bluuebunny/crossref_metadata_2025 huggingface dataset:
Synthesis and biological evaluation of heterocyclic 1,2,4-Triazole scaffolds as promising pharmacological agents
Authors: Kumari Mukesh , Tahlan Sumit , Narasimhan Balasubramanian , Ramasamy Kalavathy , Lim Siong Meng , Shah Syed Adnan Ali , Mani Vasudevan , Kakkar Saloni
Published: March 2020

Background: Triazole is an important heterocyclic moiety that occupies a unique position in heterocyclic chemistry, due to its large number of biological activities. It exists in two isomeric forms i.e. 1,2,4-triazole and 1,2,3-triazole and used as core molecule for the design and synthesis of many medicinal compounds. 1,2,4-Triazole possess broad spectrum of therapeutically interesting drug candidates such as analgesic, antiseptic, antimicrobial, antioxidant, anti urease , anti-inflammatory, diuretics, anticancer, anticonvulsant, antidiabetic, antimigrain agents.
Methods: The structure of all synthesized compounds were characterized by physicochemical properties and spectral means (IR and NMR). The synthesized compounds were evaluated for their in vitro antimicrobial activity against Gram-positive ( B. subtilis ), Gram-negative ( P. aeruginosa and E. coli ) bacterial and fungal ( C. albicans and A. niger ) strains by tube dilution method using ciprofloxacin, amoxicillin and fluconazole as standards. In-vitro antioxidant and anti- urease screening was done by DPPH assay and indophenol method, respectively. The in-vitro anticancer evaluation was carried out against MCF-7 and HCT116 cancer cell lines using 5-FU and cisplatin as standards.
Results, discussion and conclusion: The biological screening results reveal that the compounds T 5 (MIC BS, EC = 24.7µM, MIC PA, CA = 12.3 µM) and T 17 (MIC AN = 27.1µM) exhibited potent antimicrobial activity as comparable to standards ciprofloxacin, amoxicillin (MIC Cipro = 18.1µM, MIC Amo = 17.1µM) and fluconazole (MIC Flu = 20.4µM), respectively. The antioxidant evaluation showed that compounds T 2 (IC 50 = 34.83 µg/ml) and T 3 (IC 50 = 34.38 µg/ml) showed significant antioxidant activity and comparable to ascorbic acid (IC 50 = 35.44 µg/ml). Compounds T 3 (IC 50 = 54.01µg/ml) was the most potent urease inhibitor amongst the synthesized compounds and compared to standard thiourea (IC 50 = 54.25 µg/ml). The most potent anticancer activity showed by compounds T 2 (IC 50 = 3.84 μM) and T 7 (IC 50 = 3.25 μM) against HCT 116 cell lines as compared to standard 5-FU (IC 50 = 25.36 μM).
Prevalence of Zika virus neutralizing antibodies in healthy adults in Vietnam during and after the Zika virus epidemic season: a longitudinal population-based survey
Authors: Nguyen Co Thach , Moi Meng Ling , Le Thi Quynh Mai , Nguyen Thi Thu Thuy , Vu Thi Bich Hau , Nguyen Hai Tuan , Pham Thi Thu Hang , Le Thi Hien Thu , Nguyen Le Manh Hung , Ly Minh Huong Phu , Ng Chris Fook Sheng , Takemura Taichiro , Morita Kouichi , Hasebe Futoshi
Published: March 2020

Background : Between 2016 and 2019, 265 cases of Zika virus (ZIKV) infection were reported in Vietnam, predominantly in southern Vietnam. In 2016, a case of ZIKV-associated microcephaly was confirmed in the Central Highlands, and several members of the infant’s family were confirmed to be infected with ZIKV. The study aims to determine the level of immunity to ZIKV in the general population of the ZIKV epidemic region. Methods: A total of 879 serum samples were collected from 801 participants between January 2017 and July 2018, during and after the ZIKV epidemic in Vietnam. The samples were tested for anti-ZIKV immunoglobulin M (IgM) and immunoglobulin G (IgG), and anti-dengue virus (DENV) IgG antibodies using enzyme-linked immunosorbent assays (ELISA). Plaque-reduction neutralization test (PRNT) for ZIKV was performed on all samples, and for DENV on the samples that ZIKV neutralizing antibody positive. Results: A total of 83 (10.3%) participants had anti-ZIKV IgM. Of the 83, 6 were confirmed to be ZIKV antibodies positive using PRNT and anti-ZIKV IgG ELISA. Of the 718 participants who were anti-ZIKV IgM negative, a further 3 cases were confirmed as positive for antibodies against ZIKV. Of the 9 participants with ZIKV infection, 5 lived in the same village as the infant with ZIKV-associated microcephaly and the other 4 lived in 2 neighboring communes. Repeat samples were collected from the 83 ZIKV IgM positive participants 1.5 years after the first collection. No new cases of ZIKV infection were detected. In addition, 2 of 3 participants with anti-ZIKV NS1 IgG demonstrated a 4- to 8-fold increase in ZIKV neutralizing antibody titer. Conclusions: ZIKV was present in the area around Krong Buk, with the rate of ZIKV-specific antibodies was 1.1% in the community since at least 2016. While the low levels of circulation together with low seroprevalence suggests a limited outbreak in the region, the results also reflect on low levels of protective immunity to Zika within the population. These results provide a better understanding of the current ZIKV epidemic status in the region and demonstrate a need for implementation of more effective ZIKV infection control measures.
The prevalence of type 2 diabetes in people with psychiatric disorders: an umbrella review protocol
Authors: Lindekilde Nanna , Scheuer Stine , Rutters Femke , Henriksen Jan Erik , Rubin Katrine Hass , Lasgaard Mathias , Andersen Gregers Stig , Pouwer Frans
Published: March 2020

