bluuebunny/crossref_metadata_2025 huggingface dataset:
A Cellular Study of Inflammatory Responses in Women with Polycystic Ovary Syndrome as: “An In vitro Model of Anti Breast Tumor Response”A Case Control Study
Authors: Rezayat Fatemeh , Hajiaghaei Mehri , Ghasemi Nazanin , Mesdaghi Mehrnaz , Tehrani Fahimeh Ramezani , Mosaffa Nariman
Published: April 2020

Background: Although Polycystic Ovary syndrome (PCOS) is a common endocrine disorder among women of reproductive age; is unclear whether PCOS increases the risk of subsequent development of, Gynecologic cancers namely breast cancer. The present study we aimed to compare the antitumoral ability of peripheral blood mononuclear cells (PBMCs) of women with PCOS with that of healthy controls using the co-culture system between effector cells and target tumor cell lines. Materials & Methods: PBMCs were isolated from 25 women with PCOS and 25 non hirsute eumenorrheic healthy controls by density gradient centrifugation ficoll. Breast tumor cell lines (MDA-468, MCF-7) were incubated as the two target cells and were cultured adjacent to PBMCs in the transwell co-culture system. Proliferation rate of the effectors cells evaluated by BrdU cell proliferation assay after 48 and 72 hours and T CD3+ lymphocytes were assessed using flow cytometry. TNF-α cytokine production was evaluated in cell culture supernatant by sandwich ELISA technique. Results: After 48 hours incubation with MDA-468 and MCF-7, the mean proliferation score of PBMCs was significantly higher in women with PCOS compared to that of healthy controls (921.04; P=0.021 vs 287.6; P=0.002, respectively). In PCOS women, after 72 hours of incubation, TNF-α concentration was significantly reduced compared to 48-hour cultures (921.04 ± 271.4 pg/dl vs 545.6 ± 151.1 pg/dl at 48 h and 72 h intervals respectively, P<0.05); it was increased in healthy controls. There was no significant difference in CD3+ CD8+ cells between the PCOS group and healthy controls. Conclusion: The ability of PBMCs to produce of TNF-α in women with PCOS decreased gradually; as a result of which they may lack the ability required to form an in vitro efficient antitumor response to breast tumor cell lines. It is assumed that threshold activation of mononuclear cells is reduced in women with PCOS and a low-grade inflammatory condition may provide a positive background for arising myeloid derived suppressor cells (MDSCs).
Periodized resistance training for persistent non-specific low back pain: A mixed methods feasibility study
Authors: Tjøsvoll Svein O. , Mork Paul J. , Iversen Vegard M. , Rise Marit B. , Fimland Marius S.
Published: April 2020

Background: We investigated the feasibility of a 16-week supervised heavy resistance training program with weekly undulating periodization for individuals with persistent non-specific low-back pain (LBP). Methods: Twenty-five adults with persistent non-specific LBP participated in this mixed methods feasibility study. Participants trained a whole-body program consisting of squat, bench press, deadlift and pendlay row two times per week for 16 weeks. We assessed pain intensity, pain-related disability, pain self-efficacy and one-repetition maximum strength at baseline, 8 weeks and 16 weeks. Three focus group interviews were conducted at the end of the program. Linear mixed models were used to assess changes in outcomes, and the qualitative data was assessed using systematic text condensation. Results: We observed clinically meaningful reductions in pain intensity after 8 and 16 weeks of training. The mean difference on the numeric pain rating scale (0-10) in the last two weeks from baseline to 8 weeks was 2.6 (95% CI: 1.8-3.6) and from baseline to 16 weeks 3.4 (95% CI: 2.5-4.4). In addition, there were improvements in pain-related disability (3.9, 95% CI: 2.3-5.5), pain self-efficacy (7.7, 95% CI: 5.4-10.1) and muscle strength. In the focus group interviews, participants talked about challenges regarding technique, the importance of supervision and the advantages of periodizing the training. Perceived benefits were improved pain, daily functioning, energy level and sleep, and changes in views on physical activity.Conclusion: Periodized resistance training with weekly undulating periodization is a feasible training method for this group of individuals with persistent non-specific LBP. A randomized clinical trial should assess the efficacy of such an intervention.Trial registration clinicaltrials.gov/ Identifier – NCT04284982, Registered on February 24th 2020.
Anti-inflammatory effect of piperine ameliorates insulin resistance in monosodium glutamate–treated obese mice
Authors: Liu Chaolong , Yuan Yanting , Zhou Ji , Hu Ruixin , Ji Lixia , Jiang Guohui
Published: April 2020

