bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictive Value of D-dimer on Mortality in Patients with Acute Aortic Dissection
Authors: Li Shuangshuang , Du Pengcheng , Dong Jian , Zhou Jian , Jing Zaiping
Published: December 2020

ObjectiveTo clarify the relation between D-dimer and in-hospital mortality of acute aortic dissection, a meta-analysis was performed by summarizing all relevant studies.MethodsAll related studies were retrieved and identified in PubMed and Embase databases. Precise data was extracted from standard articles, such as sample size, odds ratio, and 95% confidence interval. Then pooled odds ratio (OR) accompanying 95% confidence interval (CI) were calculated using random model. Study heterogeneity examined by Q text and I2 statistic. Sensitivity analysis was performed to assess the stability of the results. Publication bias was assessed by Egger’s test. ResultsTen studies (1954 patients) that met the inclusion criteria were included in this review. The results suggested a link between D-dimer and in-hospital mortality of acute aortic dissection (OR=1.17 95%CI=1.08-1.27). With higher of cutoff value of D-dimer, the closer for the mortality of AAD, with ORs (95% CIs) ranging from 1.13(1.09–1.16) to 4.12 (1.56–10.93). The relationship was also found in six Type A AAD studies without heterogeneity (OR=1.13 95%CI=1.08-1.18). According to sensitivity analysis, the link was stable after exclusion of one study at a time. Publication bias was find among studies (P=0.02). ConclusionsThe result of this meta-analysis indicated that D-dimer maybe a predictor in-hospital mortality of acute aortic dissection patients. What’s more, the higher of cutoff value of D-dimer, the stronger for the predictive ability.
Non Applicability of Validated Predictive Models for Intensive Care Admission and Death of COVID-19 Patients in a Secondary Care Hospital in Belgium.
Authors: Parisi Nicolas , Janier-Dubry Aurore , Ponzetto Ester , Pavlopoulos Charalambos , Bakalli Gaetan , Molinari Roberto , Guerrier Stéphane , Mili Nabil
Published: December 2020

BackgroundSimple and reliable predictive scores for intensive care admissions and death based on clinical data are still lacking. The goal of this study is to implement such scores based on patients coming from our population catchment area and to compare them to available ones. These scores adhere to the TRIPOD (transparent reporting of a multivariable prediction model for individual prognosis or diagnosis) reporting guidelines.MethodsMonocentric retrospective cohort study run from early March to end of May in Clinique Saint-Pierre Ottignies, a secondary care hospital located in Ottignies-Louvain-la-Neuve, Belgium. The outcomes of the study are (i) admission in the Intensive Care Unit and (ii) death. All patients admitted in the Emergency Department with a positive RT-PCR SARS-CoV-2 test were included in the study. Routine clinical and laboratory data were collected at their admission and during their stay. Chest X-Rays and CT-Scans were performed and analyzed by a senior radiologist. A recently published predictive score conducted on a large scale was used as a benchmark value (Liang score)1. Logistic regressions were used to develop predictive scores for (i) admission to ICU among emergency ward patients; (ii) death among ICU patients on 40 clinical variables. These models were based on medical intuition and simple model selection tools. Their predictive capabilities were then compared to Liang score. ConclusionsOur results suggest that Liang score may not provide reliable guidance for ICU admission and death. Predictive score based on a large-scale Chinese study cannot be applied in the Belgian population, suggesting a predominant role in genetic factors for SARS-CoV-2 susceptibility. In our small cohort, it appears that LDH above 579 UI/L and venous lactate above 3.02 mmol/l may be considered as good predictive biological factors for ICU admission. With regards to death risk, Neutrophil/lymphocyte ratio above 22.1, tobacco abuse status and respiratory impairment appears to be relevant predictive factors. Predictive score for admission to ICU or death based on clinical data are still needed in secondary hospital and hospitals in developing countries that do not have high-performance laboratories. Optimal allocation of resources guided by evidence-based indicators will best guide patients at time of admission and avoid futile treatments in intensive care units.
Influence of Insurance Type on Rate and Type of Initial Concussion-Related Medical Visits among Youth
Authors: Radlicz Chris , Jackson Kenneth , Hautmann Amanda , Shi Junxin , Yang Jingzhen (Ginger)
Published: December 2020

Background: A growing number of studies report increased concussion-related health care utilization in recent years, but factors impacting care-seeking behaviors among youth following a concussion are not well described. This study aimed to evaluate the influence of insurance type on the rate and type of initial concussion visits and the time from injury to the initial visit in youth. Methods: We extracted and analyzed initial concussion-related medical visits for youth ages 10 to 17 from electronic health records. Patients must have visited Nationwide Children’s Hospital’s (NCH) concussion clinic at least once between 7/1/2012 and 12/31/2017. We evaluated the trends and patterns of initial concussion visits across the study period using regression analyses.Results: Of 4,955 unique concussion visits included, 60.1% were males, 80.5% were white, and 69.5% were paid by private insurance. Patients’ average age was 13.9 years (SD=3.7). The rate of the initial concussion visits per 10,000 NCH visits was consistently higher in privately insured than publicly insured youth throughout the study period (P < .0001). Privately insured youth had greater odds of initial concussion visits to sports medicine clinics (AOR = 1.45, 95% CI = 1.20, 1.76) but lower odds of initial concussion visits to the ED/urgent care (AOR = 0.74, 95% CI = 0.60, 0.90) than publicly insured youth. Days from injury to initial concussion visit significantly decreased among both insurance types throughout the study (P < .0001), with a greater decrease observed in publicly insured than privately insured youth (P = .011).Conclusions: Results on the differences in the rate, type, and time of initial concussion-related visits may help inform more efficient care of concussion among youth with different types of insurance.
Influence of Socio-Spatial Determinants on Knowledge, Attitudes and Practices Related to the Plague in Populations Living in Endemic Areas in the Central Highlands of Madagascar
Authors: Rakotosamimanana Sitraka , Rakotoarimanana Feno Jacob , Raharimanga Vaomalala , Taglioni François , Ramamonjisoa Josélyne , Randremanana Rindra Vatosoa , Rajerison Minoarisoa , Rakotomanana Fanjasoa
Published: December 2020