Background: Many epidemiological studies have investigated the prevalence of type 2 diabetes in individuals with a psychiatric disorder. In an umbrella review, we aim to systematically summarize existing systematic reviews examining the prevalence of type 2 diabetes in people with a psychiatric disorder. When information is available in the identified systematic reviews, comparisons with control groups without a psychiatric disorder will be made. Furthermore, we aim to assess the quality of the included systematic reviews. Methods: The umbrella review will be based on a comprehensive systematic search of systematic reviews of observational (cross-sectional or longitudinal) studies investigating the prevalence of type 2 diabetes in people with a psychiatric disorder. Four electronic databases (Embase, PsycINFO, PubMed and the Cochrane Database of Systematic Reviews) will be searched. Retrieved papers will be screened for eligibility by two independent reviewers. Furthermore, the reference lists of all included publications will be screened. Data will be extracted by using an a priori developed data extraction form and two independent reviewers will assess the risk of bias in the included systematic reviews using with the Risk of Bias in Systematic Reviews (ROBIS) tool. A narrative data-synthesis and a subsequent meta-analysis based on the primary studies will be made. Discussion: For each psychiatric disorder, the data regarding the prevalence of type 2 diabetes will be summarized and discussed. When possible, comparisons with control groups will be reported and discussed. Finally, future implications and recommendations for clinical care will be presented. Systematic review registration: (registration number) Keywords: Type 2 diabetes, Psychiatric disorder, Prevalence, Umbrella review, Systematic review
The use of Lactobacillus plantarum 299v (DSM 9843) in cancer patients receiving home enteral nutrition – study protocol for a randomized, double-blind, and placebo-controlled trial
Authors: Karolina Kaźmierczak-Siedlecka , Folwarski Marcin , Skonieczna-Żydecka Karolina , Ruszkowski Jakub , Makarewicz Wojciech
Published: March 2020

Background Nutritional treatment is one of the most important components of multidisciplinary anti-cancer therapy. Home enteral nutrition is considered as a safe procedure, however, it may be associated with the risk of side effects, such as nausea, vomiting, abdominal pain, and diarrhoea. It is uncertain whether diarrhoea is the result of the enteral formula administration or gut dysbiosis. One of the methods which may be used to alter the composition of gut microbiota is the administration of a probiotic strain. Lactobacillus plantarum 299v ingestion was found to diminish the adverse events of irritable bowel syndrome and Clostridium difficile infection - entities that share the symptoms with enteral nutrition side effects. Therefore, the primary aim of this study is to determine the effect of Lactobacillus plantarum 299v on nutritional status of cancer patients receiving home enteral nutrition. The secondary aims are to evaluate the role of this probiotic strain in the improvement of enteral nutrition tolerance and patients’ quality of life. Methods Forty patients with cancer receiving home enteral nutrition will be enrolled in this clinical trial and randomized to receive one capsule of Lactobacillus plantarum 299v (Sanprobi IBS®) twice a day or placebo for 12 weeks in a double-blind manner. Laboratory tests (the level of albumin, total protein, transferrin, and total lymphocyte count), anthropometric parameters (body mass, the content of fat mass, muscle mass, and total body water), Nutritional Risk Screening (NRS 2002), enteral nutrition tolerance as well as quality of life will be measured. Measurements will be obtained at the baseline and after 4 and 12 weeks of treatment. Discussion The adverse events observed during administration of enteral nutrition have an negative impact on enteral formula tolerance and as a consequence patients’ quality of life. The previous studies have demonstrated that probiotics may reduce the gastrointestinal symptoms related to enteral nutrition. Thus, administration of Lactobacillus plantarum 299v may be effective in improvement of nutritional status, enteral nutrition tolerance, and quality of life of cancer patients receiving home enteral nutrition. Trial registration ClinicalTrials.gov Identifier: NCT03940768
Energy-dense nutrient-poor snacks and risk of non-alcoholic fattyliver disease: a case-control study in Iran
Authors: yari zahra , Cheraghpour Makan , Aghamohammadi Vahideh , Alipour Meysam , Ghanei Nila , Hekmatdoost Azita
Published: March 2020

Objective: The purpose of the present study was to determine the association between energy-dense nutrient-poor snacks intake and the risk of non-alcoholic fatty liver disease (NAFLD) in Iranian adults. For this purpose, a total of 143 cases with a newly confirmed diagnosis of NAFLD and 471 controls free of the disease were studied. Dietary intake was assessed using a food frequency questionnaire.Results: The percentage of calories from total energy-dense nutrient-poor snacks was 6.08% and 5.04%, in patients and controls, respectively (p=0.036). Compared with subjects in the lowest quartile of total energy-dense nutrient-poor snacks intake, the risk of NAFLD for those in the top quartile of consumption increased by about two times, in both crude (OR:1.94; 95% CIs: 1.16-3.26; P for trend=0.015) and adjusted (OR:2.27; 95%CIs: 1.19-4.31; P for trend=0.001) models. The relative odds of NAFLD increased significantly in the fourth quartile of dietary cake and biscuit (OR: 1.21, P for trend=0.037) and soft drinks (OR: 1.64, P for trend=0.005) intake compared with the lowest corresponding quartiles, after adjustment for age, sex, body mass index, physical activity, alcohol, energy intake. Our results indicate that there might be a moderate positive association between energy-dense nutrient-poor snacks intake and risk of NAFLD.
Subacute reconstruction using flap transfer for complex defects of the upper extremity
Authors: Kang Yongqiang , Pan Xiaoyun , Wu Yongwei , Ma Yunhong , Liu Jun , Rui Yongjun
Published: March 2020

