bluuebunny/crossref_metadata_2025 huggingface dataset:
Information Asymmetry between Physicians and Patients Undergoing Laparoscopic Cholecystectomy: Analysis of Patients’ Awareness Level
Authors: Jeddi Fatemeh Rangraz , Jabali Monireh Sadeqi , Tadayon Hamidreza , Khanmohammadi Mohammad Taghi
Published: December 2020

Background: Obtaining informed consent is essential before conducting a healthcare intervention. Primary reason for obtaining informed consent is to eliminate asymmetry information between the physicians and patients. The aim of this study was to determine the significance of information symmetry between physicians and patients undergoing laparoscopic cholecystectomy.Methods: An analytical study was carried out in 2019. Moreover, the research population consisted of patients undergoing laparoscopic cholecystectomy. As for the data collection tool, a researcher-made questionnaire was introduced. The validity and reliability of this questionnaire was confirmed. Questionnaire had five sections and Cronbach's alpha of 0.85 was achieved. The data were then analyzed by SPSS Version: 18.0.Results: A total of 96 patients participated in the study, where around 30% of them were male. Only 20.3% of patients specified that they were aware of possible complications of their treatment, of which 62% cited their physician as the main source of this information. On the other hand, 80% of patients were fully aware of the benefits of their treatment.Conclusions: The information asymmetry between physicians and patients about the benefits and complications of treatments should be somehow eliminated and the crucial information about the chosen treatment plan or alternative courses of action should be fully provided to the patient by the attending physician or nurse.
Observation of strong helical excitons and unexpectedly giant Rashba splitting in single crystal two-dimensional Organic-Inorganic Halide Perovskites
Authors: Rusydi Andrivo , Chi Xiao , Leng Kai , Li Runlai , Yu Xiaojiang , Yang Ping , Breese Mark , Loh Kian Ping
Published: December 2020

Two-dimensional (2D) organic-inorganic lead halide perovskites possess strong spin-orbit coupling, and in the presence of broken inversion symmetry, this may lead to helical excitons and Rashba splitting at the band extrema1-6. However, a direct and systematic measurement of the helical excitons and the Rashba parameter in the system is still lacking. Here, we report distinct two bright co-helical and two dark anti-helical excitons in single crystal ((CH3(CH2)3NH3)2(CH3NH3)n-1PbnI3n+1 (n = 1 to 4), where n determines quantum well (QW) thickness of inorganic layer7. By comprehensively analyzing the fine structure of helical excitons, we find that the Rashba splitting originates from surface inversion asymmetry and surface-normal electric fields, which are determined by the QW’s dielectric environment, n and temperature. The Rashba splitting parameter is found among the highest recorded of 2.66 and 2.5 eV∙Å for the conduction and valence band of n=1 Iodide, respectively, and reduces for n>1 Iodide. Our result shows the importance of helical excitons and Rashba splitting and presents a direct method to quantify the Rashba parameter in complex halide perovskites. We hope that our study inspires applications of QW materials in novel spintronic devices.
Grain Quality Characteristics and RVA Profile Analysis of Yuenongsimiao, a High Yield and Disease-resistant Rice Variety
Authors: Lu Zhanhua , Fang Zhiqiang , Liu Wei , Lu Dongbai , Wang Xiaofei , Wang Shiguang , Xue Jiao , He Xiuying
Published: December 2020

Background: Rice quality is one of the main targets for rice breeding, and is a complex trait involving grain appearance, milling, cooking, eating and nutritional quality. For a long time, rice breeding is facing the imbalance of yield, quality, disease resistance and lodging.Result: Here, the grain quality characters (milling and appearance quality, cooking quality, starch RVA profile, and nutritional quality) of Yuenongsimiao (YNSM), a new indica rice variety with high yield, high quality and disease resistance, were performed. It showed that YNSM has excellent appearance and quality with low amylose content, long gel consistency, and had significant correlation with the HPU, CPV, SB, and CS. Moreover, 5 genes related to grain size (GS3, GS9, GW5, GW7, and GW8) and Wx gene were selected to detect the main quality genotype of YNSM. The results showed YNSM was a middle-long grains with relative high brown rice rate, white rice rate and whole white rice rate, and lower chalkiness. The results indicated the grain size and food quality of YNSM might related to gs3, gw7 and Wxb. This research also reported the quality characters of hybrid rice using YNSM as a restorer lines.Conclusions: The quality characters and genotype of grain quality gene analysis in YNSM may facilitate the breeding of new rice varieties achieving a balance between grain yield, resistance and quality.
False Memory in Borderline Personality Disorder
Authors: Sajjadi Fatemeh , Sellbom Martin , Gross Julien , Hayne Harlene
Published: December 2020