Background : Metabolic inflammation has been considered as an essential event in obesity-induced diabetes and insulin resistance. In obesity, an increasing number of macrophages recruited into visceral adipose tissues undergo significant M 1 -like polarization, secreting variable amounts of pro-inflammatory cytokines and causing insulin resistance. Piperine has been proven to have excellent anti-inflammatory activity and has therapeutic effects on a variety of inflammatory diseases. Therefore, we investigated the effect of piperine on adipose tissue inflammation and insulin resistance in obese mice. Methods: In this study, the monosodium glutamate (MSG) obese mice model was used. The 6-month-old MSG mice were divided into three groups, which were treated with piperine (40 mg/kg/day), metformin (150 mg/kg/day) and vehicle for successive 10 weeks, respectively. Meanwhile, the 6-month-old normal mice without MSG treatment were selected as normal controls. Results: When the obesity model was successfully established, obesity degree, insulin resistance, fasting blood glucose(FBG) and serum lipid profiles were significantly increased. Our results showed that the 10-week administration of piperine (40 mg/kg/d) not only significantly decreased the elevated FBG, serum TC and TG levels, but also enhanced infusion rate in hyperglycemic clamp experiment and improved the oral glucose intolerance as well as abnormal insulin tolerance in adult MSG obese mice. Additionally, piperine significantly decreased the total and differential white blood cell (WBC) count and the serum level of lipopolysaccharide (LPS), pro-inflammatory cytokines such as galectin-3 (Gal-3), interleukin-1β (IL-1β). Furthermore, piperine clearly down-regulated the mRNA levels of pro-inflammatory cytokines and the protein levels of M 1 -like polarization marker CD11c and Gal-3 in adipose tissues. In addition, the in vitro study showed that piperine inhibited LPS- stimulated polarization of RAW 264.7 cells toward the M 1 phenotype. Conclusions: In summary, these findings demonstrated that piperine could significantly inhibit body weight gain, reduce fat accumulation, rectify glycolipid metabolism disorders, improve severe insulin resistance and ameliorates systemic metabolic inflammation in MSG obesity mice. Our study indicates that piperine, as a potential natural alkaloid, can be used in the treatment of obesity-associated diabetes by delaying the progression of obesity-induced insulin resistance.
Climatology of Medium-Scale Traveling Ionospheric Disturbances (MSTIDs) Observed with GPS Networks in the North African Region
Authors: Oluwadare Temitope Seun , Jakowski Norbert , Valladares Cesar E. , Akala Andrew Oke-Ovie , Abe Oladipo E. , Alizadeh Mahdi M. , Schuh Harald
Published: April 2020

We present for the first time the climatology of medium-scale traveling ionospheric disturbances (MSTIDs) by using Global Positioning System (GPS) receiver networks on geomagnetically quiet days (Kp ≤ 3) over the North African region during 2008-2016. The MSTIDs appear frequently as oscillating waves or wave-like structures in electron density induced by the passage of Atmospheric Gravity Waves (AGW) propagating through the neutral atmosphere and consequently, causing fluctuation in the ionospheric Total Electron Content (TEC). The TEC perturbations (dTEC) data are derived from dual frequency GPS-measurements. We have statistically analyzed the occurrence rate, diurnal and seasonal behavior as well as the annual MSTID occurrence characteristics. The results show a local and latitude dependence of nighttime and daytime MSTIDs. The propagation direction is predominantly towards the South (equatorward), MSTIDs event period is (10 ≤ period ≤ 43 mins), and amplitude (0.08 ≤ amp ≤ ~5.0 TECU), with a velocity higher at nighttime than daytime. The amplitudes for daytime and nighttime MSTIDs increase with solar activity. On the average, the local MSTIDs Spatio-temporal heat map for the Mid-latitude reveals variability in disturbance occurrence time to be dominant within the hours of 0900 - 1600 LT in December solstice (winter) and 1900–0400 LT in June solstice (summer) for daytime and nighttime respectively. While the low latitude reveals the disturbance occurrence time to be dominant within the hours of 1100 - 1800 LT in December solstice (winter) and 2000–0200 LT in equinox months and June solstice (summer) for daytime and nighttime respectively. The time series MSTIDs regional distribution map is also generated. Atmospheric gravity waves (AGW) might be responsible for the excitation mechanism for daytime MSTIDs.
Supporting treatment adherence for children and young people living with Cystic Fibrosis by introducing an adherence protocol in the outpatient setting – A mixed methods implementation study.
Authors: Richards Bianca Lee , Osborne Sonya , Simons Megan
Published: April 2020

Background: In cystic fibrosis care, patients are required to adhere to a burdensome daily treatment regimen. The outpatient cystic fibrosis clinic presents an opportunity for multidisciplinary healthcare teams to monitor disease progression, support daily treatment adherence, address adherence challenges and improve health outcomes. However, the complexity of adherence care, and inconsistencies in methods and delivery of adherence interventions may impact the effectiveness of healthcare teams changing adherence outcomes. Comprehensive adherence protocols have been proposed (CF My Way) to increase the visibility, consistency and efficacy of adherence work. Barriers in the clinic environment have been implicated in their unsuccessful translation into standard care. The aim of this study was to explore the feasibility, acceptability and appropriateness of implementing the ‘CF My Way’ protocol into the outpatient cystic fibrosis clinic of a tertiary, paediatric hospital Methods: This implementation study employed a pre-post observational study design using mixed methods. A four-phased implementation framework guided the implementation plan. Prior to the program introduction, qualitative data was collected from 23 clinicians, adolescents and parents using focus groups and interviews to identify barriers and enablers to implementation. Quantitative data was collected using purpose-designed audit tools and surveys throughout the implementation and analysed to inform modifications and support translation to standard care. Discussion: Theoretically and conceptually-derived implementation science frameworks can inform the process of translating an adherence protocol into an existing CF healthcare setting. Results indicate that while using an adherence protocol is acceptable and appropriate according to the perspectives of clinicians and parents, ‘CF My Way’ is not yet an “off the shelf” solution to the adherence challenge. Modifications were required to the original adherence protocol to support integration. Implementation strategies such as pilot testing, systems analysis and team cultural interventions are indicated to support effective and consistent adherence care pathways in the CF clinic. Trial registration number: ACTRN12619001730190 Trial web address: http://www.ANZCTR.org.au/ACTRN12619001730190.aspx
Assessment of Local Supply Chains and Stock Management Practices for Trauma Care Resources in Ghana: A Comparative Cross-Sectional Study
Authors: Boakye Godfred , Gyedu Adam , Stewart Melissa , Donkor Peter , Mock Charles , Stewart Barclay T
Published: April 2020

