bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk factors for lymphatic filariasis and mass drug administration non-participation in Mandalay Region, Myanmar
Authors: Dickson Benjamin Felix Rothschild , Graves Patricia M , Aye Ni Ni , Nwe Thet Wai , Wai Tint , Win San San , Shwe Myint , Douglass Janet , Wood Peter , Wangdi Kinley , McBride William J
Published: September 2020

Background: Myanmar commenced a lymphatic filariasis (LF) elimination program in 2000. Whilst the country has made considerable progress since then, a number of districts have demonstrated persistent transmission after many rounds of mass drug administration (MDA). The causes of unsuccessful MDA have been examined elsewhere, however, there remains little information on the factors that contribute in Myanmar. Methods: We conducted an analysis of factors associated with persistent infection, LF-related hydrocoele and MDA participation in an area with ongoing transmission in 2015. A cross-sectional household survey was undertaken in 24 villages across four townships of Mandalay Region. Participants were screened for circulating filarial antigen (CFA) using immunochromatographic tests and if positive, for microfilaria by night-time thick blood slide. Individuals 15 year and older were assessed for filariasis morbidity (lymphoedema and if male, hydrocoele) by ultrasound-assisted clinical examination. A pre-coded questionnaire was used to assess risk factors for LF and for never-taking MDA. Significant variables identified in univariate analyses were included in separate step-wise multivariate logistic regressions for each outcome. Results: After adjustment for covariates and survey design, being CFA positive was significantly associated with age (odds ratio (OR) 1.03, 95% CI 1.01 – 1.06), per year), male gender (OR 3.11, 1.23 – 7.87), elevation (OR 0.97, 0.94 – 1.00, per metre) and the density of people per household room (OR 1.56, 1.26 – 1.93). LF-related hydrocoele was associated with age (OR 1.06, 1.02 – 1.09, per year) and residing in Amarapura Township (OR 8.56, 1.33 – 55.22). Never-taking MDA was associated with age (less than 15 years: OR 2.89, 1.11 – 7.51; greater than 60 years: OR 4.00, 1.53 – 10.48), male gender (OR 1.85, 1.05 – 3.25), residing in Amarapura township (OR 2.99, 1.39 – 6.43), moving to one’s current village from another (OR 2.84, 1.15 – 7.02) and ever having declined medication (OR 13.76, 4.79 – 39.58). Decreased likelihood of never taking MDA was associated with a higher proportion of household members being present during the last MDA round (OR 0.18, 0.04 – 0.96)).Conclusions: These results contribute to the understanding of LF and MDA participation related risk factors, and will assist Myanmar improve its elimination and morbidity management programs.
Are There Inequalities in the Receipt of Help Among People With Dementia or Cognitive Impairment? Results From the English Longitudinal Study of Ageing
Authors: Read Sanna , Hu Bo , Dixon Josie , Brimblecombe Nicola , Wittenberg Raphael , Banerjee Sube
Published: September 2020

Background: In addition to inequalities related to gender, age and socio-economic background, poor cognitive function may affect receipt of help and impair quality of life. We investigate whether people with dementia or low cognition with a disadvantaged background, experience more unmet need and/or more unrequired help than older people with similar levels of functional limitation, and associations with quality of life. Methods: We studied people aged 50+ in the English Longitudinal Study of Ageing. Cognitive status was divided into three groups: dementia (by physician diagnosis and/or proxy questionnaire, n=405); low cognition but no dementia (lowest quartile in the mean of z-scores of orientation, immediate recall and delayed recall, n=4,520); and intact cognition (n=10,264). Counts of unmet need (not receiving help for the need) and unrequired help (receipt of help without the respective need) were used as outcomes in two-part regressions. Quality of life (CASP-19) was a continuous outcome in a linear regression. Socio-demographic factors (gender, age, having partner/child and socioeconomic status), functional limitation, and their interaction with cognitive status were included in the models. Results: People with dementia or low cognition at lower levels of functional limitation had more unmet need and received more unrequired help. At higher levels of functional limitation, unmet needs were more frequent among the cognitively intact while unrequired help did not differ by cognitive status. Women, younger individuals, and those with a partner had fewer unmet needs but received more unrequired help, mostly among the cognitively intact. Higher socioeconomic status was associated with fewer unmet needs and unrequired help regardless of cognitive status. Both unmet need and unrequired help were associated with poorer quality of life independent of cognitive status. Conclusions: Unmet need may be a particular challenge in early dementia. Unrequired help that may decrease autonomy is a problem at all levels of cognition. Lower socioeconomic status undermines the receipt of sufficient help. Our results highlight the importance of a good-quality timely diagnosis of dementia, comprehensive and accurate needs assessment, and person-centred care planning to identify those with unmet need and receiving unrequired help in order to improve their quality of life.
Learning about location-dependent threat: neural abnormalities in clinical anxiety
Authors: Suarez-Jimenez Benjamin , Balderston Nicholas , Bisby James , Leshin Joseph , Hsiung Abigail , King John , Pine Daniel (S) , Burgess Neil , Grillon Christian , Ernst Monique
Published: September 2020

