bluuebunny/crossref_metadata_2025 huggingface dataset:
Integrative Proteogenomic Analyses Identify TOPs as Prognostic Markers and Therapeutic Targets in Sarcoma
Authors: Wang Genchun , Sun Kai , Liu Li Ting , Lin Jiamin , Yao Xudong , Guo Jiachao , Guo Zhou , Hou Liang Cai , Xu Ting , guo fengjing
Published: January 2021

Background: Soft-tissue sarcomas (STSs) are uncommon malignant tumors with varied highly aggressive and histological presentations. They comprise approximately 1% of newly diagnosed adult malignancies each year, but the sarcoma's accurate diagnosis prediction remains a challenge. TOP1/1MT/2A/2B/3A/3B were aberrantly expressed in tumors and associated with tumor progression, but the roles of the six TOP members in sarcoma in clinical trials remains uncertain.Method: Relationship between the mRNA levels of the TOPs and the clinicopathological parameters evaluated by Oncomine, GEPIA, cBioPortal, TIMER, Metascape, TCGAportal, Kaplan-Meier plotter, String, and Linkedomics. We focused on the potential mechanism of TOPs in the occurrence and development of SARC. We were investigating the prognostic value of TOPs expression in patients with SARC and correlations with clinicopathological features.Results: In patients with SARC, TOPs mRNA expression level upregulated. Increased TOP family members' expression was associated with different subtypes, FNCLCC grades, Local recurrence, DNA methylation, different miRNA clusters, and poor prognosis in SARC patients. We further found that TOPs showed distinct immune infiltration patterns, TOP gene mutation rate and that TOP somatic copy number variations were negatively related to the survival of sarcoma patients. Survival data analyzed that high transcription levels of TOPs were associated with low overall survival and disease-free survival in sarcoma. Enrichment analyses for Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genome (KEGG) were conducted to reveal TOPs enriched in DNA topological change, Chromosome segregation, DNA, replication signaling pathway. BUB1B, CENPF, SPC25, NUF2, KNL1SGO1, RPS20, SNRPD3, and MED9 were significantly associated with TOP mutations. These Hub gene expressions in SARC were increased and were associated with unfavorable prognosis.Conclusion: The results show that multiple TOP family members are involved in the development and progression of sarcoma and suggest that TOPs can be used as potential targets for the diagnosis and treatment of sarcoma. TOP1/1MT/2A/2B/3A/3B may affect the prognosis of SARC through DNA topological change, Chromosome segregation, DNA, replication signaling pathway.
Compost Enhances Forage Yield and Quality of River Saltbush in Arid Conditions
Authors: Hu Zhanyao , Ding Zheli , Ali Esmat F. , Eissa Mamdouh A.
Published: January 2021

The authors have requested that this preprint be removed from Research Square.
MMP-9 in Myocardial Fibrosis and Structural Remodeling in Rheumatic Heart Disease Patients with Atrial Fibrillation: A Single-center Prospective Case-control Study
Authors: Yuan Shuguo , Li Wan , Tang Liangqiu , Liao Chengquan , Ma Shaochun , He Fengping , Fan Wenmao , Zhang Shebing , Ma Zhanzhong , Gao Shuangquan , Deng Yun , Yuan Qiuxiao
Published: January 2021

Background: Atrial fibrillation (AF) is a common arrhythmia that induces disability or death; however, the underlying pathogenesis is yet unclear. This study aimed to investigate the expression of matrix metalloproteinase-9 (MMP-9) in rheumatic valvular heart disease (RVHD) and its value in predicting AF.Methods: In this single-center, prospective case-control study, 30 patients who received valve replacement for the treatment of RVHD in the Cardiac and Major Vascular Department, Yue Bei People’s Hospital between August 2012 and January 2015 were included in this study. The patients were categorized equally into two groups according to the electrocardiogram characteristics: sinus rhythm (SR) group and chronic atrial fibrillation (AF) group. In patients hospitalized for RVHD, the fasting serum was collected on the following day in the morning, and the tissues of right auricle were collected during the operation. Hematoxylin and eosin staining and Masson staining were performed to assess the pathological structures of myocardial tissues and changes in collagen fibers. Enzyme-linked immunosorbent assay was used to measure the level of MMP-9 in serum, and the distribution of the protein in myocardial tissues was assessed by immunohistochemistry. Echocardiography was performed before the surgery to measure the left atrial diameter and ejection fraction.Results: The MMP-9 expression was significantly higher in the AF group than the SR group (4.2281 ± 0.9165 ng/mg vs. 2.7613 ± 1.2166 ng/mg, p < 0.05). The MMP-9 levels were positively associated with left atrial diameter (LAD) (p < 0.01) and collagen volume fraction (CVF) (p < 0.05).Conclusions: MMP-9 expression is elevated in AF patients and could be one of the major factors involved in the remodeling of atrial structures in AF. MMP-9 influences the metabolism of collagen and promotes the fibrosis of the myocardium, participates in cardiac structural remodeling, and plays a role in the onset and maintenance of AF.
Molecular-Sieving Energy-Efficient Gas Separation Membranes Enabled by Multi-covalent-crosslinking of Microporous Polymer Blends
Authors: Li Nanwen , Chen Xiuling , Fan Yanfang , Zhang Linzhou , Guan Dong , Ma Canghai
Published: January 2021