Background Despite advances in microsurgical techniques of flap transfer, complex upper extremity trauma reconstruction remains a challenge for surgeons. This study aimed to present the outcomes in using flaps in the subacute reconstruction of complex upper extremity injuries. Methods From July 2013 to December 2016, 35 patients ranging in age from 23 to 69 years with complicated upper extremity traumatic injuries were treated using flap reconstruction in subacute period. The number and causes of injury were 12 machine crush injuries, 18 machine strangulation injuries, two chainsaw accidents, two traffic accidents and one incident of heavy bruising. Thirty-five patients underwent flap procedures, including 24 anterolateral thigh flaps (68.57%), five latissimus dorsi flaps (14.29%) and six lateral arm flaps (17.14%). Flap sizes ranged from 3 × 4 to 42 × 16 cm 2 . The mean time of flap reconstruction was 14 days (range 5–29). During postoperative follow-up, flap appearance, sensory recovery, scarring and satisfaction were assessed. Results The overall flap survival rate was 94.3%.Two flaps developed partial necrosis, both of which were later treated with skin-grafting. Traumatic wound infections occurred in three patients. All upper limb injuries wrere completely covered. The follow-up periods ranged from 18 to 62 months with average of 2.9 months. All skin flap textures were soft with varying degrees of pigmentation. Flap sensory recovery was S 1 in three cases, S 2 in eight cases, S 3 in 15 cases, and S 4 in nine cases. There were no donor site complications other than three cases with scar hyperplasia. Conclusions The severe upper limb soft tissue defects still achieved satisfactory function and appearance with negligible complications and low amputation rates during the subacute period.
Smoking is associated with pneumonia development in lung cancer patients
Authors: Heo Jung Won , Yeo Chang Dong , Park Chan Kwon , Kim Sung Kyoung , Kim Ju Sang , Kim Jin Woo , Kim Seung Joon , Lee Sang Haak , Kang Hye Seon
Published: March 2020

Background: Various host factors can promote pneumonia susceptibility of lung cancer patients. However, data about risk factors for pneumonia in lung cancer patients receiving active treatments such as chemotherapy, radiotherapy, and surgical intervention are limited. Thus, the purpose of this study was to identify risk factors for pneumonia development in lung cancer patients. Methods: The present study used a lung cancer cohort of the Catholic Medical Center at the Catholic University of Korea from January 2015 to December 2018. Pneumonia was defined by the presence of a new or progressive infiltration on chest imaging together with any of the following: new onset purulent sputum, change in character of chronic sputum, and fever. We ruled out noninfectious infiltration such as drug or radiation toxicity and hydrostatic pulmonary edema. We especially excluded those if computed tomography revealed sharp demarcation consolidation or ground glass opacity limited radiation field. Results: A total of 413 patients were enrolled in this study. Pneumonia occurred in 118 (28.6%) patients. The pneumonia group had significantly worse overall survival (OS) than the non -pneumonia group (456.7 ± 35.0 days vs. 813.4 ± 36.1 days, log rank p < 0.001). In patients with pneumonia, OS was shorter in ex-smokers and current smokers than in never smokers (592.0 ± 101.0 days vs. 737.0 ± 102.8 days vs. 1357.0 days, log rank p < 0.001). Age (hazard ratio [HR]: 1.046; 95% confidence interval [CI]: 1.019­–1.074; p = 0.001), clinical stage IV (HR: 1.759; 95% CI: 1.004–3.083; p = 0.048), neutropenia (HR: 2.620; 95% CI: 1.562–4.396; p < 0.001], and smoking (HR: 2.040; 95% CI: 1.100–3.784; p = 0.024) were independent risk factors of pneumonia development in lung cancer patients in multivariate analysis. In subgroup analysis for patients treated with chemotherapy, age (HR: 1.043; 95% CI: 1.012–1.074; p = 0.006), neutropenia (HR: 3.199; 95% CI: 1.826–5.605; p < 0.001), and smoking (HR: 2.125; 95% CI: 1.071–4.216; p = 0.031) were independent risk factors of pneumonia development. Conclusions: Smoking and neutropenia were risk factors affecting pneumonia development in the total group and subgroup of patients with lung cancer.
The Diagnostic Value of the Short Physical Performance Battery for Sarcopenia
Authors: Phu Steven , Kirk Ben , Hassan Ebrahim Bani , Vogrin Sara , Zanker Jesse , Bernardo Solange , Duque Gustavo
Published: March 2020

BACKGROUND: Sarcopenia is defined as the age-related loss of muscle mass, strength and physical performance. The original European Working Group on Sarcopenia in Older Persons (EWGSOP1) definition, and its revision (EWGSOP2), provide new cut-points and alternate measures for sarcopenia diagnosis. However, sarcopenia is rarely diagnosed in clinical settings owing to its labour-intensive screening process. Given the Short Physical Performance Battery (SPPB) is a quick, easily administrable and objective measure of muscle strength and physical performance, both of which are key components of sarcopenia, this study examined the diagnostic value of the SPPB for this muscle disease. METHODS: A cross-sectional analysis of 294 community-dwelling older persons (≥65 years) was conducted. Appendicular lean body mass [(ALM) divided by height squared (ALM/h 2 )], muscle strength (handgrip/sit to stand), and physical performance [gait speed, timed up and go (TUG) and SPPB] were assessed using validated procedures, while participants were diagnosed with sarcopenia following the EWGSOP1 and EWGSOP2 criteria. Diagnostic ability of the SPPB independently and combined with ALM/h 2 for sarcopenia was determined using area under the curve (AUC). Potential cut-points were identified, and sensitivity and specificity calculated. RESULTS: Prevalence of sarcopenia ranged from 4 to 16% depending on the definition. The SPPB demonstrated moderate (AUC = 0.644-0.770) value in diagnosing sarcopenia, and a cut-point of ≤8points in SPPB performance resulted in high sensitivity (82-100%) but low specificity (36-41%) for diagnosing those with severe sarcopenia. CONCLUSIONS: The SPPB displayed acceptable value in diagnosing older adults with severe sarcopenia. Moreover, the high sensitivity of the SPPB when using the cut-point of ≤8 suggests it may be a favourable screening tool for sarcopenia in clinical settings where ALM measurements are not available.
DICOM segmentation and STL creation for 3D Printing: A Process and Software Package Comparison for Osseous Anatomy
Authors: KAMIO Takashi , SUZUKI Madoka , ASAUMI Rieko , KAWAI Taisuke
Published: March 2020