Anxiety disorders are characterized by maladaptive defensive responses to distal or uncertain threats. Elucidating neural mechanisms of anxiety is essential to formulate new treatment strategies tartgeting these circuits. In an fMRI scanner, patients with pathological anxiety (ANX, n=23) and healthy comparisons (HC, n=28) completed a contextual threat learning paradigm, in which they picked flowers in a virtual environment comprising a danger zone in which flowers were paired with shock and a safe zone (no shock). ANX compared with HC showed 1) global decreased ventromedial prefrontal cortex and anterior hippocampus activation during the task, 2) increased insula and dorsomedial prefrontal cortex activation in the danger zone during the task; and 3) increased amygdala and midbrain/periaqueductal gray activation in the danger zone prior to potential shock delivery. Our findings suggest that ANX exhibit a heightened reactivity to threat and show decreased activation in modulatory areas responsible for regulating context-appropriate emotional responses.
The epidemiology and association rules of concurrent pulmonary tuberculosis and extrapulmonary tuberculosis (PTB-EPTB) in China: a large-scale multi- center observational study
Authors: Kang Wanli , Du Jian , Chang Yunqing , Chen Hongyan , Liu Jianxiong , Ma Jinshan , Li Mingwu , Qin Jingmin , Shu Wei , Zong Peilan , Yan Xiaofeng , Zhang Yi , Dong Yongkang , Yang Zhiyi , Mei Zaoxian , Deng Qunyi , Wang Pu , Han Wenge , Wu Meiying , Chen Ling , Zhao Xinguo , Tan Lei , Li Fujian , Zheng Chao , Liu Hongwei , Li Xinjie , Ertai A , Du Yingrong , Liu Fenglin , Yang Song , Cui Wenyu , Wang Quanhong , Chen Xiaohong , Han Junfeng , Xie Qingyao , Feng Yanmei , Liu Wenyu , Tang Peijun , Zhang Jianyong , Zheng Jian , Chen Dawei , Yao Xiangyang , Ren Tong , Li Yang , Li Yuanyuan , Wu Lei , Song Qiang , Yang Mei , Zhang Jian , Liu Yuanyuan , Guo Shuliang , Yan Kun , Shen Xinghua , Lei Dan , Zhang Yangli , Li Liang , Tang Shenjie
Published: September 2020

Background Tuberculosis (TB) is a multi-systemic disease with a protean presentation and remains a major global health problem. Concurrent pulmonary tuberculosis (PTB) and extrapulmonary tuberculosis (EPTB) are common in clinical practice. However, the information about concurrent PTB-EPTB is scarce. This study aimed to study the epidemiology of concurrent PTB-EPTB by summarizing the diagnostic types of TB and determine the association rules by a large-scale multi-center observational study in China.Methods The study was performed at 21 hospitals from 15 provinces in China. All the consecutive inpatient with confirmed TB diagnosis during the years from Jan 2011 to Dec 2017 was included in the study. The association rules of concurrent PTB-EPTB were analyzed by Apriori algorithm. Results Of 438,979 TB inpatients evaluated, the most common were PTB (82.05%), followed by tuberculous pleurisy (23.62%), etc. Concurrent PTB-EPTB occurred in 129,422 cases (29.48%). Concurrent PTB and tuberculous pleurisy was the most common concurrent PTB-EPTB types. In the fully adjusted multivariable logistic models, the odds ratio of concurrent PTB-EPTB was different by gender and age group. In PTB with concurrent EPTB, the strongest association rule was PTB with concurrent bronchial tuberculosis (lift=1.09). In EPTB with concurrent PTB, the strongest association rule was pharyngeal /laryngeal tuberculosis with concurrent PTB (lift=1.11). The confidence and lift of concurrent PTB-EPTB varied with gender and age. Conclusions There were many types of concurrent PTB-EPTB. The confidence and lift of concurrent PTB-EPTB varied with gender and age. The clinicians should be alert to the presence of concurrent PTB-EPTB and take effective treatment regimen.
Man or Machine? Comparison of the Effect of Tutor-Guided versus Simulator-Guided Short-Time Bronchoscopy Training on Navigational Skills and Knowledge of the Tracheobronchial Anatomy
Authors: Schertel Anke , Geiser Thomas , Hautz Wolf E.
Published: September 2020

Background:
Simulation based medical education is efficient for the acquisition of flexible bronchoscopy navigational skills and the knowledge of the tracheobronchial anatomy. However, bronchoscopy simulator training is not routinely integrated into pneumologic fellowship programs or undergraduate medical education for time and/or cost reasons. Our study compares the effect of self-guided bronchoscopy simulator training versus tutor guided training on the acquisition of navigational skills and knowledge of the bronchial anatomy.
Methods:
3rd -year undergraduate medical students were randomized to either a tutor- or simulator guided bronchoscopy simulator training focusing on the acquisition of navigational skills and the knowledge of the tracheobronchial anatomy. Every student performed a baseline bronchoscopy followed by a structured bronchoscopy simulator training and finally an assessment bronchoscopy at the end of the training program. Groups were compared by means of a repeated measurement ANOVA and effect sizes calculated as Cohens’ d.
Results:
54 eligible students participated in the study. Knowledge of the tracheobronchial anatomy significantly increased from pre- to post training (all p < 0.001; all d > 2), navigational skills significantly decreased (all p < 0.005; all d < 1). There were no significant differences between groups.
Conclusion:
Short-time simulator guided bronchoscopy training improves knowledge of the tracheobronchial anatomy in novice bronchoscopists as much as tutor guided training, but navigational skills seem to worsen in both groups. Further studies assessing transfer to clinical practice are needed to find the optimal teaching method for basic flexible bronchoscopy.
Largely accelerated arterial aging in rheumatoid arthritis is associated with inflammatory activity and smoking in the early stage of the disease
Authors: Mong Nikolett , Tarjanyi Zoltan , Tothfalusi Laszlo , Bartykowszki Andrea , Nagy Aniko Ilona , Szekely Anett , Becker David , Maurovich-Horvat Pal , Merkely Bela , Nagy Gyorgy
Published: September 2020

