bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors associated with non-vaccination against measles among 12-23 months old children in Yirgachefe district of SNNPR, Ethiopia, 2016
Authors: Degife Luna Habtamu , Worku Yoseph , Tadesse Muse
Published: January 2020

Immunization is an effective and proven tool for controlling and eliminating life-threatening vaccine preventable infectious diseases. In Ethiopia 5% of childhood mortalities are due to measles. Despite the availability of a safe and effective vaccine, measles outbreaks secondary to non-vaccination are occurring in southern Ethiopia especially in Yirgachefe district. This study was done to assess the risk factors associated with non-vaccination against measles. A Community-based unmatched case control study was conducted in Yirgachefe district from December 1-31, 2016.Cases were children in the age group of 12- 23 months of age who did not take measles vaccination and controls were children in the same age group who took at least one dose of measles vaccine. The study was done in 6 randomly selected kebeles and cases and controls were selected randomly by probability proportional to size sampling. A structured questionnaire was used for data collection. Statistical significance was interpreted using Odds ratio with 95% confidence interval and P value <0.05.A total of 320 individuals (107 cases and 214 controls) were approached for interview with a response rate of 93.75%. Of the cases, 57% were males and more than half fall in the 12-18 months age group. Knowledge regarding measles vaccination was also asked and among cases 72% heard about measles, 26% knew that all children should be vaccinated, 31% had awareness about the right age of vaccination, 60% agrees that measles is vaccine preventable and 65% knew that it is contagious. In multivariable logistic regression, Lack of Ante Natal Care follow up(ANC) (Adjusted Odds Ratio (AOR) =3.57; 95% Confidence Interval (CI): 1.22-10.44), lack of knowledge on the importance of vaccination, who should be vaccinated and if measles is contagious with an AOR and CI of (AOR=6.81; 95% CI: 1.56-29.64), (AOR=4.29; 95% CI: 1.83-10.04) and (AOR=8.97; 95%CI: 3.15-25.58) respectively were independent risk factors.Education and awareness about measles and its immunization should be given to the community. Additionally, ANC follow up should also be strengthened.
The prevalence of selected non-communicable disease risk factors among HIV patients on anti-retroviral therapy in Bushbuckridge Sub-district, Mpumalanga province
Authors: Mathebula Rudy Londile , Maimela Eric , Ntuli Thembelihle Samuel
Published: January 2020

Background: The rates of non-communicable diseases (NCD’s) appear to be increasing in human immunodeficiency virus (HIV) infected people as compared to non-HIV infected people and this will have major implications for clinical care. The aim of the current study was to profile selected cardiovascular disease risk factors among HIV patients on anti-retroviral therapy (ART) in Bushbuckridge sub-district. Methodology: The current study followed a quantitative cross-sectional study design using a questionnaire which was adapted from World Health Organization STEPwise approach to Surveillance (WHO STEPS). Participants were HIV infected people on ART and data was entered into a computer software Microsoft excel, then imported to Stata 12 for analysis. Results: The overall prevalence of overweight at the initiation of ART amongst the participants was 18.1% and obesity was 11.5% as compared to the time of the study which was 21.4% overweight and 19.6% obese. The average time of ART initiation to study period was 3.6 years. The study findings revealed a significant difference (p-value 0.006) between the baseline and current body mass index at time of study for females. Hypertension was found to be having a significant difference (p-value 0.026 and 0.038) between the baseline and current body mass index at time of study for males and females respectively. The overall prevalence of hypertension was found to be 34.6%, overweight was 21.4% obesity was 19.6%. The overall prevalence of abnormal waist circumference was 31.9% and females had a higher prevalence of 42.5% as compared to 4.4% of males. The overall prevalence of smoking 10.8% and alcohol consumption was 21.7%. Males were 22.5 times more likely to be smokers than females (p<0.001) and older people were found to be 0.3 times less likely to consume alcohol as compared to young people. Conclusion: High levels of selected risk factors for NCDs among adults on ART in the current study area suggest an urgent need for health interventions to control risk factors in an era of HIV with an aim of reducing multiple morbidity of chronic diseases. occurrence of NCDs and their risk factors with an aim to achieve positive effects of the long-term ART.
Effect of caudal ketamine on minimum local anesthetic concentration of ropivacaine in children: A prospective randomized trial
Authors: Wang Huai-Zhen , Wang Ling-Yu , Liang Hui-Hong , Fan Yan-Ting , Song Xing-Rong , She Ying-Jun
Published: January 2020

Background: Caudal ketamine has been shown to provide an effective and prolonged post-operative analgesia with few adverse effects. However, the effect of caudal ketamine on the minimum local anesthetic concentration (MLAC) of ropivacaine for intra-operative analgesia is unclear. Methods: One hundred and sixty-nine children were randomized to five groups: Group C (caudal ropivacaine only), Group K 0.25 (caudal ropivacaine plus 0.25 mg/kg ketamine), Group K 0.5 (caudal ropivacaine plus 0.5 mg/kg ketamine), Group K 0.75 (caudal ropivacaine plus 0.75 mg/kg ketamine), and Group K 1.0 (caudal ropivacaine plus 1.0 mg/kg ketamine). The primary outcome was the MLAC values of ropivacaine with/without ketamine for caudal block. Results: The MLAC values of ropivacaine were 0.128% (0.028%) in the control group, 0.112% (0.021%) in Group K 0.25 , 0.112% (0.018%) in Group K 0.5 , 0.110% (0.019%) in Group K 0.75 , and 0.110% (0.020%) in Group K 1.0 . There were no significant differences among the five groups for the MLAC values (p=0.11). During the post-operative period the mean durations of analgesia were 270, 381, 430, 494, and 591 min in the control, K 0.25 , K 0. 5 , K 0.75 , and K 1.0 groups respectively, which shown significant differences among the five groups (p<0.05). Conclusions: Adding caudal ketamine to ropivacaine prolong the duration of post-operative analgesia; however, it does not decrease the MLAC of caudal ropivacaine for intra-operative analgesia in children.
Lymph node metastasis around the entrance point to recurrent laryngeal nerve in papillary thyroid carcinoma
Authors: Lv Tian , Liu Zhuoran , Kuang Jie , Yan Jiqi
Published: January 2020