Background: Borderline Personality Disorder (BPD) is a mental disorder characterized by significant impairment in intrapersonal and interpersonal functioning, as well as patterns of personality pathology. Memory deficits are not recognized as a core symptom of BPD, but BPD patients have long been suspected to have inaccurate perceptions, disturbed memory processes, and an increased tendency to develop false memories. Methods: In the present study, we examined whether there was an association between BPD and the production of false memories in the Deese-Roediger-McDermott (DRM) paradigm—a laboratory-based procedure that is frequently used to investigate false memory. We also compared the traditional and alternative model of BPD with respect to false memory. A total of 298 university students completed the McLean Screening Instrument for Borderline Personality Disorder, SCID-II Personality Questionnaire, Borderline Personality Disorder Impairment Scale, Personality Inventory for DSM-5, Beck Depression Inventory, Dissociative Experiences Scale, and Traumatic Life Events Questionnaire. The participants were also tested using both traditional DRM word lists as well as word lists that were specifically associated with BPD. Results: Using the traditional diagnosis of BPD, BPD symptoms were correlated with higher false memory for positive information; in the alternative model of BPD, identity impairment and anxiousness were correlated with the overall false memory score. We also found that trauma and dissociation mediated the relation between BPD and false memory. Conclusions: These findings are discussed in terms of how the consequences of trauma, such as dissociation and identity disturbance, are associated with false memory. Whether false memory rates are higher in a clinical population of patients with BPD remains to be determined.
New Strategy to Calculate Robust Impedance using RMHHT Estimator for Continuous and Discontinuous Broadband Magnetotelluric Time-Series Data
Authors: Chen Hao , Mizunaga Hideki , Tanaka Toshiaki , Wang Gang
Published: December 2020

Magnetotelluric (MT) method is an electromagnetic geophysical method for inferring the earth's subsurface electrical conductivity from measurements of natural geomagnetic and geoelectric field variation at the earth's surface. MT method is widely used in exploration surveys worldwide, but it was hardly applicable in urban areas because of large artificial electromagnetic noise. But in one day, there are several hours at midnight that most of the electric equipment is shutdown. The MT time-series data at midnight is much quiet than in the daytime. Therefore, we focused on calculating the MT impedance using the quiet time-series data. In this research, the data observed by the Phoenix System is used. We introduced a robust impedance estimator based on the Hilbert-Huang transform (RMHHT) and used a new strategy to calculate the broadband MT time-series data. We indicated that this technique needs 4-hour time-series data to get a reliable resistivity structure up to 1,000 seconds in the numerical simulation. This short measurement time makes it possible to carry out MT surveys in urban areas with strong noises. However, the biggest problem of the impedance estimator based on HHT is time-consuming. The total computation time can be reduced significantly by using this strategy. Finally, a successful case study using the midnight time-series data was demonstrated to get reliable resistivity structures in the areas contaminated by heavy noises.
Genome-wide identification and characterization of long non-coding RNAs in Longissimus dorsi skeletal muscle of Shandong black cattle and Luxi cattle
Authors: Liu Ruili , Liu Xianxun , Yu Kun , Bai Xuejin , Dong Yajuan
Published: December 2020

Background

There is increasing understanding of the possible regulatory role of long non-coding RNAs (LncRNA). Studies on livestock have mainly focused on the regulation of cell differentiation, fat synthesis, and embryonic development. However, there has been little study of skeletal muscle of domestic animals and the potential role of lncRNA.
Results

RNA samples were collected from longissimus dorsi muscle samples of Shandong black cattle and Luxi cattle and libraries were constructed and sequenced. A total of 1415 transcripts (of which 480 were LncRNAs) were differentially expressed (P < 0.05) in the different breeds, and fourteen of these RNAs were randomly selected and validated by qPCR. We found that the most differentially expressed LncRNAs were found on chromosome 9, with 1164 within 50 kb of a protein-coding gene. In addition, Pearson's correlation coefficients of co-expression levels indicated a potential trans regulatory relationship between the differentially expressed LncRNAs and 43844 mRNAs (r > 0.9). The identified co-expressed mRNAs (MYORG, Dll1, EFNB2, SOX6, MYOCD, and MYLK3) are related to the formation of muscle structure, and enriched in muscle system process, strained muscle cell differentiation, muscle cell development, striated muscle tissue development, calcium signaling, and AMPK signaling. Additionally, we also found that some LncRNAs (LOC112444238, LOC101903367, LOC104975788, LOC112441863, LOC112449549, and LOC101907194) may interact with miRNAs related to cattle muscle growth and development. Based on this, we constructed a LncRNAs-miRNA-mRNA interaction network as the putative basis for biological regulation in cattle skeletal muscle. Interestingly, a candidate differential LncRNA (LOC104975788) and a protein-coding gene (Pax7) contain miR-133a binding sites and binding was confirmed by luciferase reporter assay. LOC104975788 may bind miR-133a competitively with Pax7, thus relieving the inhibitory effect of miR-133a on Pax7 to regulate skeletal muscle development. These results will provide the theoretical basis for further study of LncRNA regulation and activity in different cattle breeds.
Conclusions

The data obtained in this study were used to predict muscle-related LncRNAs-miRNA-mRNA interaction networks, which can help elucidate the molecular mechanism of cattle muscle development. These results can be used to facilitate livestock breeding and improve livestock production.
A New Comprehensive Oral Health Literacy Scale: Development and Psychometric Evaluation
Authors: Sun Yue , Sun Jing , Zhao Yan , Cheng Aixiao , Zhou Junhong
Published: December 2020

