength, as measured by Medical Research Council-sum score, and muscle power (lower-extremity leg-press) were assessed prior to ICU discharge. Physical function was assessed with performance on 5-times sit-to-stand (5STS) at hospital discharge.Results: Forty-one patients with median age of 61 years (IQR 55-68), 56% male, and sequential organ failure assessment score of 8.1 ± 4.8 were enrolled. RF muscle CSA decreased significantly a median percent change of 18.5% from day 1 to 7 (F = 26.6, p = 0.0253). RF EI increased at a mean percent change of 10.5 ± 21% in the first 7 days (F = 3.28, p = 0.081). At hospital discharge 25.7% of patients (9/35) met criteria for ICU-acquired weakness. Change in RF EI in first 7 days of ICU admission and muscle power measured prior to ICU were strong predictors of ICU-AW at hospital discharge (AUC = 0.912). Muscle power at ICU discharge, age and ICU length of stay were predictive of performance on 5STS at hospital discharge.Conclusion: ICU-assessed muscle alterations, specifically RF EI and muscle power are predictors of diagnosis of ICU-AW and physical function assessed by 5x-STS at hospital discharge in patients surviving critical illness.
The effect of opioid-free anesthesia on the quality of recovery after gynecological laparoscopy: study protocol for a prospective randomized controlled trial
Authors: Song Jae Yen , Choi Hoon , Chae Minsuk , Ko Jemin , Moon Youg Eun
Published: October 2020

Background: Because of the indiscriminate use of opioids during the perioperative period, opioid-free anesthesia (OFA) has been increasingly required. Nevertheless, the studies on the detailed techniques and effects of OFA are not sufficient. The Quality of Recovery-40 (QoR-40) questionnaire is a validated assessment tool for measuring recovery from general anesthesia. However, no study has used the QoR-40 to determine if OFA leads to better recovery than standard general anesthesia. Therefore, we aim to perform this study to determine the effects of OFA using dexmedetomidine and lidocaine on the quality of recovery as well as the various postoperative outcomes. Methods: The participants (n=78) will be allocated to one of the two groups; Study group will receive bolus and infusion of dexmedetomidine and lidocaine and Control group will receive remifentanil infusion during general anesthesia for gynecological laparoscopy. The other processes including anesthetic and postoperative care will be performed similarly in two groups. Intraoperative hemodynamic, anesthetic, and nociceptive variables will be recorded. Postoperative outcomes such as QoR-40, pain severity, opioid-related side effects will be assessed. Additionally, ancillary cytokine study (inflammatory cytokine, stress hormone, and reactive oxygen species) will be performed during study period. Discussion: This will be the first study to determine the effect of OFA, using the combination of dexmedetomidine and lidocaine, on the quality of recovery after gynecological laparoscopy compared with standard general anesthesia using remifentanil. The findings from this study will provide scientific and clinical evidence on the efficacy of OFA.Trial registration: ClinicalTrials.gov: NCT04409964. Registered on 28 May 2020.
Anti-Warburg effect by targeting HRD1-PFKP pathway may inhibit breast cancer progression
Authors: Fan Ya , Wang Jia , Xu Yuemei , Wang Yipin , Song Tao , Liang Xiubin , Jin Feng , Su Dongming
Published: October 2020