Background: Extracting and three-dimensional (3D) printing an organ in a region of interest in DICOM images typically calls for segmentation in support of 3D printing as a first step. The DICOM images are not exported to STL data immediately, segmentation masks are exported to STL models. After primary and secondary processing, including noise removal and hole correction, the STL data can be 3D printed. The quality of the 3D model is directly related to the quality of the STL data. This study focuses and reports on DICOM to STL segmentation performance for nine software packages.Methods: Multi-detector row CT scanning was performed on a dry human mandible with two 10-mm-diameter bearing balls as a phantom. The DICOM images file was then segmented and exported to a STL file using nine different commercial/open-source software packages. Once the STL models were created, the data (file) properties and the size and volume of each were measured and differences across the software packages were noted. Additionally, to evaluate differences between the shapes of the STL models by software package, each pair of STL models was superimposed, with observed differences between their shapes characterized as shape error. Results: The data (file) size of the STL file and the number of triangles that constitute each STL model were different across all software packages, there was no statistically significant difference were found across software packages. The created ball STL model expanded in the X-, Y-, and Z-axis directions, with the length in the Z-axis direction (body axis direction) being slightly longer than other directions. There were no significant differences in shape error across software packages for the mandible STL model. Conclusions: The different characteristics of each software package were noticeable, such as different effects in the thin cortical bone area, likely due to the partial volume effect, which may reflect differences in image binarization algorithms. Although the shape of the STL model differs slightly depending on the software, our results indicate that shape error in 3D printing for clinical use in the operation of osseous structures.
Repairing effects of glucosamine sulfate in combination with etoricoxib on articular cartilages of patients with knee osteoarthritis
Authors: Sun Yong , Wang Changde , Gong Chunzhu
Published: March 2020

Purpose: To evaluate the repairing effects of glucosamine sulfate combined with etoricoxib on articular cartilages of patients with knee osteoarthritis (KOA). Methods: A total of 106 KOA patients were randomly divided into control (n=40) and experimental groups (n=66), and treated with etoricoxib alone and glucosamine sulfate plus etoricoxib respectively. Changes in WOMAC score and clinical efficacy were observed. The synovial fluid was extracted. Bone metabolism indices, growth factors, inflammatory factors, matrix metalloproteinases (MMPs) and NO-induced apoptosis-related factors were measured by ELISA. JNK and Wnt5a mRNA levels were determined using RT-PCR. Results: After treatment, the total WOMAC scores of both groups significantly declined (P<0.05), being lower in experimental group. The total effective rate of experimental group was higher (P<0.05). BGP and OPG levels rose, especially in experimental group (P<0.05). CTX-II, COMP and RANKL levels decreased, particularly in experimental group (P<0.05). TGF-β, IGF-1 and FGF-2 levels increased, especially in experimental group (P<0.05). Both groups, particularly experimental group, had decreased levels of IL-1β, IL-17, IL-18, TNF-α, MMP-3, MMP-9 and MMP-13 (P<0.05). JNK and Wnt5a mRNA levels of both groups dropped, which were lower in experimental group (P<0.05). NO and LPO levels reduced, being lower in experimental group. SOD level rose, especially in experimental group (P<0.05). Conclusion: Glucosamine sulfate plus etoricoxib can repair the articular cartilages of KOA patients. Probably, JNK and Wnt5a are down-regulated to inhibit the secretion of MMPs through lowering the levels of inflammatory factors, thereby delaying cartilage matrix degradation. NO-induced chondrocyte apoptosis may be suppressed via the SOD pathway.
Desquamation in Kawasaki Disease and its Relationship with Coronary Artery Abnormalities
Authors: YAN JIAHUEI , Lo Wan-Shan , Guo Mindy Ming-Huey , Huang Ying-Hsien , Chang Ling-Sai , Kuo Ho-Chang
Published: March 2020

Background

Desquamation of hands and feet is a common characteristic of Kawasaki disease (KD), and occurs in 68-98% of patients diagnosed with KD. In this study, we analyzed patients’ varying desquamation levels in their hands or feet, in correlation with clinical presentation, to assess the relationship.

Method

We retrospectively reviewed children with KD who had follow-up visits in Kaohsiung Chang Gung Memorial Hospital’s pediatric outpatient department (OPD) during 2018 and 2019. We analyzed their age, laboratory data before intravenous immunoglobulin (IVIG) treatment, and coronary artery abnormalities (CAA) based on the desquamation level of their hands and feet.