Highly permeable and selective membranes that exceed the conventional permeability-selectivity upper bound are attractive for energy-efficient gas separations. In the context microporous polymers have gained increasing attention owing to their high porosity and exceptional permeability. However, the moderate selectivity of microporous polymers caused by inherent broad distribution of cavities leads to a loss of valuable gas products, making them unfavorable for separating similarly sized gas mixtures. Here we report a new approach to designing polymeric molecular sieve membranes via multi-covalent-crosslinking of miscible blends of Polymer of Intrinsic Microporosity, i.e. bromomethyl (PIM-BM) and Tröger's Base (TB), enabling simultaneously high permeability and selectivity. Selective gas permeation is achieved via adjusting reaction temperature, reaction time and the oxygen concentration with occurrences of polymer chain scissor, rearrangement and thermal oxidative crosslinking reaction simultaneously. Upon a thermal treatment at 300 oC for 5h, membranes exhibit an O2/N2, CO2/CH4 and H2/CH4 selectivity as high as 11.1, 155.7 and 814.1, respectively, with an O2, H2 and CO2 permeability of 18.2, 358.2 and 67.6 Barrer, respectively, transcending the state-of-art upper bounds. The design strategy represents a generalizable approach to creating molecular-sieving polymer membranes with enormous potentials for energy-efficient separation processes.
The Association of 25 (OH) Vitamin D Levels and Severity and Outcome of COVID-19: A Cross-sectional Study
Authors: Vasheghani Maryam , Jannati Nasrin , Baghaei Parvaneh , Rezaei Mitra , Marjani Majid
Published: January 2021

BackgroundCoronavirus disease 2019 (COVID-19) is a pandemic disease. Experiments with influenza and severe acute respiratory syndrome (SARS) have shown supplemental vitamin D can reduce the risk of infection and death.AimThis study was performed to evaluate the relationship between vitamin D levels and the severity and outcome of admitted patients with COVID-19.Material and MethodsThis cross-sectional study was performed on COVID-19 cases diagnosed by examining RT-PCR assay for SARS-CoV-2 or a set of symptoms and typical findings in lung CT scan. Based on clinical and radiologic characteristics, the patients were categorized as mild, moderate, severe, and critical. Calcium, phosphorus, albumin, creatinine, and serum 25 hydroxy vitamin D were measured and their correlation with the severity and outcome were analyzed.ResultsFrom May 1 to June 31, 2020, 508 patients ((442 patients in general wards and 66 patients in intensive care unit (ICU)) were included in this study. The participants were 56±17 years old (mean ±SD) (range from 14 to 95 years) and 52% were male. According to the past medical history, 190 (37.4%) of them had comorbidity. Concerning severity, 13.2%, 42.3%, 35.4%, and 9.1% had the mild, moderate, severe, and critical disease, respectively. The in-hospital mortality rate was 10.8%. In the multivariate regression analysis, age had a positive correlation and use of vitamin D supplement, serum level of 25 OH vitamin D, calcium, and albumin had a negative correlation with disease severity and admission to ICU. Poor outcome was inversely related to serum levels of vitamin D, calcium, albumin, and renal function. Vitamin D deficiency increased the rate of ICU admission by 2.7 times (95%CI=1.288-5.91, P=0.009).ConclusionIn patients who are hospitalized due to COVID-19, low 25-hydroxyvitamin D, hypocalcemia, and hypoalbuminemia are associated with severe disease, ICU admission, and an increase in mortality.
Mobility-Based Contact Exposure Explains the Disparity of Spread of COVID-19 in Urban Neighborhoods
Authors: Verma Rajat , Yabe Takahiro , Ukkusuri Satish
Published: January 2021

The rapid early spread of COVID-19 in the U.S. was experienced very differently by different socioeconomic groups and business industries. In this study, we study aggregate mobility patterns of New York City and Chicago to identify the relationship between the amount of interpersonal contact between people in urban neighborhoods and the disparity in the growth of positive cases among these groups. We introduce an aggregate Contact Exposure Index (CEI) to measure exposure due to this interpersonal contact and combine it with social distancing metrics to show its effect on positive case growth. With the help of structural equations modeling, we find that the effect of exposure on case growth was consistently positive and that it remained consistently higher in lower-income neighborhoods, suggesting a causal path of income on case growth via contact exposure. Using the CEI, schools and restaurants are identified as high-exposure industries, and the estimation suggests that implementing specific mobility restrictions on these point-of-interest categories are most effective. This analysis can be useful in providing insights for government officials targeting specific population groups and businesses to reduce infection spread as reopening efforts continue to expand across the nation.
Haematological Abnormalities in Children With Sickle Cell Disease and Non-severe Malaria Infection in Western Kenya
Authors: Kosiyo Paul , Otieno Walter , Gitaka Jesse , Munde Elly , Ouma Collins
Published: January 2021