Background: There were are few reports on the lymph nodes of entrance point to recurrent laryngeal nerve (LN-epRLN) in the patients with papillary thyroid carcinoma (PTC). Therefore,Thus, we investigated the clinical significance of aimed to increase acknowledgement of LN-epRLN and implications it may have.explore clinical implication.
Methods: A prospective observational analysis including of 878 consecutive patients with PTC who underwent thyroidectomy from April 2016 to March 2017 was conductedperformed. We explored the surrounding tissue of laryngeal entry pointentrance point to recurrent laryngeal nerve, during routine central lymph node dissection (CLND). The lymph node specimens were sent separately for routine histopathological examination. Thereafter, , and the complications and follow-ups were recorded.
Results: LN-epRLNs was were found in 73 of the 878 patients, with and the metastasis metastatic rate of was 3.76%. In univariate analysis, LN-epRLN metastasis was correlated with further central nodal metastasis, tumor location in the upper third of the thyroid and tumor multifocality. Univariate and multivariate analysis showed central lymph node metastases can serve as independent predictors for LN-epRLN metastasis.
Conclusions: LN-epRLN can be the site of metastasis of PTC, and the positive LN-epRLN was highly predictive of other central nodal metastasis. LN-epRLN metastases in PTC were also associated with tumor location in the isthmus or upper third of the thyroid and tumor multifocality. In our study, we focus on acknowledgement of LN-epRLN. We emphasized the value of exactitude anatomy and the thoroughness of CLND for cN0-1a PTC.In summary, we confirmed the significance of LN-epRLN in metastasis and recurrence, which required precise anatomy and thorough CLND. In PTC patients, especially in suspicious presence of central cervical lymph node metastasis, attention should be given to excising the nodal tissue at the laryngeal entry point.
Electronic Medical Records for Discovery Research in Nonalcoholic Fatty Liver Disease
Authors: Kartoun Uri , Aggarwal Rahul , Perer Adam , Park Yoonyoung , Zhang Ping , Luo Heng , Dey Sanjoy , Corey Kathleen , Ng Kenney
Published: January 2020

Background: Nonalcoholic fatty liver disease (NAFLD) is a highly prevalent yet under-diagnosed and under-discussed disease. Given that NAFLD has not been explored sufficiently compared with other diseases, opportunities abound for scientists to discover new biomarkers (such as laboratory observations, current comorbidities, behavioral descriptors) that can be linked to the development of conditions and complications that may develop at a later stage of the patient’s life. Methods: We analyzed IBM Explorys, a repository that contains electronic medical records (EMRs) of more than 60 million individuals. We used a classification algorithm that members of our group have previously validated to identify patients at a high probability for NAFLD. The algorithm identified more than 80,000 patients with a high probability for NAFLD who had at least 5 years of follow-up. We applied standard statistical methods (such as logistic regression and bootstrapping) and used Clinical Classifications Software (CCS) definitions to identify associations between a variety of covariates and disease outcomes. Results: Our methodology identified several thousand strongly statistically significant associations between covariates and outcomes in NAFLD. Most of the associations are known, but others may be new and require further investigation in subsequent studies. Conclusions: A discovery mechanism composed of standard statistical methods applied on a large collection of EMRs, confirmed known associations and identified potentially new associations that can act as biomarkers that might merit further research.
The burden of unrecognised chronic kidney disease in patients with type 2 diabetes at a county hospital clinic in Kenya: implications to care and need for screening
Authors: Otieno Frederick C. F. , Ogola Elijah N , Kimando Mercy W , Mutai Ken K
Published: January 2020