Background: Rheumatoid arthritis (RA) patients have a shorter life expectancy than the general population primarily due to cardiovascular comorbidities.Objectives: To characterize arterial aging in RA.Patients and methods: Coronary calcium scores (CCS) were available from 112 RA patients; out of these patients, follow-up CCS were measured of 54 randomly selected individuals. Control CCS were obtained from the MESA database (includes 6000< participants); arterialage was calculated from CCS.Results: RA patients were significantly older (10.45±18.45 years, p<0.001) in terms of the arterial age compared to the age, gender and race matched controls. The proportion of RA patients who had zero CCS was significantly less (p<0.01) than in the MESA reference group. Each disease year contributed an extra 0.395 years (p<0.01) on the top of the normal aging process. However, the rate of the accelerated aging is not uniform, in the first years of the disease it is apparently faster. Smoking (p<0.05), previous cardiovascular events (p<0.05) and high blood pressure (p<0.05) had additional significant effect on the aging process. In the follow-up study, inflammatory disease activity (CRP>5 mg/L, p<0.05) especially in smokers and shorter than 10 years disease duration (p=0.05) had the largest impact.Conclusions: Arterial aging is faster in RA patients compared to control subjects, particularly in the first 10 years of the disease. Inflammation, previous cardiovascular events and smoking are additional contributing factors to the intensified coronary atherosclerosis progression. These data support that optimal control of inflammation is essential to attenuate the cardiovascular risk in RA.
Lay Persons’ Perception of the Requirements for Research in Emergency Obstetric and Newborn Care
Authors: Kaye Daniel Kabonge
Published: September 2020

Background: Factors that could potentially act as facilitators and barriers to successful recruitment strategies in perinatal clinical trials are not well documented. The objective was to assess lay persons’ understanding of the informed consent for randomized clinical trial in emergency obstetric and newborn care. Methods: This was a qualitative study conducted among survivors of severe obstetric complications who were attending the post-natal clinic of Kawempe National Referral Hospital, Uganda, 6-8 weeks after surviving severe obstetric complications during pregnancy or childbirth. The study that involved 18 in-depth interviews was conducted from June 1, 2019 to July 6, 2019. The issues explored included perceptions of the purpose and necessity to conduct such research how research-related information would be disclosed, and what could be the potential benefits and risks of participation. The data was analyzed by thematic analysis. Findings: Respondents felt that research was necessary to investigate the cause, prevention or complications of an illness, especially as much was known about some pregnancy and newborn complications. Most believed that the emergency contexts affects whether and what prospective participants may understand if information about research was disclosed. Whereas they did not see the value of procedures like randomization, they felt that if these and any other procedures necessary should be done transparently and fairly. The decisions to participate would significantly be influenced by possibility of risk to the unborn baby or the newborn. Solidarity was an important influence on decision-making. Conclusion: Respondents valued participation in RCTs in emergency obstetric and newborn care. However, they expressed concerns and valued openness, transparency and accountability with regard to how clinical trials information is disclosed and the decision-making process for clinical trial participation. While autonomy and solidarity are contradictory values, they complement each other during decision-making for informed consent.
Targeted Intracellular Degradation of SARS-CoV-2 via Computationally-Optimized Peptide Fusions
Authors: Chatterjee Pranam , Ponnapati Manvitha , Kramme Christian , Plesa Alex , Jacobson Joseph , Church George
Published: September 2020

The COVID-19 pandemic, caused by the novel coronavirus SARS-CoV-2, has elicited a global health crisis of catastrophic proportions. With no approved cure or vaccine currently available, there is a critical need for effective antiviral strategies. In this study, we report a novel antiviral platform, through computational design of ACE2-derived peptides which both target the viral spike protein receptor binding domain (RBD) and recruit E3 ubiquitin ligases for subsequent intracellular degradation of SARS-CoV-2 in the proteasome. Our engineered peptide fusions demonstrate robust RBD degradation capabilities in human cells and are capable of inhibiting infection-competent viral production, thus prompting their further experimental characterization and therapeutic development.
Genome-wide bioinformatic analyses predict key host and viral factors in SARS-CoV-2 pathogenesis
Authors: Ferrarini Mariana , Lal Avantika , Rebollo Rita , Gruber Andreas , Guarracino Andrea , Gonzalez Itziar Martinez , Floyd Taylor , de Oliveira Daniel Siqueira , Shanklin Justin , Beausoleil Ethan , Pusa Taneli , Pickett Brett , Aguiar-Pulido Vanessa
Published: September 2020