Background: It has been widely accepted that oral health status is related to oral health literacy. The need to measure oral health literacy has led to the development of measurement instruments. This study aimed to develop a comprehensive instrument for adults and to examine its reliability and validity in China.Methods: A three-step design process was used. First, a literature review and expert panel discussion were used to draw up a 37-item pool covering oral health knowledge, belief, practice, skill and functional oral health literacy. The Delphi method was used to delete and modify questions in the item pool. The draft instrument was evaluated by nine experts and the consensus among them was calculated using the content validity index. The scale was then used to conduct a psychometric study among 370 participants from community health centers in Beijing. Construct validity, discriminant validity and concurrent validity were examined. The Cronbach’s alpha coefficient, and test–retest methods were used to assess reliability.Results: The final scale included 30 items in four dimensions. The item–level content validity index was 0.90. Exploratory factor analysis extracted four fixed factors, and the Kaiser–Meyer–Olkin and Bartlett’s tests came to 0.752, with the model explaining 35.21% of the total variance. The four dimensions were associated with oral health knowledge, perceptions of oral health issues, oral health practice and skills, and functional oral health literacy. The mean score of the lowest 27% was significantly lower than the highest 27% (p < 0.01), suggesting adequate discriminant validity. The associations between comprehensive oral health literacy scores and educational level, income and self-reported literacy level were significant (P < 0.001), showing adequate overall concurrent validity. Internal consistency and test–retest reliability were acceptable, with a Cronbach’s alpha of 0.72 and a total test–retest reliability coefficient of 0.979. Conclusions: Initial testing of the comprehensive oral health literacy instrument suggested that it is a valid and reliable instrument to evaluate individuals’ oral health literacy, with four dimensions for evaluating knowledge, belief, skill and functional oral health literacy.
The Distribution of Cytotoxic Necrotizing Factors (CNF-1, CNF-2, CNF-3) and Cytolethal Distending Toxins (CDT-1, CDT-2, CDT-3, CDT-4) in Escherichia coli Strains Isolated from Extraintestinal Infections and The Determination of Their Philogenetic Relationship by PFGE
Authors: GUNERI Cansu ONLEN , KOKSAL Fatih , KIZILYILDIRIM Suna , BEDIR Basak , Nagiyev Togrul
Published: December 2020

Background: Determinants of extraintestinal infection in Escherichia coli (E. coli) remain unclear. Virulence factors making Extraintestinal pathogenic E. coli (ExPEC) different from other E. coli strains are the host cell adhesion, invasion, and two important factors/toxins, Cytotoxic Necrotizing Factor (CNF) and Cytolethal Distending Toxin (CDT) that are responsible for cell death. In the present study, prevalence of CNF-CDT genotypes was investigated in 645 E. coli strains isolated from patients. This prevalence was analyzed regarding clinical origins, phylogroups and putative phylogenetic relationships.Results: At least one virulence gene identified for ExPEC was found in 156 (24%) of 645 E. coli strains. 78, 12, 20 of ExPEC strains contained cnf1, cnf2, cnf3, respectively. Genes of cdt1, cdt2, cdt3 and cdt4 were detected as 20, 4, 4, 4. Finally, two factors were detected cnf1-cnf3 (n=6), cnf1- cdt1 (n=4), cdt1-cdt4 (n=4). These 156 strains were found to be distributed in 106 large clusters by Pulsed-Field Gel Electrophoresis (PFGE). Virulent ExPEC was primarily related to the groups B2 (60%) and D (32%). Conclusions: The CNF gene family is believed to enhance colonization of E. coli especially in the urinary system and the genes of E. coli gene pool gain the ability to survive in new environments, such as the human urinary tract. The widespread diffusion of the CNF gene in E. coli helps to distinguish ExPEC from commensal strains and these genes may be used as specific marker for non-commensal E. coli. It was concluded that different strains of E. coli gained ExPEC properties by acquiring different virulence genes resulting in deletion and recombination mutations, and it was thought that the infections caused by these strains were more likely community-acquired rather than hospital-acquired. Furthermore, in this study, cnf2, cnf3, cdt1, cdt2, cdt3 and cdt4 genes were demonstrated in Turkey for the first time.
Anti-phosphatidylserine/prothrombin Complex Antibodies in Patients With Cutaneous Vasculitis: Possible Involvement in the Pathogenesis
Authors: Tamura Yuto , Kawakami Tamihiro , Dong Yupeng , Yoshinari Miku , Nishibata Yuka , Masuda Sakiko , Tomaru Utano , Ishizu Akihiro
Published: December 2020

Objective. It was previously demonstrated that cutaneous vasculitis, including IgA vasculitis and cutaneous arteritis (CA), is associated with the presence of IgM antibodies (Abs) against the phosphatidylserine/prothrombin complex (PS/PT). Recently, novel enzyme-linked immunosorbent assay kits for the detection of IgG and IgM anti-PS/PT (aPS/PT) Abs have become commercially available.Methods. The prevalence of serum IgG and IgM aPS/PT Abs in both cutaneous and systemic vasculitis was determined using these kits. In addition, to examine whether aPS/PT Abs were involved in the pathogenesis of cutaneous vasculitis, inbred wild-type rats were intravenously administered with a rat IgM class aPS/PT monoclonal Ab established previously or with rat immunoglobulins as controls. To express PS on the surface of vascular endothelium, these rats were given a subcutaneous injection of cell-free histones (250 µg/ml, 300 µl/site) 2 hours in advance. Results. Serum IgM aPS/PT Ab levels were elevated in patients with systemic vasculitis with skin involvement and CA compared to those in patients with systemic vasculitis without skin involvement and healthy controls. There was no significant difference in the serum levels of IgG aPS/PT Abs between the patients and healthy controls. Correspondingly, inbred wild-type rats intravenously administered with the aPS/PT monoclonal IgM Ab after appropriate priming—subcutaneous histone injection—developed cutaneous vasculitis. Some rats given rat IgM instead of the aPS/PT monoclonal Ab also developed cutaneous vasculitis, whereas vasculitis did not occur in rats given IgG or only priming by histones. Conclusion. IgM aPS/PT Abs could be involved in the pathogenesis of cutaneous vasculitis.
Risk Analysis for Pulmonary Metastasis of Chondrosarcoma and Establishment and Validation of Novel Clinical Prediction Models: a Clinical Study Based on the SEER Database
Authors: LI Wenle , Hao-sheng WANG , Li-Jun NING , Sen GAO , Wen-shi ZHANG , HU Zhaohui
Published: December 2020