Background: In Plasmodium falciparum infection, clinical conditions such as anaemia, thrombocytopenia and leucocytosis are common. Mutation in haemoglobin sub-unit beta gene (HBB) may be a genetic factor responsible for these haematological changes during infection. However, the contributions of the carriage of different HBB genotypes on these changes remain largely unknown. Methodology: In this cross-sectional study, we evaluated haematological abnormalities in P. falciparum-infected children (n=217, aged 1-192 months) with different haemoglobin sub-unit beta (HBB) genotypes (HbAA, HbAS and HbSS). Children with acute febrile conditions were recruited at Jaramogi Oginga Odinga Teaching and Referral Hospital outpatient clinic between the months of April 2018 and February 2019. Haematological parameters were determined using Beckman Coulter counter ACTdiff2TM while HBB genotyping was done using TaqMan® SNP genotyping assay. Chi-square (c2) was used to determine differences between proportions. Differences in haematological parameters were compared across groups using Kruskal Wallis test and between groups using Mann Whitney U test. Partial correlation test was used to determine correlation between haematological parameters and sickle cell genotypes while controlling for age and sex. Results: Haemoglobin, [median (IQR); 7.3 (1.3), P=0.001], haematocrit, [median (IQR); 26.4 (4.4), P=0.009], RBC, [median (IQR); 3.2 (1.7), P=0.048] were markedly reduced in HbSS, however, RDW [median (IQR); 14.9 (3.3), P=0.030] was increased in malaria infected children with HbSS. Severe anaemia was highest in HbSS (23.1%) followed by HbAA (8.6%) and HbAS (7.1%). There were no differences in platelet count (P=0.399) hence no severe thrombocytopeania across the genotypes. Leucocytosis was highest in HbSS (69.2%), 42% in HbAS and 31% in HbAA. The RBC, haematocrit and hemoglobin had negative correlation with RDW in HbSS in malarial-infected children (r= -0.725, P=0.008), (r= -0.718, P=0.009) and (r= -0.792, P=0.002), respectively. Conclusion: Our study reveals that anaemia is the most common abnormality in malaria-infected children with carriage of HbSS. The RBC, haematocrit and haemoglobin concentration decrease with increase in RDW levels in infected children with carriage of HbSS compared to other HBB genotypes. Therefore, carriage of HbSS genotype is correlated with severity of haematological abnormalities.
Influence of Surgical Treatment on Complications, Readmissions and Clinical Progress of Breast Cancer in Women Participating in Breast Cancer Screening Programs
Authors: Blay Lidia , Jansana Anna , Louro Javier , Ferrer Joana , Baré Marisa , Barata Teresa , Domingo Laia , Julián Joan Francesc , Castells Xavier , Sala Maria
Published: January 2021

BackgroundComplications and readmissions derived from surgical treatment of breast cancer have been scarcely evaluated. The studies that compare mastectomy with conservative, usually focus only in recurrence and/or mortality and sometimes the results are discordant in some aspects. The aim of this study was to analyze complications and readmissions, recurrence and mortality, according to the surgical treatment received in the mammary gland.Methods This multicenter study included 1086 women diagnosed with breast cancer from the CaMISS cohort study of women aged between 50 and 69 years participating in 4 breast cancer screening programs in Spain between 2000 and 2009 with a follow up until 2014. Multivariate models were used to estimate the adjusted odds ratio of breast surgery (mastectomy vs conservative treatment) for complications and readmissions and hazard ratios for recurrences and mortality.Results Primary breast surgical treatment consisted of conservative treatment in 821 women (80.1%) and mastectomy in 204 (19.9%). Mastectomy was associated with readmissions, recurrences and mortality but this association was not statistically significant on multivariate adjusted analysis (ORa=1.51 [95%CI 0.89-2.57], HRa=1.37 [95%CI 0.85-2.19] and HRa=1.52 [95%CI 0.95-2.43] respectively). In our sample, the variables with greatest impact on complications, recurrences and mortality were stages III and IV (ORa=4.4 [95%CI 1.22-16.16], HRa=7.96 [95%CI 3.32-19.06] and HRa=3.92 [95%CI 1.77-8.67]). Conclusion Complications, readmissions, recurrence and mortality were similar in both surgical techniques. These results support that surgical treatment for breast cancer can be adapted to professional and health system circumstances, and to the surgical needs and desires of each patient.
Water Extracts From Trees Negatively Affect Oviposition Behavior and Fitness of Southern House Mosquito, Culex Quinquefasciatus Say (Diptera: Culicidae): A Simple, Easily Adoptable and Cost-Effective Approach to Control Mosquitoes
Authors: Khan Muhammad , shah Rizwan , Shad Sarfraz Ali , Majeed Shahid , Ahmad Shahbaz , Binyameen Muhammad
Published: January 2021

Background: The Culex quinquefasciatus Say is an important vector of many diseases of public health and veterinary importance. Environmental pollution, resistance development and health hazards associated with the use of synthetic insecticides have led to explore eco-friendly and cost effective management methods for mosquitoes. Methods: In our study, simple water extracts from leaves and bark of three tree species; Eucalyptus camaldulensis, Azadirachta indica (Neem), and Moringa oleifera, were tested to explore their potential negative effects on the oviposition behavior and fitness of Cx. quinquefasciatus. Results: Oviposition bioassays showed a significant delay in onset of 1st oviposition in the all treatments as compred to control. Number of egg rafts and fecundity were significantly lower in all treatments compared to control. Larval emergence was significantly less in the all treatments as compared with the control except Moringa bark. Highest pupation was observed in control as compared to all other treatments. Importantly, no adult emerged in Eucalyptus leaf, bark and in Neem bark extracts. In case of toxicity bioassays, median lethal time (LT50) was lower at higher concentrations and higher at lower concentrations. At highest tested concentration of every botanical extract, LT50 was highly age dependent that is higher for elder larvae and vice versa. Conclusions: Therefore, it could be concluded that simple water extrcats, made locally, from trees may have a great potential to be incorporated in the mosquito control programs.
Reversible Acute Fontan Circulation Failure Secondary to Retroconducted Junctional Rhythm. Clinical Echocardiographic Correlation
Authors: Ferrero Paolo , Piazza Isabelle , Sadou Youcef , Ciuffreda Matteo
Published: January 2021