Background: Plague is endemic to the central highlands of Madagascar. Sporadic human cases or outbreaks can occur annually in these areas. In Madagascar, the association between endemicity and the knowledge, attitudes and practices (KAP) of populations with regard to this disease remain poorly documented. The aim of this study was to assess KAP related to the plague of populations living in the central highlands. Methods: A cross sectional survey was conducted among the general population from June to August 2017. Based on the reported cases of plague between 2006 and 2015 in two central highland districts, a KAP questionnaire was administered to the population. Based on the proportion of correct answers provided by respondents, KAP scores were classified into three KAP categories: low (< Mean - SD), average (Mean ± SD) and good (> Mean + SD). Multivariate analyses were performed to determine the associations between population KAP scores related to plague with socio-demographic and epidemiological factors. In addition, individual interviews and focus groups with health professionals were conducted to assess plague perception.Results: A total of 597 individuals participated in the survey. Around 20% (n=119) had a good KAP score, 62% (n=370) an average KAP score and 18% (n=108) a low KAP score. Among the 119 respondents with a good KAP score, 80% (n=95) of them resided in Ambositra district and 20% (n=24) resided in Tsiroanomandidy district. According to the health professionals in the two districts, populations in endemic areas are well aware of the plague. A significant association with a lower KAP score was found in populations without mobile phone, having no contact with a former plague case and living in Tsiroanomandidy district (p<0.05).Conclusion: The results of the study showed the need to adapt plague control interventions to the local context to allow a better allocation of human and financial resources. This will minimize delays in patient management care and increase community resilience to plague epidemics.
Grave Thoraco-Intestinal Complication Secondary to an Undetected Traumatic Rupture of the Diaphragm - A Case Report
Authors: Beshay Morris , Krüger Martin , Singh Kashika , Borgstedt Rainer , Benhidjeb Tahar , Boelke Edwin , Vordemvenne Thomas , Esch Jan Schulte am
Published: December 2020

BackgroundDiaphragmatic lesions as a result from blunt or penetrating trauma are challenging to detect in the initial trauma setting. This is especially true when diaphragmatic trauma is part of a polytrauma. Complications of undetected diaphragmatic defects with incarcerating bowel are rare but as in our patient can be serious. Case presentationA 57-year-old female presented to the Emergency Room of our Hospital in a critical condition with 3 days of increasing abdominal pain. The initial clinical examination showed peritonism with tinkling peristaltic bowel sounds of mechanical obstruction. A thoraco-abdominal CT-scan demonstrated colon prolapsed through the left diaphragmatic center with a large sero-pneumothorax under tension. As the patient was hemodynamically increasingly unstable with developing septic shock an emergency laparotomy was performed. After retraction of the left colon, which had herniated through a defect of the tendinous center of the left diaphragm and was perforated due to transmural ischemia, large amounts of feces and gas discharged from the left thorax. A left hemicolectomy resulting in a Hartmann type procedure was performed. A fully established pleural empyema required meticulous debridement and lavage conducted via the 7-10cm in diameter phrenic opening followed by a diaphragmatic defect reconstruction. Due to pneumonia and recurring pleural empyema redo-debridement of the left pleural space via thoracotomy were required. The patient was discharged on day 56. A thorough history of possible trauma revealed a bicycle-fall-trauma 7 months prior to this hospitalization with a surgically stabilized fracture of the left femur and conservatively treated fractures of ribs 3-9 on the left side. ConclusionThis is the first report on a primarily established empyema at the time of first surgical intervention for faeco-pneumothorax secondary to delayed diagnosed diaphragmatic rupture following abdomino-thoracic blunt trauma with colic perforation into the pleural space, requiring repetitive surgical debridement in order to control local and systemic sepsis. Thorough investigation should always be undertaken in cases of blunt abdominal and thoracic trauma to exclude diaphragmatic injury in order to avoid post traumatic complications.
An Association Rule Analysis of Acupressure Effect on Sleep Quality
Authors: Jia Guhua , Tzeng I-Shiang , Wu Chieh-Chen
Published: December 2020

Background: Sleep is recognized as an all-important physiological process, which also contributes to maintaining several bodily functions and systems. Insufficient sleep can induce many serious side effects and have an impact on human health in general. There are five consequences of lack of sleep, including an increased chance of morbidity and mortality, poor judgment, increased risk of accidents and injuries, reduced level of functioning, and an inferior quality of life. According to the Pittsburgh Sleep Quality Index (PSQI), also known as the most widely used tool in the field of subjective assessment of self-perceived sleep quality, a combination of acupoints could be more effective than single acupoint treatment in improving sleep quality. Methods: This study has been proved based on a previous meta-analysis that consisted of some relevant studies. The present study was based on the extracted randomized control trials (RCTs) rooted in a previous meta-analysis that worked on the basis of association rule mining and examined the potential kernel acupoint combinations for improving sleep quality. Results: Depending on the Apriori algorithm, we summarized 26 acupoints as binary data from the 32 eligible RCTs and analyzed them. The top 10 most frequently selected acupoints were HT7, SP6, PC6, KI1, GV20, Taiyang, Yintang, Anmian, KI3, and Ear Shenmen. Furthermore, as deduced from 21 association rules, the primary relevant rules in the combination of acupoints are {Yintang, Anmian}=>{GV20} and {HT7, KI1}=>{PC6}. Conclusions: In order to use acupuncture to improve sleep quality, integrating {Yintang, Anmian, GV20} with {HT7, KI1, PC6} acupoints could be deemed as the kernel acupoint combination.
Cluster Analysis of Phenotypes of Patients with Behçet's Syndrome: A Large Cohort Study from a Referral Center in China
Authors: Zou Jun , Luo Jian-feng , Shen Yan , Cai Jian-fei , Guan Jian-long
Published: December 2020