Objective: Lung metastasis of chondrosarcoma is associated with poor prognosis. The purpose of this study was to develop and validate the nomogram to predict the risk of lung metastasis in patients with chondrosarcoma, thus contributing to clinical diagnosis and treatment.Methods: Data on chondrosarcoma patients from the Surveillance, Epidemiology, and End Results (SEER) database from 2010 to 2016 were then screened by univariate and multivariate Logistic regression to construct a Nomogram predicting lung metastasis risk. Nomogram model discrimination was assessed by calibration charts, while prediction accuracy and clinical values were measured by decision curve analysis (DCA) and clinical impact charts. In addition, the predicted Nomogram were validated in the internal test set. Results: A total of 944 patients were enrolled and randomly divided into the training group (n=664) and the validation group (n=280) in a ratio of 7 to 3.After logistics regression analysis, significant variables were gender, age, marital status, tumor volume and lymphatic metastasis. Calibration curves show consistency between Nomogram predictions and actual observations, while DCA and clinical impact diagrams show the clinical utility of Nomogram. In addition, ROC also showed good discrimination and calibration in the training group (AUC = 0.789, 95%CI 0.789 -- 0.808) and the validation group (AUC = 0.796, 95%CI 0.744 -- 0.841).Conclusions: Nomogram for lung metastases in chondrosarcoma can effectively predict the individual risk of lung metastases and provide clinicians with enlightening information to optimize treatment.
Using 18F-FDG PET/CT to Predict Esophageal Cancer Survival: A Meta-analysis
Authors: Wang Jingying , Song Jianbo , Li Sijin
Published: December 2020

Background: This study aimed to explore whether metabolic responses to positron emission tomography/computed tomography (PET/CT) collected before, during, or after the treatment can predict the long-term survival rate of patients with esophageal cancer.Main body: We searched for the following indices in articles listed in English and Chinese literature databases: the maximum standard uptake value (SUVmax), mean standard uptake value (SUVmean), metabolic tumor volume (MTV), and total lesion glycolysis (TLG). If their values exceeded the thresholds, we defined them as responders; if they did not, we defined them as non-responders. We then performed a meta-analysis by extracting the hazard ratio (HR) and 95% confidence interval (95% CI) from each report to predict whether the status of responder or non-responder had an impact on prognosis.We identified 34 articles with a combined sample size of 2794 patients. HRs and 95% CIs were measured as follows: SUVmax = 1.15 (0.98-1.35), MTV = 3.45 (0.78-15.25), TLG = 1.04 (1.02-1.07), and SUVmean = 1.85 (1.33-2.57) (before treatment); ΔSUVmax = 1.22 (1.06-1.39), Δ MTV = 1.07 (0.54-2.15), and ΔTLG = 1.09 (0.59-2.02) (during treatment); and SUVmax = 1.13 (1.05-1.22) and TLG = 1.05 (1.02-1.09) (after treatment). The results showed that the overall survival of the patients with low SUV (MTV, TLG) values was significantly higher than that of the patients with high SUV (MTV, TLG) values.Conclusions: This meta-analysis shows that the prognoses of patients with PET metabolic responses are significantly better than those of non-responders. Our findings may help inform the clinical treatment and prediction of the prognoses of patients with esophageal cancer.
The Impact of Daily Urinary Volume Variations and Prostate Volume on Prostate Position During Radiotherapy
Authors: Nishioka Kentaro , Hashimoto Takayuki , Abe Takashige , Osawa Takahiro , Matsumoto Ryuji , Yokota Isao , Katoh Norio , Kinoshita Rumiko , Yasuda Koichi , Yakabe Toshiaki , Yoshimura Takaaki , Takao Seishin , Shinohara Nobuo , Aoyama Hidefumi , Shimizu Shinichi
Published: December 2020

BackgroundDaily variations in bladder volumes are thought to be a major cause of prostate position changes during radiotherapy, however, the impact of such changes on prostate position is not fully established. We hypothesized that prostate volume (PV) could also be related to the susceptibility of prostate movement to changes in urinary volume (UV). The purpose of this study is to investigate the impact of daily UV variations and PV on the prostate position during radiotherapy.MethodsA total of 268 treatment sessions in 12 consecutive prostate cancer patients who were treated with proton beam therapy in our hospital were retrospectively analyzed. All patients were instructed to void urine and feces one hour before the treatment and the UV was measured by a portable ultrasound device just before the treatment. After the positional registration based on bone structure, the prostate positional difference from the planned position was measured using fiducial markers in the prostate and a real-time tumor tracking system. The measurements were for the differences in the left-right (LR), cranial-caudal (CC), and anterior-posterior (AP) directions. The PV was measured by ultrasound imaging before every treatment. The impact of the UV variations on the prostate position was evaluated by the linear mixed effect model, and including PV (<20ml and ≥20ml) as covariates. ResultsThere was significant movement of the prostate in the posterior direction with increasing UV in patients with PV ≥ 20 ml (p=0.04, estimated coefficient of regression -0.436 mm/100ml, 95% CI from -0.854 to -0.018). However, there was no significant correlation between UV changes and movement of the prostate in either of the LR, CC, or AP directions in all cases and patients with PV < 20 ml.ConclusionsOur results suggest that the increase of UV could result in posterior prostate movement in patients with prostatic hyperplasia, however, the clinical impact is thought to be small. There is however a need for further research to identify other factors that could affect the daily changes in prostate position as well as a need for a more ideal preparation protocol to improve the reproducibility of the treatment-planning CT.
The Role of Radiotherapy for Pancreatic Malignancies- A Population-based Analysis of the SEER-Medicare Database.
Authors: luo yunxiu , Xiao Shengjun
Published: December 2020