Background: Injuries are a major public health problem globally. With sound planning and organization, essential trauma care can be reliably provided with relatively low-cost equipment and supplies. However, availability of these resources requires an effective and efficient supply chain and good stock management practices. Therefore, we study aimed to assess trauma care resource-related supply management structures and processes at health facilities in Ghana. By doing so, the findings may allow us to identify specific structures and processes that could be improved to facilitate higher quality and more timely care.Methods: Ten hospitals were purposively selected using results from a previously performed national trauma care capacity assessment of hospitals of all levels in Ghana. Five hospitals with low resource availability and 5 hospitals with high resource availability were assessed using the United States Agency for International Development (USAID) Logistics Indicators Assessment Tool and stock ledger review. Data were described and stock management practices were correlated with resource availability.Results: There were differences in stock management practices between low and high resource availability hospitals, including frequency of reporting and audit, number of stock-outs on day of assessment (median 9 vs 2 stock-outs, range 3 – 57 vs 0 – 9 stock-outs, respectively; p=0.05), duration of stock-outs (median 171 vs 8 days, range 51 – 1,268 vs 0 – 182 days, respectively; p=0.02), and fewer of up-to-date stock cards (24 vs 31 up-to-date stock cards, respectively; p=0.07). Stock-outs were common even among low-cost, essential resources (e.g., nasal cannulas and oxygen masks, endotracheal tubes, syringes, sutures, sterile gloves). Increased adherence to stock management guidelines and higher percentage of up-to-date stock cards were correlated with higher trauma resource availability scores. However, the variance in trauma resource availability scores was poorly explained by these individual factors or when analyzed in a multivariate regression model (r2=0.72; p value for each covariate between 0.17 – 0.34).Conclusions: Good supply chain and stock management practices are correlated with high trauma care resource availability. The findings from this study demonstrate several opportunities to improve stock management practices, particularly at low resource availability hospitals
Infrared imageries of human body activated by teas indicate the existence of meridian system
Authors: Jin Wenli , Tao Yichen , Wang Chen , Wang Lufei , Ao Xue , Su Mingjie , Hu Binwei , Ouyang Yuxiao , Liu Jiaxing , Li Hui
Published: April 2020

BackgroundHuman meridian (Jingluo) system was hypothesized by traditional Chinese medicine (TCM) for thousands of years. In this hypothesis, there believed to be twelve formal meridian channels going through respective organs, carrying fluid and energy, and laying thermal effects. Some treatments based on meridians have been proved effective. However, existence of meridians has never been confirmed. The infrared photograph was employed to display the picture to the meridians since 1970. Unfortunately, no satisfactory results have been obtained. We think that only when a certain meridian is activated will there be thermal effect for successful infrared photograph.Methods We selected thirteen types of tea out of the herbs to activate the hypothesized twelve meridians for imagery taking. We collected 42 volunteers to drink teas and take infrared imageries in thirteen days. After every tea was drunk, infrared imageries of the human bodies were taken immediately. The highest temperatures of the fingers, palms, and above the organs were derived from the imageries. The averages and standard deviations of the standardized data of volunteers were calculated. Significances of the temperature difference among the body areas after drinking different teas were evaluated. ResultsWe found that the temperatures of the organs and fingers possibly connected by twelve hypothesized meridians rose together significantly, i.e., the thumbs and lung after white teas, index fingers and colon after blue teas, middle fingers and thymus after dark black teas, ring fingers and gallbladder after red black teas, little fingers and heart after yellow teas. The temperature distribution on the human bodies exhibited twelve patterns following the meridian hypothesis. Infrared imageries showed quite clear shapes of the organs activated by the teas, e.g., heart and kidneys by yellow teas, thymus by dark black teas, lungs and spleen by white teas, gallbladder and thyroid by red black teas, etc. Some high temperature lines also matched the hypothetic meridians. ConclusionsOur work displayed the imageries of the possible meridians for the first time, and proved with data that different foods may activate different organs following the meridian hypothesis, shedding light on a possible new method of targeted drug designs.
The impact of COVID-19 epidemic on adult Myasthenia Gravis patients
Authors: Peng Yuyao , Li Zhibin , Zeng Qiuming , Yang Huan
Published: April 2020

