bluuebunny/crossref_metadata_2025 huggingface dataset:
Preoperative Neutrophil-to-lymphocyte Ratio May Predict Postoperative Pneumonia in Stage I–III Gastric Cancer Patients After Curative Gastrectomy: A Retrospective Study
Authors: Mori Mikito , Shuto Kiyohiko , Hirano Atsushi , Narushima Kazuo , Kosugi Chihiro , Yamazaki Masato , Koda Keiji , Yoshida Masahiro
Published: August 2020

Background: Several studies have demonstrated that diverse systemic inflammatory-based prognostic parameters predict poor prognosis in patients with gastric cancer. However, few studies focused on the relationships between postoperative complications and systemic inflammatory-based prognostic parameters after curative gastrectomy. We investigated the relationships between postoperative complications and these parameters to identify parameter-specific postoperative complications, and assessed the clinical utility of the parameters as predictors of postoperative complications in stage I–III gastric cancer patients.Methods: We retrospectively reviewed 300 patients who underwent curative gastrectomy for stage I–III gastric cancer. A postoperative complication sensitive to the systemic inflammatory-based prognostic parameters was identified using a receiver operating characteristic curve, and we evaluated the relationships between the identified postoperative complication and other clinical factors.Results: In total, 101 patients (33.7%) had postoperative Clavien–Dindo grade II–IV complications, namely anastomotic complications, such as leak, stenosis, or hemorrhage (35 patients, 11.7%); pancreatic fistula (16 patients, 5.3%); and pneumonia (14 patients, 4.7%). Postoperative pneumonia had the most sensitive relationship to five systemic inflammatory-based prognostic parameters, and was associated with poor prognosis in stage I–III gastric cancer patients after curative gastrectomy. Multivariate analysis revealed that preoperative neutrophil-to-lymphocyte ratio (odds ratio: 5.228, 95% confidence interval: 1.269–21.541; P=0.022) was an independent predictor of postoperative pneumonia.Conclusions: Preoperative neutrophil-to-lymphocyte ratio may be a useful predictor of postoperative pneumonia in stage I–III gastric cancer patients after curative gastrectomy.
Prevalence of Chronic Hepatitis B and C in Malaysia- results from a community-based screening campaign.
Authors: ZZ Lim , JS Teo , Siam Tan Soek , Mohamed Rosmawati , KL Goh , Jaya Fauziah , K Senamjit , Aun Azlida Che' , Said Rosaida , EK Lim , Shahar Hamiza , AH Muhammad Radzi , Poh Tee Hoi , Seng Tan Soon , Menon Jayaram , Menon Rena , Lim Teck Onn
Published: August 2020

Introduction The epidemiology of hepatitis, which is apparently endemic in Asia, is still poorly documented in Malaysia. Available statistics are modelled estimates based on expert input or estimated from small studies on special populations. We therefore determined the prevalence of chronic hepatitis B and C in Malaysia based on a large sample data from a screening campaign. Methods A total of 10,914 subjects participated in the hepatitis screening campaign in 2018 and 2019. A low-cost Point-of-care test, which has previously been validated, was used to screen for HBsAg and anti-HCV. All screen positive subjects were recalled to undergo confirmatory serology tests and nucleic acid tests. Results We estimated 1.17% or 238,971 Malaysian adults aged 20 or older had chronic HBV, while only 0.74% or 151,144 adults had chronic HCV. Young adults below age 30 years had very low prevalence of HBV (0.09%). Women had lower prevalence of HBV and HCV, Chinese had the highest prevalence of HBV while Malay had the highest prevalence of HCV. Conclusion Young adults seems to be protected from HBV perhaps owing to the introduction of universal HBV vaccination since 1989. Chronic HBV however remains prevalent in older adults especially among the Chinese. Chronic HCV is uncommon in Malaysia.
Network Pharmacology Based Research into the Effect and Mechanism of Yinchenhao Decoction Against Cholangiocarcinoma
Authors: Chen Zhiqiang , Lin Tong , Liao Xiaozhong , Li Zeyun , Lin Ruiting , Qi Xiangjun , Chen Guoming , Sun Lingling , Lin Lizhu
Published: August 2020