Background and objective. To investigate the role of adjuvant radiotherapy in patients after surgical resection for pancreatic cancer. Methods and patients. The patients with pancreatic cancer from 18 registered institutions in the Surveillance Epidemiology and End Results (SEER) database were retrospectively analyzed. The characteristics of patients who would benefit from adjuvant radiotherapy were screened, as well as whether neoadjuvant or adjuvant radiotherapy conferred to a better clinical outcome. Results. 30249 patients included in this study (21295 vs 8954 in surgery and adjuvant radiotherapy group) .The median survivals in the surgery (S) group and adjuvant radiotherapy (S+R) group were 24 and 21 months respectively, The 1, 3, and 5-year overall survival (OS) rates in the S group and S+R group were 68%, 40%, 31% ,and 75%, 30%, 20%, respectively (p<0.001).Stratified analysis showed patients with histological classified as adenocarcinoma(15 VS 21, P<0.0001), infiltrating duct carcinoma (17 VS 21,P<0.0001), adenosquamous carcinoma(10 VS 18,P<0.0001) could be benefit from adjuvant radiotherapy. Adjuvant radiotherapy was helpful to improve the OS for patients with pancreatic head (19 VS 21, P=0.0003) and duct carcinoma (18VS 28, P=0.0121). Subgroup stratified assay indicated specific patients with early stage (AJCC 7th I, II, T2, N0) pancreatic carcinoma had better OS after additional radiotherapy than surgery alone. Conclusion. Additional radiotherapy may contribute to improved prognosis for patients with pancreatic carcinoma of specific histological types (adenocarcinoma/carcinoma, infiltrating duct carcinoma, adenosquamous carcinoma, and squamous), anatomical location, and advanced stage. A specific subgroup of patients with an early stage (I/II, T2) pancreatic cancer should be considered for additional radiotherapy.
Mediating Effect of C-reactive Protein and Aspartate Aminotransferase on Diabetes Mellitus and Myocardial Infarction Risk
Authors: Zhao Hui , Jiang Miao-miao , Hu Sang , Su Chang , Zhang Li , Cheng Zi-ping , Liu Zhao-ping , Jiang Qin , Ji Wen , Hong Jing-fang , Zhang Hui
Published: December 2020

Background: The relationship between diabetes and myocardial infarction has always been the focus of research, but it is not clear whether the DM-MI association is direct or mediated by other factors. Our hypothesis is that part of the risk of MI in DM patients may be mediated by CRP and AST. We examined this hypothesis in the mediation analysis and tried to assess the extent to which CRP and AST could explain the MI risk caused by DM.Methods: This case-control study was conducted on 130 patients with MI and 130 patients with no-MI. We compared the relevant biochemical indicators of MI and no-MI patients, and applied mediation analysis to test the association of CRP and AST with DM-MI Potential adjustment effect.Results: The study found that individuals who suffered MI were more likely to have DM as compared with Non-MI (OR = 2.117, 95%CI = 1.130-4.195, P = 0.020), and CRP and AST are positively correlated with the occurrence of MI, For every unit increase in CRP and AST levels, the risk level of MI Significantly increased by 1%, 3.1% respectively. The direct effect of DM and MI is 0.847, the mediating effect of CRP is 7.69% of the total effect, and the mediating effect of AST is 52.79% of the total effect. The mediation effect of the CRP-AST path is 0.386, accounting for 12.36% of the total effect. In the mediation model we verified, CRP and AST play a part of the mediation effect between DM with MI, and the total mediation effect accounts for 72.84%.Conclusions: CRP and AST play an important role in the risk of DM-induced MI. This provides evidence for the mechanism and is of great significance for the exploration of therapeutic targets.
Comparison of Framingham 10-Year Cardiovascular Event Risks in Native- and Foreign-born Primary Healthcare Populations in Sweden
Authors: Taloyan Marina , Wågström Victor , Steiner Kristin Hjörleifdottir , Östenson Claes-Göran , Yarbakht Danial , Salminen Helena
Published: December 2020

