bluuebunny/crossref_metadata_2025 huggingface dataset:
Diagnosis and Treatment of Obturator Hernia: Retrospective Analysis of 86 Clinical Cases at a Single Institution.
Authors: LI ZHENGZHENG , Gu Chaoyang , Wei Mingtian , Yuan Xing , Wang Ziqiang
Published: October 2020

Background: To explore the clinical characteristics, diagnosis and treatment of obturator hernia.Methods: Eighty-six patients who were diagnosed as obturator hernia by abdominal CT in the Department of Gastrointestinal Surgery of our hospital between 2009 and 2019 were enrolled in this study. Patient characteristics, surgical method, postoperative complications and mortalities were retrospectively reviewed, and the patients were followed by telephone or clinic visit to check for the recurrence.Results: 30 days mortality rate of 5.5% and 46.1% were observed in surgery group and non-surgery group, respectively. Surgery was performed as an emergency procedure in 59 cases and elective procedure in 14 cases depending on different hernia contents, intestinal necrosis and signs of peritonitis. In the emergency surgery group, segmental intestinal resection with anastomosis was performed in 24 patients(24/59, 40.7%). There were 4 deaths(4/59, 6.8%) in this group ,all of which occurred in patients undergoing SI resections. In contrast, no bowel resection, postoperative complications, or death occurred in the elective surgery group. 3 -year recurrence rates of 5.1% (3/59)and 7.1%(1/14) were observed in the emergency surgery and the elective surgery group, respectively. Conclusions: CT examination plays an important role in improving the diagnostic rate of obturator hernia. In elderly people with comorbidities, timely surgical treatment is the key to improve the efficacy of obturator hernia and prevent the deterioration of the condition. In addition, postoperative mortality is significantly associated with bowel resection and postoperative complications.
Clinical analysis of ECOG PS and adverse reactions in patients with anlotinib at advanced NSCLC as the third or further line treatment: a retrospective observational study
Authors: gu wei guo , Hu MingBin , Deng JianXiong , Qiu Feng
Published: October 2020

Background: Previous studies have shown that anlotinib be a decent choice in third- or futher line treatment of advanced NSCLC. However, the study anslysis of relationship between Eastern Cooperative Oncology Group performance status(ECOG PS) and adverse reactions in advanced NSCLC with anlotinib therapy is less. Methods: We evaluated the efficacy and toxicity of anlotinib in patients with previously treated advanced NSCLC from June 2018 to March 2019. Survival analysis was performed by the Kaplan–Meier method.Results: According to ECOG PS devided into PS 0-1 group(n=63) and PS 2 group(n=28) . The PS 0-1 of median progression-free survival (mPFS, 5.5 vs.2.7 months, P＜0.05) , overall survival (mOS, 9.2 vs.4.7 months，P＜0.05) was longer than PS 2. The PS 0-1 of objective remission rate(ORR, 45.1% vs 6.6%), disease control rate(DCR, 8.8% vs 1.1%) was significanly more than PS 2. The PS 0-1 group of I-II adverse reactions was high than PS 2 group(52.3% vs 32.1%), but the III-IV adverse reactions were less than PS 2 group(9.5% vs 10.7%). Moreover, multivariate analysis indicated that PS was independent risk factor of PFS（HR=2.816, 95%CI：1.661-4.773，P<0.0001）as well as OS(HR=3.188, 95%CI：1.789-5.682，P=0.0001) for anlotinib therapy in NSCLC. Conclusions: Patients in advanced NSCLC with PS 0–1 get better PFS and OS than PS 2 followed by anlotinib treatment in NSCLC. Advanced lung squamous cell carcinoma(LUSC) recived anlotinib treatment with the same efficacy comparable to adenocarcinoma, and patients with PS 0-1 may benefit the most than PS 2.
Absorbable self-retaining barbed double-needle suture(SRBDS) in transperitoneal laparoscopic partial nephrectomy for T1 renal neoplasms
Authors: Wei Hai-bin , Bai Yu-chen , Zhang Qi , Mao Zu-jie , Li En-hui , Wang Shuai , Qi Xiao-long , Liu Feng , Zhang DaHong
Published: October 2020

PurposeThe purpose of study was to evaluate the safety and hemostatic efficacy of absorbable self-retaining barbed double-needle suture (SRBDS) in transperitoneal LPN for T1 renal neoplasms.MethodsIn total, 75 patients with renal neoplasm masses (< 7 cm) undergoing transperitoneal LPN were collected since January 2018 to October 2019. After tumor resection with a cold Endoscissor, 3-0 and 0 SRBDS was performed for inner and outer running stitches without either hem-o-lok or LapraTy clip, respectively. Patient demographic information, neoplasm characteristics, perioperative factors, and oncologic outcomes were collected and analyzed. ResultsAccording to our result, Median tumor size and R.E.N.A.L score was 4.69 cm and 7. Median operative time and overall warm ischemia time was 73 min and 13.14 min. Mean estimated blood loss was 67 ml. intraoperative complications was not showing up and no case was switched to open radical nephrectomy. Postoperative pathological assessment confirmed that negative surgical margins. only single patient experienced secondary surgery-related hemorrhage on the fifth day post-operation, and was treated by transfusion and digital subtraction angiography (DSA) highly selective embolization of the bleeding vessel. No patients developed urinoma or urinary fistula. the overall complications were manageable during three-year follow-up period. ConclusionSRBDS was a safe and efficient surgical endoscopic suturing technique with low complication rate in T1 renal neoplasms, which might be considered as an alternative to other suturing techniques, tissue sealants and glues for partial nephrectomy in the future.
Pancreatic Duct Occlusion: A Safe and Valid Alternative to Duct Anastomosis After Pancreaticoduodenectomy in a Low Volume Centre
Authors: Giuliani Antonio , Rocca Aldo , Segreto Anna Lucia , Paccone Marianna , Izzo Maria Lucia , Buondonno Antonio , Luciani Claudio , Natale Giuseppe Di , Coluzzi Mariagrazia , Komici Klara , Amato Bruno , Calise Fulvio
Published: October 2020