Introduction: Behcet’s syndrome (BS) is a complex, heterogeneous disorder. However, classification of its subgroups is still debated. The purpose of this study was to investigate the clinical features and aggregation of patients with BS in China, based on manifestations and organ involvements.Methods: This was a cross-sectional study of BS patients in Huadong Hospital of Fudan University between September 2012 and January 2020. We calculated relative risks (RRs) of clinical variables according to sex. Moreover, we conducted a hierarchical cluster analysis applied according to eighteen variables to determine subgroups of patients.Results: A total of 860 BS patients were included. Male sex was associated with ocular involvement (RR 2.32, 95% CI: 1.67, 3.22, P < 0.0001), vascular involvement (RR 2.00, 95% CI: 1.23, 3.23, P = 0.004), cardiac lesion (RR 5.46, 95% CI: 2.33, 12.77, P < 0.0001) and central nervous system involvement (RR 2.73, 95% CI: 1.10, 6.76, P = 0.025) and was negatively associated with genital ulcers (RR 0.84, 95% CI: 0.79, 0.91, P < 0.0001). Five clusters (C1–C5) were observed. C1 (n=307) showed the skin and mucosa type. In C2 (n=124), all had articular involvement, barely having major organ involvement except for 18 cases with intestinal lesions. In C3 (n=156), the gastrointestinal type, 144 patients presented with intestinal involvement, and 36 patients with esophageal ulcers. In C4 (n=142), all subjects presented with uveitis. C5 (n=131) consisted of 44 patients with cardiac lesions, 58 with vascular involvement and 26 cases having central nervous system involvement.Conclusion: Our analysis confirmed sex differences in phenotypes of BS. Cluster analysis identified gastrointestinal, uveitis and cardiovascular involvement cluster separately in different subsets,which represents the most commonly involved organs. Further research is required to replicate and clarify the patterns of phenotype in BS.
Gene Dysregulation in Peripheral Blood of Young Females With Temporomandibular Joint Osteoarthritis
Authors: Kang Jeong Hyun
Published: December 2020

BackgroundEarly onset of the disease and female preponderance are the unique features of the temporomandibular joint (TMJ) osteoarthritis (OA). The immune modulation mechanisms related to etiology of OA from other joints such as knee or hip have been suggested, but the immune-associated pathophysiology of TMJ OA, especially in young females, has not been elucidated. The present study aimed to investigate the immune-related pathophysiology of TMJ OA by analyzing transcriptional profiles of peripheral blood mononuclear cells which identify the differentially expressed genes (DEGs) in young females with TMJ OA. MethodsRNA-sequencing (RNA-seq) was conducted on 24 young females with TMJ OA (mean age 19.3 ± 3.1 years) (RNAOA) and 11 age and sex matched healthy control (mean age 20.5 ± 3.7 years) (CON). RNA-seq datasets were analyzed to identify genes, pathways, and regulatory networks of those who were involved in the development of TMJ OA. ResultsRNA-seq data analysis revealed 41 DEGs between RNAOA and CON. A total of 16 gene ontology (GO) terms including 3 molecular and 13 biological terms were annotated via the GO function of molecular function and biological process. Through ingenuity pathway analysis (IPA), 21 annotated categories of diseases and functions were identified. There were six hub genes which showed significant results in both GO enrichment analysis and IPA, namely HLA-C, HLA-F, CXCL8, IL11RA, IL13RA1, and FCGR3B. Conclusions﻿The young females with TMJ OA showed alterations of the gene related to immune function in the blood and some of the changes may reflect inflammation, auto-reactivity, and altered T cell functions.
The Effect of Toric Intraocular Lens Implantation in Irregular Corneal Steep and Flat Meridian.
Authors: Hwang Ho Sik , Kim Hyun Seung , Kim Man Soo , Kim Eun Chul
Published: December 2020

Purpose: To evaluate the effect of toric intraocular lens implantation in cataract patients with irregular corneal steep and flat meridian. Methods: Data of 112 eyes of 78 patients who underwent toric intraocular lens implantation were analyzed retrospectively. Steep meridian deviations (not 180 degrees) and steep and flat meridian deviations (not 90 degrees) were classified as 0, 1~9, 10~19, 20~29, 30~39, and over 30 degrees. Meridian deviation was measured with Sagittal map of rotating Scheimpflug camera (Pentacam®: Oculus, Wetzlar, Germany) using PicPickTools (NGWIN, Seoul, Korea). Results: Residual astigmatism (D) of the 0 (0.48±0.12, 0.53±0.12) and the 1~9 (0.59±0.15, 0.63±0.17) were significantly lower than those of 10~19 (0.85±0.21, 0.85±0.26), 20~29 (0.96±0.31, 0.99±0.34), and over 30 degrees groups (1.06±0.36, 1.02±0.38) both in steep meridian deviations and horizontal and vertical meridian deviations at 2 months (P< 0.05). Postoperative mean UCVA (logMAR) of 0 (0.08±0.03, 0.08±0.03) (logMAR) and 1~9 (0.09 ± 0.04, 0.08 ± 0.04) were significantly improved compared to those of 10~19 (0.13±0.04, 0.15±0.05), 20~29 (0.16±0.05, 0.17±0.05), and over 30 degrees groups (0.19±0.07, 0.18±0.06) both in steep meridian deviations and horizontal and vertical meridian deviations (P< 0.05).Conclusions: Correction of astigmatism with toric intraocular lens implantation is not accurate in cornea with steep meridian deviations and steep and flat meridian deviations of more than 10 degrees. Therefore, care should be taken when we perform toric intraocular lens implantation in patients with irregular corneal meridian.
Impaired Hypoxic Ventilatory Drive Induced by Diabetic Autonomic Neuropathy, A Cause of Misdiagnosed Severe Cardiac Events. Brief Report of Two Cases.
Authors: Schubert Louis , Laroche Suzanne , Hartemann Agnès , Bourron Olivier , Phan Franck
Published: December 2020