The novel betacoronavirus named Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) caused a worldwide pandemic (COVID-19) after initially emerging in Wuhan, China. Here we applied a novel, comprehensive bioinformatic strategy to public RNA sequencing and viral genome sequencing data, to better understand how SARS-CoV-2 interacts with human cells. To our knowledge, this is the first meta-analysis to predict host factors that play a specific role in SARS-CoV-2 pathogenesis, distinct from other respiratory viruses. We identified differentially expressed genes, isoforms and transposable element families specifically altered in SARS-CoV-2 infected cells. Well-known immunoregulators including CSF2, IL-32, IL-6 and SERPINA3 were differentially expressed, while immunoregulatory transposable element families were overexpressed. We predicted conserved interactions between the SARS-CoV-2 genome and human RNA-binding proteins such as hnRNPA1, PABPC1 and eIF4b, which may play important roles in the viral life cycle. We also detected four viral sequence variants in the spike, polymerase, and nonstructural proteins that correlate with severity of COVID-19. The host factors we identified likely represent important mechanisms in the disease profile of this pathogen, and could be targeted by prophylactics and/or therapeutics against SARS-CoV-2.
Direct Observation of Deviations from Taylor's Frozen Hypothesis and Scaling Laws in Canonical Jet Flows
Authors: Roy Sukesh , Miller Joseph , Gunaratne Gemunu
Published: September 2020

The legendary difficulties in studying turbulent flows stem, in part, from the lack of high-frequency, high-resolution measurements to interrogate small-scale structures and their rapid evolution. Our experiments, employing a burst-mode laser system, capture both spatially resolved velocity fields and their dynamics using high-resolution particle image velocimetry measurements at 100 kHz. We show directly that fluctuations of flow velocity in an axisymmetric jet flow are inhomogeneous and anisotropic. The velocity of the peak of the time-delayed cross correlation function C(r, r 0 ; τ ) is smaller than the convection velocity; thus Taylor’s frozen hypothesis [Taylor GI, Proc. R. Soc. London, Ser A 164, 476 (1938)] fails to generalize for inhomogeneous jet flows, consistent with prior studies. Its peak decays exponentially in time. Second, the structure functions are found to be isotropic at small distances, but not at large distances. Extended self-similarity is found to hold [Benzi R et al., Physics Review E 48, R29 (1993)], but no inertial range is found where the Kolmogorov 2 3 -law [Kolmogorov AN, Dokl. Akad. Naud. SSSR 30, 299 (1941)] holds. Spectral-energy density of the jet flow, although anisotropic, is consistent with the Kolmogorov-Obukhov 5 3 -law [Obukhov AM, Izvestiya Akad. Nauk. SSSR 32, 19 (1941)] in the flow direction.
Bridging Adsorption Analytics and Catalytic Kinetics for Metal-Exchanged Zeolites
Authors: Xie Pengfei , Pu Tiancheng , Aranovich Gregory , Guo Jiawei , Donohue Marc , Kulkarni Ambarish , Wang Chao
Published: September 2020

Metal-exchanged zeolites have been widely used in industrial catalysis and separation, but fundamental understanding of their structure-property relationships has remained challenging, largely due to the lack of quantitative information concerning the atomic structures and reaction-relevant adsorption properties of the embedded metal active sites. We report on the use of low-temperature chemisorption to titrate Cu-exchanged ZSM5. Quantitative descriptors of the atomic structures and adsorption properties of Cu-ZSM5 are established by combining atomistic simulation, DFT calculations, operando molecular spectroscopy, chemisorption and titration measurements. These descriptors are then applied to interpret the catalytic performance of Cu-ZSM5 for NO decomposition. Linear correlations are established to bridge the low-temperature adsorption analytics and high-temperature reaction kinetics, which are demonstrated to be generally applicable for understanding the structure-property relationships of metal exchanged zeolites and foregrounded for guiding the development of advanced catalytic materials.
Post-treatment work patterns amongst survivors of lymphoma treated with high-dose chemotherapy with autologous stem-cell transplantation
Authors: Hernaes Kjersti Helene , Smeland Knut Halvor Bjøro , Fagerli Unn Merete , Kiserud Cecilie Essholt
Published: September 2020

BackgroundThis study describes post-treatment work patterns in lymphoma survivors treated with high-dose chemotherapy with autologous stem-cell transplantation (HDT-ASCT). It aims to identify determinants for labour force participation and exclusion after HDT-ASCT.MethodsEligible patients were survivors of HDT-ASCT for lymphoma in Norway between 1995 and 2008, aged >= 18 years at HDT-ASCT. We divide survivors by current employment status (working (full vs. part-time) and unemployed). Main outcomes are current employment status, work hours and work ability. Withdrawals are patients who were employed when diagnosed but not before HDT-ASCT.ResultsOf the 274 who completed the survey, 82% (N=225) were included in the final analyses. Mean age at survey was 52 years, 39% were female, 85% were employed when diagnosed, 77% before HDT-ASCT and 69% at survey. Employment before HDT-ASCT corresponds with a higher probability of employment at survey for a given symptom burden. In the most extensive statistical model, it increases with 37.3 percentage points. Work hours amongst withdrawals plummet after HDT-ASCT while work ability shows a rebound effect. The potential economic gain from their re-enter into the work force equals 2/3 of the average annual wage in Norway in 2012.ConclusionsFor a given symptom burden, staying employed throughout diagnosis and treatment is associated with a higher probability of future employment. These results favour policies for labour force inclusion past diagnosis and treatment increasing cancer survivors’ probability of future employment. However, we need more research on withdrawal mechanisms, and on policy measures that promote inclusion.
The physicochemical and phylogenetic properties of twelve spike glycoprotein models for SARS-CoV-2 from China, Iran, and Tunisia
Authors: Odhaib Samih A. , Al-Aubaidy Hayder
Published: September 2020