Background : Chronic Kidney Disease (CKD) in patients with type 2 diabetes enhances their cardiovascular risk and diseases, and a strong predictor of progression to end-stage kidney disease. Early diagnosis is encouraged for referral to specialist kidney care to initiate active management that optimizes outcomes, including forestalling progression to end-stage kidney disease.
This study was conducted in a regional referral public health facility in Central Kenya with a high prevalence of type 2 diabetes. It was aimed at finding out the burden of undiagnosed chronic kidney disease in their clinic of ambulatory patients with type 2 diabetes who dwell mainly in the rural area.
Methods : A cross-sectional study was conducted at the out-patient of Nyeri County hospital where 385 patients were enrolled over five months. Informed consent was obtained and clinical evaluation was done. A spot sample of urine was obtained for albuminuria and venous blood drawn for HbA1c, Lipids and serum creatinine. Estimated GFR (eGFR) was calculated using the Cockroft-Gault equation. Chronic kidney disease (CKD) was classified on KDIGO scale. Albuminuria was reported as either positive or negative.
Main outcomes measure: Estimated Glomerular filtration rate and albuminuria as markers of chronic kidney disease.
Results : A total of 385 participants were included in the study, 252 (65.5%) were females. There were 39.0 % (95%CI 34.3-44.2) patients in CKD/KDIGO stages 3, 4 and 5 and 32.7% (95%CI, 27.8-37.4) had Albuminuria. The risk factors that were significantly associated with chronic kidney disease/KDIGO stages 3, 4 and 5 were: age >50years, long duration with diabetes >5years and hypertension. Employment and paradoxically, obesity reduced the odds of having CKD, probably as markers of better socio-economic status.
Conclusion : Unrecognized CKD of KDIGO stages 3,4 and 5 occurred in over thirty percent of the study patients. The risk factors of hypertension, age above 50, long duration of diabetes should help identify those at high risk of developing CKD, for screening and linkage to care. They are at high risk of progression to end-stage kidney disease and cardiovascular events. The imperative of screening for chronic kidney disease is availing care in publicly-funded hospitals.
Predictors of advanced fibrosis in elderly patients with biopsy-confirmed nonalcoholic fatty liver disease: The GOASIA study
Authors: Author) Panyavee Pitisuttithum(Former Corresponding , Chan Wah Kheong , Piyachaturawat Panida , Imajo Kento , Nakajima Atsushi , Seki Yosuke , Kasama Kazunori , Kakizaki Satoru , Fan Jian Gao , Song Myeong Jun , Yoon Seung Kew , Dan Yock Young , Lesmana Laurentius , Ho Khek Yu , Goh Khean Lee , Wong Vincent Wai Sun , Author) Sombat Treeprasertsuk(New Corresponding
Published: January 2020

Background: The Gut and Obesity in Asia (GOASIA) Workgroup was formed to study obesity and gastrointestinal diseases in the Asia Pacific region. We aimed to 1) compare the characteristics of elderly (i.e. age ≥ 60) vs. non-elderly patients with biopsy-proven nonalcoholic fatty liver disease (NAFLD); 2) identify predictors of advanced fibrosis in elderly patients with NAFLD; and 3) assess the performance of non-invasive fibrosis scores in the prediction of advance fibrosis in the elderly population.
Methods: We abstracted the data of 1008 patients with NAFLD from nine centers across eight countries. Characteristics of elderly and non-elderly patients with NAFLD were compared using 1:3 sex-matched analysis.
Results: Of the 1008 patients, 175 were elderly [age 64 (62-67) years], who were matched with 525 non-elderly patients [46 (36-54) years]. Elderly patients were more likely to have advanced fibrosis (35.4% vs. 13.3%; p<0.001). By multivariable analysis, factors associated with advanced fibrosis in elderly patients included female sex [odds ratio (OR) 3.21; 95% confidence interval (CI) 1.37-7.54] and hypertension (OR 3.68; 95%CI 1.11-12.23). The area under receiver-operating characteristics curve (95% CI) of aspartate aminotransferase-to-platelet ratio index, NAFLD fibrosis score and Fibrosis-4 index for predicting advanced fibrosis in elderly patients were 0.62 (0.52-0.72), 0.65 (0.55-0.75) and 0.64 (0.54-0.74) respectively.
Conclusions: Elderly patients with NAFLD had a higher prevalence of advanced fibrosis than non-elderly patients. Female and hypertension were predicting factors for advanced fibrosis in the elderly. Non-invasive fibrosis scores had a lower specificity in elderly.
Assessing health system challenges and opportunities for better noncommunicable disease outcomes: the case of Mauritius
Authors: Musango Laurent , TIMOL Maryam , BURHOO Premduth , SHAIKH Faisal , DONNEN Philippe , KIRIGIA Joses Muthuri
Published: January 2020

Background: The objectives of the study reported in this paper were: (a) to score the coverage of core NCD population-based interventions and individual services in Mauritius; (b) to analyse and score the presence of 15 common health system challenges that impede delivery of core NCD interventions and services in Mauritius; and (c) to provide policy recommendations for Mauritius to address health system barriers to delivery of NCD interventions and services.Methods: The Mauritius country assessment applied the guidelines developed by the World Health Organization Regional Office for Europe for systematically scoring coverage of NCD interventions and assessing health system challenges for improving NCD outcomes. The assessment used qualitative research design approach. Results: Of the 24 core population-based interventions for addressing key NCD risk factors, 16.7% were rated extensive, 37.5% moderate and 45.8% limited. Three (20%), 8 (53%) and 4 (27%) of the 15 individual/personal CVD, diabetes and cancer services were rated extensive, moderate and limited respectively. The top five health system challenges hampering scale-up of coverage of population-based NCD interventions in Mauritius were inadequate interagency cooperation; limited application of explicit priority setting approaches; inadequate change management; sub-optimal distribution and mix human resources; insufficient population empowerment; and insufficient political commitment. The top five challenges had average scores of between 3.1 (interagency cooperation) and 2.4 (distribution and mix of human resources).The top five health system challenges constraining expansion in coverage of individual NCD services were limited integration of evidence into practice; limited use of explicit priority-setting approaches; inadequate application of information and technology solutions; insufficient population empowerment; and sub-optimal distribution and mix of human resources. The top five challenges for individual interventions had mean scores varying between 2.6 (integration of evidence into practice) and 1.7 (distribution and mix of human resources).Conclusions: Mauritius needs to increase its domestic general government investments into the national health system and requisite multi-sectoral action to address the priority health system challenges with a view of bridging the existing gaps in coverage of NCD population-based interventions and individual services.
A survey of the working status of family medicine physicians in clinics and hospitals in Korea
Authors: Shin Hyun-Young
Published: January 2020