Background: Sudden cardiac death are twice more frequent in diabetic patients with cardiac autonomic neuropathy. Sudden cardiac death etiologies remain unclear and no recommendation are made to identify factor associated with cardiorespiratory arrest in diabetic patients. We hypothesized, from two clinical cases, that impaired hypoxic ventilatory drive, induced by diabetic autonomic neuropathy, is a cause of misdiagnosed severe cardiac events.Case presentation: We describe the cases of two patients with isolated low blood saturation on pulse oximeter during the systematic nurse check-up (77% and 85% respectively) contrasting with the absence of any complaint as well as any dyspnea, polypnea or other respiratory insufficiency signs observed during the clinical examination. Arterial blood gas measurements subsequently confirmed that blood saturation was low and that both patients were indeed hypoxemic. Patient 1 suffered of vascular overload complicated by cardiac arrest caused by hypoxemia in light of the quick recovery observed after ventilation. Pulmonary edema was diagnosed in patient 2. The common denominator of these 2 cases described in this brief report is the absence of respiratory failure clinical signs contrasting with the presence of confirmed hypoxemia. Also, in both cases, such absence of precursory signs seems to be induced by an impaired ventilatory drive to hypoxemia. This appears to be related to the autonomic diabetic neuropathy encountered in those 2 patients.Conclusions: Therefore, we describe, in this brief report, cardiac autonomic neuropathy as a cause of impaired hypoxic ventilatory drive involved in severe acute cardiorespiratory events in two type 1 diabetic patients. We assume that altered response to hypoxemia due to cardiac autonomic neuropathy and non-functional central neurological breathing command could play a key role in sudden deaths among diabetic patients. A point to emphasize is that hypoxemia can be easily missed since no clinical signs of respiratory failure are reported in these two clinical cases. Systematic screening of cardiac autonomic neuropathy in diabetic patients and proactive detection of impaired hypoxic ventilatory drive for early management (e.g. treatment of hypoxemia) should be systematically undertaken in diabetic patients to prevent its dramatic consequences such as cardiorespiratory arrest and death.
Electron Liquid State in the Symmetric Anderson Lattice
Authors: Karnaukhov Igor
Published: December 2020

Using mean field approach, we provide analytical and numerical solution of the symmetric Anderson lattice for arbitrary dimension at half filling. The symmetric Anderson lattice is equivalent to the Kondo lattice, which makes it possible to study the behavior of an electron liquid in the Kondo lattice. We have shown that, due to hybridization (through an effective field due to localized electrons) of electrons with different spins and momenta k and k+→π, the gap in the electron spectrum opens at half filling. Such hybridization breaks the conservation of the total magnetic momentum of electrons, the spontaneous symmetry is broken. The state of electron liquid is characterized by a large Fermi surface. A gap in the spectrum is calculated depending on the magnitude of the on-site Coulomb repulsion and value of s-d hybridization for the chain, as well as for square and cubic lattices.
WITHDRAWN: Morphological and Biochemical Changes in the Rat Ovaries Following Electromagnetic Field Exposure
Authors: Kanbur Savaş , ONGER Mehmet Emin
Published: December 2020

PurposeThis study aims to investigate the effect of electromagnetic field (EMF) exposure which is environmental toxic agent on rat ovary. MethodsA total of 30 female Wistar albino rats are randomly divided into three groups (n=10) as Control, Sham, and EMF groups. The rats are not exposed any processes in Control group. The rats are kept in special cage for the same duration as in the EMF group without any EMF exposure in Sham group while the rats are exposed to 900 MHz EMF with a special mechanism in EMF group. At the end of day 28, the ovarian tissues are collected. Stereological and biochemical examinations are performed.ResultsConcerning the GSI values, there are statistical differences between the Control and EMF (p=0.001), and Sham and EMF (p=0.001) groups, respectively. There are also statistical differences between Control and EMF groups in terms of volumetric parameters including medullary, and follicular antral volumes. Regarding the biochemical parameters, there are statistically differences between the Control and EMF (p=0.000), and Sham and EMF (p=0.000) groups, respectively.Conclusion﻿It may be concluded that exposure to a 900-MHz EMF leads to changes in ovarian follicle volumes which may affect the ovarian reservoir.
Mitochondrial Phosphoenolpyruvate Carboxykinase (PCK2) Maintains the Function of Bone Marrow Mesenchymal Stromal/stem Cells to Rescue Osteoporotic Phenotype Partly Through Autophagy Dependent Manner
Authors: Li Zheng , Liu Xuenan , Liu Xuejiao , Du Yangge , Zhu Yuan , Lv Longwei , Zhang Xiao , Liu Yunsong , Zhang Ping , Zhou Yongsheng
Published: December 2020