Background: This study aimed to screen out the effective active components of Yinchenhao decoction (YCHD) using network pharmacology, estimate their potential targets, screen out the pathways, as well as delve into the potential mechanisms on treating cholangiocarcinoma. Methods: By the traditional Chinese medicine system pharmacology database and analysis platform (TCMSP) as well as literature review, the major active components and their corresponding targets were estimated and screened out. Using the software Cytoscape 3.6.0, a visual network was established using the active components of YCHD and the targets of cholangiocarcinoma. Based on STRING online database, the protein interaction network of vital targets was built and analyzed. With the Database for Annotation, Visualization, and Integrated Discovery (DAVID) server, the gene ontology (GO) biological processes and the Kyoto encyclopedia of genes and genomes (KEGG) signaling pathways of the targets enrichment were performed. The AutoDock Vina was used to perform molecular docking and calculate the binding affinity. The PyMOL software was utilized to visualize the docking results of active compounds and protein targets. In vivo experiment, the IC50 values and apoptosis rate in PI-A cells were detected using CCK-8 kit and Cell Cycle Detection Kit. The predicted targets were verified by the real-time PCR and western blot methods. Results: 32 effective active components with anti-tumor effects of YCHD were sifted in total, covering 209 targets, 96 of which were associated with cancer. Quercetin, kaempferol, beta-sitosterol, isorhamnetin, and stigmasterol were identified as the vital active compounds, and AKT1, IL6, MAPK1, TP53 as well as VEGFA were considered as the major targets. The molecular docking revealed that these active compounds and targets showed good binding interactions. These 96 putative targets exerted therapeutic effects on cancer by regulating signaling pathways (e.g., hepatitis B, the MAPK signaling pathway, the PI3K-Akt signaling pathway, and MicroRNAs in cancer). Our in vivo experimental results confirmed that YCHD showed therapeutic effects on cholangiocarcinoma by decreasing IC50 values, down-regulating apoptosis rate of cholangiocarcinoma cells, and lowering protein expressions. Conclusion: As predicted by network pharmacology strategy and validated by the experimental results, YCHD exerts anti-tumor effects through multiple components, targets, and pathways, thereby providing novel ideas and clues for the development of preparations and the treatment of cholangiocarcinoma.
Diagnostic value of neutrophil CD64, procalcitonin, and interleukin-6 in sepsis: A meta-analysis
Authors: Wang Ke , Cong Shan , Ma Tiangang , Di Xin , Tian Chang , Zhao Min
Published: August 2020

The aim of the study was to conduct a meta-analysis to evaluate the accuracy of neutrophil CD64, procalcitonin (PCT), and interleukin-6 (IL-6) for the diagnosis of sepsis. The sample articles were searched in various databases to collect published studies on the diagnosis of sepsis by neutrophil CD64, PCT, and IL-6. By using the Stata SE 15.0 software, forest plots and the area under the summary receiver operating characteristic curves were drawn. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under the curve (AUC) were calculated. 54 articles were included in the study. The number of studies that evaluated the diagnostic value of neutrophil CD64, PCT, and interleukin-6 were 20, 39, and 15, respectively. The pooled sensitivity, specificity, and AUC of neutrophil CD64 for the diagnosis of sepsis were 0.88 [95% confidence interval (CI), 0.81–0.92], 0.88 (95% CI, 0.83–0.91), and 0.94 (95% CI, 0.91–0.96), respectively. The pooled sensitivity, specificity, and AUC of PCT for the diagnosis of sepsis were 0.82 (95% CI, 0.78–0.85), 0.78 (95% CI, 0.74–0.82), and 0.87 (95% CI, 0.83–0.89), respectively. Subgroup analysis showed that the AUC for PCT diagnosis of intensive care unit (ICU) sepsis was 0.86 (95% CI, 0.83–0.89) and the AUC for PCT diagnosis of non-ICU sepsis was 0.82 (95% CI, 0.78–0.85). The pooled sensitivity, specificity, and AUC of IL-6 for the diagnosis of sepsis were 0.72 (95% CI, 0.65–0.78), 0.70 (95% CI, 0.62–0.76), and 0.77 (95% CI, 0.73–0.80), respectively. Of the three biomarkers studied, neutrophil CD64 showed the highest diagnostic value for sepsis, followed by PCT, and IL-6. On the other hand, PCT showed a better diagnostic value for the diagnosis of sepsis in patients with severe conditions compared with that in patients with non-severe conditions.
A Preliminary Study on Various Types of 4-Aminoquinolines for Pre- or Post-Exposure Prophylaxis and for Treatment in Severe COVID-19
Authors: Bright Bisi , Ali Wael , Fajimi Niyi , Adesope Toyin , Tairu Suzanne , Sobande Patrick , Itodo Ewaoche Sunday
Published: August 2020

Background: LiveWell Initiative LWI is a self-funded nonprofit social enterprise that thrives on innovation.The organization has, for 5 years, supervised MPH and DrPH Practicums for the Harvard T. H. Chan School of Public Health, Harvard University, Boston USA. It also supervises the PhD thesis at the University of Helsinki, Finland. At the inception of COVID-19, LWI designed and compiled three (3) sets of study protocols in response to the COVID-19 response in Africa with a goal to arrive at a practical and affordable solution to the pandemic using 4-aminoquinolines. Method: A concurrent cohort/descriptive study of observation in patients exposed to HCQ/CQ prophylaxis and treatment with HCQ/CQ and quinine with categorization as specified as not critically ill, critically ill but not on a ventilator and critically ill on a ventilator. One hundred and twenty-three (123) subjects were categorized into shelter-in-place, self-quarantine and self-isolation (not critically ill, critically ill but not on a ventilator and critically ill on a ventilator). The 4-aminoquinolines were administered macrolide and zinc sulfate as appropriate for a defined duration and dose. Results: The preliminary study of the 123 subjects covering all categories listed above resulted in 100% positive outcomes: Nil death, Nil relapse in symptomatic persons and total recovery with no relapse after 6 weeks lockdown, and asymptomatic persons post-prophylaxis after 6 weeks lockdown. The results have been gathered principally from Clinician Reported Outcomes with a few Patient Reported Outcomes. Conclusion: These repurposed drugs with unique strengths—chloroquine and its analogue Hydroxychloroquine as well quinine—hold sway in the treatment of COVID-19.
Live attenuated varicella vaccine may affect the sensitivity of tuberculin skin test
Authors: Li Tingting , Zhu Kai , Kuang Yujie , Qu Hongbo , Zhang Qi , Xu Zhuping , Ding Zhiyuan , Qian Chaojun , Shen Xiaowen
Published: August 2020