Background: Pancreaticoduodenectomy is the only possible choice of treatment for peri-ampoullar neoplasms. Morbidity in pancreatic surgery is mainly related to the development of a postoperative pancreatic fistula (POPF). According to International Study Group on Pancreatic Fistula it is possible to grade POPF based on clinical variables. Three main different surgical strategies have been proposed to deal with the pancreatic stump following pancreaticoduodenectomy: pancreatojejunostomy, pancreatogastrostomy and pancreatic duct occlusion, but none of them has been clearly demonstrated to be superior to the others. The aim of our study is to evaluate the feasibility of duct occlusion and its correlations with postoperative pancreatic fistula, “brittle diabetes” and overall survival in a low volume centre. We decided to review our previous experience in the light of the recent Covid pandemic where, in our country, it has been forced in many regions to displace treatment of oncological patients in low volume hospitals with limited experienceMethods: We retrospectively reviewed 56 consecutive patients, from a prospective maintained database, who underwent Whipple’s procedure from January 2007 to December 2014 in a tertiary Hepatobiliary Surgery and Liver Transplant Unit with a low volume of pancreatic resections. The mean follow-up was 24.5 months. Results: The overall incidence of postoperative pancreatic fistula was 66.6%: 15 patients had a Grade A (31.25%), 13 a Grade B fistula (27.03%), and 4 (8.3%) suffered from a life-threatening Grade C fistula. At the last follow-up, 24 of the 28 patients who were alive (85.6%) habitually used substitutive pancreatic enzyme. Conclusion: Duct occlusion can be a safe alternative to pancreatic anastomosis especially in low volume centres and for those patients (age >75 years, obese, hard pancreatic texture, small pancreatic duct) at higher risk of clinically relevant POPF.Trial registration: 'retrospectively registered'
Association Between Prenatal Phthalate Exposure and Anthropometric Measures of Newborns in a Sample of Iranian Population
Authors: Darvishmotevalli Mohammad , Moradnia Maryam , Hosseini Reza , Bina Bijan , Feizi Awat , Pour Karim Ebrahim , Pourzamani Hamid Reza , Kelishadi Roya
Published: October 2020

Background: This study aimed to examine the associations between the urinary concentrations of phthalate metabolites among a sample of Iranian pregnant women with anthropometric measures of neonates. Methods: Urine samples were obtained from 121 pregnant women at their first trimester of pregnancy; the levels of monobutyl phthalate (MBP), mono-benzyl phthalate (MBzP), mono-2-ethylhexyl phthalate (MEHP), and mono (2-ethyl-5hydroxyhexyl) phthalate (MEHHP) metabolites were determined by gas chromatography mass spectrometry (GC/MS). The correlation between the urinary concentration of these metabolites and some socio-demographic factors of the participants (maternal education, age, family income, pre-pregnancy body mass index), their lifestyle variables (smoking habit, food pattern, and physical activity), cleaning products use data (cosmetic and household cleaning products) with anthropometric measures of neonates were investigated. Results: MBzP, MBP, MEHP, and MEHHP were detected in 100% of participants with the concentration ranged from 120 to 860 μg/g creatinine. Significant correlations were observed between the urinary levels of maternal MBzP (adjusted β =0.3 (0.001), p=0.03) and MEHHP and (adjusted β =0.3 (0.001), p=0.04) with the birth weight of female neonates. MBP (adjusted β = -0.3(0.02), p=0.04) and MBzP (adjusted β =-0.3 (0.001), p=0.02) were found negatively associated with head circumference in male and female newborns, respectively. Significant differences existed in the birth weight of infants whose mothers used plastic packaging for pickle and those who had history of passive smoking (p-value< 0.05). Conclusions: the studied metabolites had higher concentration in the Iranian pregnant women urine compared to the other countries. Higher levels of prenatal exposure to phthalate metabolites may adversely impact the health status of newborns.
Mental Distress and Associated Factors Among Hospitalized Medical Surgical Adult Inpatients in Public Hospitals, Addis Ababa, Ethiopia, 2020. Cross-sectional Study
Authors: Tesfa Shegaw , Giru Berhanu Wordofa , Bedada Tadesse
Published: October 2020