BackgroundMitochondrial phosphoenolpyruvate carboxykinase (PCK2) is a rate-limiting enzyme that plays critical roles in multiple physiological processes. We unveiled the important role of PCK2 on the regulation of osteogenesis by mesenchymal stromal/stem cells (MSCs) in our previous work. Here we further investigated the roles of PCK2 on regulating adipogenesis of MSCs and its therapeutic effect on osteoporosis. MethodsWe investigated PCK2 function in adipogenic differentiation of MSCs in vitro through loss-and-gain-of-function experiments. This was followed by heterotopic adipose formation assay in nude mice. In addition, ovariectomized (OVX) and aged mice were used as osteoporotic models to test the effect of PCK2 on osteoporosis. The bone formation and adipocyte accumulation were assessed by micro-CT and histological analysis. The multipotent capacity of control and osteoporotic BMMSCs were evaluated by quantitative real time-polymerase chain reaction (qRT-PCR) and western blot analysis. ResultsPCK2 expression levels were signiﬁcantly decreased in BMMSCs from OVX and aged mice. Furthermore, PCK2 could inhibit adipogenesis of BMMSCs and thus resisting lipid droplet formation and attenuating bone loss in osteoporotic mice. Mechanistically, we detected that autophagy level was decreased in BMMSCs of osteoporotic mice, while overexpression of PCK2 in vivo could rescued the autophagy activity. We further indicated that PCK2 could reverse osteopenia phenotype and adipose formation in OVX and aged mice partially via autophagy.Conclusions﻿Collectively, we suggested that PCK2 could attenuate bone loss and adipocyte accumulation of BMMSCs in osteoporotic mice through autophagy dependent manner. Our study indicated that PCK2 could be a brand and effective therapeutic target for osteoporosis treatment.
An Immune-Related Long Noncoding RNA Signature as a Prognostic Biomarker for Human Endometrial Cancer
Authors: Wang Ziwei , Liu Yan , Zhang Jun , Zhao Rong , Zhou Xing , Wang Hongbo
Published: December 2020

Endometrial cancer is one of the most common malignant tumors threatening women's health. Recently, immunity and long noncoding RNA (lncRNA) have become hot topics in oncology. Here, to search for prognostic biomarkers, immune-related lncRNAs were identified by collecting endometrial cancer samples’ information from The Cancer Genome Atlas (TCGA) database, and immune-related genes from Gene set enrichment analysis (GSEA) gene sets. These included ELN-AS1, AC103563.7, PCAT19, AF131215.5, LINC01871, AC084127.1, NRAV, SCARNA9. AL049539.1, POC1B-AS1, AC108134.4, and AC019080.5. Models based on these 12 immune-related lncRNAs were constructed. Survival analysis showed that the survival rate in the high-risk group was significantly lower than in the low-risk group. Independent prognostic analysis results showed that the patient's age, pathological grade, FIGO stage, and risk status were risk factors. Clinical correlation analysis showed that the 12 immune-related lncRNAs correlated with patients’ age, pathological grade, and FIGO stage. After principal component analysis and functional annotation, to further determine the effects of these lncRNAs on prognosis, samples were divided into training and validation groups. Multivariate Cox regression analysis of the training group showed that the patient's age, FIGO stage, and risk status were prognostic risk factors. A nomogram constructed with the risk factors was used to estimate the patient's survival rate. C-indexes were calculated and multi-index ROC curves were plotted to evaluate the accuracy and stability of the nomogram. Finally, Kaplan-Meier survival analysis showed that age, pathological grade, FIGO stage, and risk status were all related to patients’ survival. In summary, we identified 12 immune-related lncRNAs that affect the prognosis of endometrial cancer, and that may act as therapeutic targets and molecular biomarkers for the disease.
Innovative Method for Amplatzer Device Implantation in Patients With Bronchopleural Fistulas
Authors: Zhang Jisong , Hu Huihui , Xu Li , Xu Shan , Zhu Jihong , Wu Fengjie , Chen Enguo
Published: December 2020

Background: Bronchopleural fistula (BPF) is a relatively rare complication after various types of pulmonary resection. The double-sided mushroom-shaped occluder (Amplatzer device, AD) has been gradually used for BPF blocking due to its reliable blocking effect. We have improved the existing AD implantation methods to facilitate clinical use and named the new approach the Sheath-free method (SFM the aim of the present report was to explore the reliability and advantages of SFM for AD implantation.Methods: We improved the existing placement methods by abandoning the sheath of the AD and using the working channel of the bronchoscope to directly store or release the AD without the use of general anesthesia, rigid bronchoscopy, fluoroscopy, or bronchography. A total of 6 patients (5 men and 1 woman, aged 66.67±6.19 years [mean ± SD]) had bronchopleural fistulas sealed using the SFM for AD implantation. Results: Closure was successfully performed in all 6 patients with the SFM, and the average duration of operation was 16.17 minutes (16.17±4.67 minutes [mean ± SD]). Five patients achieved complete occlusion after the operation, and 1 patient who had multiple fistulas did not. No patients died due to operation complications and BPF recurrence. The average follow-up time was 13.2 months (range: 10-17 months).Conclusion: We observed that the SFM for AD implantation—with accurate device positioning and a clear field of vision—is efficient and convenient. The AD is effective in BPF sealing, and patient symptoms significantly improved after sealing.
In Vivo Brain Region-specific TSPO Imaging by PET/MRI [18F]FEPPA
Authors: Chang Chi-Wei , Chiu Chuang-Hsin , Lin Ming-Hsien , Wu Hung-Ming , Yu Tsung-Hsun , Wang Pao-Yeh , Kuo Yu-Yeh , Huang Ya-Yao , Shiue Chyng-Yann , Huang Wen-Sheng , Yeh Skye Hsin-Hsien
Published: December 2020