Results

We enrolled a total 112 patients in the study, and 92 patients (82.1%) had hand or feet desquamation. We found the hands’ high-grade desquamation was positively associated with age and segmented neutrophil percentage (p=0.047 and 0.029, respectively) but negatively associated with lymphocyte and monocyte percentage (p=0.03 and 0.006, respectively). Meanwhile, the feet’s high-grade desquamation was positively associated with total white blood cell count (p=0.033). Furthermore, we found that high-grade hand desquamation had less probability of CAA formation compared with that of a low grade (7.1% vs. 40.8%, p=0.016). We observed no significant difference in IVIG resistance between the groups.

Conclusion

This report is the first to demonstrate that the desquamation level of hands or feet in Kawasaki disease is associated with different coronary artery abnormalities and laboratory findings. Physicians should be cautious of CAA formation, particularly in patients with low-grade hand peeling.
Expression and prognostic roles PRDXs gene family in hepatocellular carcinoma
Authors: Xu Mingxing , Xu Jianliang , Zhu Dun , Su Rishun , Zhuang Baoding , Xu Ruiyun , Li Lingli , Chen Shuxian , Ling Yunbiao
Published: March 2020

Background: As the second leading cause of cancer-related death in the world, the therapeutic effect and 5-year overall survival of hepatocellular carcinoma (HCC) are not optimistic. Previous researches indicated that the disorder of PRDXs was related to the occurrence and development of cancer.Methods: In this study, analyzing through CCLE, UALCAN, HCCDB and Human Protein Atlas database databases, PRDXs not only existed in various tumor cell lines, but also had maladjusted expression on mRNA and protein levels in HCC tissues. Besides, the correlations between mRNA as well as methylation levels of PRDXs and clinical characterization were evaluated using UALCAN.Results: Kaplan-Meier Plotter demonstrated that high expression of PRDX1 or low expression of PRDX2/3 suggested poor prognosis for HCC patients. The mutation frequency, type and biological interaction network of PRDXs were obtained from c-Bioportal. By LinkedOmics, PRDXs related differential expressions genes were obtained, which were involved in several canonical pathways and certain amino acid metabolism, as well as miRNAs targeting PRDXs, some of which may effect on the progression of HCC.Conclusions: In conclusion, the disordered expression of PRDXs was correlated with prognosis of HCC patients analyzing by online tools, suggesting that PRDXs could be new molecular targets for HCC treatment and prognosis prediction.
Sociodemographic inequalities in utilizing maternal healthcare services in Cambodia
Authors: Zhou Donghua , Zhou Zhonghe , Yang Cheng , Ji Lu , Ghose Bishwajit , Tang Shangfeng
Published: March 2020

Background Cambodia is a Southeast Asian country and has one the highest rates of maternal and child mortality with inadequate use of maternal healthcare services in the region. The present study aimed to analyse the progress made in terms of using maternal healthcare services since 2000.Methods Two rounds of Demographic and Health Surveys (DHS 2000 and DHS 2014) were used in the study. Sample population consisted 11,961 women aged between 15-49 years. The outcome measures were: Timing of first ANC attendance, adequacy of ANC attendance, place of delivery and postnatal checkup. WHO guidelines were used to set the cut-off/define these measures.Results Findings indicated that the overall prevalence of making the first ANC visit in the first trimester was 64.19% [95%CI=62.22,66.11], and that of having at least four ANC visits was 43.80% [95%CI=41.89,45.73]. Prevalence of health facility delivery was 48.76% [46.62,50.90] and that of postnatal checkup was 71.14% [95%CI=69.21,73.01]. Between 2000 and 2014, the percentage of timely and adequate use of ANC increased by respectively 61.8% and 65.3%, while that of health facility delivery and postnatal care increased by respectively 74.5% and 43.9%. Important demographic, socioeconomic and geographic disparities were observed in the utilization of ANC, health facility delivery and postnatal care services. Urban residency, having better educational status, white collar job, access to electronic media showed positive association, whereas higher parity (having >2 children) and unwanted pregnancy showed negative association with the use of maternal healthcare services. Having at least four ANC visits was associated with significantly increased higher odds of using health facility delivery and postnatal care.Conclusion There has a been a remarkable increase in the prevalence of women who are using the maternal healthcare services since 2000. Although the data are cross-sectional that precludes assuming any causal relationship, the current findings provide important insights regarding the pattern of sociodemographic inequalities in the use of maternal healthcare services in Cambodia.
Measuring parent proxy-reported quality of life of 11 rare diseases in children in Zhejiang, China
Authors: Gao Qisheng , Wang Shanshan , Ren Jianping , Wen Xin
Published: March 2020

Background It is increasingly important to measure the health-related quality of life (HRQoL) of rare disease in children and adolescents in recent decades. Much attention has been paid to investigate the HROoL of one specific rare disease by self-report in previous studies. This study aimed to evaluate and compare the HROoL of 11 rare diseases in Chinese children by parent proxy-report, to explore the factors associated with HROoL of patients and to know the problems of most concern. Methods A total of 651 children aged from 2 to 18 were enrolled from the Children’s Hospital Affiliated Zhejiang University in 2018. Their parents completed the parent proxy-reports version of the Pediatric Quality of Life Inventory TM 4.0 (PedsQL TM ). Independent-samples t -test, one-way ANOVA or Kruskal-Wallis H test was used to compare HROoL scores between groups. Multilevel linear regression models with random intercepts was applied to analyze the relationship between socioeconomic variables and both the total score and sub-domain scores. Results The total PedsQL scores of Patent ductus arteriosus, Infantile agranulocytosis, Autoimmune thrombocytopenia, Polysyndactyly, Hirschsprung disease, Cleft lip and palate, Tetralogy of fallot, Myasthenia gravis, Guillain-barre syndrome, Glycogen storage disease and Langerhans cell histiocytosis children were 79.65±5.46, 95.88±3.48, 71.39±3.27, 91.77±6.35, 76.18±6.92, 96.33±4.22, 77.85±8.90, 95.99±3.31, 85.77±4.56, 82.97±4.13 and 77.6±5.15, respectively. Age was significantly associated with physical functioning, school functioning and psychosocial health score. Gender and household registration place were significantly associated with overall score. The most urgent desire of patients was reducing the overall medical costs. Conclusions These data show that Patent ductus arteriosus scores lowest in physical functioning, Autoimmune thrombocytopenia (ITP) ranks the lowest in emotional functioning score, social functioning score, school functioning score, psychosocial health score and total score. Incentive policies should be further adopted to improve orphan drug availability and reduce the financial burden of rare diseases.
Semaphorin 4D induces an imbalance of Th17/Treg cells by activating the aryl hydrocarbon receptor in ankylosing spodylitis
Authors: Xie Jianmin , Zitao Wang , Jieruo Gu
Published: March 2020