Background: Tuberculin skin test (TST) has been the most commonly used test for diagnosis of tuberculosis (TB) infection in China for many years, because of well-established algorithms for test interpretation and a good cost-effectiveness. To our knowledge , there is no report or guideline on the influence of varicella vaccine on the sensitivity of TST in China. This paper aims to explore the effect of live attenuated varicella vaccine on the sensitivity of TST.Methods: A retrospective cohort study was carried out in a high school in Wuxi, Jiangsu province in 2020. TST and emergency varicella vaccine were administered to students in grade one of the high school which had both TB and varicella cases. The mean diameter of induration of TST were compared between 73d before varicella vaccine, 9d and 120d after varicella vaccine respectively. The retrospective cohort study was used to analyze the effect of live attenuated varicella vaccine on TST.Results: There were 45 students in the class of the high school had three TST, and 22 of them were vaccinated varicella. After 9 days of varicella vaccination, the mean diameter of induration was significantly smaller than that before the vaccination of 73 days and after the vaccination of 120 days (p<0.05), respectively. Moreover, there is no significant different for mean diameter of induration between the TST before the vaccination of 73 days and after the vaccination of 120 days (p=0.551). The retrospective cohort study analysis indicated that 9 days after varicella vaccination ( RR, 6.071, 95%CI, 1.667～22.116, P=0.007 ) was associated with the changed mean induration diameter of TST. After vaccination of 120 days ( RR, 3.474, 95%CI, 0.333～36.240, P=0.346 ) was not associated with the changed mean induration of TST.Conclusions: Live attenuated varicella vaccine may temporarily affect the sensitivity of tuberculin skin test.
Evaluation of the MGIT 960/EpiCenter TB eXiST system for drug susceptibility testing for Mycobacterium abscessus group
Authors: Arbeit Robert D , CARVALHO Natalia de , LEÃO Sylvia , CHIMARA Erica
Published: August 2020

BackgroundDrug susceptibility test (DST) of the Mycobacterium abscessus group (MAG) and other rapidly growing nontuberculous mycobacteria by conventional microplate techniques is complicated due to inducible resistance to clarithromycin and other technical factors. This study evaluated the application of the BACTEC MGIT 960/Epicenter TB eXiST for DST of MAG clinical isolates. MethodsM. abscessus ATCC19977 was used as the reference strain for the standardizing the DST by MGIT 960 and as the internal control for testing of 31 clinical isolates tests submitted to a reference laboratory for DST and confirmed as MAG. Clarithromycin genotyping was performed for the loci in the rrl and erm (41) genes known to impact resistance phenotype. ResultsThe 31 MAG isolates included 14 M. abscessus , 8 M. massiliense , and 9 M. bolletii . Using conventional microplate technique according to CLSI guideline, the isolates had a high percentage of resistance for cefoxitin (93.5%) and imipenem (100%), and sensitivity for amikacin (96.7%). Comparing microplate and MGIT 960 results across those 93 pairs of results (31 isolates x 3 antibiotics), 73 (80.6%) were concordant and the remaining 18 (19.4%) represented minor errors; there were no major or very major errors. Concordance was 100% for amikacin, 84% for imipenem and 58% for cefoxitin. Clarithromycin DST by microplate identified 14 isolates as susceptible (all susceptible by MGIT 960), 3 isolates as resistant after 3 days incubation, and 14 isolates demonstrating inducible resistance from Day 5 through 14. Among the latter isolates, MGIT 960 reported 8 as resistant and 6 as intermediate, without modifications to the protocol developed. For all isolates, the observed clarithromycin susceptibility phenotypes were consistent with the genotypes. ConclusionThe present study is the first description of a DST protocol for MAG isolates using the MGIT 960/Epicenter TB eXiST system. The protocol developed provided highly reliable results based on direct comparison with the conventional microplate method, including, without further modification, detection of isolates with inducible-resistance to clarithromycin. Laboratories using MGIT 960 for DST of other mycobacteria may find benefit to incorporating MAG into their routine.
Feasibility of a Multidisciplinary Lifestyle Program for Obese Patients With Atrial Fibrillation
Authors: Limpt Nicole Tenbult - van , Kraal JJ , Brouwers RWM , Spee RF , Eijsbouts SCM , Kemps HMC
Published: August 2020

Aims: Atrial Fibrillation (AF) is often associated with obesity. The effects of traditional lifestyle programs are often not maintained in the longer term effects because the programs do not sufficiently focus on behavioral change. We want to study the feasibility of a multidisciplinary lifestyle program, cardiac rehabilitation (CR) focusing on behavioral change in patients with AF and obesity. Methods and results: Patients received CR for three months including exercise training, lifestyle counseling by an Advanced Nursing Specialist, dietary advice and psychosocial therapy when deemed necessary. Main endpoints were weight loss and burden of AF (AFSS questionnaire). Secondary endpoints were physical fitness (6MWT), depression (PHQ9) and anxiety (GAD7). Measurements were performed at baseline and post-CR. Weight and 6MWT were also assessed at 1-year follow-up. After following a lifestyle program, patients improved their weight and physical condition, and were less symptomatic. The frequency of AF-related symptoms was considerably reduced immediately after rehabilitation and was even lower after 1 year. The severity of AF complaints post-CR was similar to the baseline, but significantly lower after 1 year. Conclusion: A multidisciplinary lifestyle program with an emphasis on structural lifestyle improvement is feasible for obese patients with AF and potentially effective in reducing symptoms, weight and physical fitness, thereby decreasing the burden of AF.
Scl-Ab reverts pro-osteoclastogenic signaling and resorption in estrogen deficient osteocytes
Authors: Allison Hollie , Holdsworth Gill , McNamara Laoise M
Published: August 2020