Background: Expression of translocator protein (TSPO) on the outer mitochondrial membrane of activated microglia is strongly associated with neuroinflammation. The second-generation PET ligand [18F]FEPPA specifically binds TSPO to enable in vivo visualization and quantification of neuroinflammation. We optimized an fully automated radiosynthesis method and evaluated the utility of [18F]FEPPA, the second-generation PET ligand specifically binds TSPO, in a mouse model of systemic LPS challenge to detect TSPO-associated signals of central and peripheral inflammation. In vivo dynamic PET/MR imaging was performed in LPS-induced and control mice after [18F]FEPPA administration. The relationship between the [18F]FEPPA signal and the dose of LPS was assessed. The cytokine levels (i.e. TNF-α, Il-1β, Il-6) in LPS-induced mice were measured by RT-PCR. Standard uptake value (SUV), total volume of distribution (VT) and area under the curve (AUC) were determined based on the metabolite-uncorrected plasma input function. Western blotting and immunostaining were used to measure TSPO expression in the brain. Results: The fully automated [18F]FEPPA radiosynthesis produced an uncorrected radiochemical yield of 30 ± 2% within 80 min, with a radiochemical purity greater than 99% and specific activity of 148.9‒216.8 GBq/µmol. Significant differences were observed in the brain after [18F]FEPPA administration: SUV, VT, and AUC were 1.61 ± 0.1, 1.25 ± 0.12, and 1.58 ± 0.09-fold higher in LPS-injected mice than controls. TNF-α, Il-1β and Il-6 mRNA levels were also elevated in the brains of LPS-injected mice. Western blotting revealed TSPO (p<0.05) and Iba-1 (p<0.01) were upregulated in the brain after LPS administration. In LPS-injected mice, TSPO immunoactivity colocalized with Iba-1 in the cerebrum and TSPO was significantly overexpressed in the hippocampus and cerebellum. The peripheral organs (heart, lung) of LPS-injected mice had higher [18F]FEPPA signal-to-noise ratios than control mice. Conclusions: Based on the robust data on ligand specificity and selectivity in both central and peripheral tissues using 7T PET/MR imaging, we demonstrate that the high affinity, stability and high-contrast visualization indicate detection of TSPO using [18F]FEPPA represents a promising, specific biomarker for early diagnosis and neuropathological follow-up of neuroinflammatory processes.
Isolation and characterization of high affinity and highly stable anti-Chikungunya virus antibodies using ALTHEA Gold Libraries™
Authors: Pedraza-Escalona Martha , Guzmán-Bringas Omar , Arrieta-Oliva Ivan , Gómez-Castellano Keyla , Salinas-Trujano Juana , Torres-Flores Jesus , Muñoz-Herrera Juan , Camacho-Sandoval Rosa , Contreras-Pineda Paola , Chacón-Salinas Rommel , Pérez-Tapia Sonia Mayra , Almagro Juan Carlos
Published: December 2020

Background: More than three million infections were attributed to Chikungunya virus (CHIKV) in the 2014-2016 outbreak in Mexico, Central and South America, with over 500 deaths directly or indirectly related to this viral disease. CHIKV outbreaks are recurrent and no vaccine nor approved therapeutics exist to prevent or treat CHIKV infection. Reliable and robust diagnostic methods are thus critical to control future CHIKV outbreaks. Direct CHIKV detection in serum samples via highly specific and high affinity anti-CHIKV antibodies has shown to be an early and effective clinical diagnosis. Methods: To isolate highly specific and high affinity anti-CHIKV, Chikungunya virions were isolated from serum of a patient in Veracruz, México. After purification and characterization via electron microscopy, SDS-PAGE and binding to well-characterized anti-CHIKV antibodies, UV-inactivated particles were utilized as selector in a solid-phase panning in combination with ALTHEA Gold Libraries™, as source of antibodies. The screening was based on ELISA and Next-Generation Sequencing. Results: The CHIKV isolate showed the typical morphology of the virus. Protein bands in the SDS-PAGE were consistent with the size of CHIKV capsid proteins. UV-inactivated CHIKV particles bound tightly the control antibodies. The lead antibodies here obtained, on the other hand, showed high expression yield, > 95% monomeric content after a single-step Protein A purification, and importantly, had a thermal stability above 75oC. Most of the antibodies recognized linear epitopes on E2, including the highest affinity antibody called C7. A sandwich ELISA implemented with C7 and a potent neutralizing antibody isolated elsewhere, also specific for E2 but recognizing a discontinuous epitope, showed a dynamic range of 0.2 – 40.0 mg/mL of UV-inactivated CHIKV purified preparation. The number of CHIKV particles estimated based on the concentration of E2 in the extract suggested that the assay could detect clinically meaningful amounts of CHIKV in serum.Conclusions: The newly discovered antibodies offer valuable tools for characterization of CHIKV isolates and development of robust diagnostic tools for CHIKV infection surveillance. Therefore, the strategy here followed using whole viral particles and ALTHEA Gold Libraries™ as universal source of antibodies could expedite the discovery and development of antibodies for detection and control of emergent and quickly spreading viral outbreaks.
Assessing a national policy on strengthening chronic care in primary care settings of a middle-income country using patients’ perspectives.
Authors: Aekplakorn Wichai , Suriyawongpaisal Paibul , Srithamrongsaw Samrit , kaewkamjonchai Phanuwich
Published: December 2020