Background: Semaphorin 4D (Sema4D) is constitutively expressed on T cells and osteoclasts, and regulates T cell proliferation and bone remodeling. In addition, several studies have shown that Sema4D is involved in the pathogenesis of autoimmunity. We undertook this study to investigate the mechanism by which Sema4D affects the pathogenic progress of ankylosing spondylitis (AS). Methods: Soluble Sema4D (sSema4D) levels in serum were analyzed by enzyme-linked immunosorbent assay. The cell surface levels and transcripts of Sema4D were evaluated in CD4+ and CD19+ cells from the AS patients and healthy individuals. The mRNA expression levels were assessed by quantitative polymerase chain reaction (qPCR). The proportions of Treg cells and IL-17-producing T-cells (Th17 cells) differentiated from CD4+ T cells were analyzed by flow cytometric analysis. The aryl hydrocarbon receptor (AhR) agonistic effect of Sema4D was detected by analyzing the activation of downstream signaling pathways and target genes using Luciferase and EROD assay.Results: Levels of sSema4D were elevated in both serum from AS patients, and clinical features markers were correlated with serum sSema4D levels. Sema4D facilitated CD4+ T cells proliferation and Th17 cells differentiation and inhibited Treg cells differentiation by enhancing RORγt expression and reducing Foxp3 expression, with increasing expression and secretion of IL-17 and IL-22. It induced the expression and activity of AhR target gene CYP1A1 and XRE reporter activity via interaction with CD72. Conclusions: These findings indicate that Sema4D as a potent activator of T cells in the immune response contributes to the inflammation of AS by inducing imbalance in Th17 and Treg cell populations in an AhR-dependent manner, suggesting it is a crucial participant in AS pathogenesis.
Validation of T-MoCA in the screening of mild cognitive impairment in Chinese patients with atrial fibrillation
Authors: Lai Yiwei , Jiang Chao , Du Xin , Wang Zhiyan , Zhang Jingrui , Liu Xiaobo , Li Jingye , Bai Yu , Xu Baolei , Zhang Weiwei , Bai Rong , Tang Ribo , Liu Nian , Guo Xueyuan , Jiang Chenxi , Li Songnan , Long Deyong , Yu Ronghui , Dong Jianzeng , Sang Cai-hua , Ma Chang-sheng
Published: March 2020

Background: Atrial fibrillation (AF) is associated with high risk of mild cognitive impairment (MCI) and dementia. However, feasible and simple instruments that facilitates regular assessment of cognitive status in AF patients remain underdeveloped. Methods: Cognitive function of 136 AF patients was first evaluated using T-MoCA. Cognitive function of 101 patients was then assessed through in-person interview by physicians who are blinded to telephone interview results, using both Clinical Dementia Rating (CDR) and Mini-Mental Status Evaluation (MMSE). Using CDR=0.5 as a reference standard, the ability of T-MoCA and MMSE to discriminate cognitive dysfunction, stratified by education level, was tested by receiver-operating curve (ROC) analysis. Net reclassification index was calculated for comparison between the performance of T-MoCA and MMSE. Results: Thirty-five MCI patients were identified as MCI using the criteria of CDR=0.5. The areas under the ROC curve of T-MoCA were 0.80 (0.71-0.89), 0.83 (0.71-0.95), and 0.85 (0.64-0.92) for all patients, patients with high educational level, and patients with low education level, respectively. The optimal threshold was achieved at 16/17 with a sensitivity of 85.7% and a specificity of 69.7% in overall patients, 15/16 with a sensitivity of 88.2% and a specificity of 64.5% in the low educational level patients, and 16/17 with a sensitivity of 77.8% and a specificity of 87.9% in the high educational level patients. Compared to the criterion MMSE≤27 and MMSE norms for the Chinese community elderly, stratified T-MoCA threshold improves correct classification by 23.7% (p=0.033) and 30.3% (p=0.020) respectively. Conclusion: T-MoCA is a feasible and effective method for MCI screening in patients with AF.
Analysis of risk factors for revision in distal femoral fractures treated with lateral locking plate: a retrospective study in Chinese patients
Authors: Hou Guojin , Zhou Fang , Tian Yun , Ji Hongquan , Zhang Zhishan , Guo Yan , Lv Yang , Yang Zhongwei , Zhang Yawen
Published: March 2020