Background

The coronavirus spike glycoprotein is a trimeric structural surface protein that facilitates the viral adhesion through attaching receptors on the human cell surface. This study aims to analyse and compare the genomic and phylogenetic properties of these spike glycoproteins from China, Iran, and Tunisia.
Methods

This is a descriptive cross-sectional comparative study for the different properties of S glycoprotein from 12 SARS-CoV-2 specimens from GenBank. Clustal Omega was used to study model sequences alignment, residual conservation, phylogeny, and identity matrix. SWISS-MODEL developed and validated the 3D models for three protein sequences with the highest model quality. The different physicochemical characteristics of different models were assessed by ExPASy proteomics.
Results

The Chinese and the Iranian sequences share 100% identity, although they have a different amino acids number, and 25-29.27% identity to the Tunisian sequences. The 12 models are monophyletic, with varying stages of evolutionary divergence. There are six fully, three highly, and five lowly conserved residues across the sequences. The resulting three highly reliable 3D models were of different global qualities, being the lowest for the Tunisian, and the highest for the Iranian models. All the models are highly hydrophilic. The Tunisian models were unstable in comparison to the relatively stable other models with different physicochemical characteristics.
Conclusion

The models had different N-terminal residues and side groups polarity and charge. The S glycoproteins are not identical nor unique in model structure nor the physicochemical profiles in different parts of the world. The Tunisian models are drastically biodiverse from the Chinese and Iranian models.
Metabolic and Behavioral Features of Acute Hyperpurinergia and the Connection to Autism Spectrum Disorder
Authors: Zolkipli-Cunningham Zarazuela , Naviaux Jane C. , Nakayama Tomohiro , Hirsch Charlotte M. , Monk Jonathan M. , Li Kefeng , Wang Lin , Le Thuy P. , Meinardi Simone , Blake Donald , Naviaux Robert K.
Published: September 2020

Background. Since 2012, studies in mice, rats, and humans have suggested that abnormalities in purinergic signaling may be a final common pathway for many genetic and environmental causes of autism spectrum disorder (ASD). The current study in mice was conducted to characterize the bioenergetic, metabolomic, breathomic, and behavioral features of acute hyperpurinergia triggered by systemic injection of the purinergic agonist and danger signal, extracellular ATP (eATP). Methods. Responses were studied in C57BL/6J mice with ASD-like behaviors in the maternal immune activation (MIA) model and controls. Basal metabolic rates, respiratory exchange ratios (RER = VCO2/VO2), and locomotor activity were measured in CLAMS cages. Plasma metabolomics measured 401 metabolites. Breathomics measured 98 volatile organic compounds. Results. A 0.5 µmol/g dose of ATP dropped whole body oxygen consumption by 74% ± 6% (mean ± SEM, 5,303 to 1,382 ml/kg/hr, p<0.0001) and rectal temperature by 6.2˚ ± 0.3˚C (p<0.0001) in 30 minutes. Over 200 metabolites from 37 different biochemical pathways where changed. MIA animals were hypersensitive to the metabolic and behavioral responses triggered by eATP and poly(IC). Breathomic and metabolomic analysis revealed changes in folate-methylation-1-carbon, purines, pyrimidines, acyl-carnitines, glycolysis, aromatic and branch-chain amino acids, Krebs cycle, glutathione, urea cycle, phospholipids, sphingolipids, eicosanoids, cholesterol, bile acids, vitamins, and microbiome metabolism similar to children with ASD. Limitations. The responses to ATP were studied in only a single genetic strain of mice (C57BL/6J). Although similar to metabolic results reported in FVB mice and a small clinical trial in children with ASD, the generalizability of these results to larger studies in humans is unknown. The chronic effects of repeated postnatal ATP exposures were not tested. Conclusions. Acute hyperpurinergia produced metabolic and behavioral changes in mice that were similar to those found in children with ASD. These behaviors and metabolic changes were associated with mitochondrial functional changes that were profound but reversible.
Ocular abnormalities in a large Western China patient cohort with Retinitis Pigmentosa
Authors: Tan Lian , Long Yanling , Li Ziyang , Ying Xi , Ren Jiayun , Sun Cheng , Meng Xiaohong , Li Shiying
Published: September 2020