Objects: To investigate the impact of COVID-19 epidemic on adult myasthenia gravis (MG) patients, in order to provide better medical advice for special patient population during the quarantine period.Methods: Adult MG patients were randomly recruited to participate. The survey consisted of self-designed questionnaires and the revised 15-item Myasthenia Gravis Quality of Life Questionnaire (MGQOL15r). Participation was strictly voluntary and remained anonymous.Results: A total of 214 adult MG patients (84 males and 130 females) gave valid replies. There were 49.53% patients reported they had the fear of COVID-19 outbreak at different levels. And female patients had a significant higher level of fear to COVID outbreak (p=0.009). It was found that the adult MG patients are more likely to be influenced by the COVID-19 epidemic compared to the general population. During the COVID-19 outbreak, 36.45% patients reported they got an improvement of MG disease severity. 57.01% patients reported they felt no change. 6.54% patients reported their condition got worse. The average of MGQOL15r score was 7.38±6.22. The higher level of the fear of COVID-19 outbreak, the higher score of MGQOL15r (p=0.029), the poorer quality of life. 96.73% patients hoped the specialist physicians could provide online consult. In addition, 64.95% patients would go to the tertiary hospital without hesitation if the Outpatients Department was opened even during the COVID-19 epidemic.Conclusions: The COVID-19 epidemic has significant impact on the quality of life and psychological status in the adult MG patients. Compared to the general population, the adult MG patients are more likely to be influenced by the COVID-19 epidemic. Hence, it is important for health care organizations to provide professional therapeutic advice and psychosocial support in time.*, Contributed to this work equally.
Multicenter randomized controlled trial comparing digital and traditional chest drain in a VATS pulmonary lobectomy cohort: interim analysis
Authors: Mendogni Paolo , Tosi Davide , Marulli Giuseppe , Comacchio Giovanni Maria , Pieropan Sara , Rossi Veronica , Brascia Debora , Andriolo Luigi Gaetano , Imbriglio Giovanna , Bonitta Gianluca , Lopez Camillo , Rea Federico , Nosotti Mario
Published: April 2020

Background The usefulness of digital chest drain is still discussed. We are carrying out a study to determine if the use of a digital system compared with a traditional system reduces the duration of chest drainage. To evaluate safety, benefit, or futility of this trial we planned the current interim analysis. Methods An interim analysis on preliminary data from ongoing investigator-initiated, multicenter, interventional, prospective randomized trial. Original protocol number: (NCT03536130). The interim main endpoint was overall complications; secondary endpoints were the concordance between the two primary endpoints of the RCT (chest tube duration and length of hospital stay). We planned the interim analysis when half of the patients have been randomised and completed the study. Data were described using mean and standard deviation or absolute frequencies and percentage. T-test for unpaired samples, Chi-square test, Poisson regression and absolute standardized mean difference (ASMD) were used. P-value <0.05 was considered significant. Results From April 2017 to November 2018, out of 317 patients were enrolled by 3 centers, 231 fulfilled inclusion criteria and were randomized. Twenty-two of them dropped out after randomization. Finally, 209 patients were analyzed: among them 94 used the digital device and 115 the traditional one. The overall postoperative complications were 35 (16.8%) including prolonged air leak (1.9%). Mean chest tube duration was 3.6 days (SD=1.8), with no differences between two groups (p=0.203). The overall difference between hospital stay and chest tube duration was 1.4 days (SD=1.4). Air leak at first postoperative day detected by digital and traditional devices predicted increasing in tube duration of 1.6 day (CI 95% 0.8-2.5, p<0.001) and 2.0 days (CI 95% 1.0-3.1, p<0.001), respectively. Conclusions This interim analysis supported the authors’ will to continue with the enrollment and to analyze data once the estimated sample size will be reached.
Investigating the healthcare pathway through patient’s experience and profiles: implications for the breast cancer healthcare providers
Authors: Cherif Emna , Verdier Elisabeth Martin , Rochette Corinne
Published: April 2020

BackgroundHealthcare systems are facing many changes. Particularly, patients are more engaged in the care process. The medical perspective of the process is insufficient to provide patients with high care quality and service personalization. This research presents an attempt to complete this medical perspective through an experiential perspective, especially for chronic diseases such as cancer. We investigated patients’ experiences and profiles to reach a deeper understanding of their needs and expectations when they confront the disease.The objectives of this research were to model the key stages underling the patient pathway and to identify the challenging touchpoints of the interactions between the patients and the healthcare providers. Bringing together findings of patient experience, pathway, and profiles would help all the stakeholders involved to develop better practices for the healthcare process.MethodsA qualitative observational nethnography on a French specialized forum for breast cancer patients “les Impatientes” was conducted. A total of 967 reviews were collected over a complete year period from all over France. Thematic and lexicometric content analysis were performed according to the experience dimensions, the pathway stages and touchpoints, as well as the patients’ profiles.ResultsData analysis shows that the healthcare pathway experienced by the patients is built around three stages. The discovery stage is closely related to the emotional dimension regarding the patient and physician relationship. The examination stage is characterized by a more technical and informational needs for the types of treatments. The follow-up and control stage illustrates the patients’ need to assess the treatments’ effectiveness and the quality of the follow-up. Moreover, three profiles of patients were identified. The newcomers, the altruists and the autonomous are characterized by different attitudes depending on the stage of the healthcare pathway they are living.ConclusionsOur research presents an original modelling of the patient pathway and profiles beyond the medical process. It gives practical tracks to improve of the healthcare pathway. Patients expect healthcare providers to integrate and strengthen several challenging touchpoints in order to create satisfactory patient experiences and high service quality.
FRET-based Tau seeding assay does not represent prion-like templated assembly of Tau filaments
Authors: Kaniyappan Senthilvelrajan , Tepper Katharina , Biernat Jacek , Chandupatla RamReddy , Hübschmann Sabrina , Irsen Stephan , Bicher Sandra , Klatt Christoph , Mandelkow Eva-Maria , Mandelkow Eckhard
Published: April 2020