Background: Sequential atrioventricular activation plays a critical role in the physiology of Fontan circulation. Although bradycardia is usually well tolerated, retroconducted junctional rhythm may acutely increase atrial pressure impairing cardiac output. Echocardiographic evaluation can reveal clues of this hemodynamic condition. The clinical impact of arrhythmic disturbance on the follow up of patients who had undergone total cavo-pulmonary connection is well recognized but the role of, transient periods of retroconducted junctional rhythm on the immediate post-operative course is less defined. Case presentation: We describe two cases of acute Fontan circulatory failure due to postoperative retroconducted escaping junctional rhythm despite an adequate heart rate and circadian variation. The patients rapidly improved after atrial pacing, allowing discharge with a minimal dose of diuretic.Conclusion: In the absence of any hemodynamic target, hearth rhythm should be systematically checked after TCPC irrespective of adequacy of heart rate. Likewise, efficiency of temporary atrial pacing should be granted and surgeons should have a low threshold for epicardial lead implantation.
The Investigation of the Volatile Metabolites of Lung Cancer From the Microenvironment of Malignant Pleural Effusion
Authors: Chen Ke-Cheng , Tsai Shih-Wei , Zhang Xiang , Zeng Chian , Yang Hsiao-Yu
Published: January 2021

Lung cancer is the leading cause of cancer death. For malignant pleural effusions, pleural fluid cytology is a diagnostic method, but sensitivity is low. Many patients need to undergo invasive diagnostic tests such as thoracoscopic pleural biopsy. Pleural space is an enclosed microenvironment, and the pleural fluid contains metabolites directly released from cancer cells. The objective of this study was to diagnose lung cancer with malignant pleural effusion using the volatilomic profiling method. We recruited lung cancer patients with malignant pleural effusion and patients with nonmalignant diseases with pleural effusion as controls. We analyzed the headspace air of the pleural effusion by gas chromatography-mass spectrometry. We used partial least squares discriminant analysis (PLS-DA) to identify metabolites and the support vector machine (SVM) to establish the prediction model. We split data into a training set (80%) and a testing set (20%) to validate the accuracy. A total of 68 subjects were included in the final analysis. The PLS-DA showed high discrimination with an R2 of 0.95 and Q2 of 0.58. The accuracy of the SVM in the test set was 0.93 (95% CI: 0.66, 0.998), and kappa was 0.85, and the area under the receiver operating characteristic curve was 0.96 (95% CI: 0.86, 1.00). Pathway analysis revealed disturbances in pyruvate metabolism, the tricarboxylic acid, glycolysis, and lysine degradation. The volatile metabolites identified from malignant pleural effusion of lung cancer were primarily methylated alkanes. The pleural effusion contained volatile metabolites that have high accuracy in diagnosing lung cancer with malignant pleural effusion.
Coronavirus (COVID-19): A Systematic Review and Meta-analysis to Evaluate the Significance of Demographics and Comorbidities
Authors: Bhattacharyya Arinjita , Seth Anand , Srivast Niharika , Imeokparia Michael , Rai Shesh
Published: January 2021

Background The unprecedented outbreak of a contagious respiratory disease caused by a novel coronavirus has led to a pandemic since December 2019, claiming millions of lives. The study systematically reviews and summarizes COVID-19’s impact based on symptoms, demographics, comorbidities, and demonstrates the association of demographics in cases and mortality in the United States.Methods PubMed and Google Scholar were searched from December 2019- August 2020, and articles restricted to the English language were collected following PRISMA guidelines. US CDC data was used for establishing statistical significance of age, sex, and race.Results• Among 3745 patients in China, mean age is 50.63 (95% CI: 36.84, 64.42) years, and 55.7 % (95% CI: 52.2, 59.2) were males. Symptoms included fever 86.5% (82.7, 90.0), fatigue 41.9% (32.7, 51.4), dyspnea 29.0% (21.2, 37.5), cough 66.0% (61.3, 70.6), mucus 66% (61.3, 70.6), lymphopenia 18.9% (5.2, 38.0). Prevalent comorbidities were hypertension 16.4% (12.5, 20.8), diabetes 8.9% (7.0, 11.1), CVD 10.9% (6.1, 16.7), ARDS 14.6% (4.9, 27.8), malignancy 1.5 ( 0.05, 2.8), 1.3% (0.08, 1.9), COPD 1.3 (0.08, 1.9). 63.5 % (33.5, 88.7) received oxygen therapy, 20.8% (8.9, 35.7) were in ventilation, 23.5% (5.9, 47.8) were at the ICU. 86.5% (76.8, 94) had antiviral, 73.9% (55.3, 89.0) had antibiotics, 30% (20.6, 40.2) corticosteroids treatment.• In the US, the odds ratio of infection in males to females is 0.873 (CI: 0.052,14.791), while the odds of dying from infection is 1.378 (CI: 0.081, 23.528) for males. The prevalence of infection is higher in females; case and death rates are higher in whites and Hispanics than other races; the death rate is higher in males irrespective of race and age; death rate per 100,000 population increases monotonically with age.Conclusion Results showed that metabolic diseases comprising CVD, diabetes, hypertension, and respiratory diseases, including COPD, ARDS, are the most common comorbidities to severe condition and poor prognosis in covid-19 patients. Following the recent FDA's guidance for designing Covid-19 vaccine trials, stratification factors of age, race, sex, and comorbidities need consideration in allocation. This study aimed to provide clinical researchers, health policy planners a detailed insight into the coronavirus disease.
Core-Shell Au@Ag Nanoparticles Synthesized with Polyphenols as Antimicrobial Agents
Authors: Villalobos-Noriega Jesús Mauro Adolfo , Leon Ericka Rodríguez , Rodríguez-Beas César , Larios-Rodríguez Eduardo , Plascencia-Jatomea Maribel , Martínez-Higuera Aarón , Acuña-Campa Heriberto , Iñiguez-Palomares Ramón Alfonso
Published: January 2021