Background In the approximately 35 years since family medicine was established in South Korea, family medicine physicians have sought to expand their expertise to cover clinical fields beyond primary medicine. This study examines their working status and compares the working conditions of family medicine physicians in clinics and hospitals in Korea.Methods We conducted an online survey with 4,057 family medicine physicians in Korea in 2016. The results were analyzed using descriptive statistics.Results Of the respondents, 572 doctors were working in clinics and 441 in hospitals. In the analysis of treatment pattern by doctors, the rate of chronic disease management was 84.7% in clinics and 93.4% in hospitals ( p < 0.001), and the rate of diseases covered by national insurance was 74.8% in clinics and 76.9% in hospitals ( p = 0.005). Among physicians younger than 40 years, the rate of chronic disease management and diseases covered by national insurance were 64.6% and 68.0% in clinics and 93.6% and 78.5% in hospitals, retrospectively.Conclusions Family medicine physicians working in hospitals have higher rates of chronic disease management and diseases covered by national insurance. This discrepancy of treatment pattern became larger for doctors younger than 40 years. More in-depth studies of the treatment pattern and its tendencies between family medicine physicians in clinics and hospitals are needed in the future.
Finite Elements Analysis of the Temporomandibular Joint Disc in Patients with Intra-articular Disorders
Authors: Lai Linfeng , Xiong Guofeng , Huang Chenyao , Zhou Fan , Xia Fujian
Published: January 2020

Background：Anterior and/or medial displacement of the temporomandibular joint disorder(TMJ) disc or intra-articular disorders( ID) is the most common form of TMJ dysfunction(TMD).TMD cause change of friction coefficient during TMJ movement. In the present study, We provided a 3D finite elements models(FEM) including the maxilla, disc and mandible and evaluated the stress distribution with different friction coefficient.Methods: 14 volunteers without TMD and 20 TMD patients,who were diagnosed by MRI, were selected.CT and MRI data were collected to build 3D FEA model of mandibular and TMJ disc.Stress distribution with different friction coefficient was measured.Result: In the normal model, stress distribution on TMJ disc was 2.07±0.17,1.49±0.14,1.41±0.14MPa with 0.001 0.3 and 0.4 friction coefficient.In TMD model,stress distribution is 3.87±0.15,7.23±0.22,7.77±0.19MPa respectively. Conclusion:When the friction coefficient of the side with anterior displacement increased, stress on the disc, condyle and mandible of the opposite side increased. Simultaneously, stress values of the disc, condyle and mandible were higher than those of the normal lateral joint.
Hard-threshold-Neural-Network based Prediction of Organic Synthetic Outcomes
Authors: Hu Haoyang , Yuan Zhihong
Published: January 2020

Retrosynthetic analysis is the canonical technique to plan the synthesis route of organic molecules in drug discovery and development. In this technique, the screening of synthetic tree branches requires accurate forward reaction prediction, but existing software is still far from completing this step independently. Previous studies have attempted to apply neural network in the forward reaction prediction, but the accuracy is not satisfying. Through using the Edit Vector based description and Extended-Connectivity Fingerprints to transform reaction into vector, the presented work focuses on the update of neural network to improve the template-based forward reaction prediction. Hard-threshold activation and target propagation algorithm are implemented by introducing the mixed-convex combinatorial optimization. Comparative tests are conducted to explore the optimal hyperparameter set. Using 15, 000 experimental reaction extracted from granted United States patents, the proposed hard-threshold neural network is systematically trained and tested. The results demonstrate that a higher prediction accuracy is obtained when compared to the traditional neural network with backpropagation algorithm. Some successfully predicted reaction examples are also briefly illustrated.
Adjuvant chemotherapy could not bring survival benefit to HR-positive, HER2-negative, pT1b-c/N0-1/M0 invasive lobular carcinoma of the breast: a propensity score matching study based on SEER database
Authors: Hu Guangfu , Hu Guangxia , Zhang Chengjiao , Lin Xiaoyan , Shan Ming , Yu Yanmin , Lu Yongwei , Niu Ruijie , Ye Hui , Wang Cheng , Xu Cheng
Published: January 2020