Background: Mental distress is a mental or psychological syndrome, which influences the health status and treatment effectiveness, getting quality of care in a hospitalized medical surgical inpatient. It is more common in hospital setting than community setting population. Thus, this study aimed to assess the prevalence of mental distress and associated factors among hospitalized medical surgical adult inpatients in public hospitals, Addis Ababa, Ethiopia, 2020.Methods: Institutional based cross-sectional study was conducted with a total of 408 study subjects from March 1-30, 2020. Systematic random sampling technique was used and data was collected using interviewer administered questionnaire. Data was collected by trained nursing students and collected data was entered into Epi-data 3.1 and exported to SPSS version 26 for analysis, and then binary and multiple logistic regressions was performed to check the association between dependent and independent variable.Result: The prevalence of mental distress among hospitalized medical surgical adult inpatients in public hospitals was 53.1% with (95%CI; 48%, 58%). Variables of being married [AOR=2.67; 95%CI(1.065,6.683)], private employee [AOR=2.21; 95%CI(1.001, 4.900)], daily laborer [AOR=4.70; 95%CI(1.218, 18.215)], rural residence [AOR=1.85; 95%CI(1.047,3.264)], taking alcohol [AOR=1.68; 95%CI(1.025, 2.740)], previous psychiatric illness [AOR=3.40; 95%CI(1.078, 10.737)] and co-morbidity [AOR=1.93; 95%CI (1.200, 3.094)] were found to be significantly associated with mental distress; while age, sex, ethnicity, religion, educational status, income, smoking, chat, social support, living condition, history of hospitalization, ward admitted and length of hospital stay were not significantly associated.Conclusion: The prevalence of mental distress was high and being married, private employee, daily laborer, residence in rural area, previous history of psychiatric illness, alcohol used and comorbidity disorder were associated with mental distress among hospitalized adult inpatients. Therefore, health care providers should provide special consideration to those group of patients admitted to the hospital.
Spatio-Temporal Modelling of Culicoides Latreille (Diptera: Ceratopogonidae) Populations on Reunion Island (Indian Ocean)
Authors: Grimaud Yannick René Pierre , Tran Annelise , Benkimoun Samuel , Boucher Floriane , Esnault Olivier , Cêtre-Sossah Catherine , Cardinale Eric , Garros Claire , Guis Hélène
Published: October 2020

Background: Reunion Island regularly faces outbreaks of bluetongue and epizootic hemorrhagic diseases, two insect-borne orbiviral diseases of ruminants. Hematophagous midges of the genus Culicoides (Diptera: Ceratopogonidae) are the vectors of bluetongue (BTV) and epizootic hemorrhagic diseases of deer (EHDV) viruses. In a previous study, statistical models based on environmental and meteorological data were developed for the five Culicoides species present in the island to provide a better understanding of their ecology and predict their presence and abundance. The purpose of this study was to couple these statistical models with a Geographic Information System (GIS) in order to produce dynamic maps of the distribution of Culicoides throughout the island. Methods: Based on meteorological data from ground weather stations and satellite-derived environmental data, the abundance of each Culicoides species was estimated for the 2,214 husbandry locations on the island for the period ranging from February 2016 to June 2018. A large-scale Culicoides sampling campaign including 100 farms was carried out in March 2018 to validate the model. Results: According to the model predictions, no husbandry location was free of Culicoides throughout the study period. The five Culicoides species were present on average in 57.0% of the husbandry locations for C. bolitinos, 40.7% for C. enderleini, 26.5% for C. grahamii, 87.1% for C. imicola and 91.8% for C. kibatiensis. The models also showed high seasonal variations in their distribution. During the validation process, predictions were acceptable for C. bolitinos, C. enderleini and C. kibatiensis, with normalized root mean square errors (NRMSE) of 15.4%, 13.6% and 16.5% respectively. The NRMSE was 27.4% for C. grahamii. For C. imicola, the NRMSE was acceptable (11.9%) considering all husbandry locations except in two specific areas, the Cirque de Salazie – an inner mountainous part of the island- and the sea edge, where the model overestimated its abundance. Conclusions: Our model provides, for the first time, an operational tool to better understand and predict the distribution of Culicoides in Reunion Island. As it predicts a wide spatial distribution of the five Culicoides species throughout the year and taking into consideration their vector competence, our results suggest that BTV and EHDV can circulate continuously on the island. It implies significant limitations for any preventive or control actions targeting vector populations. To assess other control strategies, our model could be coupled with an epidemiological model of BTV and EHDV transmission.
Ultrasound Assisted Extraction and Response Surface Methodology and Artificial Neural Network Optimization of Pectin From Orange Peel
Authors: Hundie Ketema Beyecha
Published: October 2020

The objective of study was ultrasound-assisted extraction of pectin from orange peel using response surface method and artificial neural network technique. The following findings are absorbed from the effects of extraction parameters and technique used. The pH solution was highly significant compared to ultrasound power. As well as interaction between ultrasound and pH were found to be strongly influenced the extraction yield of pectin. The optimal parameters for extraction were irradiation time of 22.5min, pH of 1.5, and ultrasound power of 155W and liquid-solid ratio 22.5:1 mL/ g. Under these conditions, yield of pectin was 26.87% experimentally, while 26.74 and 26.93% of yield were predicted by response surface and artificial neural network model respectively.The extracted pectin was categorized as high methoxyl pectin, since it has 63.13% degree of esterification, which is above 50% affirmed by Fourier transform infrared spectroscopy detection. Both response surface methodology and artificial neural network model prediction was in good agreement with experimental data; however, the prediction of artificial neural network prediction was better than artificial neural network. Therefore, artificial neural network model is much more accurate in estimating the values of pectin yield and mean square error when compared with the response surface methodology.
Optimization of Reducing Ffa Content of Waste Cooking Oil by Using Response Surface Methodology
Authors: Primandari Sri Rizki Putri , Arafat Andril , Karudin Arwizet
Published: October 2020

The authors have requested that this preprint be removed from Research Square.
Efficacy of a Novel Hemostatic Adhesive Powder in Patients With Upper Gastrointestinal Tumor Bleeding
Authors: Shin Jongbeom , Cha Boram , Park Jin-Seok , Ko Weonjin , Kwon Kye Sook , Lee Jin-Woo , Kim Hyung Kil , Shin Yong Woon , Lee Don Haeng
Published: October 2020