Background: Our previous studies have shown that the E3 ubiquitin ligase of HMG-CoA reductase degradation 1 (HRD1) functions as a tumor suppressor, as overexpression of HRD1 suppressed breast cancer proliferation and invasion. However, its role in breast cancer cell glucose metabolism was unclear. Here, our aim was to uncover the role and molecular mechanisms of HRD1 in regulating aerobic glycolysis in breast cancer. Methods: The effect of HRD1 on robic glycolysis in breast cancer cells were assessed. Then the proliferation, colony formation ability, invasion and migration of breast cancer cells were evaluated. The relationship between HRD1 and PFKP was validated by Mass spectrometry analysis, immunofluorescence and co-immunoprecipitation. The level of PFKP ubiquitination was measured using ubiquitylation assay. Furthermore, the tumor growth and metastasis in mice xenografts were observed. Results: We found that upregulation of HRD1 clearly decreased aerobic glycolysis, and subsequently inhibited breast cancer proliferation and invasion. Mass spectrometry analysis results revealed a large HRD1 interactome, which included PFKP (platelet isoform of phosphofructokinase), a critical enzyme involved in the Warburg Effect in breast cancer. Mechanistically, HRD1 interacted and colocalized with PFKP in the cytoplasm, targeted PFKP for ubiquitination and degradation, and ultimately reduced PFKP expression and activity in breast cancer cells. HRD1 inhibited breast cancer growth and metastasis in vivo through a PFKP-dependent wayConclusions: Our findings reveal a new regulatory role of HRD1 in Warburg effect and provide a key contributor in breast cancer metabolism.
A realistic evaluation of evidence-based therapeutic processes in mental health services– Context-Mechanisms-Outcomes
Authors: Badu Eric , O’Brien Anthony Paul , Mitchell Rebecca , Osei Akwasi
Published: October 2020

Background

Evidence-based clinical practice is an inherent component of developed countries mental health professional practice, however, little is known about Ghana mental health professional perspectives on evidence-based practice. This paper outlines the processes involved in the delivery of best practice in Ghana. The paper describes a realistic evaluation of mental health nurses and allied health opinions regarding the evidenced-based therapeutic process in Ghana mental health facilities.
Methods

A purposive sample of 30 Mental Health Professionals (MHPs) was recruited to participate in semi-structured in-depth interviews. Thematic analysis was used to analyse the data. A programme theory of Context + Mechanism = Outcome (CMO) configuration was developed from the analysis.
Results

The thematic analysis identified two CMO configurations: 1) technical competency stimulates evidence-based mental health services; and, 2) therapeutic alliance-building ensures effective interaction. The study demonstrated that contextual factors (technical competencies and therapeutic alliance building) together with mechanisms (intentional and unintentional) help to promote the quality of mental health services. However, contextual factor such as the lack of sign language interpreters yielded an unintended outcome such as consumer-provider communication barrier for consumers with hearing impaired and those from linguistically minority background.
Conclusion

We conclude that government stakeholders and policymakers should prioritize policy documents, periodic monitoring and adequate financial incentives to support the on-going mechanisms that promote mental health professional technical competence and therapeutic alliance building.
Induced in vivo transdifferentiation of vertebrate muscle into early endoderm-like cells
Authors: Dong P. Duc , Lancman Joseph , Campbell Clyde , Espin-Palazon Raquel , Matalonga Jonatan , He Jiaye , Graves Alyssa , Mishra Rashmi , Yin Jun , Zhao Chengjian , Zeng Xin-Xin , Huisken Jan , Traver David
Published: October 2020

The extent to which differentiated cells, while remaining in their native microenvironment, can be reprogrammed to assume a different identity will reveal fundamental insight into cellular plasticity and impact regenerative medicine. To investigate in vivo cell lineage potential, we leveraged the zebrafish as a practical vertebrate platform to determine factors and mechanisms necessary to induce differentiated cells of one germ layer to adopt the lineage of another. We discovered that ectopic co-expression of Sox32 and Oct4 in several non-endoderm lineages, including skeletal muscle, can specifically trigger an early endoderm genetic program in a cell-autonomous manner. Gene expression, live imaging, and functional studies reveal that the endoderm-induced muscle cells lose muscle gene expression and morphology, while specifically gaining endoderm organogenesis lineage markers, such as the pancreatic specification genes, hhex and ptf1a, via a mechanism resembling normal development. Endoderm induction by a pluripotent defective form of Oct4, endoderm markers appearing prior to loss of muscle cell morphology, and a lack of mesoderm, ectoderm, dedifferentiation, and pluripotency gene activation, together, suggests that reprogramming is endoderm specific and occurs via direct transdifferentiation. Our work demonstrates that within a living vertebrate animal, differentiated cells can be induced to directly adopt the identity of a completely unrelated cell lineage, while remaining in a distinct microenvironment, suggesting that differentiated cells in vivo may be more amenable to lineage conversion than previously appreciated. This discovery of extensive lineage potential of differentiated cells, in vivo, challenges our understanding of cell lineage restriction and may pave the way towards new in vivo sources of replacement cells for degenerative diseases such as diabetes.
Definition of Acute Respiratory Distress Syndrome in Plateau of Xining,Qinghai: Verification of Berlin Definition Plateau Criteria
Authors: Liu Xiaoqin , Pan Chun , Si Li-Ning , Tong Shijun , Niu Yi , Qiu Haibo , Guifen Gan
Published: October 2020