Background : The benefit of adjuvant chemotherapy in invasive lobular carcinoma (ILC) is still unclear. The objective of the current study was to elucidate the effectiveness of adjuvant chemotherapy in hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative, pT1b-c/N0-1/M0 ILC.
Methods: Based on Surveillance, Epidemiology, and End-Results (SEER) database, we identified original 12334 HR-positive, HER2-negative, pT1b-c/N0-1/M0 ILC patients, who were then divided into adjuvant chemotherapy group and control group. End-points were overall survival (OS) and breast cancer-specific mortality (BCSM). Aiming to minimize the selection bias of baseline characteristics, Propensity Score Matching (PSM) method was used.
Results : In a total of 12334 patients with HR-positive, HER2-negative, pT1b-c/N0-1/M0 ILC, 1785 patients (14.5%) were allocated into adjuvant chemotherapy group and 10549 (85.5%) into control group. Used PSM, the 1785 patients in adjuvant chemotherapy group matched to the 1785 patients in control group. By Kaplan-Meier survival analyses, we observed no beneficial effect of adjuvant chemotherapy on OS in both original samples ( P =0.639) and matched samples ( P =0.962), however, ineffective or even contrary results of adjuvant chemotherapy on BCSM both in original samples (P =0.001) and in matched samples ( P= 0.002). In both original and matched multivariate Cox models, we observed ineffectiveness of adjuvant chemotherapy on OS (hazard ratio (HR) for overall survival = 0.82, 95% confidence interval (CI) [0.62-1.09]; P =0.172 and HR=0.90, 95%CI [0.65-1.26]; P =0.553, respectively), unexpectedly promoting effect of adjuvant chemotherapy on BCSM (HR=2.33, 95%CI [1.47-3.67]; P =0.001 and HR=2.41, 95%CI [1.32-4.39]; P =0.004, respectively). Standard surgery was beneficial to the survival of patients. Lymph node metastasis was detrimental to survival and radiotherapy brought survival benefit in original samples, but two issues had unobvious effect in matched samples.
Conclusion: In this study, adjuvant chemotherapy did not improve survival for patients with HR-positive, HER2-negative pT1b-c/N0-1/M0 ILC.
Individualized procedures for splenic artery dissection during laparoscopic distal pancreatectomy.
Authors: Wada Yusuke , Aoki Takeshi , Murakami Masahiko , Fujimori Akira , Koizumi Tomotake , Kusano Tomokazu , Matsuda Kazuhiro , Nogaki Koji , Hakozaki Tomoki , Shibata Hideki , Tomioka Kodai
Published: January 2020

[Background] There are no established standard criteria for choosing the most appropriate procedure of splenic artery dissection during laparoscopic distal pancreatectomy (LDP). The aim of this study was to evaluate the clinical benefits of individualized procedures for splenic artery dissection during LDP based on the variations in arterial structure visualized on preoperative three-dimensional computed tomography (3D-CT).
[Methods] Patients who underwent LDP following 3D-CT at a single center were retrospectively evaluated. 3D-CT images were used to construct virtual 3D laparoscopic images for surgical planning. The splenic artery was classified into two major anatomic types: type S that curves and runs suprapancreatic and type D that runs straight and dorsal to the pancreas. Splenic artery dissection was planned according to these two variations, with type S dissected using ansuprapancreatic approach and type D using a dorsal approach.
[Results] Type-specific dissection was applied for 30 patients: 25 (83%) with type S and 5 (17%) with type D splenic artery anatomies. In 25 (83%) patients, the splenic artery was successfully dissected using the planned surgical procedure, whereas the surgical plan had to be altered in 5 cases (17%) due to difficulty in dissecting the splenic artery.
[Conclusion] The individualized procedures for splenic artery dissection according to anatomic variations visualized on 3D-CT images can help improve the success and safety of LDP.
Epigenetic induction of tumor stemness via the Lipopolysaccharide-TET3-HOXB2 signaling axis in esophageal squamous cell carcinoma
Authors: Xu Fengkai , Liu Zhonghe , Liu Ronghua , Lu Chunlai , Wang Lin , Mao Wei , Zhu Qiaoliang , Shou Huankai , Zhang Kunpeng , Li Yin , Chu Yiwei , Gu Jie , Ge Di
Published: January 2020

Background: Esophageal squamous cell cancer (ESCC) is one kind of frequent digestive tumor. The inflammatory environment plays an important role in the tumorigenesis and development of ESCC. Cancer stem cells are a small group of tumor cells with stem cell characteristics, which can potentially hinder the tumor management and treatment.
Methods: ELISA was performed to detect the lipopolysaccharide concentration in cancer tissues. qPCR, Western blot, FACS, Immunohistochemistry, Immunofluorescence and Dot blot were applied to detect target genes expression. CCK-8, Colony-formation, Transwell, Sphere and Xenograft were conducted to investigate the function of cells, influenced by risk factors. The survival curve was drawn with the Kaplan-Meier product limit estimator. Nano-hmC-Seal-seq was utilized to detect the downstream target of TET3. ChIP-qPCR was adopted to demonstrate the transcriptional regulation of stem cell-associated genes by HOXB2.
Results: Lipopolysaccharide concentration was significantly up-regulated in ESCC. High concentration of lipopolysaccharide stimulation induced the stemness of ESCC cells. TET3 expression was elevated with lipopolysaccharide stimulation via p38/ERK-MAPK pathway in ESCC and negatively correlated with patients’ survival. TET3 induced the stemness of ESCC cells. Nano-hmC-Seal-seq showed that TET3 overexpression led to a significant increase in 5hmC levels of HOXB2 gene region, which was thus identified as the downstream target of TET3. The binding of HOXB2 to NANOG and cMYC was veriﬁed by ChIP-qPCR.
Conclusions: Lipopolysaccharide served as a tumor promotor in ESCC by inducing cancer cell stemness through the activation of a LPS-TET3-HOXB2 signaling axis, which might provide a novel therapeutic strategy for ESCC.
Intestinal flora imbalance affects bile acid metabolism and is associated with gallstone formation
Authors: Wang Qiang , Hao Chenjun , Yao Wenchao , Zhu Defu , Lu Haifeng , Li Long , Ma Biao , Xue Dongbo , Zhang Weihui
Published: January 2020