Background To improve care for patients with chronic diseases, a recent policy initiative in Thailand focuses on strengthening primary care including training of the team to deliver healthcare based on the concept of Chronic Care Model (CCM). This study aimed to assess the perception of patients on the health care services after the implementation. Methods We conducted a cross-sectional survey of 4,071 patients with hypertension and/or diabetes registered to 27 primary care units and 11 hospital Non-communicable diseases (NCDs) clinics in 11 provinces.The patients were interviewed at home using a validated questionnaire of the Patient Assessment of Chronic Illness Care (PACIC+). It contains 20 items from the original PACIC, which measure different parts of the CCM, and an additional 6 items assess the 5A Model including assess, advise, agree, assist, and arrange subscales. Upgraded primary care unit (PCUs) were ordinary PCUs with the multi-professional team including a physician. Trained upgraded PCUs were upgraded PCUs with the training input. Structural equation modeling was used to create subscale scores for CCM and 5 A model characteristics. Mixed effect models were employed to compare subscale of patient perception of the care quality between trained upgraded PCUs, upgraded PCUs, ordinary PCUs and NCD clinics.Results There was an independent association between every PACIC subscale (as a measure of CCM) and facility type with the maximum likelihood for patients of ordinary PCU reporting high to highest scores (ORs: 1.46-1.85; p<0.05) compared to hospital NCD clinics. This is also the case for patients: seeing the same doctor on repeated visits (ORs: 1.82-2.17; p<0.05) or having phone contacts of the providers (ORs:1.53-1.99; p<0.05). Similarly, across all of the 5A model subscales, ORs for patients attending ordinary PCU responded with high to highest scores were 1.48-2.10 times compared to those for patients attending hospital NCD clinics (p<0.05). Conclusions The training and allocation of family physician approach in PCU may not satisfy the patients’ perception on quality of chronic care. Further studies might focus on other factors such as mismatch between health workforce and workload as a key factor influencing the success of the policy implementation.
Applying the LASSO method to predict the impact of tariff reductions on customs revenues in Vietnam
Authors: Thi Anh Tuyet Le
Published: December 2020

The study assesses the impact of tariff reductions on fluctuations in customs revenues in Vietnam. The collection of research data was based on the official sources, namely the Government’s Web Portal and the World Bank’s website, and took place between 2002 and 2017. This paper uses the LASSO (Least Absolute Shrinkage and Selection Operator) linear regression model to estimate and predict the relationship of data series, thereby drawing a regression equation to consider the impact of various factors on customs revenues. The results have proven that tariff reductions have no negative impact on customs revenues. When tariffs are reduced, import turnover increases, the level of compliance with tax laws by import-export enterprises increases, and smuggling and trade fraud decrease. Based on these conclusions, the paper proposes several policies aimed at ensuring future customs revenues in Vietnam. As follows from the findings provided below, in order to ensure customs revenues, the Vietnamese Government should introduce appropriate policies to improve the efficiency of customs management in Vietnam; envisage accurate planning and reasonable investment for the customs office in terms of facilities and human resources; establish reasonable non-tariff barriers to prevent fraud and abuse causing losses in customs revenues.
Characteristics of chloride loading from urban and agricultural watersheds during storm and non-storm periods
Authors: Beom Jina , Jeung Minhyuk , Choi Woojung , Her Younggu , Yoon Kwangsik
Published: December 2020

The chloride ion (Cl−) can adversely affect an aquatic ecosystem, but it is not clear how Cl− moves with runoff and how its transport processes are related to land uses and land cover. This study investigated how the loading characteristics of Cl− vary depending on storm events and land cover in a temperate region. We monitored Cl− concentrations in three study watersheds that have different compositions of urban and agricultural land uses. In addition, a Mass First Flush ratio (MFFn) was determined to quantify the effect of first flush on Cl− loading. Overall, the observed concentrations and loadings in this study were found to be less than those reported in cold northern regions. The monitoring data showed that Cl− concentrations and loads observed in an urban watershed were significantly larger than those of a rural watershed. The results suggest water management plans should focus on urbanized areas and their storm water to efficiently reduce chloride loading to downstream waterbodies. However, a further study is recommended to identify the sources and pathways of Cl− loaded to waterbodies.
EDITH projekt – učinak različitih modaliteta liječenja bubrežne bolesti te prakse donacije i transplantacije organa u zemljama Europske unije na troškove u zdravstvu i ishod liječenja
Authors: Bušić Mirela , Dragović Marijana , Živčić-Ćosić Stela
Published: December 2020

Procjenjuje se da u Europi oko 10 % odraslih osoba (75 milijuna) ima početni stupanj kronične bubrežne bolesti. Kod velikog broja pacijenata bubrežna bolest otkrije se tek u uznapredovalom stupnju, često praćenom komplikacijama i drugim bolestima koje uvelike umanjuju kvalitetu pacijentova života te povećavaju smrtnost i troškove liječenja. Učestalost primjene pojedinih metoda nadomjesnog bubrežnog liječenja razlikuje se između europskih država, no sveobuhvatni podaci o učinku tih metoda manjkavi su ili nedostupni. Projekt EU-a EDITH ima za cilj istražiti čimbenike koji utječu na odabir metoda nadomjesnog bubrežnog liječenja u državama Europske unije (EU) te analizirati ishode liječenja i troškove za svaku od pojedinih metoda, kako bi se mogao usporediti njihov učinak na pacijente i zdravstvene sustave. Praćenje zdravstvenog stanja primatelja presatka i ishoda transplantacije kao najučinkovitije metode nadomjesnog bubrežnog liječenja planira se provesti uspostavom nacionalnih i zajedničkog Europskog registra. Za pouzdanu procjenu rizika povezanog s darovanjem bubrega potrebno je dugoročno i sveobuhvatno praćenje zdravstvenog stanja (živih) darovatelja bubrežnog presatka kroz jedinstveni registar na (nacionalnoj) i europskoj razini. Sveobuhvatna analiza i usporedba učinka pojedinih metoda nadomjesnog bubrežnog liječenja, u pogledu uspješnosti odnosno ishoda, kao i troškova liječenja, preduvjet su za kreiranje učinkovitih strategija i održivih javno-zdravstvenih politika na nacionalnoj i/ili razini EU-a. Očekuje se da će rezultati ovog projekta dati snažan poticaj široj stručnoj zajednici, nadležnim tijelima i pacijentima za zajedničko djelovanje u cilju unapređenja preventivnih mjera te ujednačavanja dostupnosti optimalnih modaliteta liječenja bubrežnih pacijenata na razini EU-a.
Transplantacijski turizam
Authors: Zibar Lada , Šunić Kristina
Published: December 2020