Tau aggregation into amyloid fibers based on the cross-beta structure is a hallmark of several Tauopathies, including Alzheimer Disease (AD). Trans-cellular propagation of Tau with pathological conformation has been suggested as a key disease mechanism. This is thought to cause the spreading of Tau pathology in AD by templated conversion of naive Tau in recipient cells into a pathological state, followed by assembly of pathological Tau fibers, similar to the mechanism proposed for prion pathogenesis. In cell cultures, the process is usually monitored by a FRET assay where the recipient cell expresses the Tau repeat domain (Tau RD ) with a pro-aggregant mutation, fused to GFP-based FRET pairs. Since the diameter of the reporter GFP (~3 nm) is ~6.5 times larger than the β-strand distance (0.47nm), this points to a potential steric clash. Hence, we investigated the influence of the GFP tag on Tau aggregation. Using biophysical methods (light scattering, atomic force microscopy (AFM), and scanning-transmission electron microscopy (STEM)), we found that the assembly of Tau-GFP was severely inhibited and incompatible with that of Alzheimer filaments. These observations argue against the hypothesis that the propagation of Tau pathology in AD is caused by the prion-like templated aggregation of Tau protein, transmitted via cell-to-cell spreading of Tau. As a consequence, the observed local increase of FRET in recipient cells must be caused by alternative processes.
The Effects of Mechanical Insufflation-Exsufflation on Lung Function and Complications in Cardiac Surgery Patients
Authors: Wu Meng-Fang , Wang Tsai-Yu , Chen Da-Shen , Shiao Shou-Fong , Hu Han-Chuang , Chung Fu-Tsai , Lin Ting-Yu , Lin Shu-Min
Published: April 2020

Background: Postoperative positive pressure lung expansion is associated with decreased pulmonary complications and improved clinical outcomes. The aim of the present study was to compare the differences in post-operative pulmonary complications and clinical outcomes between two groups of study subjects who underwent cardiac surgery; one included subjects who received mechanical insufflation-exsufflation (MI-E) and the other included subjects who received intermittent positive pressure breathing (IPPB) therapy.Methods: This retrospective study included 48 subjects, who underwent cardiac surgery in an intensive care unit of a tertiary hospital during the time period from June 2017 to February 2018. After liberation from mechanical ventilation, the subjects received lung expansion therapy by means of two type of positive pressure devices, MI-E (n=20) or IPPB (n=28). The pulmonary complications, lung function, and clinical outcomes were compared between the two groups.Results: Subjects in both groups displayed similar baseline characteristics and underwent similar types of surgical procedures. Compared to subjects who received non-oscillatory therapy, those who received MI-E therapy had higher post-operative force vital capacity (58.9±4.96 % vs. 45.21±3.60 %, p=0.026), forced expiratory volume in one second (63.35±5.4 % vs. 45.48±3.63 %, p=0.007), and peak flow rate (68.5±5.53 % vs. 54.75±4.11 %, p=0.047). However, the incidence of chest pain was higher in the MI-E group (n=13, 65%) than in the IPPB group (n=4, 14.3%; odds ratio, 11.14, 95% confidence interval, 2.74-45.26; p=0.001). The length of hospital and ICU stay, development of atelectasis, pneumonia, and pleural effusion were similar in both the groups.Conclusion: Both IPPB and MI-E therapies have similar effects on preventing post-operative complications in cardiac surgery patients. However, compared to IPPB therapy, MI-E therapy was associated with improved pulmonary function and higher incidence of chest pain.
Potential Molecular Mechanism of the NPPB Gene in Post-Ischemic Heart Failure with and without T2DM
Authors: Guan Yao-Zong , Yin Rui-Xing , Deng Guo-Xiong , Zheng Peng-Fei , Liu Chun-Xiao , Wei Bi-Liu
Published: April 2020

Background: This study aimed to investigate natriuretic peptide B (NPPB) co-expression genes and the pathways involved in post-ischemic heart failure (HF) among patients both with and without type 2 diabetes mellitus (T2DM). Methods: The microarray dataset of GSE26887 was examined to detect the genes that co-expressed with NPPB from 19 post-ischemic HF patients’ peripheral blood samples (7 with T2DM and 12 without T2DM). NPPB co-expression genes were then screened using the R packet. Further, using online analytical tools, we determined the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis, Gene Ontology (GO) annotation, and protein-protein interaction (PPI) network of the co-expression genes. The modules and hub genes of the PPI network were then identified using the Cytoscape software. Results: In patients with T2DM, a total of 41 biological processes (BP), 20 cellular components (CC), 13 molecular functions (MF), and 41 pathways were identified. Further, a total of 61 BPs, 16 CCs, 13 MFs, and 22 pathways in patients without T2DM were identified. In both groups of patients, 17 BPs, 10 CCs, 6 MFs, and 13 pathways were enriched. We also identified 173 intersectional co-expression genes (63 positive, 106 negative, and 4 differently co-expressed in patients with and without T2DM, respectively) in both types of patients, which enriched in 16 BPs, 8 CCs, 3 MFs, and 8 KEGG pathways. Moreover, the PPI network (contained 237 edges and 170 nodes) with the top module significantly enriched in 4 BPs (the tricarboxylic acid metabolic process, citrate metabolic process, tricarboxylic acid cycle, and aerobic respiration) and 3 pathways (the citrate cycle, malaria parasite metabolic pathway, and AGE-RAGE signaling pathway in diabetic complications) was constructed. DECR1, BGN, TIMP1, VCAN and CTCF are the top hub genes. Conclusions: This study used genome-wide co-expression genes to identify the potential functions and mechanisms of the NPPB gene in post-ischemic HF with and without T2DM. Our findings may elucidate the functions and roles of NPPB in patients with post-ischemic HF and facilitate HF management. Key words: Co-expression genes, NPPB, Heart failure, Diabetes mellitus, Microarray dataset
Identification of an Immune-Related Prognostic Signature Associated with Immune Infiltration in Melanoma
Authors: Liu Nian , Liu Zijian , Liu Xinxin , Duan Xiaoru , Huang Yuqiong , Jin Zilin , Zhang Liling , Chen Hongxiang
Published: April 2020