Background: The gut microbiota participates in the metabolism of substances and energy, promotes the development and maturation of the immune system, forms the mucosal barrier, and protects the host from pathogen attacks. Although the pathogenesis of cholesterol gallstones is still not clear, studies have suggested that gut microbiota dysbiosis plays an important role in their formation. Methods: Microbial DNA from faeces of normal control patients and those of patients with calculi was subjected to 16S rRNA gene sequencing to detect gene expression changes in intestinal microbes. ELISA kits were used to measure free bile acids, secondary bile acids and coprostanol according to the manufacturer’s instructions. The relationship between flora and their metabolites was then analysed. Results: In the gallstone group, the diversity of intestinal bacteria and the abundances of certain phylogroups were significantly decreased (p<0.05), especially Firmicutes (p<0.05), the largest phylum represented by the gut microbiota. This study found an increase in free bile acids (p<0.001) and secondary bile acids (p<0.01) in the enterohepatic circulation. Bile salt hydrolase activity was not related to the abundances of BSH-active bacteria. 7a-dehydroxylating gut bacteria were significantly increased (p<0.01), whereas cholesterol-lowering bacteria were significantly reduced (p<0.05). The Ruminococcus gnavus group could be used as a biomarker to distinguish the gallstone group from the control group. Conclusion: We conclude that intestinal flora imbalance affects bile acid and cholesterol metabolism and is associated with gallstone formation.
Proportion of NAFLD patients with normal ALT value in overall NAFLD patients: a systematic review and meta-analysis
Authors: Ma Xuefeng , Liu Shousheng , Zhang Jie , Dong Mengzhen , Wang Yifen , Wang Mengke , Yongning Xin
Published: January 2020

Background: ALT value is often used to reflect the hepatic inflammation and injury in NAFLD patients, but many studies proved that ALT values were normal in many NAFLD patients. The aim of this study was to identify the summarized proportion of NAFLD patients with normal ALT value in the overall NAFLD patients. Methods: Electronic databases PubMed, EMBASE, Ovid, and the Cochrane Library were searched for potential studies published from January 1, 2000 to September 30, 2019. Studies that have reported the number of NAFLD or NASH patients with normal and abnormal ALT value were included and analyzed. Abstracts, reviews, case reports, and letters were excluded. Results: A total of 11 studies with 4084 patients were included for assessing the summarized proportion of NAFLD patients with normal ALT in overall NAFLD patients. As the results shown, the summarized proportion of NAFLD patients with normal ALT value in overall NAFLD patients was 25% (95%CI: 20%-31%) which was calculated by the random-effects model. The summarized proportion of NASH patients with normal ALT value in overall NASH patients was 19% (95%CI: 13%-27%). Subgroup analysis includes region, study type, diagnostic method, and group size were conducted to investigate the resource of heterogeneity in the summarized proportion of NAFLD and NASH patients with normal ALT value. Conclusions: 25% NAFLD patients and 19% NASH patients possess the normal ALT value in the clinical manifestation. The value of ALT in the clinical diagnosis of NAFLD and NASH remains need be further testified.
WITHDRAWN: Physiological and molecular changes to short and prolonged heat in highlands China potato genotype
Authors: Liu Bailin , Cao Minxuan , Kong Lingshuang , Chen Qin , Liao Yuncheng
Published: January 2020

Background: Potato is the fourth world's most important crops. Global warming has heavily constrained potato production. Although some work has been undertaken regarding the response of potato to moderately increased temperature (25-30°C), few studies have examined the extreme high temperature above 35°C and sustaining high temperature impact on physiological, biochemical and molecular responses of potato. Methods: Potato plants were subjected to high temperature (35°C/33 °C day/night) treatments for 6 h (short) and 3 days (long), physiological and biochemical response of electrolyte leakage and photosynthetic performance were measured, transcriptome and metabolome profiles of leaves were examined. Expression profiles of 20 DEGs were verified by RT–qPCR, heat induced conserved genes were transient expressed in Nicotiana benthamiana.Results: Growth at short heat stress induced stomata open and lower membrane stability. Prolonged heat stress decreased the photosynthetic parameters and increased photosynthetic pigments. Integration of transcriptomics and metabolomics methods demonstrated that 448 heat upregulated and 918 heat downregulated genes as well as 325 and 219 compounds in the positive and negative ionization modes, respectively, that were up- or down-regulated in leaves detected in responsive to short and prolonged heat stress. Global transcripts changes were mainly induced by short heat stress, where metabolites changes were mainly activated by prolonged heat stress. General responses to heat stress in gene expression and metabolite accumulation enriched in amino acid metabolism and secondary metabolism pathway. Metabolite and transcript abundances for the up-regulation of flavone and flavonol biosynthesis under the prolonged heat stress were closely correlated. Both conserved and heat- and potato-specific stress responsive genes were identified by comparing heat and drought stress in potato as well as heat stress in potato and Arabidopsis shoots, transient expression of four heat induced genes in Nicotiana benthamiana exhibited heat tolerance to higher temperature.Conclusions: A new potato leaf transcriptomes and metabolomes revealed a widely adaptive response to high temperature by mainly generation and accumulation of heat shock proteins.
The Impact of an Inpatient Treatment on the Psychodynamic and Symptomatology in Couples Concordant for Substance Use: A Qualitative Study
Authors: Hansen Aksel , Brokatzky Stefan , Thomas Kai , Sternbauer Christina , Rudaz Myriam , Dammann Gerhard
Published: January 2020