BackgroundThe prevalence of cardiovascular disease (CVD) around the world varies by ethnicity and region of birth. Immigrants living in Sweden may have a higher prevalence of CVD than native-born Swedes, but little is known about their actual risk of cardiovascular events (CVE). The Framingham Risk Score (FRS) uses cardiovascular risk factors to estimate the 10-year CVE risk. The aim of this study was to examine the relationship in Sweden between an elevated 10-year CVE risk and both birthplace and other risk factors.MethodsThis cross-sectional study was based on CVD risk factor data obtained from the 4D Diabetes Project, a Programme 4D subproject in Sweden. Participants were recruited from two primary healthcare centres in Stockholm, from 2013 through 2015, were between 18 and 74 years old, had no history of diabetes or pre-diabetes, and were divided into two birthplace groups (Sweden-born and foreign-born, the largest group born in the Middle East). FRS was calculated and 10-year CVE risk was determined for each participant. Logistic regression analysis was performed to generate odds ratios (OR) for the outcome, an elevated (≥10%) risk of CVE within 10 years. ResultsOf the 830 participants in the study, 170 (20.5%) had an elevated 10-year CVE risk. A significantly higher proportion of Sweden-born (vs. foreign-born) participants had an elevated 10-year CVE risk (35.6% vs. 12.9%; P < 0.0001). Foreign-born participants had a significantly lower mean age (45.6 vs. 55.8 years, P < 0.001), but a significantly higher proportion were smokers (23.9% vs. 13.7%; P = 0.001). Participants born in Sweden (vs. foreign-born) were almost two times more likely to have an elevated 10-year CVE risk, even when adjustments were made for age, sex, education, waist circumference, and high-sensitivity C-reactive protein level (Adjusted OR=1.73; 95% CI, 1.10-2.77).ConclusionsIn Sweden, native-born participants were more likely to have an elevated 10-year CVE risk than those born in other countries (including the Middle East). These results contradict reports of higher rates of CVD in Middle-Eastern countries than in Sweden. A cardiovascular risk scoring system modified for region of birth or ethnicity may be needed in Sweden.PermitAn ethical permit was granted by the Regional Ethical Review Board in Stockholm, review number 2013/2303-31/3.
Molecular Diagnosis of a Hybridized Tapeworm (Between Taenia Saginata and Taenia Asiatica) Infection Case in Yunnan, China, 2019
Authors: Zhang Yun-Zhi , Liao Ce-Heng , You Zhi , Qiu Ye , He Zuo-Shun , Liu Juan , Fang Wen , Li Hong-Ying , Daszak Peter , Hu Jun-Jie , Ge Xing-Yi
Published: December 2020

Human taeniasis is still prevalent in many countries in the world and affecting human health. Three species of tapeworms in the genus Taenia, including Taenia asiatica, Taenia saginata, and Taenia solium are the most common pathogens for the diseases. The genetic relationships of T. saginata and T. asiatica are close. The natural hybridization between these two has not been clinically diagnosed in China. In this study, we report an 18-year-old male patient with taeniasis hospitalized in Yunnan, China, in 2019. The patient was treated with traditional Chinese medicine, and a tapeworm around 2.7 m long was expelled. The morphology of egg and gravid proglottid of the tapeworm were revealed. More interesting is that the tapeworm was identified as a T. saginata-T. asiatica hybridized by the molecularly and phylogenetic analysis. The case study reported the first human taeniasis caused by the T. saginata and T. asiatica hybridization and suggested that the new types of hybridized taeniases exist in China and further investigation and research on the pathogens in Yunnan is needed.
The deposition characteristics of Schistosoma japonicum eggs and its application in hatching method
Authors: man yang , Ji Rongyi , Shen Yuanxi , Zhu Chuangang
Published: December 2020

Background

Schistosomiasis is an important zoonotic parasitic disease, which remains a major public concern in china. However, the detection of schistosomiasis in the field is still based on the traditional faecal hatching method, which is tedious and time-consuming. Therefore, method for detecting schistosomiasis in the field needs to be improved.
Methods

New Zealand rabbits artificially infected with S. japonicum cercariae were used as animal models to study the deposition characteristics of Schistosoma japonicum eggs. The distributions of eggs in the intestinal wall at 42 d and 60 d post-infection were compared. The distributions of eggs in rabbit faecal samples were also observed. Goat faeces were used to compare the conventional faecal hatching method and the simplified direct immersion faecal hatching method.
Results

The distribution of eggs in the intestinal wall in the animal model at 42 d post-infection was as follows: the number of eggs per gram (EPG) was the highest (42780.13 ± 4789.81 eggs/g) in the rectum. The caecum had the largest proportion (42.97%) of eggs deposited. At 60 d post-infection, the rectum still had the highest EPG (117868.20 ± 67232.80 eggs/g). However, instead of the caecum, the lower colon had the largest proportion (64.90%). Moreover, 42.20% of eggs occupied the periphery of rabbit faeces. In the comparison between the conventional faecal hatching method and the simplified direct immersion faecal hatching method, the direct faecal hatching method was simpler, and the results were similar to those of the conventional faecal hatching method.
Conclusion

The deposition characteristics of eggs and their distributions in faecal samples suggest that the direct faecal hatching method can be used to simplify routine faecal hatching detection.
Outcomes of Renal Cell Carcinoma with Associated Venous Tumor Thrombus: Experience from a Large Cohort and Short Time Span in a Single Center
Authors: Chen Zhigang , Yang Feilong , Ge Liyuan , Qiu Min , Liu Zhuo , Liu Cheng , Tian Xiaojun , Zhang Shudong , Ma Lulin
Published: December 2020