Background: Melanoma is the leading cause of cancer-related death among skin tumors, with an increasing incidence worldwide. Few studies have effectively investigated the significance of an immune-related genes (IRGs) signature for melanoma prognosis. Methods: Here, we constructed an IRGs prognostic signature using bioinformatics methods and evaluated and validated its predictive capability. Then, immune cell infiltration and tumor mutation burden (TMB) landscapes associated with this signature in melanoma were analyzed comprehensively. Results: With the 10-IRG prognostic signature, melanoma patients in the low-risk group showed better survival with distinct features of high immune cell infiltration and TMB. Importantly, melanoma patients in this subgroup were significantly responsive to MAGE-A3 in the validation cohort. Conclusions: This immune-related prognostic signature is thus a reliable tool to predict melanoma prognosis; as the underlying mechanism of this signature is associated with immune infiltration and mutation burden, it might reflect the benefit of immunotherapy to patients.
Assessing longitudinal and cross-sectional effects of age on adult obesity in an Iranian population: results from a large population-based cohort study
Authors: Alhossaini Mahsa Rafiee , Kazemnejad Anoshirvan , Zayeri Farid , Sadeghi Masoumeh
Published: April 2020

BackgroundObesity is a significant risk factor for Noncommunicable diseases, and it is related to many adverse health consequences. The risk of obesity commonly changes with age, which is called a longitudinal or aging effect. Also, individuals born or enter to the study of the same age have similar living conditions that may influence their obesity risk in a particular way; this is a cross-sectional effect. In the current study, an advanced statistical model is used to distinguish between longitudinal and cross-sectional effects of age on the risk of obesity for men and women.MethodsParticipants are a group of 6504 Iranian adults over 35 years of age in 2001, who live in the central region of Iran. They were followed up for 12 years in a large community-based study. Various medical indexes, including Body Mass Index, were collected in 2001, 2007, and 2013. The Marginal Logistic Regression model, which includes linear and quadratic effects of the Baseline Age and its difference with current age, is used.ResultsBetween 2001 and 2013, the prevalence of obesity raised from 13% to 18% in men and from 31% to 44% in women. The odds of obesity for women was approximately three times the odds of obesity for men on average adjusting for the age effects. Both cross-sectional and longitudinal effects of age were significantly associated with the odds ratio of obesity. There was a rise in the prevalence of obesity for individuals with Baseline Age 35 to 55 and a decline thereafter. Also, the odds ratio of obesity across one’s life course, had about 3% increase, on average, by each year aging, regardless of the age at baseline.ConclusionsThe high rate of obesity and its fast growth is a serious public health issue among Iranians, especially in adults age 35-55, and women. In the present study, Baseline Age was more strongly associated with the risk of obesity than aging. Considering both cross-sectional and longitudinal effects of age, helps us to understand the effect of age on obesity better and to identify the related factors.
Three-dimensional printing simulated operation combined with robot-aided minimally invasive lumbopelvic fixation in treatment of unstable bilateral sacral fractures: technical notes and 8 case series
Authors: liu Zhaojie , Tian Wei , Jin Xin , Qi Haotian , Sun Yuxi , Hu Yongcheng , Jia Jian
Published: April 2020