Background: To report the prevalence of ocular abnormalities and investigate visual acuity in a large Western China cohort of retinitis pigmentosa (RP) patients.Methods: A retrospective study was performed, reviewing the medical records and ophthalmic examination reports of 2,127 eyes from 1,065 RP patients in one eye hospital. The authors investigated the prevalence of ocular abnormalities and the relationship between best corrected visual acuity (BCVA) and macular abnormalities.Results: Nyctalopia (58.2%) and blurred vision (27.1%) were the leading consultation causes. BCVA measurements in the better eyes at first clinical presentation showed that 304 patients (28.5%) were categorised as blind and 220 patients (20.7%) as low vision. The most common ocular abnormalities were cataracts (43.1%) and macular abnormalities (59.7%), including epiretinal membranes (51.1%), cystoid macular oedema (18.4%), vitreomacular traction syndrome (2.4%), macular holes (2.3%) and choroidal neovascular membranes (0.05%). Glaucoma was found in 35 eyes (1.6%). The proportions of epiretinal membranes (P = 0.001) and macular holes (P = 0.008) increased significantly with age. The proportions of vitreomacular traction syndrome (P = 0.003) and epiretinal membranes (P < 0.001) in pseudophakia and aphakia eyes were significantly higher than in eyes that had not received operations (including cataracts and clear lens). Cystoid macular oedema was significantly associated with poorer visual acuity in RP patients with clear lens (P = 0.002).Conclusion: Cataracts and macular abnormalities are common in RP patients. In the macular abnormalities, cystoid macular oedema may have a negative effect on BCVA in RP patients with clear lens.
A Novel “Three-Port” Trocar Placement Technique for Laparoscopic Radical Prostatectomy
Authors: Xu Ben , Song Hai-feng , Luo Cheng , Zhang Qian
Published: September 2020

Background: To introduce a novel “three-port” trocar placement technique for laparoscopic radical prostatectomy (LRP) in prostate cancer (PCa) patients.Methods: We retrospectively reviewed 300 patients with PCa who received surgical treatment between November 2010 and June 2015 at our institution. They were divided into group A: three-port LRP, group B: conventional four-five port LRP, group C: open RP (ORP) and group D: robotic-assisted RP (RARP). A learning curve was analyzed by dividing patients of group A into the early and late stages.Results: All groups were comparable with regard to the preoperative characteristics except for the relatively smaller prostate volume in group A. The three-port LRP operations were performed successfully with only 8 cases conversion to the conventional LRP. None of any severe complications or conversion to ORP occurred. In group A, the mean operative time (OT) duration was 113.8 min, the mean estimated blood loss (EBL) was 94.2 ml, the mean drainage days was 4.0d, the mean hospitalization was 5.1 d, and 27.8% of the prostate specimen margins (PSM) were positive. The differences of OT, EBL, drainage days, hospitalization and transfusion in group A were statistically significant among the majority of the other groups (p<0.05). After undergoing the early stages of a learning curve analysis in three-port LRP, the EBL was obviously decreased.Conclusions: Three-port LRP is a novel technique that exhibits superior intraoperative advantages to the conventional LRP. Due to its less OT, EBL, drainage days, hospitalization and transfusion with a shorter learning curve, it should be recommended and popularized in the clinical practice!
Career-computer simulation increases perceived importance of learning about rare diseases
Authors: Sarrafpour Babak , Hegde Shwetha , Delamare Eduardo , Weeks Ruth , Denham Rebecca A , Thoeming Alix , Zoellner Hans
Published: September 2020

Background
Rare diseases may be defined as occurring in less than 1 in 2,000 patients. Such conditions are, however, so numerous that up to 5.9% of the population is afflicted by a rare disease. The gambling industry attests that few people have native skill evaluating probabilities. We believe that both students and academics, under-estimate the likelihood of encountering rare diseases. This combines with pressure on curriculum time, to reduce both student interest in studying rare diseases, and academic content preparing students for clinical practice. Underestimation of rare diseases, may also contribute to unhelpful blindness to considering such conditions in the clinic.
Methods
We first developed a computer simulation, modelling the number of cases of increasingly rare conditions encountered by a cohort of clinicians. The simulation captured results for each year of practice, for each clinician throughout the entirety of their careers. 462 theoretical conditions were considered, with prevalence ranging from 1 per million people through to 64.1% of the population. We then delivered a class with two in-class on-line surveys evaluating student perception of the importance of learning about rare diseases, one before and the other after, an in-class real-time computer simulation. Key simulation variables were drawn from the student group, so students could see a projection of their own careers.
Results
The in-class computer simulation revealed that all graduating clinicians from that class would frequently encounter rare conditions. Comparison of results of the in-class survey conducted before and after the computer simulation, revealed a significant increase in the perceived importance of learning about rare diseases (p < 0.005).
Conclusions
The computer career simulation appeared to affect student perception. Because the computer simulation demonstrated clinicians frequently encounter patients with rare diseases, we further suggest this should be considered by academics during curriculum review and design.
Dynamic Prognosis Model for Predicting Survival in Severe and Critically Ill COVID-19 Patients Using Machine Learning
Authors: Wei Yongyue , He Jieyu , Chen Jiao , Zhu Ying , Chen Jiajin , Ding Jingjing , Wang Hao , Hu Yahua , Huang Yingzi , Jiang Yue , Pan Zoucheng , Shen Sipeng , Zhao Wei , Gao Wei , Chen Feng , Lu Xiang
Published: September 2020