Background
Neutralising antibodies to sclerostin (Scl-Ab) have shown significant potential to induce bone formation and decrease bone resorption, increase strength and substantially reduce fracture risk in animal studies and clinical trials. Mechanical loading negatively regulates sclerostin expression, and sclerostin has been shown to induce RANKL synthesis in osteocytes. We have recently discovered that osteoblasts and osteocytes alter osteoclastogenic signalling (RANKL/OPG) during estrogen-deficiency, and that osteoblast-induced osteoclastogenesis and resorption are exacerbated. However, it is not known whether estrogen deficient osteocytes exhibit exacerbate osteoclastogenesis. The aims of this study were to (1) establish whether osteocytes induce osteoclastogenesis and bone resorption during estrogen deficiency in vitro (2) investigate whether the sclerostin antibody can revert osteocyte-mediated osteoclastogenesis and resorption by attenuating RANKL/OPG production.
Results
Using conditioned media and co-culture experiments we found increased osteocyte-induced osteoclastogenesis and bone resorption in estrogen deficient conditions. This is the first study to report that administration of Scl-Ab decreased RANKL/OPG ratio and increased WISP1 expression in osteocytes and reduced osteoclastogenesis and bone resorption in vitro.
Conclusions
This study provides an enhanced understanding of the biological changes underpinning decreases in bone resorption following Scl-Ab treatment observed in vivo by revealing that Scl-Ab can reduce pro-osteoclastogenic cell signalling between osteocytes and osteoclasts.
Effect of heat on Organic and Inorganic components in some Non-coking Lower Gondwana Coals
Authors: Bhatta Rajesh , Dash Nilima , Nayak Bibhuranjan
Published: August 2020

The concentration of different maceral groups and minerals in coal influence the quality as each of them behaves differently during heat treatment. The purpose of this study is to know how the maceral groups and minerals are behaving at different temperature conditions. Therefore, various maceral groups and minerals were concentrated by using heavy liquids of different specific gravities (1.3, 1.7 and 1.9). The generated density fractions were treated with heat at 400, 600, 800 and 1000°C. All the density fractions at various temperature conditions along with feed sample were investigated by Optical Microscopy, X-ray Diffractometry (XRD), Electron-probe Micro Analysis (EPMA) and Fourier Transform Infrared Spectroscopy (FTIR) analysis. The results from these analyses suggest that fusinite and sclerotinite are the most stable macerals, whereas quartz is the most stable mineral during pyrolysis. Telocollinite found to be oxidized very prominently at 400 °C . Siderite and pyrite thermally altered to form hematite above 400°C and 800 °C respectively. Kaolinite converted to metakaolin followed by mullite with increasing temperature.
S-1-Propenylcysteine Improves TNF-α-Induced Vascular Endothelial Barrier Dysfunction by Suppressing the GEF-H1/RhoA/Rac Pathway
Authors: Kunimura Kayo , Miki Satomi , Takashima Miyuki , Suzuki Jun-ichiro
Published: August 2020

Background: Vascular endothelial barrier function is maintained by cell-to-cell junctional proteins and contributes to vascular homeostasis. Various risk factors such as inflammation disrupt barrier function through down-regulation of these proteins and promote vascular diseases such as atherosclerosis. Previous studies have demonstrated that aged garlic extract (AGE) and its sulfur-containing constituents exert the protective effects against several vascular diseases such as atherosclerosis. In this study, we examined whether AGE and its sulfur-containing constituents improve the endothelial barrier dysfunction elicited by a pro-inflammatory cytokine, Tumor-necrosis factor-α (TNF-α), and explored their mode of action on TNF-α signaling pathway.Methods: Human umbilical vein endothelial cells (HUVECs) were treated with test substances in the presence of TNF-α for various time periods. The endothelial permeability was measured by using a transwell permeability assay. The localization of cell-to-cell junctional proteins and actin cytoskeletons were visualized by immunostaining. RhoA and Rac activities were assessed by using GTP-binding protein pulldown assay. Gene and protein expression levels of signaling molecules were analyzed by real-time PCR and western blotting, respectively. Results: We found that AGE and its major sulfur-containing constituent, S-1-propenylcysteine (S1PC), reduced hyperpermeability elicited by TNF-α in HUVECs. In addition, S1PC inhibited TNF-α-induced production of myosin light chain (MLC) kinase and inactivation of MLC phosphatase through the suppression of the Rac and RhoA signaling pathways, respectively, which resulted in the dephosphorylation of MLC2, a key factor of actin remodeling. Moreover, S1PC inhibited the phosphorylation and activation of guanine nucleotide exchange factor-H1 (GEF-H1), a common upstream key molecule and activator of Rac and RhoA. These effects of S1PC were accompanied by its ability to protect the disruption of junctional proteins on the cell-cell contact regions and the increase of actin stress fibers induced by TNF-α. Conclusions: The present study suggested that AGE and S1PC improve endothelial barrier disruption through the protection of junctional proteins on plasma membrane.
Clinicopathological characteristics, molecular alterations and prognosis of mucinous histology in colorectal adenocarcinoma patients
Authors: Jia Xiaoli , Li Bin , Yan Zhe
Published: August 2020