Background Despite their seldom appearance, unstable bilateral sacral fractures are severe injuries and always cause surgical management difficulties. Lumbopelvic fixation is reliable for rigid method, but wound-related complications with open procedure have been relatively common. Methods Data of 8 patients with unstable bilateral sacral fractures who were treated surgically in our institution from March 2016 to April 2019 were retrospectively analyzed. There were 5 men and 3 women with an average age of 38.5 years (range, 19-60years). According to the sharp of sacral fractures, there were one case with simple bilateral vertical fracture lines, 6 cases with “U” and one case with “H”. According to Roy-Camille classification, 7 of 8 sacral fractures involving sacral canal were classified with type I 2 cases, type II 4 cases and type III 1 case. Three-dimensional(3D) printing pelvis were performed to simulate lumbopelvic and sacroiliac screw fixation for preoperative planning. Eight bilateral sacral fractures were treated with minimally invasive lumbopelvic fixation under robotic guidance. Results The screws inserted with robotic assistance were exposed to radiation with an average of 41.6±10.2 times (range, 27–53 times) intraoperatively. The total fluoroscopy time was 32–59 s, and the average fluoroscopy time for each screw was 4.2±0.6s. According to modified Gras classification of screw position, there were Grade I in 7 cases and Grade II in one case (left S1 screw). The average operation time was 150.6 min (range, 95-220 min), and intraoperative blood loss was 87.5 ml (range, 60-120 ml). Eight patients were followed up consecutively for at least 12 months, with an average of 17.0 months (range, 12–24months). No patient suffered a neurovascular injury intraoperatively. There were no incision-related complications. All fractures healed with an average time of 4.2 months (range, 3–10 months). According to Majeed functional assessment investigation, the mean score was 88.4 points (range, 78–98 points), which were graded as follows: 5, excellent and 3, good. Conclusion Under robot guidance, minimally invasive lumbopelvic fixation for unstable bilateral sacral fractures is a feasible option with the advantages of accuracy, less radiation and safety. Simulated operation with 3D printing for preoperative planning can simplify the actual surgery.
Factors Related to Sexual Satisfaction in Women with Gestational Diabetes in the Third Trimester
Authors: zare ommolbanin , simbar masoumeh , ozgoli giti , bahar adaleh , majd hamid alavi
Published: April 2020

Background: Sexual satisfaction is important for maintaining pregnant women’s self-esteem and interpersonal relationships, and serves as a major indicator of health. Affecting a woman's sexual issues will indirectly affect her quality of life. The present study aimed to examine the factors related to sexual satisfaction in women with gestational diabetes in the third trimester. Method: This cross-sectional descriptive-analytic study was conducted in 2019 on 120 women with gestational diabetes visiting the clinics affiliated with Mazandaran University of Medical Sciences. Multistage random cluster sampling was performed, and the sample was selected in a non-probability and convenience manner. The data collection instruments included a demographic and midwifery-related information questionnaire, Hudson’s Index of Sexual Satisfaction, the Female Sexual Function Index, ENRICH Marital Satisfaction Scale (short version), the Female Sexual Distress Scale, The World Health Organization Quality of Life questionnaire, the Parental Distress Questionnaire, and the Depression, Anxiety, and Stress Scale. Data were analyzed in SPSS 23 by using descriptive statistics, chi-squared test, t-test, ANOVA, Pearson’s correlation coefficient, Kruskal-Wallis test, Mann-Whitney U test, and Spearman correlation coefficient. Results: Results showed that about 50% of women with gestational diabetes had low and moderate sexual satisfaction. In women with gestational diabetes, sexual satisfaction was positively correlated with sexual function (β = 0.215, p = 0.02) and marital satisfaction (β = 0.298, p = 0.003), and negatively correlated with depression (β = -0.269, p = 0.05). Conclusion: Half of the women with gestational diabetes had low and moderate sexual satisfaction. Marital satisfaction, sexual function, and depression significantly predicted sexual satisfaction in women with gestational diabetes. Examination of sexual function, marital satisfaction, and depression must be part of the routine evaluation for women with gestational diabetes. To increase the sexual satisfaction of these women, it is essential to offer interventions for reducing depression and improving sexual function, marital satisfaction and, thus, their quality of life. Keywords: Sexual satisfaction, gestational diabetes, pregnancy
Gastrointestinal Bleeding in Patients Admitted to Cardiology: risk factors and a new risk score
Authors: Zhang Ming , Liu Demin , Wang Qian , Geng Xue , Hou Qian , Gu Guoqiang , Xie Ruiqin , Cui Wei
Published: April 2020

Background: Although the early use of a risk stratification score in gastrointestinal bleeding(GIB) is recommended, there has been no risk score for GIB in patients admitted to cardiology so far.Objective:To describe the risk factors of GIB and develop a new risk score model in patients admitted to cardiology. Methods: A total of 633 inpatients with GIB from January 2014 to December 2018 were recruited, 4,231 inpatients with non-GIB recruited as the control group. Multivariate logistic regression was used to describe the risk factors of GIB,A new risk score model was developed in the derivation cohort. Accuracy to predict GIB was assessed by the area under the receiver operating characteristic (AUROC) curve in the validation cohort.Results: Male, coronary heart disease, hypertension, stroke, systolic blood pressure, hematocrit, plasma albumin and alanine aminotransferase(ALT) were associated with GIB . The model had a high predictive accuracy (AUROC 0.816; 95%CI, 0.792-0.839), which was supported by the validation cohort (AUROC 0.841; 95% CI, 0.807~0.874). Besides,the prediction of the model better than HAS-BLED score(AUROC 0.557; 95%CI, 0.513~0.602) and CRUSADE score(AUROC 0.791; 95%CI, 0.757~0.825), respectively. Among the inpatients with a score 0-3, 4-7, and ≥8 points, the incidence of GIB, the proportion of inpatients requiring suspended red blood cells transfusion, length of stay and in-hospital mortality all increased gradually(P< 0.001). Conclusions: Male, coronary heart disease, hypertension, stroke, systolic blood pressure, hematocrit, plasma albumin and ALT are associated with GIB. The new risk score model is an accurate risk score that predicts GIB in patients admitted to cardiology.
Oral health related quality of life and satisfaction with dental condition of school age children with dental pain in Ibadan, Nigeria
Authors: Lawal Folake , Oke Gbemisola Aderemi
Published: April 2020