Background Novel coronavirus disease (COVID-19) is an emerging, rapidly evolving situation. At present, the prognosis of severe and critically ill patients has become an important focus of attention. We strived to develop a prognostic prediction model for severe and critically ill COVID-19 patients.MethodsTo assess the factors associated with the prognosis of those patients, we retrospectively investigated the clinical, laboratory characteristics of confirmed 112 cases of COVID-19 admitted between 21 January to 6 March 2020 from Huangshi Central Hospital, Huangshi Hospital of Traditional Chinese Medicine, and Daye People’s Hospital. We applied machine learning method (survival random forest) to select predictors for 28-day survival and taken into account the dynamic trajectory of laboratory indicators. Results Fifteen candidate prognostic features, including 11 baseline measures (including platelet count (PLT), urea, creatine kinase (CK), fibrinogen, creatine kinase isoenzyme activity, aspartate aminotransferase (AST), activation of partial thromboplastin time (APTT), albumin, standard deviation of erythrocyte distribution width (RBC-SD), neutrophils (%) and red blood cell count (RBC)) and 4 trajectory clusters (changes during hospitalization in the white blood cell (WBC), PLT large cell ratio (P-LCR), PLT distribution width (PDW) and AST), combined with covariates achieved 100% (95%CI: 99%-100%) AUC and reached 87% (95%CI: 84%-91%) AUC in an external validation set. Conclusions Taking advantage of random forest technique and laboratory dynamic measures, we developed a forest model to predict survival outcome of COVID-19 patients, which achieved 87% AUC in the external validation set. Our online tool will help to facilitate the early recognition of patients with high risk.
The Value of Neutrophil/monocyte Ratio in Early Diagnosis of Children Mycoplasma Pneumoniae Pneumonia
Authors: Yao Shasha , Xie Yao , Chen Fei , Chen Xiao , Zhang Miao , Li Yan
Published: September 2020

Background:To investigate the value of blood cell analysis in early diagnosis of mycoplasma pneumoniae pneumonia (MP). Methods:The clinical parameters, including patient characteristics, clinical symptoms, imaging characteristics and laboratory examination data of the patients hospitalized in the Department of Pediatrics, Nanjing Jiangning Hospital from January 2018 to March 2020 due to community-acquired pneumonia were collected for retrospective analysis. The data were analyzed by SPSS 22.0 software for statistical analysis. P<0.05 was considered statistically significant.Results:The levels of white blood cell count (WBC), absolute neutrophil count (NEU), absolute monocyte count (MON), platelet count (PLT), neutrophil/lymphocyte ratio(NLR), mean platelet volume/platelet count (MPV/PLT) and neutrophil/monocyte ratio (NMR) in children with bacterial pneumonia (BP)were significantly higher than those of children withMP and children withviral pneumonia (VP), the NMR level in children withMP was higher than that of children with VP,the NMR levelsin the three groups of children were significantly different (P<0.05).Combined with the NMR level, the children’s age andpulmonary consolidation information,the AUC areas of MP, BP and VP had high accuracy fordifferential diagnosis of MP. Conclusion:As a comprehensive indicator of neutrophils and monocytes, NMR may differentiate pneumonia caused by mycoplasma pneumoniae, bacterial and viral infections, which provides new direction for early differential diagnosis of pneumonia.
Bursty Topic Detection in Cancer Field Based on Multi-features of Burst Words
Authors: gong xiaocui , an xinying , shan lianhui , hao yingxin , li yifei
Published: September 2020

Background:With the increase in the amounts and types of medical information resources and the interdisciplinarity of the related works,it has become increasingly challenging for researchers and information personnel to grasp the theme development.Considering the prominent position of cancer field among all the subject areas in scientific research, and in order to carry out a new bursty topic detection method, the author proposes a method based on the multi-features of burst words and demonstrates its operating process. Methods:The main stages in the process include concept mapping,topic words extraction,burst words extraction,burst topics identification.This paper continues to take the study of breast neoplasms treatment research as a field to test the new method for identifying burst topics in medical research. Result:With this method,we identified four burst topics in breast neoplasms treatment research, including Molecular Targeted Therapy of Triple Negative Breast Neoplasms,molecular pharmacology of Triple Negative Breast Neoplasms,Immunological Antineoplastic Agents therapeutic use of Breast Neoplasms and Surgery therapy of Breast Neoplasms. Conclusion:The test results are highly concordant with authoritative literature reviews in the field and are further confirmed by interviews with the field’s leading experts,thus verifying the reliability of the techniques and approaches proposed by the study.
Dexmedetomidine protects against burn-induced intestinal barrier injury via the MLCK/p-MLC signalling pathway
Authors: Qin Chao , Jiang Yi , Chen Xing , Bian Yingxue , Wang Yaoqi , Xie Keliang , Yu Yonghao
Published: September 2020