Background: The surgical management and outcomes of renal cell carcinoma (RCC) with venous tumor thrombus (VTT) have been reported in limited sample size, and there remain discrepancies over the factors that influence oncologic outcomes after radical nephrectomy with thrombectomy (RNTE).The aim of the study was to analyze the outcomes of the patients with RCC with VTT in our institution and identify the independent prognostic factors. Methods: Patients with RCC with VTT were enrolled for the study from February 2015 to December 2018. All patients underwent RNTE. Clinical data were compared using the chi-square and Fisher’s exact tests. Over-all survival (OS) was estimated using the Kaplan-Meier method. Univariable and multivariable survival analyses were performed using COX.Results: 121 patients (91 men & 30 women) were identified with a mean age of (59.3±10.8) years. VTT level was 0 in 25 patients, I in 20, II in 50, III in 12 and IV in 14. The mean follow-up time was (25.7±14.6) months. During the follow-up period, 50 (41.3%) patients died and 69 (57.0%) patients experienced recurrence or metastasis. The 3-year and 5-year OS rate were 57.8% and 38.9%. Among the several factors examined, positive lymph node (P=0.008), tumor necrosis (P =0.022), sarcomatoid differentiation (P <0.001) and perinephric fat invasion (P =0.041) were demonstrated as independent significant risk factors on multivariate analysis. Conclusion: The OS was poor for patients with RCC with VTT. Rather than VTT level, positive lymph node, tumor necrosis, sarcomatoid differentiation and perinephric fat invasion were independent prognostic predictors.
Immunotherapy is Associated with a Survival Benefit in Patients Receiving Chemotherapy for Metastatic Pancreas Cancer
Authors: Hue Jonathan J. , Bingmer Katherine , Sugumar Kavin , Markt Sarah C. , Rothermel Luke D. , Hardacre Jeffrey M. , Ammori John B. , Winter Jordan M. , Ocuin Lee M.
Published: December 2020

Background: Immunotherapy (IT) has led to improved survival in several common cancers but success in pancreatic ductal adenocarcinoma (PDAC) has been limited. We analyzed if combination IT-chemotherapy (IT-CT) is associated with improved survival compared to chemotherapy alone (CT) in patients with metastatic PDAC. Methods: The National Cancer Database (2004-2016) was queried for patients who were diagnosed with metastatic PDAC. Patients were categorized by treatment group: CT only and IT-CT. Patients were excluded if they received radiation or a surgical procedure. The primary outcome was overall survival.Results: A total of 59,289 patients were identified, of whom 58,947 (99.4%) received CT and 342 (0.6%) received IT-CT. The IT-CT group was younger, had fewer comorbidities, and was more often treated at an academic center. The utilization of multi-agent chemotherapy was similar between the groups. Median survival of patients treated with IT-CT was longer than CT alone (7.9 vs 6.3 months, p=0.005). On multivariable analysis, receipt of IT-CT was associated with a survival advantage as compared to CT (HR=0.86, 95% CI 0.76-0.97) when adjusting for demographics and type of chemotherapy regimen.Conclusions: In patients with metastatic PDAC, it appears that combination IT-CT may be associated with a survival advantage compared to CT alone.
Pedestrians in Iran: Determinants of Unsafe Traffic Behaviors of Pedestrians
Authors: Aghdam Fatemeh Bakhtari , Bazargani Homayoyn Sadeghi , Sarbakhsh Parvin , Pashaie Tahere , Ponent Koen , Nicknejad Maryam
Published: December 2020

Background: Pedestrians are among the most vulnerable groups in traffic accidents. This study investigates the determinants of traffic behaviors of pedestrians. Methods: In this cross-sectional study, the behavior of 600 pedestrians in the city of Urmia, northwestern Iran, was evaluated from May to October 2018, using a pedestrian traffic behavior questionnaire consisting of five dimensions: traffic violations, traffic distraction, adherence to traffic rules, aggressive behavior, and positive behaviors. Cluster sampling was conducted among 30% of the health centers in each district of the city. Thereafter, individuals were randomly selected from each center depending on the covered population. Results: Although 17% of the pedestrians demonstrated safe traffic behaviors, over 85% were distracted, more than 80% did not comply with traffic laws, the majority violated rules and displayed no positive traffic behaviors, and half of the participants were aggressive. Age, gender, marital status, education level, daily walking rate, and transportation mode were significant predictors of traffic behavior.Conclusion: Most pedestrians demonstrate unsafe traffic behaviors. The youth, those who were single, those with lower education, and those with less walking rate showcased higher unsafe behaviors. Training and intervention programs should be implemented to improve all domains of pedestrian traffic behaviors factoring in age and other predictors.
A new tool for predicting in-hospital mortality in Chinese older patients with exacerbation of chronic obstructive pulmonary disease(AECOPD): frailty index based on common laboratory tests (FI-Lab)
Authors: Gu Jinjin , Zheng Lijie , Liu Qiang
Published: December 2020