Transplantacijski turizam (TT) označava putovanja radi protuzakonitog darovanja i presađivanja (transplantacije, TX, od engl. transplantation) organa, pri čemu darovatelj prodaje „darovani“ organ (trgovina organima). Najčešće se „trguje“ bubrezima. Postoji globalni trend borbe protiv takve prakse. Ipak, kontinuirano se nalaze primjeri TT-a diljem svijeta. Procjenjuje se da je 10 % svih TX-a protuzakonito (često dio TT-a). Nedostatak organa i nesrazmjer socioekonomskog stanja između darivatelja i primatelja organa glavni je uzrok TT-a. Unatoč tomu što „darovatelji“ (prodavatelji) organa tako često rješavaju egzistencijske probleme, prodaja dijelova ljudskog tijela u bilo koju svrhu nije etički prihvatljiva.
Urološke komplikacije nakon transplantacije bubrega – iskustvo Referentnog centra u Hrvatskoj
Authors: Markić Dean , Rahelić Dražen , Španjol Josip , Bošnjak Ana , Jakšić Ante , Sušanj Ivan Marin , Smolić Klara , Vukelić Ivan , Trošelj Marin , Materljan Mauro , Rubinić Nino , Juraj Ahel , Gršković Antun , Krpina Kristian , Sotošek Stanislav , Oguić Romano
Published: December 2020

Cilj: Prikazati učestalost uroloških komplikacija nakon transplantacije bubrega u našem transplantacijskom centru. Ispitanici i metode: Retrospektivnim istraživanjem bili su obuhvaćeni svi pacijenti u Kliničkom bolničkom centru Rijeka u kojih je između 30. siječnja 1971. godine i 31. prosinca 2018. godine učinjena transplantacija bubrega. Rezultati: U promatranom razdoblju u našem transplantacijskom centru učinjeno je 1160 transplantacija bubrega. Urološke komplikacije imala su ukupno 154 pacijenta (13,3 %). Najčešće komplikacije su bile stenoza uretera u 52 pacijenta (4,5 %), urinarna fistula u 50 pacijenata (4,3 %), retencija urina u 23 pacijenta (1,9 %) te urolitijaza u 8 pacijenata (0,7 %). U većine pacijenata je provedeno kirurško liječenje. U posljednje vrijeme značajno se povećalo rješavanje uroloških komplikacija korištenjem minimalno-invazivnih metoda. U dvoje pacijenata (0,17 %) je zbog uroloških komplikacija došlo do gubitka grafta, a u troje pacijenata (0,25 %) su one dovele do smrtnog ishoda. Zaključak: Urološke komplikacije u našoj transplantacijskoj populaciji nisu česte. U pacijenata u kojih je potrebno kirurško liječenje endourološke metode predstavljaju danas inicijalnu metodu liječenja.
Uspješna primjena izvantjelesne membranske oksigenacije za liječenje pacijenata u kardiogenom šoku nakon transplantacije bubrega
Authors: Jurilj Zdravko , Barbalić Berislav , Čačić Branka , Tunaj Hana
Published: December 2020

Cilj: Veno-arterijska izvantjelesna membranska oksigenacija (engl. veno-arterial extracorporeal membrane oxygenation; VA-ECMO) metoda je pružanja potpore funkciji srca u pacijenata s kardiogenim šokom kod kojih medikamentozna terapija nije dovoljna. Cilj rada je ukazati, kroz prikaz liječenja pacijenta koji je u ranom poslijeoperacijskom tijeku po transplantaciji bubrega razvio kardiogeni šok, na veliki potencijal primjene izvantjelesne mehaničke potpore radu srca kao metode liječenja kardiogenog šoka u ovih pacijenata, koja je, u opisanom tijeku liječenja, omogućila ne samo preživljavanje pacijenta, već i očuvanje funkcije transplantata. Prikaz slučaja: Na Odjel intenzivnog liječenja (OIL) primljen je šezdesetjednogodišnji pacijent sa završnim stadijem kronične bubrežne bolesti, kojem je učinjena transplantacija bubrega. Tijek operacijskog zahvata komplicirao se razvojem značajne hemodinamske nestabilnosti. Pacijent je, usprkos svim poduzetim medikamentoznim mjerama liječenja, razvio infarkt miokarda s kardiogenim šokom. S obzirom na to da je stanje bilo refraktorno na primijenjenu medikamentoznu terapiju, donesena je odluka o primjeni izvantjelesne mehaničke potpore cirkulaciji. Mehanička potpora dovela je do hemodinamske stabilizacije pacijenta i poslužila je kao most do oporavka srčane funkcije s uspješnim očuvanjem funkcije transplantata. Zaključci: U rastućem broju radova mehanička cirkulatorna potpora je označena kao budućnost liječenja kardiogenog šoka, neovisno o njegovoj etiologiji. Kao i sve druge metode liječenja, nosi rizik od razvoja komplikacija, koji se razvojem tehnologije polako smanjuje. Ona postaje sve dostupnija te se njezina primjena širi na različite skupine pacijenata. Važno je naglasiti da je za uspjeh terapije nužna suradnja specijalista različitih specijalnosti u liječenju ovako kompleksnih pacijenata.