Background: Gastrointestinal tumor bleeding remains a clinical challenge because it is difficult to treat with conventional endoscopic hemostatic options. Recently, an endoscopic hemostatic powder (UI-EWD) was developed and reported to provide effective control of upper gastrointestinal bleeding. The aim of current study was to evaluate the feasibility and efficacy of this novel hemostatic powder in tumor bleeding.Methods: A total of 41 consecutive patients with upper gastrointestinal tumor bleeding were included. UI-EWD was applied in all patients as an auxiliary hemostatic method as a salvage therapy or monotherapy during endoscopic treatment. Hemostasis success rates, adverse event related to UI-EWD, and rates of re-bleeding were evaluated.Results: In all cases, UI-EWD application was successful at tumor bleeding sites. Immediate hemostasis occurred in 40/41 (97.5%) patients, and re-bleeding within 28 days occurred in 10 of 40 (22.5%) patients that achieved initial hemostasis. The success rate of immediate hemostasis for UI-EWD monotherapy was 100% (23/23). The re-bleeding rate at 28 days after UI-EWD monotherapy was 26.1% (6/23). No adverse events associated with UI-EWD application were encountered.Conclusions: The success rate of UI-EWD for immediate hemostasis in cases of GI tumor bleeding was excellent and UI-EWD produced promising results with respect to the prevention of re-bleeding. Based on these results, we suggest that UI-EWD be considered an effective salvage therapy or even monotherapy for GI tumor bleeding.
Effect of Instruction on Preventing Delayed Bleeding After Colorectal Polypectomy and Endoscopic Mucosal Resection
Authors: Okugawa Takuya , Oshima Tadayuki , Nakai Keisuke , Eda Hirotsugu , Tamura Akio , Hara Ken , Ogawa Tomohiro , Kono Tomoaki , Kondo Takashi , Tozawa Katsuyuki , Fukushima Masashi , Tomita Toshihiko , Fukui Hirokazu , Watari Jiro , Miwa Hiroto
Published: October 2020

Background: The frequency of delayed bleeding after colorectal polypectomy has been reported as 0.6 – 2.8%. With the increasing performance of polypectomy under continuous use of antithrombotic agents, care is required regarding delayed post-polypectomy bleeding. Better instruction to educate endoscopists is therefore needed. We aimed to evaluate the effect of instruction and factors associated with delayed bleeding after endoscopic colorectal polyp resection.Methods: This single-center, retrospective study was performed to assess instruction in checking complete hemostasis and risk factors for onset of delayed post-polypectomy bleeding. The incidence of delayed bleeding, comorbidities, and medications were evaluated from medical records. Characteristics of patients before and after instruction were compared. Univariate analysis and forward stepwise logistic regression analysis were performed to test the influence of factors in association with delayed post-polypectomy bleeding.Results: A total of 3318 polyps in 1002 patients were evaluated. The before-instruction group comprised 1479 polyps in 458 patients and the after-instruction group comprised 1839 polyps in 544 patients. Polyp size, pedunculated type, polyp location, and rate of cold snare polypectomy did not differ between before and after instruction. Clip placement was significantly more common after instruction (22.6%, 416/1839) than before (9.7%, 144/1479, P < 0.01). Delayed post-polypectomy bleeding occurred in 1.1% of cases before instruction, and 0.4% after instruction. Instruction significantly decreased delayed bleeding, particularly in cases with antithrombotic agents. Multivariate logistic regression analysis showed that hot polypectomy, clip placement, and use of antithrombotic agents were significant independent risk factors for delayed post-polypectomy bleeding even after instruction.Conclusion: The rate of delayed bleeding significantly decreased after instruction to check for complete hemostasis. Even after instruction, delayed bleeding can still occur in cases with antithrombotic agents or hot polypectomy.
P2Y12 Inhibitor Utilization for Acute Coronary Syndrome in the Elderly: A Provincial Analysis From 2008 to 2018
Authors: Gupta Saurabh , Belley-Cote Emilie P , Eqbal Adam , McEwen Charlotte , Basha Ameen , Wu Nicole , Cerasuolo Joshua , Mehta Shamir , Schwalm Jon-David , Whitlock Richard P
Published: October 2020

Background Guidelines recommend acetylsalicylic acid (ASA) and ticagrelor following acute coronary syndrome (ACS), but appropriate prescription practices lag. We analyzed the impact of government medication approval, national guideline updates, and publicly funded drug coverage plans on P2Y12 inhibitor utilization.Methods Accessing provincial databases, we obtained data for elderly ACS patients in Ontario, Canada between 2008 and 2018. Using an interrupted-time series, we evaluated types of P2Y12 inhibitors prescribed at discharge, and changes to their utilization following ticagrelor’s national approval by Health Canada, national antiplatelet therapy guidelines (by the Canadian Cardiovascular Society (CCS)), and ticagrelor's coverage by a publicly funded medication plan.Results We included 114,142 patients (49.4%-PCI and 7.7%-CABG). Proportion of PCI patients utilizing P2Y12 inhibitors increased from 73.4% to 86.9% (p<0.001) and 11.4% to 46.5% (p<0.001) for CABG patients. Among PCI patients, clopidogrel utilization declined monthly after 2010 national guidelines were published (0.7%; p<0.0001) and within the first month after ticagrelor’s national approval by Health Canada (5.3%; p=0.03). Among PCI patients, ticagrelor utilization increased within the first month (24.5%; p<0.0001) and continued increasing monthly (0.4%; p<0.0001) after its coverage by a publicly funded medication plan. Among CABG patients, ticagrelor’s coverage was associated with a monthly increase in its utilization (0.2%; p<0.0001). Among PCI patients, clopidogrel utilization declined within the first month (6.1%; p=0.003) and ticagrelor utilization increased monthly (0.3%; p=0.05) after 2012 CCS guidelines.Conclusion National guideline updates and drug coverage by a publicly funded medication plan significantly improved P2Y12 inhibitor utilization. Barriers to appropriate antiplatelet therapy in the surgical population must be explored.
The Effectiveness of Two Implementation Strategies for Improving Teachers’ Delivery of an Evidenced-based HIV Prevention Program
Authors: Wang Bo , Deveaux Lynette , Cottrell Lesley , Li Xiaoming , Adderley Richard , Dorsett Barbara , Firpo-Triplett Regina , Koci Veronica , Marshall Sharon , Forbes Nikkiah , Stanton Bonita
Published: October 2020