Background: Much literature is devoted to describing the psychosocial situation of patients with a substance use disorder and the course of their families and healthy partners. Couples where both partners have a substance use disorder are less well described and even less often studied. Method: This study described the psychodynamic and symptomatology, as measured by the Brief Symptom Inventory (BSI), of five concordant couples treated simultaneously as inpatients at the same specialized substance use disorder ward. Results: The psychodynamic characterization of the couples revealed that the female was often the organizer, whereas the male was either the motivator or the lackey. In addition, the female was often emotionally dependent on the male. Most individuals showed symptom reductions from pre- to post-treatment, although the men seemed to benefit to a greater extent than the women. Moreover, the patients did not necessarily desire couples therapy. Conclusion: Treating couples concordant for substance use together in the same inpatient setting is unusual, but possible. The dynamics of couples in drug rehabilitation should be further investigated taking into account possible gender differences.
Metropolitan age-specific mortality trends at borough and neighbourhood level: The case of Mexico City
Authors: Baca-Lopez Karol , Fresno Cristobal , Espinal-Enriquez Jesus , Flores-Merino Miriam V. , Camacho-Lopez Miguel A. , Hernandez-Lemus Enrique
Published: January 2020

Background Understanding the spatial and temporal patterns of mortality rates in a highly inhomogeneous metropolis, is a matter of public policy interest. In this context, there is no previous study that correlates both spatio-temporal and age-specific mortality rates in Mexico City. Methods Spatio-temporal kriging modelling was used over six age-specific mortality rates (from the years 2000 to 2016 in Mexico City), to gain both spatial (borough and neighbourhood) and temporal (year and trimester) data level description. Resulting data were modelled using time-evolution mixed effect models to unblurred mortality age-specific patterns. Posterior tests were carried out to compare mortality averages between geospatial locations. Results Mortality correlation extends in all study groups for as long as 12 years and as far as 13.27 km. The highest mortality rate takes place in the Cuauhtémoc borough, as it is the commercial, touristic and cultural core downtown Mexico City. On the contrary, Tlalpan borough is the one with the lowest mortality rates in all the study groups. Interestingly, post-productive mortality is the first age-specific cause of death, followed by infant, productive, pre-school and scholar groups. Conclusion The combinations of spatio-temporal Kriging estimation and time-evolution mixed effect models, allowed us to unveil relevant time and location trends that may be useful for public policy planning in Mexico City.
Decreasing incidence of pregnancy among HIV-positive adolescents in a large HIV treatment program in western Kenya between 2005 and 2017: A retrospective cohort study.
Authors: Millar Heather Christine , Keter Alfred K. , Musick Beverly S. , Apondi Edith , Wachira Juddy , MacDonald Katherine R. , Spitzer Rachel F. , Braitstein Paula
Published: January 2020

Background: The objective of this study was to estimate the prevalence, incidence and risk factors for pregnancy among HIV-positive adolescents in a large HIV treatment program in western Kenya. Methods: The Academic Model Providing Access to Healthcare (AMPATH) program is a partnership between Moi University, Moi Teaching and Referral Hospital and a consortium of 11 North American academic institutions. AMPATH currently provides care to 85,000 HIV-positive individuals in western Kenya. Included in this analysis were adolescents aged 10-19 enrolled in AMPATH between January 2005 and February 2017. Socio-demographic, behavioural, and clinical data at baseline and time-updated antiretroviral treatment (ART) data were extracted from the electronic medical records and summarized using descriptive statistics. Follow up time was defined as time of inclusion in the cohort until the date of first pregnancy or age 20, loss to follow up, death, or administrative censoring. Adolescent pregnancy rates and associated risk factors were determined. Results: There were 8565 adolescents eligible for analysis. Median age at enrolment in HIV care was 14.0 years. Only 17.7% had electricity at home and 14.4% had piped water, both indicators of a high level of poverty. 12.9% (1104) were pregnant at study inclusion. Of those not pregnant at enrolment, 5.6% (448) became pregnant at least once during follow-up. Another 1.0% (78) were pregnant at inclusion and became pregnant again during follow-up. The overall pregnancy incidence rate was 21.9 per 1000 woman years or 55.8 pregnancies per 1000 women. Between 2005 and 2017, pregnancy rates have decreased. Adolescents who became pregnant in follow-up were more likely to be older, to be married or living with a partner and to have at least one child already and less likely to be using family planning. Conclusions: A considerable number of these HIV-positive adolescents presented at enrolment into HIV care as pregnant and many became pregnant as adolescents during follow-up. Pregnancy rates remain high but have decreased from 2005 to 2017. Adolescent-focused sexual and reproductive health and ante/postnatal care programs may have the potential to improve maternal and neonatal outcomes as well as further decrease pregnancy rates in this high-risk group.
Modeling the Impact of Climate Change on Hydrological Responses in the Lake Tana Basin, Ethiopia
Authors: Teklay Achenafi , Dile Yihun T. , Asfaw Dereje H. , Bayabil Haimanote K , Sisay Kibruyesfa
Published: January 2020