In this work, we used a sequential method of synthesis for gold-silver bimetallic nanoparticles with core@shell structure (Au@AgNPs). Rumex hymenosepalus root extract (Rh), which presents high content in catechins and stilbenes, was used as reductor agent in nanoparticles synthesis. Size distribution obtained by Transmission Electron Microscopy (TEM) give a diameter mean of 36 nm for Au@AgNPs, and 24 nm for gold nanoparticles (AuNPs). The geometrical shapes of NPs were principally quasi-spherical. The thickness of silver shell over AuNPs are around 6 nm and covered by active biomolecules onto surface. Microstructural characterization included high angle annular dark field images (HAADF) recorded with a scanning transmission electron microscope (STEM), Energy-Dispersive X-ray Spectroscopy (EDS), X-Ray Diffraction (XRD), UV-Vis Spectroscopy, and Zeta Potential. Also, a growth kinetic curve analysis using the Gompertz model for Staphylococcus aureus (Gram-positive), Escherichia coli (Gram-negative), and Candida albicans (yeast) were carried out for Au@AgNPs and monometallic AuNPs and AgNPs. Interestingly, Gompertz analysis indicates that Au@AgNPs present a higher effect on the growth kinetic of microorganisms than shown by monometallic nanoparticles.
Myeloid-derived Suppressor Cell and Non-classical Monocyte Frequencies Are Directly Related to the Immunological Status of Patients With Active Tuberculosis
Authors: Amiano Nicolas , Pellegrini Joaquín , Morelli María , Rolandelli Agustín , Martinena Camila , Castello Florencia , Casco Nicolás , Ciallella Lorena , de Casado Graciela , Armitano Rita , Stupka Juan , Gallego Claudio , Palmero Juan , García Verónica , Tateosian Nancy
Published: January 2021

Alterations of myeloid cell populations have been reported in patients with tuberculosis (TB). Since myeloid-derived suppressor cells (MDSC) and non-classical monocytes (CD14+CD16+) seem to play an important role in TB, we studied the relationship between these cells and the immunological status of patients. TB patients were classified as high responders (HR-TB) or low responders (LR-TB) according to their T cell responses against a whole cell lysate of Mycobacterium tuberculosis (Mtb-Ag). Thus, LR-TB, individuals with severe disease, display a weaker immune response to Mtb compare to HR-TB, subjects with strong immunity against the bacteria. We observed that LR-TB presented higher percentages of CD14+CD16+ monocytes as compared to HR-TB and healthy donors (HD). Moreover, monocyte-like (M-MDSC) and polymorphonuclear-like MDSC (PMN-MDSC) were increased in TB patients as compared to HD. Furthermore, the proportion of M-MDSC of TB patients inversely correlated with the levels of IFN-γ released after Mtb-Ag stimulation. We also found that LR-TB displayed the highest levels of circulating M-MDSC. Interestingly, in LR-TB, the frequencies of non-classical monocytes and M-MDSC were restored after only three weeks of anti-TB treatment. Together, our findings show a direct relationship between the immunological status of TB patients and the levels of different circulating myeloid cell populations.
Family Planning Providers and Contraceptive users in Rwanda Employ Strategies to Prevent Discontinuation
Authors: Schwandt Hilary , Boulware Angel , Corey Julia , Herrera Ana , Hudler Ethan , Imbabazi Claudette , King Ilia , Linus Jessica , Manzi Innocent , Merrit Maddie , Mezier Lyn , Miller Abigail , Morris Haley , Musemakweli Dieudonne , Musekura Uwase , Mutuyimana Divine , Ntakarutimana Chimene , Patel Nirali , Scanteianu Adriana , Shemeza Biganette-Evidente , Sterling-Donaldson Gi’anna , Umutoni Chantal , Uwera Liz , Zeiler Madeleine , Feinberg Seth
Published: January 2021

Background: Contraceptive discontinuation is a common event. Family planning programs often focus more on recruitment of new users as opposed to maintaining use among current users. A focus on sustaining users is imperative for long-term family planning program success.Methods: This qualitative study in Rwanda in 2018 included eight focus group discussions with 88 family planning providers and 32 in-depth interviews with contraceptive users. The data were collected in the two districts with the highest and lowest rates of contraceptive use, Musanze and Nyamasheke, respectively. The aim of this study is to better understand how providers and contraceptive users in Rwanda navigate one of the greatest challenges to family planning programs: contraceptive discontinuation.Results: Family planning providers and current users in Rwanda do not consider method discontinuation an option. Providers give support and medicine for side effects for continuers and counseling for those opting to switch. Current users are willing to try many methods until they find the right one for them – and once they find the right method, they plan to, or use the method, for long durations.Conclusions: The Rwandan family planning program is primed to meet the needs of users in their sustained use of contraceptives through empathetic and responsive counseling. Concurrently, family planning users are determined to use family planning to meet their desired family size goals. The matching goals of both providers and clients indicates that contraceptive use will likely continue to increase in Rwanda. Due to long periods of pregnancy prevention desired by users the increased use of long acting methods should be encouraged.
Neuroprotective Roles of the Adenosine A3 Receptor Agonist AST-004 in Mouse Model of Traumatic Brain Injury
Authors: Bozdemir Eda , Vigil Fabio A , Chun Sang H , Espinoza Liliana , Bugay Vladislav , Khoury Sarah M , Holstein Deborah M , Stoja Aiola , Lozano Damian , Tunca Ceyda , Sprague Shane M , Cavazos Jose E , Brenner Robert , Liston Theodore E , Shapiro Mark S , Lechleiter James Donald
Published: January 2021