Background: Effective implementation strategies are needed to enhance the success of evidence-based prevention programs. The current study evaluates the effects of two implementation strategies on teachers’ implementation of an evidenced-based HIV intervention.Methods: Using our 7-item Pre-Implementation School Screening tool, we identified teachers who were at-risk for not implementing the Focus on Youth HIV-risk reduction intervention curriculum which targets middle and high school youth. After completing a two-day curriculum workshop, 84 low- and moderate-performing teachers were randomly assigned to one of four experimental conditions and were asked to teach the intervention curriculum for nearly two months. This optimization trial examines the impact of two implementation strategies including biweekly monitoring/feedbacks (BMF) and site-based assistance/mentorship (SAM). The primary outcome is implementation fidelity defined as number of core activities taught. General linear model was used to examine the association of the implementation strategies with implementation fidelity.Results: BMF and SAM were significantly associated with teachers’ implementation fidelity. Teachers who received both BFM and SAM taught the greatest numbers of core activities, followed by teachers who received either BMF or SAM. Teachers who did not receive BMF or SAM taught the lowest numbers of core activities (15.0 vs. 7.9 vs. 6.9 vs. 4.1, p< 0.001). Teachers’ confidence in implementing five core activities, attitudes towards sex education in schools, and perceived principal support were significantly related to increased self-efficacy, which in turn was related to teachers’ fidelity of implementation. Teacher full attendance at the training workshop and teachers’ sustained implementation of FOYC in the prior school year were related to increased implementation fidelity. Conclusion: BMF and SAM are effective in promoting teachers’ implementation of youth evidence-based interventions. Researchers and future program implementers should consider teacher training, teachers’ attitudes towards sex education, perceived principal support and self-efficacy when attempting to maintain the effects of teacher-delivered interventions in schools.
Hemagglutinin Stalk-based Monoclonal Antibody Elicits Broadly Reactivity Against Group 1 Influenza A Virus
Authors: Huang Jingjin , Huang Nan , Fan Menglu , Zhao Lingcai , Luo Yan , Ding Pingyun , Tian Miao , Liu Qingzheng , Guo Yanna , Zhao Jinhua , Zheng Yiqing , Zhang Haitao , Ping Jihui
Published: October 2020

Background: Influenza virus remains a continuous and serious threat to public health worldwide, and its prevention and treatment have always been a major international issue. Because of its ability to evade immune surveillance through rapid antigenic drift and antigenic shift, broad-spectrum vaccines seem increasingly important. Methods: A mAb named 3C12 from an immortalized hybrid cell was generated via immunizing mice with HA2 protein from A/chicken/Anhui/BRI99/2016 (AH/BRI99/16, H9N2) generated by prokaryotic expression. Then, its broad-spectrum activity was analyzed by WB and IFA. Next, the minimal linear epitope was identified via analyzing the reaction of a series of HA truncations with 3C12. Finally, the protective effects of 3C12 were evaluated in vitro and in vivo infection experiments.Results: The mAb could react with the viruses of subtypes H1, H2, H5, H8, H9, H12, H13, H16, and HA protein of H18 in group 1, but failed to react with viruses in group 2. The minimal linear epitope targeted by the mAb was 433NAELLVL439 in full length of HA and localized in the C-helix region of HA2 (residue 95-101, HA2 numbering). What’s more, the mAb 3C12 inhibited H1, H2, H5, H8, H9, H12, H13 and H16 virus-replication in vitro and also has shown effectiveness in preventing and treating disease in mice challenged with lethal dose of AH/BRI99/16 (H9N2) virus in vivo. These results suggested that the broadly reactive anti-HA stem mAb 3C12 exhibited prophylactic and therapeutic efficacy.Conclusions: Here, we have demonstrated that the linear epitope identified in this study could be a novel target for developing broad-spectrum influenza diagnostics or vaccine design, and the HA2-based monoclonal antibody is indeed a promising strategy for broad-spectrum protection against seasonal and pandemic influenza viruses.
Promoting Respectful Maternity Care using a Behavioral Design Approach in Zambia: Results from a Mixed-Methods Evaluation
Authors: Smith Jana , Schachter Allison , Banay Rachel , Zimmerman Emily , Sellman Abigail , Kamanga Ameck
Published: October 2020