BackgroundAcute respiratory distress syndrome（ARDS） is a common respiratory critical illness. The high altitude hypoxic environment has a great influence on its occurrence and development. Now we lack clear diagnostic definition of high altitude acute respiratory distress syndrome.To verify the application value of Berlin Definition plateau criteria of Acute Respiratory Distress Syndrome in Xining , Qinghai ( 2261m).MethodsRetrospective analysis of the clinical data of ARDS patients admitted to the Department of Critical Care Medicine of the Affiliated Hospital of Qinghai University from January 2018 to December 2018. The severity was divided according to the Berlin definition, the plateau standard, and the Zhang standard, and the differences of three standards were compared.ResultsIn this study, 512 patients with mechanical ventilation were selected. 229 patients who met the criteria of Berlin Definition plateau criteria , including 107 patients with mild ARDS (46.72%), 84 moderate patients (36.68%) and 38 severe ARDS patients (16.59%). Among 253 meet Berlin definition patients , 49(19.77%) were mild,148(58.50%) were moderate,and 56 (22.13%) were severe ARDS. There are 204 patients that meet Zhang criteria, among the 204 enrolled patients, 87(42.65%) were ALI and 117(57.35%) were ARDS. The AUROC of the Berlin Definition, the Plateau criteria and Zhang criteria were 0.6675 (95% CI 0.5866-0.7484), 0.6216 (95%CI 0.5317-0.7116) and 0.6050 (95% CI 0.5084-0.7016).ConclusionFor Xining, Qinghai, the Berlin Definition Plateau oxygenation index correction criteria can distinguish the severity of ARDS , but it needs to be enlarged and confirmed by multicenter clinical studies.
Study on optimization and stability of a single dose streptozotocin-induced diabetic modeling in rats
Authors: Zhang Yao , Zhang jiao , Hong Ming , Huang Jingyi , Wang Rui , Tan Bo , Huang Ping , Cao Hongying
Published: October 2020

BackgroundOptimization of experimental conditions in streptozotocin induced diabetic model in Sprague Dawley (SD) rats to evaluate the stability of the model.MethodsMale and female SD rats were randomly divided into control group, STZ 45 group (STZ: 45 mg / kg), STZ 65 group (STZ: 65 mg / kg), STZ 85 group (STZ: 85 mg / kg), high fat diet with STZ 45 group (STZ: 45 mg / kg), high fat diet with STZ 65 group (STZ: 65 mg / kg), high fat diet with STZ 85 group (STZ: 85 mg / kg). N = 6 in each group. The changes of body weight and blood glucose were observed dynamically.ResultsThere was no significant difference in blood glucose or body weight between the STZ 45 group and the control group in both male and female rats, whether or not they were on a high-fat diet. However, there were significant differences in blood glucose between the high-dose STZ group and the control group in both male and female rats, regardless of whether the rats were on a high-fat diet or not (P < 0.05 or P < 0.01). Compared with the control group, there were significant differences in blood glucose levels (P < 0.05 or P < 0.01) and higher blood glucose levels in the male rats fed with the normal diet than that in those fed with the high-fat diet.ConclusionsIn this study, male rats fed with ordinary feed and injected STZ dose of 65 mg / kg were the most stable and ideal diabetic rat.
Applying high throughput and comprehensive immunoinformatics approaches to design a trivalentsubunit vaccine forinduction of immune response against human emerging coronaviruses SARS-CoV, MERS-CoV and SARS-CoV2
Authors: Rahmani Abolfazl , Baee Masoud , Saleki Kiarash , Moradi Saead , Nouri Hamid Reza
Published: October 2020