Background: Traumatic brain injury (TBI) remains one of the greatest public health concerns with increasing morbidity and mortality rates worldwide. Our group reported stimulation of astrocyte mitochondrial metabolism by P2Y1 receptor agonists significantly reduced cerebral edema and reactive gliosis in a TBI model. Subsequent data on the pharmacokinetics (PK) and rapid metabolism of these compounds suggested neuroprotection was likely mediated by a metabolite, AST-004, which binding data indicated was an adenosine A3 receptor (A3R) agonist. Methods: The neuroprotective efficacy of AST-004 was tested in a controlled closed cortical injury (CCCI) model of TBI in mice. Results: Twenty-four (24) hours post-injury, mice subjected to CCCI and treated with AST-004 (0.22mg/kg) exhibited significantly less secondary brain injury. These effects were quantified with less cell death (PSVue794 fluorescence) and loss of blood brain barrier breakdown (Evans Blue extravasation assay), compared to vehicle treated TBI mice. TBI treated mice also exhibited significantly reduced neuroinflammatory markers, glial-fibrillary acidic protein (GFAP, astrogliosis) and ionized Ca2+ binding adaptor molecule 1 (Iba1, microgliosis), both at the mRNA (gRT-PCR) and protein (western blot and immunofluorescence) levels, respectively. Four (4) weeks post-injury, AST-004 treated TBI mice presented significantly reduced impairment of long-term memory. Spatial memory was assessed with a contextual fear conditioning behavior assay (freezing behavior after shock). Finally, AST-004 treatments were found to increase in vivo ATP production in astrocytes (gfap-targeted luciferase activity), consistent with the proposed mechanism of action. Conclusions: These data reveal AST-004 as a novel A3R agonist that increases astrocyte energy production and enhances their neuroprotective efficacy after brain injury.
Early Diabetes Aggravates Renal Ischemia/reperfusion-induced Acute Kidney Injury 
Authors: Ponte Mariana de , Cardoso Vanessa , Costa-Pessoa Juliana , Oliveira-Souza Maria
Published: January 2021

Acute kidney injury (AKI) due to ischemia and reperfusion (IR) can be associated with the progression of chronic kidney injury. In addition, studies suggest that chronic diabetes is an independent risk factor for AKI; however, the impact of early diabetes on the severity of AKI remains unknown. We investigated the effects of early diabetes on the pathophysiology of renal IR-induced AKI. C57BL/6J mice were randomly assigned into the following groups: 1) sham-operated; 2) renal IR; 3) streptozotocin (STZ - 55 mg/kg/day) and sham-operated; and 4) STZ and renal IR. On the 12th day after treatments, the animals were subjected to bilateral IR for 30 minutes followed by reperfusion for 48 hours, and the mice were euthanized by exsanguination. Renal function was assessed by analyzing the plasma creatinine and urea concentrations with biochemical methods. Proteinuria was evaluated using a commercial kit. Kidney tissue was used to evaluate the morphology, gene expression by qPCR, and protein expression by Western blotting. Compared to the sham operated, renal IR resulted in increased plasma creatinine and urea levels, decreased nephrin mRNA expression, increased tubular cast formation, and Kim-1, Ki-67, pro-inflammatory and pro-fibrotic factor mRNA expression. Compared with the sham treatment, STZ treatment resulted in hyperglycemia, but did not induce changes in kidney function or pro-inflammatory or pro-fibrotic factors. However, STZ treatment aggravated renal IR-induced AKI by exacerbating glomerular and tubular injury, inflammation, and the profibrotic response. Early diabetes constitutes a relevant risk factor for renal IR-induced AKI.
Significance of Mixed Convection and Arrhenius Activation Energy in a Non-Newtonian Third Grade Fluid Flow Containing Gyrotactic Microorganisms Towards Stretching Surface
Authors: Dawar Abdullah , Islam Saeed , Shah Zahir , Kumam Poom
Published: January 2021

In most scenarios of concern, the bulk of fluids treated by researchers and engineers, such as air, water, and oils, can be considered as Newtonian. The inference of Newtonian action however is not true in many situations and the much more complicated non-Newtonian reaction should be superimposed. Such situations exist in the chemical manufacturing sector and the plastics processing plants. Here, we present the mixed convective flow of non-Newtonian third grade fluid containing gyrotactic microorganisms through a stretching surface. The flow is considered as unsteady, laminar, and incompressible. Furthermore, the flow is magnetized and electrically conducting with the help of applied magnetic field. Chemical reaction along with Arrhenius activation energy and viscous dissipation influences are taken into attention. The governing PDEs are transformed to ODEs through appropriate similarity transformations. Analytical and numerical solutions of the present analysis are done with the help of incorporated codes in MATHEMATICA 10.0. Convergence of HAM is presented through Figures. Also, the outcomes of the embedded factors on the nanofluid flow are displayed through Figures.
Amyand’s Hernia: A Ten-year Experience With 6 Cases
Authors: Gao Yijie , Zhang Taotao , Zhang Min , Hu Zhengxu , Li Qiao , Zhang Xiangwen
Published: January 2021