Background: Respectful maternity care (RMC) has been elevated in the global discourse, however, instances of disrespect and abuse remain prevalent. While several studies have highlighted promising approaches to promote RMC, this body of literature is still limited and few approaches have been scaled outside the initial study sites. Building on formative research conducted through a behavioral science lens, we sought to develop and test evidence-based, low-cost solutions to promote RMC which would be well-positioned for scale-up. Our study highlights the effectiveness of the solution package on provider provision of better care and client satisfaction, as well as intermediary outcomes and behavioral mechanisms. Methods: A quasi-experimental evaluation, informed by the behavioral design approach, was completed to test the effectiveness of a 5-component solution package in Chipata, Zambia. Quantitative surveys were collected from health facility providers and postpartum clients at baseline and endline in intervention and comparison facilities. Additional qualitative interviews were conducted with health facility providers and postpartum clients at endline. We also conducted interviews with health facility in-charges and observed labor and delivery practices at intervention facilities over the course of implementation. Results: Evidence suggested that at endline, clients at implementation facilities were less likely to experience disrespect and abuse compared to clients at comparison facilities (ß= -0.15 p=.01). Clients at intervention facilities were more likely to request pain management compared to clients at comparison facilities (ß=.33, p=.003). The solutions were simple for providers to implement and were easily integrated into existing services by providers during labor and delivery. Providers at intervention facilities also described the pain management toolkit as helpful in expanding the types of pain management techniques used during labor.Conclusions: The results of this small-scale study act as a proof of concept, demonstrating that the behavioral design approach can lead to solutions that show potential for impact. In other settings where providers face similar barriers to providing RMC, an adaptation of this solution package might lead to similarly positive results. Given the global scale of disrespectful care, these low-cost solutions hold promise for improving the quality of care women receive during labor and delivery.
Diagnostic and Prognostic Impact of Cytokeratin 18 Expression in Human Tumors: A Tissue Microarray Study on 11,952 Tumors
Authors: Menz Anne , Weitbrecht Timo , Büscheck Franziska , Luebke Andreas M , Kluth Martina , Hube-Magg Claudia , Hinsch Andrea , Höflmayer Doris , Weidemann Sören , Fraune Christoph , Möller Katharina , Bernreuther Christian , Lebok Patrick , Clauditz Till , Sauter Guido , Uhlig Ria , Wilczak Waldemar , Steurer Stefan , Minner Sarah , Burandt Eike , Krech Rainer , Dum David , Krech Till , Marx Andreas , Simon Ronald
Published: October 2020

BackgroundCytokeratin 18 (CK18) is an intermediate filament protein of the cytokeratin acidic type I group and is primarily expressed in single-layered or “simple” epithelial tissues and carcinomas of different origin. MethodsTo systematically determine CK18 expression in normal and cancerous tissues, 11,952 tumor samples from 115 different tumor types and subtypes (including carcinomas, mesenchymal and biphasic tumors) as well as 608 samples of 76 different normal tissue types were analyzed by immunohistochemistry in a tissue microarray format. ResultsCK18 was expressed in normal epithelial cells of most organs but absent in normal squamous epithelium. At least an occasional weak CK18 positivity was seen in 90 of 115 (78.3%) tumor types. Wide-spread CK18 positivity was seen in 37 (31.9%) of tumor entities, including adenocarcinomas of the lung, prostate, colon and pancreas as well as ovarian cancer. Tumor categories with variable CK18 immunostaining included cancer types arising from CK18 positive precursor cells but show CK18 downregulation in a fraction of cases, tumor types arising from CK18 negative precursor cells occasionally exhibiting CK18 neo-expression, tumors derived from normal tissues with variable CK18 expression, and tumors with a mixed differentiation. CK18 downregulation was for example seen in renal cell cancers and breast cancers, whereas CK18 neo-expression was found in squamous cell carcinomas of various origins. Down-regulation of CK18 in invasive breast carcinomas of no special type and clear cell renal cell carcinomas (ccRCC) was related to adverse tumor features in both tumors (p≤0.001) and poor patient prognosis in ccRCC (p=0.0088). Up-regulation of CK18 in squamous cell carcinomas was linked to high grade and lymph node metastasis (p<0.05). In summary, CK18 is consistently expressed in various epithelial cancers, especially adenocarcinomas. ConclusionsDown-regulation or loss of CK18 expression in cancers arising from CK18 positive tissues as well as CK18 neo-expression in cancers originating from CK18 negative tissues is linked to cancer progression and may reflect tumor dedifferentiation.
Cloning and Expression of the EsxA Gene and Analysis of the Growth-Promoting Effects of the Encoded Protein on Rice Seedlings
Authors: Yu Wen Qing , Wang Xin , Tang Yi Cong , Yan Feng Chao , Liu Wen Zhi , Zheng Gui Ping , Yin Dong Mei
Published: October 2020

An EsxA-encoding gene was previously identified in the genome of the plant growth-promoting rhizobacterium Paenibacillus terrae strain NK3-4. The EsxA gene was cloned and expressed in Pichia pastoris , after which the effects of the EsxA protein on rice seedling growth were analyzed to determine whether EsxA contributes to the plant growth-promoting activity of strain NK3-4. The EsxA gene was successfully cloned from the NK3-4 genome and ligated to the eukaryotic expression vector pPICZαA. The resulting pPICZαA- EsxA recombinant plasmid was inserted into P. pastoris cells, and EsxA gene expression in the yeast cells was confirmed. The treatment of seed- buds with the EsxA protein increased the root length by 1.35-times, but decreased the bud length. Additionally, in rice seedlings treated with EsxA, the root and shoot lengths increased by 2.6- and 1.7-times, respectively. These findings imply that EsxA is important for the promotion of rice plant growth by P. terrae strain NK3-4. Furthermore, the construction of the EsxA gene expression vector and the engineered strain may be useful for future investigations of the mechanism underlying the plant growth-promoting effects of EsxA, with implications for the application of EsxA for regulating plant growth.
Data Sharing Across Osteoarthritis Research Groups and Disciplines: Opportunities and Challenges
Authors: Evans Jill , Biggs Paul , Elliott Mark
Published: October 2020