Background

Mucinous adenocarcinoma (MAC) is conventionally diagnosed by WHO definition when the extracellular mucin is more than 50% of the tumour area. The study is aimed at analyzing the clinicopathological characteristics, mutation spectrum, and prognosis of the colorectal adenocarcinoma (CRC) with any mucinous proportion or feature.
Methods

Clinical and pathological information for 50 patients were reviewed and recorded. Mutation analyses for exon 2–4 of KRAS gene and exon 15 of BRAF gene were performed by Sanger sequencing. Expression of DNA mismatch repairs (MMRs) and P53 proteins was evaluated by immunohistochemistry (IHC). Density of tumour infiltrating lymphocyte (TIL) status was scored. We also evaluated the percentage of glands producing mucin and the morphology of the different tumor cells types in mucin pools. We retrospectively analyzed prognosis of 43 patients with Stage II-III MAC. The primary outcome was progression-free survival (PFS).
Results

The overall frequencies of KRAS and BRAF mutations were 37.9% and 4.4%, respectively. Patients with MAC exhibiting high levels of mucin were related to the increase of tumor diameter (P = 0.038), but were not associated with any of the other clinicopathological parameters. The proportion or variable morphology of mucinous component did not stratify PFS in Stage II-III tumours. It is interesting to note that male patients had lower TIL compared with female patients (P = 0.018). TIL-low tumors were also correlated with advanced stage (P = 0.041). TIL status was a strong independent predictor of PFS in stage II-III mucinous component tumours (p < 0.001). All four IV stage patients were also classified into TIL-low case. No parameters were independently associated with outcome after adjusting for tumour stage in multivariate analysis.
Conclusions

TIL status could more accurately determine the biology of the MAC feature for appropriate management, irrespective of quantity or morphology of mucinous component.
A semi-dominant mutation in OsCESA9 improves rice straw return to the field and increases salt tolerance by remodeling the cell wall in rice
Authors: Ye Yafeng , Wang Shuoxun , Wu Kun , Ren Yan , Jiang Hongrui , Chen Jianfeng , Tao Liangzhi , Fu Xiangdong , Liu Binmei , Wu Yuejin
Published: August 2020

Background Cellulose synthase (CESA) mutants have potential use in straw processing due to their lower cellulose content, but almost all of the mutants exhibit defective phenotypes in plant growth and development. Balancing normal plant growth with reduced cellulose content remains a challenge, as cellulose content and normal plant growth are typically negatively correlated with one another.Result Here, the rice (Oryza sativa) semi-dominant brittle culm (sdbc) mutant Sdbc1, which harbors a substitution (D387N) at the first conserved aspartic acid residue of OsCESA9, exhibits lower cellulose content and reduced secondary wall thickness as well as enhanced biomass enzymatic saccharification compared with the wild type. Further experiments indicated that the OsCESA9D387N mutation may compete with the wild-type OsCESA9 for interacting with OsCESA4 and OsCESA7, further forming non-functional or partially functional CSCs. The OsCESA9/OsCESA9D387N heterozygous plants increase salt tolerance through scavenging and detoxification of ROS and indirectly affecting related gene expression. They also improve rice straw return to the field due to their brittle culms and lower cellulose content without any negative effects in grain yield and lodging.Conclusion Hence, manipulation of OsCESA9D387N can enhance biomass saccharification and simultaneously facilitate the decay of rice straw in the soil, providing a new strategy for bioenergy crop breeding.
Prevalence and Correlates of Fatigue and Its Association with Quality of Life Among Clinically Stable Older Psychiatric Patients During the COVID-19 Outbreak: A Cross-Sectional Study
Authors: Zou Siyun , Liu Zi-Han , Yan Xiaona , Wang Huan , Li Yulong , Xu Xiuying , Du Xiangdong , Zhang Lan , Zhang Qinge , Jackson Todd , Ungvari Gabor S. , Xiang Yu-Tao
Published: August 2020

Background: The pattern of fatigue in older psychiatric patients during the COVID-19 outbreak was unknown. This study examined the prevalence of fatigue and its association with quality of life (QOL) in clinically stable older patients with psychiatric disorders during the COVID-19 outbreak. Methods: This is a multicenter, cross-sectional study. Fatigue, depression, pain, insomnia symptoms, and QOL were assessed with standardized instruments. Results: A total of 1,063 patients were recruited. The prevalence of fatigue was 47.1% (95%CI: 44.1% - 50.1%). Analysis of covariance revealed that QOL was significantly lower in patients with fatigue compared to those without (P=0.011). Multiple logistic regression analysis revealed that more severe depression (OR=1.15, P<0.001), insomnia symptoms (OR=1.08, P<0.001) and pain (OR=1.43, P<0.001) were significantly associated with fatigue.Conclusions: Fatigue was common among clinically stable older patients with psychiatric disorders during the COVID-19 outbreak. Considering its negative impact on QOL, regular assessment of fatigue and appropriate treatment warrant attention in this subpopulation.
Outcomes of Uninterrupted vs Interrupted Periprocedural Direct Oral Anticoagulants in Atrial Fibrillation Ablation: A Meta-Analysis
Authors: Basu-Ray Indranill , Khanra Dibbendhu , Kupó Péter , Bunch Jared , Theus Sue A , Mukherjee Anindya , Shah Sumit K , Komocsi Andras , Adeboye Adedayo , Jefferies John
Published: August 2020