Background: To analyze the risk factors of revision operation after the treatment of distal femoral fracture with lateral locking plate (LLP). Methods: Retrospective analysis of the clinical data of 152 cases with distal femoral fracture treated in our hospital from March 2005 to March 2019. SPSS 26.0 software (univariate analysis and Logistic regression analysis) was used to analyze the general condition, fracture related factors, operation related factors and construct characteristics of internal fixation. Results: 16 of 152 patients who were included in the study underwent revision surgery, with a revision rate 10.5%. Univariate analysis showed that there were significant differences in age, body mass index(BMI), fracture type, supracondylar involved or not, type of incision, quality of reduction, ratio of length of plate/fracture area(R1), the ratio of the length of the plate/fracture area above the condylar(R2), ratio of distance between proximal part of fracture and screw/working length of proximal plate(R3) between the two groups (P＜0.05). Logistic regression analysis showed that age[OR for age >61.5 group is 4.900(1.071-22.414)], fracture type[OR for A3 fracture is 8.572(1.606-45.750), the OR for periprosthetic fracture after TKA is 9.073(1.220-67.506)], poor reduction quality[OR is 7.663(1.821-32.253)] and the ratio of the length of the plate/fracture area above the condylar were the possible risk factors (P＜0.05). Conclusion: Age, fracture type (A3 and periprosthetic fracture after TKA), poor reduction quality and the ratio of the length of the plate/fracture area above the condylar were the possible risk factors of the revision in distal femoral fractures treated with lateral locking plate. The appropriate application of the locking plate and operation strategy are the key to reduce the revision rate in distal femoral fractures.
The target matters – general vs. individualized exercise prescription for fertile-aged women with metabolic risk: a randomized controlled trial
Authors: Poyhonen-Alho Maritta K , Hyrylä Vesa , Tarvainen Mika P. , Tikkanen Heikki O. , Koivusalo Saila , Koponen Anne S. , Peltonen Juha E. , Tiitinen Aila
Published: March 2020

Background Little is known about the associations of different depths of individualization of the exercise intervention on cardiorespiratory fitness (CRF), metabolic outcomes and cardiac autonomic regulation in at-risk subjects. This randomized trial compared the effect of general physical activity (PA) guideline -targeted and highly individualized exercise intervention on maximal oxygen uptake, heart rate variability, body composition, and glucose and lipid profiles in fertile-aged women with increased risk for gestational diabetes. Methods Forty-five women with previous gestational diabetes or BMI>30kg/m 2 were randomized into general advice without intervention (Group 1), individualized intervention planned according to PA questionnaires and general guidelines for exercise training (Group 2) and highly individualized intervention based on results from the pre-intervention cardiopulmonary exercise test (CPET) groups (Group 3). All subjects performed pre-intervention CPET on a cycle ergometer with step incremental protocol until volitional fatigue, followed by a 3-month intervention period and post-intervention CPET. Examinations included HRV assessment during CPET and body composition (bioimpedance), blood glucose and lipid profiles. Results Total dropout was 53.8% at various points of the study leaving 8 subjects in Group 1, 12 subjects in Group 2 and 10 subjects in Group 3. CRF improved only in Group 3 (+1.9 ml/kg/min, 95% CI 0.3 to 3.5). This was associated with an increase in high-density lipoprotein (0.18 mmol/L, 95% CI 0.04 to 0.32) and increased HRV. In Group 2, we found a decrease in body mass index (-0.7 kg/m 2, 95% CI -1.3 to -0.1), fasting insulin (-4.14 mU/L, 95% CI -6.58 to -1.70), insulin resistance (-1.21, 95% CI -1.88 to -0.54), and low-density lipoprotein (-0.44 mmol/L, 95% CI -0.79 to -0.09). The dropouts in Group 1 had significantly less weight, smaller waist circumference, less visceral fat, and higher maximal oxygen uptake compared to the continuers in Group 1. Conclusions To improve CRF and cardiac autonomic function the exercise intervention should be highly individualized. PA intervention focused to achieve general exercise guidelines is not enough to improve CRF over 3-month period but combined with weight loss has beneficial effects on the metabolic profile. In randomized controlled trials, dropout may be biased. Trial Registration clinicaltrials.gov (NCT01675271)
Identification and characterization of metastasis-associated individualized gene expression signature in osteosarcoma
Authors: Zhang Guofeng , Zhu Yonglin , Jin Chengzhen , Zhou Baisui , Zhao Shanrun , Li Chuanbo , Fu Fangang , Li Shanhui
Published: March 2020

Introduction: Osteosarcoma (OS) patients with complete surgical resection still relapse with poor prognosis. Part of this is due to the inability to accurately detect distant metastasis. Thus it’s enssential to identify metastasis-related biomarkers for OS.Methods: In present study, a computational pipeline based on relative expression orderings (REOs) using gene expression proles was constructed in metastases and non-metastases OS patients. Results: 138 metastasis-associated gene pair signature (MGPS) were identified follow two independent datasets. In order to further extract metastasis-associated biomarker for clinical application, a metastases-specific co-expressed MGPS network was constructed and analyzed. MGPS such as MYL5 and RPL27A showed strong positive correlation (Cor =0.75, P <0.001) in metastatic OS patients. There were thirteen MGPSs in above network were associated with prognosis. These prognostic MGPSs could become as a specific classifier to distinguish metastases and non-metastases OS patients. Functional analysis showed MGPSs were associated with cancer metastasis-related functions. Drug and MGPS network could provide some drug candidates for treatment of OS. Conclusions: Collectively, the roles of the MGPSs in OS were elucidated, which could be beneficial for understanding OS pathogenesis and treatment.
Chronic lymphocytic thyroiditis (CLT) has a negative prognostic value in papillary thyroid cancer of the young and middle ages: a retrospective analysis of 635 patients
Authors: Ma Bing'e , Chen Xiyi , Zhao Zhengping , Ji Qin , Zhou Yifan , Yin Xiaoyang , Ma Chaoqun , Wang Jianhua
Published: March 2020