Background: Pain of dental origin is a major reason why school age children seek dental care in low resource settings but how it affects their oral health related quality of life and satisfaction with dental condition remains under researched. The aim of the study was to determine the impact of dental pain on oral health related quality of life as well as its association with satisfaction with dental condition of school age children in Ibadan, Nigeria. Methods: This cross-sectional study was conducted among 1006 pupils aged 9-12 years who attended randomly selected primary schools in Ibadan, Nigeria. An interviewer administered questionnaire, Child–Oral Impact on Daily Performances inventory (C-OIDP) in addition to oral examination was used to obtain data. Analysis was done with SPSS version 23 and p value < 0.05 was considered significant. Results: The prevalence of self-reported dental pain was 10.2%. The mean C-OIDP score was 2.6 (±7.2) overall and 9.8 (±12.4) for pupils with pain. There was higher impact on oral health related quality of life of respondents who reported dental pain than those who did not (Mean Rank = 749.54 vs 475.4, U = 21162, Z = -12.724, p < 0.001) compared to those with and without clinically assessed pain (Mean Rank = 541.21 vs 502.97, U = 6416, Z = - 0.692, p = 0.489). Those who reported dental pain were more dissatisfied with their dental condition (OR = 7.7, CI = 5.0 – 12.0, P < 0.001) compared to those with clinically assessed dental pain (OR = 1.3, CI = 0.4 – 4.9, p = 0.687). Children with self-reported dental pain and who were dissatisfied with their dental condition reported highest odds of impairment in maintaining social contact (OR = 6.5, CI =0.7 - 58.3, p = 0.093). Conclusion:Self-reported dental pain significantly impacted the quality of life of the pupils and caused dissatisfaction with dental condition when compared to clinically assessed pain.
Medical Cost and Healthcare Utilization of Amyotrophic Lateral Sclerosis in China: A Study Based on Hospital Data from 2015 to 2018
Authors: Song Han , Liu Jianchao , Cao Zipeng , Luo Wenjing , Chen Jingyuan
Published: April 2020

Background: Amyotrophic Lateral Sclerosis (ALS), a specific neurodegenerative disease, imposed increased economic and utilizations burden on the healthcare system, especially with the progress of the diseases severity. However, the economic burden on Chinese ALS patients remained unclear. This study therefore was aimed to investigate medical cost and healthcare utilization for Chinese ALS patients.Methods: Longitudinal health data of over 20 million individuals, including military personnel and civilians, was collected from all Chinese military hospitals. We identified 480 patients with a first major diagnosis for ALS from 2015 to 2018, while matched 400 controlled patients on age, gender, ethnic group, geographic region, length of stay, year of diagnosis and comorbidity. Their medical cost and healthcare utilizations were then measured 1 year before, and 1 year after ALS diagnosis. Results: The median annual medical cost of ALS patients was about two-fold higher, 17,087 CNY during the index year than 1 year before, 7,859 CNY. The highest increase in utilizations may account for medical costs on ALS patients, which was represented by hospitalizations (Odd Ratio (OR)=4.26, 95% Confidence Interval (CI) 3.52, 5.15), Electromyography (EMG) (OR=4.14, 95% CI 2.37, 7.22), Nerve Conduction Velocity (NCV) (OR=3.26, 95% CI 2.23, 4.77).Conclusions: This study is the first one reporting direct economic burden on Chinese ALS patients. Efforts should be made to develop cost-effective diagnostic tools in order that sources of medical cost were more effectively allocated, and this disease was detected earlier.
Ethnomedicinal Knowledge of Pwo People in Northern Thailand
Authors: Pongamornkul Wittaya , Muangyen Nattee , Phookaphin Benjaporn , Panyadee Prateep , Inta Angkhana
Published: April 2020

Background: Northern Thailand is the home of many ethnic groups who possess great knowledge of ethnomedicine, so it is the location with the highest number of ethnobotanical studies in Thailand. However, the Pwo have never been included in. Therefore, this study is the first ethnobotanical study of Pwo people. Methods: In this study, 50 Pwo informants from 8 villages in Omkoi district were interviewed about their ethnomedicinal knowledge. They were asked about the vernacular name(s) and uses of plant species found in their villages and nearby forests. Results : A total of 122 ethnomedicinal species with 930 use-reports were recorded. Leaves were the most preferred plant part and decoction was the most preferred preparation method. Herbs were the most favored life form of ethnomedicinal plants used by Pwo people. Asteraceae, Fabaceae, and Zingiberaceae were the three most dominant plant families, which contributed 22% of the total species. Most plants with high Use value (UV) values were common species which also found and reported in other ethnobotanical studies however, the exception was Garcinia pedunculata Roxb. ex Buch.-Ham. Although only a single individual was found in nearby forests, but it was commonly used by Pwo people in the studied sites. The five ailments with high recorded IAR included: injuries, muscular-skeletal system, pain, respiratory systems, and digestive systems. These ailments were directly related to the life-style of Pwo people. Conclusion : The comparison between the species found in this study and a study of Sgaw Karen in a nearby area showed that their knowledge differed from each other in both species and their uses despite their close proximity. The results emphasize the importance and the need of ethnobotanical studies although in the areas where many studied have been carried out. The more understanding of the traditional knowledge would increase our chance of understanding and identification of medicinal properties of plants. The results would lead to the discovery and development of new pharmaceutical substances to improve human life quality.