BACKGROUND: Studies indicate that uninterrupted anticoagulation is superior to interrupted anticoagulation in the periprocedural period during catheter ablation of atrial fibrillation and has better thromboembolic and hemorrhagic outcomes. Conversely, the few studies addressing the safety and efficacy of interrupted direct oral anticoagulant regimens during catheter ablation of atrial fibrillation are limited by small samples, short follow-up periods, rare events, and variable outcomes. The purpose of this meta-analysis was to compare interrupted and uninterrupted direct oral anticoagulation during catheter ablation of atrial fibrillation.METHODS: A systematic search into PubMed, EMBASE, and the Cochrane databases were performed and five studies were selected that directly that directly compared interrupted versus uninterrupted anticoagulation before ablation and reported procedural outcomes and embolic and bleeding events. The primary outcome of the study was major adverse cerebrocardiovascular events which was a composite of stroke/ transient ischemic attacks and major bleedings, total bleeding which was a composite of major and minor bleedings and silent cerebral events.RESULTS The meta-analysis included 840 patients with uninterrupted anticoagulation and 938 patients with interrupted anticoagulation. Median follow-up was 30 days. Baseline parameters were similar between groups. Activated clotting time before first heparin bolus was significantly longer with uninterrupted anticoagulation (P=.006), whereas mean activated clotting time was similar between the 2 groups (P=.19). Total heparin dose needed was significantly higher with interrupted anticoagulation (mean, ‒1.61; 95% CI, ‒2.67 to ‒0.55; P=.003). Mean procedure time did not vary between groups (P=.81). Overall complication rates were low, with similar major adverse cerebrocardiovascular event (P=.40) and total bleeding (P=.55) rates between groups. Silent cerebral events were significantly more frequent with interrupted anticoagulation (log odds ratio, ‒0.90; 95% CI, ‒1.59 to ‒0.22; P<.01; I2, 33%). Rates of major bleeding, minor bleeding, pericardial effusion, cardiac tamponade, and puncture complications were similar between groups.CONCLUSIONS Uninterrupted anticoagulation during atrial fibrillation ablation has similar bleeding event rates, procedural times, and mean activated clotting times as interrupted anticoagulation, with fewer silent cerebral events.
YiQiFuMai Lyophilized Injection Attenuates Sepsis-Induced Acute Lung Injury via TLR4/Src/VE-cadherin/p120-catenin Signaling Pathway
Authors: Pan Xue-wei , Xue Li-xuan , Zhou Qian-liu , Zhang Jia-zhi , Dai Yu-jie , Li Fang , Zhang Yuan-yuan , Kou Jun-ping
Published: August 2020

Background: Sepsis is a severe disorder leading to a clinically critical syndrome of multiple organ dysfunction syndrome. Most patients with sepsis will be associated with acute lung injury (ALI), which is an independent risk factors of organ failure and death in patients with sepsis at the same time. YiQiFuMai Lyophilized Injection (YQFM) is a modern traditional Chinese prescription preparation, which could ameliorate ALI induced by lipopolysaccharide (LPS) or fine particulate matter. The current study aimed to investigate the effect of YQFM on sepsis-induced ALI and the underlying mechanism.Methods: Male C57BL/6J mice were treated with cecal ligation and puncture (CLP) after tail intravenous injected with YQFM (1, 2 and 4 g/kg). The measurements of lung edema, evans blue leakage, myeloperoxidase content, inflammatory cells in bronchoalveolar lavage fluid, histopathological assay and expression of associated proteins were performed at 18 h after CLP.Results: The results illustrated that YQFM inhibited pulmonary edema and inflammatory response, thus ameliorated ALI in sepsis mice. Furthermore, the expression of TLR4 and phosphorylated Src was down-regulated, and the expression of p120-catenin and VE-cadherin was restored by YQFM administration.Conclusion: Our study suggested the therapeutic potential of YQFM on treating sepsis-induced ALI via regulating TLR4/Src/VE-cadherin/p120-catenin signaling pathway.
Preoperative Computerized Tomography Screening for COVID-19 Pneumonia in Asymptomatic Patients: experiences from two centers
Authors: Gumus Terman , Kabaoglu Zeynep Unal , Kartal Furkan , Coskun Bilgen , Artukoglu Feyzi , Atasoy K. Cetin
Published: August 2020