Purpose: Amyand’s hernia is a rare hernia defined as an inguinal hernia that contains the appendix within the hernia sac. Current treatment of Amyand’s hernia remains controversial. Our study retrospectively reviewed 6 cases of Amyand’s hernia, aiming to provide a reference for the surgical treatment of Amyand's hernia.Methods: Six patients diagnosed with Amyand’s hernia from September 2010 to May 2020 were retrospectively enrolled in our study. We summarized clinical data of six patients including the chief complaint, physical examinations, laboratory examinations, imaging examinations, surgical methods, and postoperative treatments and outcomes.Results: The diagnosis of six cases with Amyand’s hernia was made during surgery. Two patients had normal appendixes whereas the remaining four patients had inflamed appendixes. Two patients with normal appendix received tension-free mesh repair through the inguinal incision. Among those with inflamed or perforated appendixes, two received mesh repair and the other two did not. The discharge time after surgery of six patients was 9.8±6.1 days. One patient suffered from an incision infection. No additional postoperative complications were detected. Conclusions: Computed tomography and ultrasonography are helpful but limited in the definite diagnosis of Amyand’s hernia. The presence of a normal appendix does not require to be resected, but appendicectomy is necessary if the appendix is inflamed. The treatment of Amyand's hernia should be tailored based on the patient's condition and the type of Amyand's hernia.
Post-Discharge Telephonic Follow-Up of Pediatric Patients Affected by SARS-CoV2 Infection: A Safe and Feasible Way to Monitor Children After Hospitalization. The Experience of a Single Italian Pediatric COVID Center.
Authors: Clemente Vitangelo , Tripiciano Costanza , Moras Patrizio , Deriu Daniele , Giuseppe Martina Di , Piscitelli Annalucia , Cammerata Michela , Ioris Maria Antonietta De , Carducci Francesca Ippolita Calò , Bernardi Stefania , Campana Andrea , D'Argenio Patrizia , Rossi Paolo
Published: January 2021

BackgroundSARS-CoV-2 infection in children is often non severe and in the majority of cases does not require long term hospitalization, nevertheless it is burdened with social issues and managing difficulties. To our knowledge there is no literature on telephonic follow up in pediatric patients with positive PCR for SARS-CoV-2 on rhino-pharyngeal swab after discharge. The aim of the study is to describe our experience in a telephonic follow up which can allow early and safe discharge from hospital while keeping the patients under close clinical monitoring.Materials and Methods65 children were admitted for SARS-CoV-2 infection at Bambino Gesù Pediatric Hospital COVID Center from 16th March to 3rd July. We monitored through a telephonic follow-up, using a specific survey, the patients discharged still presenting a positive PCR for SARS-CoV-2. We checked if any symptoms occurred at home until recovery, defined as two consecutive negative PCR for SARS-CoV-2 on rhino-pharyngeal swabs.ResultsDuring the follow up 7 patients had mild and self-limited symptoms related to SARS-CoV-2 infection, while 2 patients were re-hospitalized. 1 patient had Multisystem Inflammatory Syndrome in Children (MIS-C), the other patient had an increase in troponin and D-dimers. We also monitored the average time of viral shedding, resulting in a median duration of 28 days.ConclusionOur experience describes the daily telephonic follow up as safe in pediatric patients discharged with positive PCR. As a matter of fact it could avoid long term hospitalization and allow to promptly re-hospitalize children with major complications such as MIS-C.
High Baseline SHBG, as an Independent Predictor, Was Associated With High Ovulation: a Secondary Analysis of PCOSAct
Authors: Chang Hui , Wu Qi , Ge Hang , Li Jian , Zhu Meng-Yi , Luo Xi , Han Yan-Hua , Wang Chi Chiu , Wu Xiao-Ke
Published: January 2021

Background: Sex hormone-binding globulin (SHBG) is related to several human systems such as reproductive system and endocrine system. SHBG binds to testosterone and estradiol, therefore we explored ethe role of SHBG on reproductive process. Methods: We carried out secondary analysis of Polycystic Ovary Syndrome and Acupuncture Clinical Trail (PCOSAct) at 21 sites in China, comprising a total of 1000 women with PCOS. A total of 954 women with baseline homocysteine (HCY) were included in the study. Results: Multivariate analysis of predictors of ovulation showed that age, body mass index (BMI), estradiol (E2), total testosterone (T) and SHBG are predictors of ovulation (P=0.0211, 0.0011, 0.0211, 0.0029, 0.0434) whereas luteinizing hormone (LH) to follicle-stimulating hormone (FSH) ratio is negatively correlated with ovulation (P=0.0539). A multivariate logistic regression model (MLRM) of all baseline serum parameters showed the strongest predictive ability for ovulation, followed by MLRM without SHBG. In addition to treatment, baseline SHBG was the strongest single predictor for ovulation. Patients in higher SHBG quartile showed significantly higher ovulation rate (HR=1.138; 95%CI [1.054,1.229], P=0.0009). Notably, significance was observed after adjustment for testosterone (HR=1.139, 95%CI [1.055,1.229], P=0.0009). However, quartiles of T, free testosterone (FT) and E2 all showed no correlation with ovulation. Kaplan-Meier curves showed that high SHBG is positively correlated with high ovulation, conception and pregnancy rates. Conclusions: Higher baseline SHBG is associated with higher ovulation rate and is an independent predictive marker.Trial registration: ClinicalTrials.gov (No. NCT01573858). Registered 10 April 2012, https://clinicaltrials.gov/ct2/show/NCT01573858?cond=NCT01573858&draw=2&rank=1.
Feasibility and Effectiveness of Remotely Supervised tDCS Combined With Computerized Cognitive Training for Patients With Stroke: A Randomized Sham-Controlled Study
Authors: Yoon Ju-Yul , Son Mi-Nam , Jo Yun-Ju , Kim Da-Sol , Kim Gi-Wook , Won Yu-Hui , Park Sung-Hee , Seo Jeong-Hwan , Kim Yun-Hee , Ko Myoung-Hwan
Published: January 2021