Background: The study was aimed at investigating the potential role of chronic lymphocytic thyroiditis (CLT) in papillary thyroid cancer (PTC) prognosis in distinct age groups, as well as the association between CLT and recurrence risk estimation.Methods: A total of 635 adult patients were retrospectively analyzed. On the basis of postoperative pathology examination, 188 patients were diagnosed with coexistent CLT and the remaining 447 were classified as non-CLT. Then the characteristics of CLT-coexisted patients and non-CLT ones were compared respectively when patients were aged ≥55 years or below. The association among postoperative clinicopathological features were also analyzed using multivariate regression. In addition, the prognostic value of several variables relating to high-risk recurrence were estimated within different age groups.Results: When divided in two age groups (55 years as the line), non-CLT group had a remarkable frequency of small size lesion (D max ≤1cm) compared with CLT-coexisted patients (54.6% to 43.0%, p =0.016). In addition, non-CLT patients tended to have intrathyroidal extension as opposed to those with coexistent CLT (20.2% to 28.2%, p =0.05). In multivariate analysis, CLT still significantly acted as an independent risk factor of greater lesion size (D min >1 cm) (OR=1.7, p =0.02) and mildly promoted gross extrathyroidal extension (ETE) (OR=1.4, p =0.06). However, associations didn't emerge in the characteristics mentioned above with CLT when patients were ≥55 years old. The prognostic value of CLT in high-risk recurrence was evident only in patients aged 35-44 years. (OR=2.4, 95%CI:1.2-5.4, p =0.02). Greater lesion size independently promoted gross ETE, no matter patients were aged above 55 years or not. Besides, its prognostic value of high-risk recurrence was significant throughout all age groups. Conclusion: These findings revealed that CLT coexistence might be the unfavorable factor of PTC prognosis in young and middle-aged (<55 years) patients, and its role in recurrence risk stratification was presented only in the specific age (35-44 years).
Biovalorisation of crude glycerol and xylose into xylitol by oleaginous yeast Yarrowia lipolytica
Authors: Prabhu Ashish , Thomas Dominic J , Amaro Rodrigo Ledesma- , Leeke Gary A , Vaya Angel Medina , Verheecke-Vaessen Carol , Coulon Frederic , Kumar Vinod
Published: March 2020

Background: Xylitol is a commercially important chemical with multiple applications in food and pharmaceutical industries. According to the US Department of Energy, xylitol is among the twelve platform chemicals that can be produced from biomass. The chemical method for xylitol synthesis is however expensive and energy intensive. In contrast, the biological route involving microbial cell factories offers a potential cost-effective alternative process. The bioprocess occurs under ambient conditions and makes use of biocatalysts which can be sourced from renewable carbon coming from a variety of cheap feedstocks classified as wastes. Result: In this study, biotransformation of xylose to xylitol was investigated using Yarrowia lipolytica an oleaginous yeast grown on glycerol/glucose screening of primary carbon source, media optimisation in shake flask, scale up in bioreactor and downstream processing of xylitol were carried out. With the two step medium optimization involving central composite design and artificial neural network coupled with genetic algorithm, the yeast amassed 53.2 g/L of xylitol using glycerol and xylose with a bioconversion yield of 0.97 g/g. Similar results were obtained when pure glycerol was substituted with crude glycerol from biodiesel industry (titer: 50.5 g/L; yield: 0.92 g/g). Even when xylose from lignocellulosic hydrolysate was used as opposed to pure xylose, a xylitol yield of 0.54 g/g was achieved. Xylitol was successfully crystallized from fermented broth using pure glycerol/xylose and crude glycerol /xylose with a recovery of 35 and 39.45%, respectively. Conclusion: To the best of the author’s knowledge, this is the first study demonstrating the potential of Y. lipolytica as microbial cell factory for xylitol synthesis from inexpensive feedstocks. The results obtained are competitive with other xylitol producing organisms.
Comparison of suprapatellar versus infrapatellar approaches of intramedullary nailing for distal tibia fractures
Authors: Lu Yao , Wang Gen , Hu Bin , Ren Cheng , Sun Liang , Wang Zhimeng , He Changjun , Xue Hanzhong , Li Zhong , Zhang Kun , Ma Teng , Wang Qian
Published: March 2020

Background: This study aimed to analyze and compare the clinical and functional outcomes of distal tibia fractures treated with intramedullary nailing (IMN) using the suprapatellar (SP) and infrapatellar (IP) surgical approaches. Methods: A retrospective analysis was performed in 63 patients with distal fractures that were treated with IMN between August 2014 and August 2018. A total of 27 and 36 patients underwent IMN using the SP and IP techniques, respectively. The surgical time, blood loss, closed reduction rate, rate of adjuvant reduction technique, fracture healing time, and complications were reviewed in this study. Anterior knee pain was assessed using the visual analog scale. The Lysholm Knee Scoring Scale and American Orthopaedic Foot and Ankle Society (AOFAS) scale were used as clinical measurements. Results: A total of 63 patients, with a minimum follow-up of 12 months, were evaluated. The average surgical time, blood loss, rate of adjuvant reduction technique, closed reduction rate, fracture healing time, and Lysholm Knee Scoring Scale score were insignificantly different (P>0.05) between the two groups. However, the SP approach was superior to the IP approach in terms of pain score, AOFAS score, and fracture deformity rate (P<0.05). Conclusions: In the treatment of distal tibia fractures, the SP IMN technique is associated with a significantly higher functional outcome, lower knee pain, and lower rate of fracture deformity than the IP IMN technique.