BACKGROUND: Chest CT screening for COVID-19 in preoperative patients is recommended in selected patients. The aim of this retrospective study is to evaluate the preoperative screening performance of chest CT (computerized tomography) examination to detect COVID-19 positive individuals. STUDY DESIGN: In this retrospective study 218 adult patients who had preoperative chest CT and RT-PCR were enrolled. CT imaging results, which have been reported according to the Radiological Society of North America (RSNA) expert consensus on COVID-19, were collected from the picture archiving and communicating system (PACS). Demographic data, planned surgeries, and postoperative outcomes were collected from the electronic patient records.RESULTS: One patient (0.5%) showed typical CT features for COVID-19 pneumonia; 12 patients (5.5%) were reported as indeterminate, and eight (3.7%) were reported as atypical for COVID-19 pneumonia. Only one of the three patients with positive RT-PCR had abnormalities on CT. When RT-PCR tests were taken as reference, the sensitivity, specificity, and accuracy of chest CT in showing COVID-19 infection in asymptomatic patients were 33.3%, 90.7%, and 90.0% respectively.CONCLUSION: Chest CT screening for COVID-19 has a very low yield in asymptomatic preoperative patients and shows false positive findings in 9.2% of cases, potentially leading to unnecessary postponing of the surgery.
Influence of thermal stratification and storms on acoustic telemetry detection efficiency: a year-long test in the US Southern Mid-Atlantic Bight
Authors: O'Brien Michael Henry Patrick , Secor David Hallock
Published: August 2020

Background: The detection efficiency of ultrasonic transmitters is seasonally variable, requiring long-term studies to evaluate key environmental features that mask, alter speed, bend, or reflect transmissions. The US Southern Mid-Atlantic Bight shelf is characterized by a strong summer thermocline capping remnant winter water, known as the Cold Pool, and a well-mixed water column in other seasons. To investigate the effects of interactions between temperature stratification and storm-induced noise on transmission detectability, we conducted a year-long range test in the bottom waters of the US Southern Mid-Atlantic Bight. We used generalized additive models and cross-validation to develop and evaluate a predictive model of detection efficiency and visualize variability in detection distance throughout the year of deployment.Results: The most-predictive model utilized the interaction between temperature stratification and ambient noise, predicting that stratification results in a 54% increase in detectability and 56% increase in detection distance. The model had an overall error rate of 16.3% and an 18.7% error at a distance of 800 m, predicting 9% detectability when the water column was not stratified and 63% when the difference between surface and bottom temperatures was greater than 4.6 °C. The distance at 50% detectability increased with the formation of the Cold Pool during spring, shifting from 559 ± 149 m to 872 ± 81 m over 3 days. All seasons were associated with storm-induced reductions in overall detectability and distance at 50% detectability.Conclusion: Thermal stratification within the Southern Mid-Atlantic Bight increases bottom water ultrasonic transmitter detection distance and reduces the impact of surface noise associated with large storms. This effect leads to a seasonal increase in detection distance from the late-spring through the summer. To our knowledge, this study is the first to report and quantify an increase in detection range as a result of temperature stratification, likely due to placing transmitters and receivers on the same side of a strong thermocline.
New oral anticoagulants combined with antiplatelet therapy in the treatment of coronary heart disease: an updated meta-analysis
Authors: Liu Leiling , Hu Jiahui , Wang Yating , Lei Hao , Xu Danyan
Published: August 2020

Objective New oral anticoagulants (NOACs) combined with antiplatelet therapy for acute coronary syndrome (ACS) may reduce ischemic events, but there is no consensus on bleeding risk. Moreover, the effect of NOACs on stable coronary artery disease (CAD) needs to be elucidated. We conducted a meta-analysis, to summarize the efficacy and safety of NOACs combined with antiplatelet therapy in the treatment of stable CAD and ACS.Methods We searched PubMed, Web of Science, and the Cochrane Library, then performed a systematic review of all 17 randomized controlled trials.Results For patients with stable CAD, rivaroxaban combined with antiplatelet therapy significantly reduced the rate of major adverse cardiovascular events (MACEs) (risk ratio; 95% confidence interval: 0.88; 0.81–0.95) and ischemic stroke (0.62; 0.50–0.77), with a relatively low risk of major bleeding (1.72; 1.42–2.07). For patients with ACS, the combination of NOACs could reduce the risk of MACEs (0.91; 0.85–0.97), myocardial infarction (MI) (0.90; 0.83–0.98) and ischemic stroke (0.75; 0.58–0.97), accompanied by increased non–fatal bleeding events and intracranial hemorrhage (3.42; 1.76–6.65). Results were similar when restricting the analysis to phase III studies except for the rate of stroke in patients with ACS.Conclusions Combination therapy can reduce the incidence of MI in ACS patients, but the risk of bleeding from intracranial hemorrhaging outweighs the benefit of MACEs driven by MI. That is due to combination therapy having no positive impact on mortality, thus the benefit-risk balance may be more favorable with patients with stable CAD.
Corticosteroids treatment in severe patients with COVID-19: a propensity score matching study
Authors: Chen Qian , Song Yang , Wang Lu , Han Lu , Zhang Yipeng , Liu Jingru , Yang Mengyu , Ma Jingdong , Wang Tao
Published: August 2020