BackgroundCognitive impairment after stroke is an unfavorable factor for long-term functional independence. Transcranial direct current stimulation (tDCS) is a promising tool for improving cognitive function in patients with stroke. Home-based rehabilitation is increasingly required for patients with stroke, with greater benefits expected if supplemented with remotely supervised tDCS (RS-tDCS). We evaluated cognitive improvement and the feasibility of RS-tDCS in patients with chronic stroke.MethodsThirty chronic stroke patients with cognitive impairment (K-MoCA <26) received a computerized cognitive training package (ComcogTM, Neofact, Seoul, Korea), and were randomized into real RS-tDCS and sham RS-tDCS groups according to the application of tDCS. Participants were treated 5 days/week for 4 weeks. To ensure correct self-application of tDCS (Mindd Stim®, Ybrain Inc., Korea), patients and caregivers received training and were monitored. Several cognitive evaluations were performed. Rate of adherence to the appropriate RS-tDCS session was also investigated. ResultsAmong the 30 participants, 2 chose to withdraw and 2 were excluded due to noncompliance. In the within-group comparison, unlike the sham group (n= 14), the real group (n=12) showed a significant improvement in K-MoCA (intra-p=0.004 vs. 0.132), particularly in patients with moderate cognitive impairment (K-MoCA: 10–17; intra-p=0.001 vs. 0.835, K-MoCA: 18-25; intra-p=0.060 vs. 0.064). However, in K-DRS2, Stoop and K-BNT, both groups showed significant improvement, but there was no group time interaction. In the Trail Making Test, Go/no Go, and Controlled Oral Word Association Test, both groups did not show statistically significant improvement. A total of 551 of the 560 sessions conducted by 28 people were successfully performed (adherence rate: 98.4%) and no serious adverse effects were detected.ConclusionRS-tDCS is a safe and feasible rehabilitation modality for post-stroke cognitive dysfunction. It has the potential to enhance the effect of home-based CT. RS-tDCS seems to be particularly effective in patients with relatively more severe cognitive impairment who are capable of home-based training. Trial registration: Clinical Research information Service (KCT0003427). Registered 26 June 2018, https://cris.nih.go.kr/cris/en/search/search_result_st01.jsp?seq=12363
The Influence Factors of Medical Disputes in Shanghai and Implications - From the Perspective of Doctor, Patient and Disease (Observational Study)
Authors: Liu Yu , Yu Fei , Zhao Feng , Yang Xingchen , Ji Guangyao , Pan Xiao , Leng Feng , Dan Dongdong , Wang Pei , Bai Yonghai
Published: January 2021

Objective Based on the cases collected in eight hospitals in Shanghai in recent three years, causes of medical disputes in Shanghai and influence factors of medical dispute levels were discussed, and targeted suggestions were put forward. Methods Multistage sampling were used to collect 561 cases of medical disputes occurred in two Class A Tertiary hospitals, two Class A Secondary hospitals and four community hospitals in Shanghai in recent three years. On the basis of questionnaire, the causes of medical disputes were analyzed by descriptive statistics and the factors affecting the level of medical dispute were analyzed by means of one-way ANOVA and Logistic regression analysis.Results Factors of doctor and patient are involved in the causes of medical disputes, with 87.1% disputes related to doctors and 13.9% related to patients. The doctor’s factors include lack of communication (28.82%), low technical level (16.91%), lack of sense of responsibility (8.86%), defective case records (6.92%), imperfect operation (6.44%), inadequate experience (6.44%), inadequate condition evaluation (5.8%), irregular management process (4.03%), violation of diagnosis and treatment regulation (4.03%), misdiagnosis and mistreatment (3.54%), belated diagnosis and treatment (2.58%), postoperative complications (2.42%), equipment problems (1.13%), missed diagnosis (0.81%), poor condition monitoring (0.48%), unreasonable charge (0.48%) and poor service attitude (0.32%). The patient's factors include misunderstanding of medical behavior (43.48%), high expectation of prognosis (25%), bad attitude (13.04%), inadequate medical knowledge (7.61%), disturbance (6.52%), poor compliance (3.62%) and mistrust (1.09%). Among all medical disputes, there are 406 cases of level-4 medical disputes (78%), 95 cases of level-3 medical disputes (18%), 19 cases of level-2 medical disputes (4%), and no level-1 medical dispute. Meanwhile, the classification of diseases, treatment effect, doctors' violation of diagnosis and treatment regulation, and low technical level are the reasons for the level differences in medical disputes.Conclusion Factors of doctor in medical disputes in Shanghai mainly include inadequate communication and low technical level while the patient’s factors mainly contain misunderstanding of medical behavior and high expectation of the prognosis. Level-3 and 4 medical disputes take up the major part in all medical disputes. The classification of diseases, treatment effect, doctors' violation of diagnosis and treatment regulation, and doctor’s deficient technical level are high-risk factors requiring critical attention in medical disputes.
Oblique Incidence Ultrasonic Reflectometry Device Based on c-axis Tilted ScAlN Films for Evaluating Viscoelastic Properties of Liquids Above 100 MHz
Authors: Kinoshita Sarina , Yanagitani Takahiko
Published: January 2021

Ultrasound-based evaluation of fluid properties allows for real-time measurement of small amounts of liquid samples. The ultrasonic reflection method is used to obtain the complex reflection coefficient, which can be used to evaluate the viscoelastic properties of liquids. However, this method has not been used with shear waves at frequencies above 100 MHz because shear-mode piezoelectric films are difficult to obtain at such frequencies. We propose using the oblique incidence reflectometry with quasi-shear waves excited by c-axis tilted scandium aluminum nitride (ScAlN) thin films to realize high-sensitivity evaluation of the viscoelastic properties of liquids in the above 100 MHz. In experiments, the shear elasticity and shear viscosity of glycerin solutions were estimated from their complex reflection coefficients.