Background: Osteoarthritis is a heterogeneous condition characterised by a wide variety of factors and represents a worldwide healthcare challenge. There are multiple clinical and research specialisms involved in the diagnosis, prognosis and treatment of osteoarthritis, and there may be opportunities to share or pool data which are currently not being utilised. However, there are challenges to doing so which require carefully structured solutions and partnership working.Methods: Interviews were conducted with nine experts from various fields within osteoarthritis research. A semi-structured approach was used, and thematic analysis applied to the results.Results: Generally, osteoarthritis researchers were supportive of data sharing, provided it is done responsibly and without impacting data integrity. Benefits identified included increasing typically low-powered data, the potential for machine learning opportunities, and the potential for improved patient outcomes. However, a number of challenges were identified, in particular related to; data security, data harmonisation, storage costs, ethical considerations and governance.Conclusions: There is clear support for increased data sharing and partnership working in osteoarthritis research. Further investigation will be required to navigate the complex issues identified; however, it is clear that collaborative opportunities should be better facilitated and there may be innovative ways to do this. It is also clear that nomenclature within different disciplines could be better streamlined, to improve existing opportunities to harmonise data.
TGF-β and CCL18 as Indicators for Predicting and Monitoring the Development of Pulmonary Fibrosis in Patients with COVID-19
Authors: Zong Ming , Zheng Liang , Zhou Huan , Lu Liu , He Long , Wu Xiaodong , Chen Nianzhen , Wang Lan , Yuan Jiayi , Jiang Erpeng , Shi Yan , Li Qiang , Fan lieying , Liu Zhongmin
Published: October 2020

BackgroundMany COVID-19 patients have been discharged, but lung injury, including pulmonary fibrosis, might lead to long-term impairment. This study aimed to evaluate predictors and monitors of pulmonary fibrosis in patients with COVID-19.MethodsThirty-five convalescent patients with severe COVID-19, after appropriate medical treatments, were recruited. According to evidence of fibrosis on initial computed tomography (CT), the patients were divided into mild-to-moderate and severe groups. Levels of transforming growth factor beta (TGF-β), chemokine ligand 18 (CCL18), type III procollagen peptide (PⅢP), hyaluronic acid (HA), laminin (LN), and type IV collagen (CⅣ) were determined. Laboratory tests, clinical data, and CT features at different stages were collected and analyzed, and the prognostic performance of these parameters was evaluated.ResultsSevere fibrosis was found in 76.29% (26/35) of patients. However, most baseline laboratory characteristics were normal. Fibrosis indicators (TGF-β: 66.67±158.57 vs 55.84±126.43 pg/mL, P=0.006; CCL18: 364.27±167.70 vs 84.47±60.67 ng/mL, P=0.000; PⅢP: 54.12±55.34 vs 17.15±2.48 ng/mL, P=0.000; HA: 122.47±78.84 vs 59.74±18.01 ng/mL, p=0.000; LN: 55.43±46.44 vs 24.25±7.79 ng/mL, P=0.000; CⅣ: 24.77±14.97 vs 15.32±1.15 ng/mL, P=0.001) were elevated in patients compared with controls. Over 90 days’ follow-up, HRCT scores gradually decreased from 22.48±16.13 to 10.33±11.11 (P<0.001), and mMRC scores decreased from 3.27±0.32 to 1.48±0.33, and all fibrosis indicators, except for PⅢP, gradually declined with the improvement of pulmonary fibrosis. Moreover, TGF-β and CCL18 levels were lower in the mild-to-moderate than severe fibrosis group (88.16±97.45 vs 205.93±170.57 pg/mL, P=0.024; 241.84±125.37 vs 366.64±161.06 ng/mL, P=0.038), and patients with elevated baseline levels of serum TGF-β and CCL18 had longer rehabilitation times.ConclusionsTGF-β and CCL18 may be promising biomarkers for predicting and monitoring the development of pulmonary fibrosis in patients with COVID-19.
MIEF2 over-expression promotes tumor growth and metastasis through reprogramming of glucose metabolism in ovarian cancer
Authors: Zhao Shuhua , Shi Yuan , Zhang Xiaohong , Cheng Lu , Song Tingting , Wu Bing , Li Jia , Yang Hong
Published: October 2020

Background: Increasing evidence has revealed the close link between mitochondrial dynamic dysfunction and cancer. MIEF2 (mitochondrial elongation factor 2) is mitochondrial outer membrane protein that functions in the regulation of mitochondrial fission. However, the expression, clinical significance and biological functions of MIEF2 are still largely unclear in human cancers, especially in ovarian cancer (OC). Methods: The expression and clinical significance of MIEF2 were determined by qRT-PCR, western blot and immunohistochemistry analyses in tissues and cell lines of OC. The biological functions of MIEF2 in OC were determined by in vitro and in vivo cell growth and metastasis assays. Furthermore, the effect of MIEF2 on metabolic reprogramming of OC was determined by metabolomics and glucose metabolism analyses. Results: MIEF2 expression was significantly increased in OC mainly due to the down-regulation of miR-424-5p, which predictes poor survival for patients with OC. Knockdown of MIEF2 significantly suppressed OC cell growth and metastasis both in vitro and in vivo by inhibiting G1-S cell transition, epithelial-to -mesenchymal transition (EMT) and inducing cell apoptosis, while forced expression of MIEF2 had the opposite effects. Mechanistically, mitochondrial fragmentation-suppressed cristae formation and thus glucose metabolism switch from oxidative phosphorylation to glycolysis was found to be involved in the promotion of growth and metastasis by MIEF2 in OC cells. Conclusions: MIEF2 play a critical role in the promotion of OC progression and may serve as a valuable prognostic biomarker and therapeutic target in treatment of this malignancy.
ESCO2 promotes lung adenocarcinoma progression by regulating hnRNPA1 acetylation
Authors: Zhu Hui-er , Li Tao , Shi Shengnan , Chen De-xiong , Chen Weiping , Chen Hui
Published: October 2020