Introduction: The exacerbation of chronic obstructive pulmonary disease(AECOPD)is a common and fetal disease but with no ideal predictor of in-hospital mortality. Frailty prevails in older adults with AECOPD and can cause increased vulnerability to many adverse health outcomes including death. However, we know little about how frailty affects in-hospital mortality in older AECOPD patients. Objective: To explore the predictive validity of FI-Lab—an objective tool for assessing frailty including 21 routine blood tests plus systolic and diastolic blood pressure (a score between 0 and 1, a higher score indicates greater frailty)—for in-hospital mortality in patients with AECOPD. Methods: We reviewed the hospitalization records of older AECOPD inpatients from September 2016 to June 2019 at Zhenjiang First People's Hospital. We compared survivors to non-survivors. We used propensity score matching (PSM) to balance priori differences between survivors and non-survivors. Logistic regression analysis was used to select the associated predictors of in-hospital mortality. Receiver-operating characteristic (ROC) curves were calculated to estimate the area under the ROC curve (AUCs) for FI-Lab and DECAF(a commonly used predictor of AECOPD including dyspnea, eosinophilia, pulmonary consolidation, acidemia, and atrial fibrillation; a score between 1and 6; a higher score indicates poorer condition)in relation to mortality. Data were analyzed using IBM SPSS for Windows, Version 23.0. Results: A total of 154 patients—77 survivors and 77 non-survivors—were included in the study finally. The mean age of these patients was 79.73 ± 8.38 years. Both of the mean DECAF score, the mean FI-Lab value of non-survivors were statistically higher than those of survivors(4.45 ± 0.80 versus 3.03 ± 0.90,P = 0.000; 0.51 ± 0.13 versus 0.29 ± 0.10,P = 0.000,respectively). Logistic regression analysis suggested that high DECAF grade and high FI-Lab grade were strong related factors of death in AECOPD patients (OR:5.620, 95%CI 2.811–11.236, P = 0.000; OR:8.705, 95%CI 3.646–20.782, P = 0.000, respectively). The DECAF scores of most non-survivors were ≥ 4༈n = 71,92.21%༉. FI-Lab value predicted in-hospital mortality at a cut-off value of 0.4388 with 70.1% sensitivity, 96.1% specificity, 0.675 Youden index. DECAF score predicted in-hospital mortality at a cut-off value of 3.5 with 92.2% sensitivity, 72.7% specificity, 0.649 Youden index. The areas under the ROC curves were 0.906 for FI-Lab and 0.870 for DECAF with no statistically significant༈P = 0.2991). Conclusions: FI-Lab has a slightly stronger screening ability than DECAF. FI-Lab is a simple, effective and objective indicator and can be quick to help clinicians to assess in-hospital mortality of AECOPD patients.
Two cases of sporadic intra-abdominal desmoid tumor with a very unusual onset
Authors: Kuwabara Hiroshi , Katayanagi Sou , Koganezawa Itsuki , Nakagawa Masashi , Katsumata Kenji , Tsuchida Akihiko , Kawachi Shigeyuki
Published: December 2020

BackgroundIntra-abdominal desmoid tumors are rare soft tissue tumors that arise mainly in the mesentery and pelvis. Causes include mutations in the APC gene, which is the causative gene of familial adenomatous polyposis (FAP), estrogen-associated changes after childbirth, and mechanical factors, such as history of abdominal surgery. However, there are cases of intra-abdominal desmoid tumors that develop in the absence of such causes, although they are rare, and diagnosis is often difficult from clinical findings. We encountered 2 cases of patients with sporadic intra-abdominal desmoid tumors with a very unusual onset.Case presentationThe first patient was a 51-year-old man. He presented to the clinic with sudden onset of abdominal pain, and was referred to our department because of a giant tumor detected on abdominal ultrasonography. Imaging diagnosis displayed a 19-cm tumor with internal tumoral hemorrhage, but no definitive diagnosis was made. Resection of the tumor was performed for diagnostic and therapeutic purposes. The second patient was a 41-year-old man. Right hydronephrosis was detected on abdominal ultrasonography at a medical check-up. We diagnosed invasion of the primary mesenteric tumor into the right ureter by diagnostic imaging, and performed ileocecal resection with partial right ureteral resection for a definitive diagnosis and therapeutic purposes. The tumors of both patients had developed from the ileal mesentery. Although the tumors were substantially different in their macroscopic morphology and progression pattern, they showed similar pathological characteristics, i.e., they consisted of bundles of collagen fibrils of spindle-shaped fibroblasts with low cell atypia, and were diagnosed to be desmoid tumors by positive immunohistochemical staining for β-catenin. Both patients had no susceptibility factors for desmoid tumors.ConclusionsTo our knowledge, there have been very few reports to date of sporadic intra-abdominal desmoid tumors that were diagnosed owing to acute abdominal pain caused by tumoral hemorrhage or asymptomatic ureteral obstruction. Intra-abdominal desmoid tumors can cause various symptoms depending on the location of their occurrence and their progression pattern and are often difficult to differentiate from other mesenchymal tumors on imaging findings. Diagnosis therefore requires experience and knowledge that is not bound by preconceptions.
Expression and characterization of functional human vascular endothelial growth factor (VEGF165) in Kluyveromyces lactis
Authors: Ceylan Hülya Kuduğ , Tayhan Seçil Erden , Gökçe İsa
Published: December 2020

Among the vascular endothelial growth factor (VEGF) family variants, the 165-amino acid isoform (VEGF165) is the best characterized and most potent endothelial cell mitogenic factor. It is known that VEGF165 mediates angiogenesis and has the potential for the therapeutic applications. In this study, the expression system of Kluyveromyces lactis that produces the recombinant human VEGF165 has been evaluated. The gene encoding human VEGF165 was successfully cloned in the pKLAC2 expression vector containing a strong LAC4 promoter, after which a pKLAC2-VEGF165 plasmid was constructed. After the transformation, the recombinant human vascular endothelial growth factor 165 (rhVEGF165) was expressed in K. lactis GG799 cells (~ 5.7 mg/L) confirmed by SDS-PAGE and Western blotting and downstream purification processed comprising ammonium sulphate precipitation and affinity chromatography. The biological activity of the purified rhVEGF165 was confirmed by the proliferation of the human umbilical vein-derived endothelial cells (HUVEC) in a dose- and time-dependent manner. The K. lactis-derived rhVEGF165 exhibited a higher proliferative activity compared with a commercially available rhVEGF165 with a half-maximal effective concentration of 3.0. Cell migration analysis was conducted to evaluate the in vitro wound healing effect of the produced rhVEGF165 via a scratch assay. These findings indicate that K. lactis could be a suitable host for secreting bioactive human VEGF165 for therapeutic use.