Background

Coronaviruses (CoV) cause diseases such as severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS) and Coronavirus disease 2019 (COVID-19). Therefore, this study was conducted to contrast a trivalent subunit vaccine against SARS, MERS and COVID-19. The CTL, HTL, MHC I, and IFN-γ epitopes were predicted. Moreover, to stimulate strong helper T lymphocytes (HTLs) responses, Pan HLA DR-binding epitope (PADRE) was used. Also, for boosting immune response, β-defensin 2 was added to the construct as an adjuvant. Furthermore, TAT was applied in the vaccine to facilitate the intracellular delivery.
Results

Based on the predicted epitopes, a trivalent multi-epitope vaccine with a molecular weight of 74.8 kDa as a strong antigen, a non-allergenic, and soluble protein was constructed. Furtheremore, analyses validated the stability of the proposed vaccine. The binding affinity of the vaccine construct with the TLR3 was confirmed by molecular docking and, stability of the docked complex was simulated. The predicted epitopes demonstrated strong potential to stimulate T and B-cell mediated immune responses. Furthermore, codon optimization and in silico cloning guaranteed increased expression.
Conclusions

In this work, immunoinformatics investigations demonstrated that this next-generation approach may provide a new horizon for the development of a highly immunogenic vaccine against SARS-CoV, MERS‐CoV, and SARS-CoV-2.
Enhance Image Classification Performance Via Unsupervised Pre-trained Transformers Language Models
Authors: Shen Dezhou
Published: October 2020

Image classification and categorization are essential to the capability of telling the difference between images for a machine.
As Bidirectional Encoder Representations from Transformers became popular in many tasks of natural language processing recent years,
it is intuitive to use these pre-trained language models for enhancing the computer vision tasks, \eg image classification.
In this paper, by encoding image pixels using pre-trained transformers, then connect to a fully connected layer,
the classification model outperforms the Wide ResNet model and the linear-probe iGPT-L model,
and achieved accuracy of 99.60%～99.74% on the CIFAR-10 image set and accuracy of 99.10%～99.76% on the CIFAR-100 image set.
Profile of Patients with Heart Failure: A Multi-Site Thailand Heart Failure Snapshot Study
Authors: Tankumpuan Thitipong , Sindhu Siriorn , Perrin Nancy , Commodore-Mensah Yvonne , Budhatthoki Chakra , Padula William , Himmelfarb Cheryl Dennison , Davidson Patricia M.
Published: October 2020

Background: The prevalence of heart failure (HF) is increasing in many low- and middle-income countries but the limited availability of data on the patient profile and clinical outcomes of patients with HF challenges health services planning. Methods: The Thai HF Snapshot Study was a multi-site, observational study conducted in Thailand to document demographic, clinical and sociodemographic characteristics, and to compare clinical outcomes by the level of the hospital. Results: A total of 512 participants: mean age 64.9±15.3 years; female (55.9%) were recruited across Thailand. The most frequently identified admitting diagnosis was ischemic heart disease (45.1%). Most patients (70.3%) were classified as New York Heart Association class II at discharge. Patients in super tertiary care settings were frailer (3.2 vs. 2.9; p=0.015), had more depressive symptoms (8.1 vs. 5.7; p<0.001) and had lower functional status (66.2 vs. 73.3; p<0.001) than patients in tertiary care. Conclusion: Although HF patients admitted to super tertiary centers have access to advanced technology and healthcare specialists, clinical outcomes were worse. Interventions are urgently needed to ensure improved HF management considering the psychosocial determinants of health in Thailand.