Background Dexmedetomidine, a potent α2-adrenoceptor agonist with analgesic, sedative, anti-inflammatory, and anti-apoptotic effects, is commonly used in patients with critical illness in intensive care units. Accumulating evidence indicates that dexmedetomidine can protect against intestinal dysfunction. However, the specific mechanisms of its protective effects against burn-induced intestinal barrier injury remain unclear. Here, we aimed to explore the possible positive effects of dexmedetomidine on burn-induced intestinal barrier injury and the role of the myosin light chain kinase (MLCK)/phosphorylated myosin light chain (p-MLC) signalling pathway in an experimental model of burn injury.Methods In this study, the intestinal permeability of burn-induced intestinal barrier damage was assessed by estimating the plasma concentration of 4.4 kDa fluorescein isothiocyanate-labelled dextran (FITC-dextran). Histological changes were evaluated using haematoxylin and eosin (HE) staining. Tight junction proteins were evaluated by western blot and immunofluorescence analyses to assess the structural integrity of intestinal tight junctions. The level of inflammation was determined by enzyme-linked immunosorbent assay (ELISA).Results Our findings demonstrated that the increase in intestinal permeability caused by burn injury is accompanied by histological damage to the intestine, decreases in the expression of the tight junction proteins Zonula Occludens-1 (ZO-1) and Occludin, increases in inflammatory cytokine levels and elevation of both MLCK protein expression and MLC phosphorylation. After dexmedetomidine treatment, the burn-induced changes were ameliorated.Conclusions In conclusion, dexmedetomidine exerted an anti‑inflammatory effect and protected tight junction complexes against burn‑induced intestinal barrier damage by inhibiting the MLCK/p-MLC signalling pathways, suggesting that it may be an effective drug in the treatment of burn-induced intestinal injury.Trial registration Not appliance.
Analysis of cesarean section rates using Robson Ten Group Classification System in a tertiary teaching hospital, Addis Ababa, Ethiopia: a cross-sectional study
Authors: Abubeker Ferid A. , Gashawbeza Biruck , Gebre Thomas Mekuria , Wondafrash Mekitie , Teklu Alula M. , Degu Demis , Bekele Delayehu
Published: September 2020

Background: Cesarean section (CS) is an important indicator of access to, and quality of maternal health services. The World Health Organization recommends the Robson ten group classification system as a global standard for assessing, monitoring and comparing CS rates at all levels. This study aimed to assess the rate of CS and perform an analysis based on Robson classification system.Methods: A facility-based cross-sectional study was conducted at a tertiary hospital in Addis Ababa, Ethiopia. Data were collected from medical charts of all women who delivered from January-June 2018. The overall CS rate was calculated then women were categorized into one of the ten Robson groups. Relative size of each group, contribution of each group to the overall CS rate, and CS rate within each group were calculated.Results: A total of 4,200 deliveries were analyzed. Of these 1,459 (34.7%) were CS. The largest contributors to the overall CS rate were Group 10 (19.1%), Group 2 (18.3%), Group 5 (17.1%), and Group 4 (15.8%). There was also a high rate of pre-labor CS in Group 2, Group 4, and Group 10.Conclusion: Through implementation of the Robson ten group classification system, we identified the contribution of each group to the overall CS rate as well as the CS rate within each group. Group 10 was the leading contributor to the overall CS rate. This study also revealed a high rate of CS among low-risk groups. These target groups require more in-depth analysis to identify possible modifiable factors and to apply specific interventions to reduce the CS rate. Evaluation of existing management protocols and further studies into indications of CS and outcomes are needed to design tailored strategies and improve outcomes.
The Effect of Oketani Breast Massage on Successful Breastfeeding, Mothers’ Breastfeeding Support Need, and Breastfeeding Self-Efficacy: A Clinical Trial Study
Authors: Shahri Maryam Mahdizadeh , Nourian Manijeh , Varzeshnejad Maryam , Nasiri Maliheh
Published: September 2020

Background: The most important factor in the survival and health of infants is breastfeeding. One of the complications of cesarean sections is their negative effect on the quality of breastfeeding. This study aimed to determine the effect of Oketani breast massage on the maternal need for support during breastfeeding, breastfeeding success, and breastfeeding selfefficacy. Methods: The research sample in this clinical trial study included pregnant women who referred to Mahdiyeh, Taleghani, and Imam Hossein hospitals as candidates for a cesarean section. The mothers were selected using convenience sampling and randomly assigned to the intervention group (n = 55) and the control group (n = 58). The data were collected using, the Infant Breastfeeding Assessment Tool (IBFAT), the Breastfeeding Charting System (LATCH), and the Breastfeeding Self-Efficacy Scale (BSES). To assess the breastfeeding success rate, the number of breastfeeding times, and the onset time of the first breastfeeding were recorded. The collected data were analyzed using SPSS software (version 20) via the independent samples t-test, the Mann–Whitney U test, and chi-square test. Results: The results of the study suggested that the breastfeeding success rate in both the first two breastfeeding stages and the last pre-discharge breastfeeding was significantly higher for the participants in the intervention group than the members of the control group (p <0.001). Besides, the mother's need for support in the first two breastfeeding stages (p = 0.044) and the last pre-discharge breastfeeding (p <0.001) in the intervention group was less than that of the mothers in the control group. The number of breastfeeding in the intervention group was higher than the control group (p = 0.002). Furthermore, the mothers in the intervention group breastfed their infants in a significantly less time interval (p = 0.002). The breastfeeding self-efficacy was significantly higher in the intervention group than in the control group (p <0.001). Conclusion: Oketani massage can be used as a care intervention by nurses to improve breastfeeding in mothers who undergo cesarean sections and have more breastfeeding problems. Trial registration Iranian Registry of Clinical Trials (IRCT): IRCT20190129042542N1.