Background: Emerging evidence indicates that metabolism reprogramming and abnormal acetylation modification play an important role in lung adenocarcinoma (LUAD) progression, although the mechanism is largely unknown. Methods: Here, we used three public databases (Oncomine, Gene Expression Omnibus [GEO], The Cancer Genome Atlas [TCGA]) to analyze ESCO2 (establishment of cohesion 1 homolog 2) expression in LUAD. The biological function of ESCO2 was studied using cell proliferation, colony formation, cell migration, and invasion assays in vitro, and mouse xenograft models in vivo. ESCO2 interacting proteins were searched using gene set enrichment analysis (GSEA) and mass spectrometry. Pyruvate kinase M1/2 (PKM) mRNA splicing assay was performed using RT-PCR together with restriction digestion. LUAD cell metabolism was studied using glucose uptake assays and lactate production. ESCO2 expression was significantly upregulated in LUAD tissues, and higher ESCO2 expression indicated worse prognosis for patients with LUAD. Results: We found that ESCO2 promoted LUAD cell proliferation and metastasis metabolic reprogramming in vitro and in vivo. Mechanistically, ESCO2 increased hnRNPA1 (heterogeneous nuclear ribonucleoprotein A1) binding to the intronic sequences flanking exon 9 (EI9) of PKM mRNA by inhibiting hnRNPA1 nuclear translocation, eventually inhibiting PKM1 isoform formation and inducing PKM2 isoform formation. Conclusions: Our findings confirm that ESCO2 is a key factor in promoting LUAD malignant progression and suggest that it is a new target for treating LUAD.
Determinants of early days of newborn feeding mal-practice among mothers of children less than one years of age in Mizan-Aman Town, South-west Ethiopia, 2020
Authors: Amare Muluken
Published: October 2020

Back ground: Neonatal death remained a global public health issue, especially in Ethiopia due to sub-optimal breast-feeding practices. While several interventions have been made to comply with the WHO guideline, sub-optimal feeding practices are commonly seen in Ethiopia. The goal of this study was therefore to identify gaps in optimal breast-feeding practice in South West Ethiopia.Objective: To assess the prevalence and determinant of early days of newborn feeding mal-practices among recently delivered women in Mizan-Aman Town, southwestern Ethiopia, 2020.Methods: A community-based cross-sectional study was undertaken on recently delivered women from March-April/2020. A total of 487 mothers-child (<12month) pair were selected by using multistage randomized sampling technique and the data was collected through face to face interview by using structured questionnaire. The result was analyzed via SPSS version 26. Multivariate logistic regression analysis was used to assess determinant of newborn feeding mal-practices and a p<0.05 was deem to be significant.Result: Prevalence of prelacteal feeding and colostrum avoidance was approximately 21.9% and 15.5% respectively. The most common prelacteal food was Rue / Tenadam/49 (10.1 %). The key reasons were: 49(10.1 %) Cultural activity followed by 45 (9.3 %) clean-up of the intestine / throat / mouth of babies. Determinants of pre-lacteal feeding were found to be: mothers recognizing risks of prelacteal feeding, multipara mothers, having ≥4 number of children and infant’s birth order 4-6. Likewise, exposure to infant formula advertisement, absence of home to home health education, multipara mothers and spontaneous vaginal birth were the determinants of colostrum avoidance.Conclusion: The study found that there was a sub-optimal breast-feeding practice, one in four newborns. As a result, activities to discourage pre-lacteal feeding and to improve early initiation of colostrum feeding practices shall be carried out.
APOC1 is a Potential Prognostic Biomarker and Correlated With Immune Infiltration in ESCC
Authors: XIE Jia-yi , Liu Ming , Luo Yaxin , Wang Zhen , Lu Zhenghong , Ruan Xiaohui , Xu Li , Huang Rong , Li Aimin , Liu Side , Luo Xiaobei , Han Zelong
Published: October 2020

PurposeEsophageal cancer (EC) is the sixth leading cause of cancer death worldwide. Esophageal squamous cell carcinoma (ESCC) is a predominant subtype of EC. Identifying diagnostic biomarkers for ESCC is necessary for cancer practice. Increasing evidence illustrates that apolipoprotein C-1 (APOC1) participates in the carcinogenesis. However, the biological function of APOC1 in ESCC remains unclear. Patients and methodsWe investigated the expression level of APOC1 using TIMER2.0 and GEO databases, the prognostic value of APOC1 in ESCC using Kaplan-Meier plotter and TCGA databases. We used LinkedOmics to identify co-expressed genes with APOC1 and perform GO and KEGG pathway analysis. The target networks of kinases, miRNAs and transcription factors were predicted by gene set enrichment analysis (GSEA). The correlations between APOC1 and immune infiltration were calculated using TIMER2.0 and CIBERSORT databases. We further performed the prognostic analysis based on APOC1 expression levels in related immune cells subgroups via Kaplan-Meier plotter database. ResultsAPOC1 was found overexpressed in tumor tissues in multiple ESCC cohorts and high APOC1 expression was related to a dismal prognosis. Multivariate analysis confirmed that APOC1 overexpression was an independent indicator of poor OS. Functional network analysis indicated that APOC1 might regulate the natural killer cell mediated cytotoxicity, phagosome, AMPK and hippo signaling through pathways involving some cancer-related kinases, miRNA and transcription factors. Immune infiltration analysis showed that APOC1 was significantly positively correlated with M0 macrophages cells, M1 macrophages cells and activated NK cells, negatively correlated with regulatory T cells, CD8 T cells, neutrophils and monocytes. High APOC1 expression had a poor prognosis in server immune cells subgroups in ESCC, including decreased CD8+ T cells subgroups. Conclusion﻿These findings suggest that increased expression of APOC1 is related to poor prognosis and immune infiltration in ESCC. APOC1 holds promise for serving as a valuable diagnostic and prognostic marker in ESCC.