BackgroundHydrologic systems have been changing due to the impact of climate change and climate variability. The impacts of climate change are set to increase in the future due to the rise of global warming. Quantifying the impact of climate change on the spatial and temporal hydrological processes is important for integrated water resource management. The Lake Tana basin, which is the source of the Upper Blue Nile, is vulnerable to climate change and variability. This study was carried out in the four major tributary watersheds of the Lake Tana basin: Gilgel Abay, Gumara, Ribb, and Megech. The climate model and hydrological model was used to (i) to evaluate the performance of the Soil and Water Assessment Tool for study watershed, (ii) to assess the future rainfall and temperature variability and change in the study watershed, and (iii) to examine the impact of climate change on future watershed hydrology. The study used dynamically downscaled climate data for the baseline (2010–2015) and future period (2046–2051) under two Representative Concentration Pathways (RCP4.5 and RCP8.5). The climate scenarios were simulated using the Weather Research and Forecasting (WRF) model, with a 4-km horizontal resolution. A linear scaling method was applied to minimize model biases. The SWAT model was used to estimate the baseline and future hydrology using the bias-corrected climate data. ResultsThe performance of the SWAT model was ‘good’ to ‘very good’ for both the calibration and validation periods, with the Nash–Sutcliffe efficiency values between 0.71 to 0.92. The projected changes in rainfall vary with seasons and watershed under both scenarios. On average, annual rainfall may increase by 9.8% and 21.2% under RCP4.5 and RCP8.5 scenarios, respectively. Minimum temperature may rise by 1.68 °C and 2.26 °C while maximum temperature may increase by 1.65 °C and 2.75 °C under RCP4.5 and RCP8.5 scenarios, respectively. The changes in climate may cause an increase in surface runoff by 20.9% and 46.5% under RCP4.5 and RCP8.5 scenarios, respectively, while the evapotranspiration increase by 4.7% and 12.2% under RCP4.5 and RCP8.5, respectively. ConclusionThe findings provide valuable insights to implement appropriate water management strategies to mitigate and adapt to the negative impacts of climate change and variability on the Lake Tana basin, and other regions which have similar agro-ecology.
Multi-drug-resistant diarrheagenic Escherichia coli pathotypes in pediatric patients with gastroenteritis from central Iran
Authors: Abbasi Elnaz , Mondanizadeh Mahdieh , Belkum Alex van , Ghaznavi-Rad Ehsanollah
Published: January 2020

Background Diarrheagenic Escherichia coli (DEC) is a significant cause of gastroenteritis and a major public health problem. This study investigates the prevalence and the antibiotic resistance patterns of DEC that were isolated from infectious diarrhea samples of pediatric patients from central Iran.Methods Pediatric diarrhea samples were collected from 230 pediatric patients visiting the hospital. E. coli pathotypes were diagnosed by using conventional culture methods and PCR. Antibiotic resistance profiles, the frequency of multi-drug resistance (MDR), and the phenotypic and genotypic characteristics of extended spectrum-β-lactamase (ESBL), AmpC and integron-associated genes were analyzed.Results Of the 230 samples of infectious diarrhea, 91 (39.5%) produced E. coli isolates. Of these, 32 cases (35.1%) were identified as DEC by culture and PCR. The frequency of the E. coli pathotypes obtained was as follows: EAEC 11/32 (34.3%), EPEC 9/32 (28.1%), ETEC 6/32 (18.7%), EIEC 3/32 (9.3%), and EHEC 3/32 (9.3%). The antibiotic resistance rates were greater for nalidixic acid (30/32; 93.7%), ampicillin (29/32; 90.6%), and tetracycline (25/32; 78.1%) than for any of the other tested antibiotics. High levels of MDR (25/32; 78.1%) and the presence of ESBL (18/32; 56.2%) and AmpC (9/32; 28.1%) were observed in the DEC isolates. The isolates showed a higher frequency of the ESBL genes [ bla TEM (18/18; 100%), bla CTX-M15 (17/18; 94.4%)], and AmpC [ bla CIT (4/9; 44.4%) and bla DHA (4/9; 44.4%)] than of the other ESBL and AmpC genes.Conclusion DEC appeared to be the second-most abundant agent of diarrhea in pediatric patients after Campylobacter jejuni , with frequent MDR and ESBL presence.
Masquelet Technique: Effects of Topical Mechanical Stability on the Formation of Masquelet Membrane in a Rabbit Radial Defect Model
Authors: Jie Xie , Donghao Liu , Haoyi Wang , Haitao Long , Yong Zhu , Yihe Hu , Liang Cheng , Zeng Min
Published: January 2020

Purpose The Masquelet technique is a commonly treatment strategy for segmental bone defects. Still, the exact generating mechanism is unknown. This study intends to explore the effects of topical mechanical stability on the formation of Masquelet membrane. Methods Thirty-six New Zealand white rabbits were evenly randomized into three groups. Segmental left radius shaft defect (length, 9 mm) was created in all rabbits. Bone defects were filled with polymethylmethacrylate (PMMA) in Non-fixation group, and with PMMA fixed with plates in Fixation group, and subjected to no disposal in control group. The stability of PMMA and plates were monitored via X-ray. And the membranes were excised for further Histological, IHC (Ki67, COL I, and CD31), and Western-Blotting analysis (RUNX2, ALP, VEGFA, and TGF-β1), 4 and 6 weeks post-operatively Results X-ray revealed no sign of plates loosening, or shift of PMMA. Pathological examinations suggested that vascularized and osteogenic membranes were formed around PMMA. IHC and Western-Blotting analysis revealed that both Fixation and Non-fixation group exerted significant effects on the expression of Ki67, COL I, and CD31 positive cells, as well as the protein expression of osteogenic (RUNX2, ALP) and angiogenic (VEGFA, TGF-β1) factors. And compared with membrane in Non-fixation group, Fixing PMMA spacer with plates caused a significant increase in osteogenic and angiogenic expression, 4 and 6 weeks post-operatively. Conclusion The present study indicates that rigid fixation provided by internal plate in Masquelet technique positively alters the quality of membrane formed surrounding PMMA, in terms of significantly osteogenic and angiogenic potential.