Objectives Explore the efficacy of corticosteroid treatment in patients with severe COVID-19 pneumonia and the association between corticosteroid use and patient mortality.Methods A retrospective investigation was made on the medical records of the patients with severe and critical patients with COVID-19 pneumonia from January to February 2020. First, the patients who received corticosteroid treatment were compared with patients without given corticosteroid treatment. Then a propensity score matching method was used to control confounding factors. Cox survival regression analysis was used to evaluate the effect of corticosteroid therapy on the mortality of severe and critical patients with COVID-19.Results A total of 371 severe and critical patients were enrolled in our statistics. 209 patients were treated with corticosteroid therapy. Most of them were treated with methylprednisolone (197[94.3%]). The median corticosteroid therapy was applied 3(IQR 2–6) days after admission, 13(IQR 10–17) days after symptoms appeared. Temperature on admission(OR = 1.255,[95%CI 1.021–1.547],p = 0.032), ventilation(OR = 1.926,[95%CI 1.148–3.269],p = 0.014) and ICU admission(OR = 3.713, [95%CI 1.776–8.277],p < 0.001) were significantly associated with corticosteroids use. After PS matching, the cox regression survival analysis showed that corticosteroid use was significantly associated with a lower mortality rate (HR = 0.592, [95%CI 0.406–0.862], p = 0.006).Conclusion Corticosteroid therapy use in severe and critical patients with COVID-19 pneumonia leads to lower mortality but may cause other side effects. Corticosteroid therapy should be used carefully.
Transcranial Doppler combined with quantitative electroencephalography brain function monitoring for estimating the prognosis of patients with posterior circulation cerebral infarction
Authors: Cao Yanting , Song Xiaonan , Wang Lijuan , Qi Yajie , Chen Ying , Xing Yingqi
Published: August 2020

Background: Posterior circulation cerebral infarction (PCCI) leads to decreased cerebral blood flow (CBF) and metabolism. Neural activity is closely related to regional CBF both spatially and temporally. Transcranial Doppler (TCD) combined with quantitative electroencephalography (QEEG) can evaluate neurovascular coupling and involves synergy between the metabolic and vascular systems. This study aimed to monitor brain function using TCD-QEEG and estimate its efficacy in predicting the prognosis of patients with PCCI.Methods: We used TCD-QEEG to perform quantitative brain function monitoring; we recorded the related clinical variables simultaneously. The data were analyzed using a Cox proportional hazards regression model. Receiver-operating characteristic (ROC) curve analysis was used to evaluate the cut-off for the diastolic flow velocity (VD) and (delta+theta)/(alpha+beta) ratio (DTABR). The area under the ROC curve (AUROC) was calculated to assess the predictive validity of the study variables. Results: Forty patients (aged 63.7±9.9 years; 30 men) were assessed. Mortality at 90 days was 40%. The TCD indicators of VD (hazards ratio [HR] 0.168, confidence interval [CI] 0.047–0.597, p=0.006), and QEEG indicators of DTABR (HR 12.527, CI 1.637–95.846, p=0.015) were the independent predictors of the clinical outcomes. The AUROC after the combination of VD and DTABR was 0.896 and showed better predictive accuracy than the Glasgow Coma Scale score (0.75), VD (0.76), and DTABR (0.781; all p<0.05).Conclusion: TCD-QEEG provides a good understanding of the coupling mechanisms in the brain and can improve our ability to predict the prognosis of patients with PCCI.
Gallbladder cancer-associated fibroblasts promote vasculogenic mimicry formation and tumor growth of gallbladder cancers via upregulating the expression of NOX4, a poor prognosis factor, through activating IL-6-JAK-STAT3 signal pathway
Authors: Pan Musu , Wang Hui , Ansari Kamar Hasan , Li Xin-Ping , Sun Wei , Fan Yue-Zu
Published: August 2020

Background Cancer-associated fibroblasts (CAFs) and vasculogenic mimicry (VM) play important roles in the occurrence and development of tumors. However, the relationship between CAFs and VM formation, especially in gallbladder cancer (GBC) has not been clarified. In this study, we investigated whether gallbladder CAFs (GCAFs) can promote VM formation and tumor growth and explored the underlying molecular mechanism.Methods A co-culture system of human GBC cells and fibroblasts or HUVECs was established. VM formation, proliferation, invasion, migration, tube formation assays, CD31-PAS double staining, optic/electron microscopy and tumor xenograft assay were used to detect VM formation and malignant phenotypes of 3-D co-culture matrices in vitro, as well as the VM formation and tumor growth of xenografts in vivo, respectively. Microarray analysis was used to analyze gene expression profile in GCAFs/NFs and VM (+)/VM (-) in vitro. QRT-PCR, western blotting, IHC and CIF were used to detected NOX4 expression in GCAFs/NFs, 3-D culture/co-culture matrices in vitro, the xenografts in vivo and human gallbladder tissue/stroma samples. The correlation between NOX4 expression and clinicopathological and prognostic factors of GBC patients was analyzed. And, the underlying molecular mechanism of GCAFs promoting VM formation and tumor growth in GBC was explored.Results GCAFs promote VM formation and tumor growth in GBC; and the finding was confirmed by facts that GCAFs induced proliferation, invasion, migration and tube formation of GBC cells in vitro, and promoted VM formation and tumor growth of xenografts in vivo. NOX4 is highly expressed in GBC and its stroma, which is the key gene for VM formation, and is correlated with tumor aggression and survival of GBC patients. The GBC patients with high NOX4 expression in tumor cells and stroma have a poor prognosis. The underlying molecular mechanism may be related to the up-regulation of NOX4 expression through paracrine IL-6 mediated IL-6/JAK/STAT3 signaling pathway.Conclusions GCAFs promote VM formation and tumor growth in GBC via upregulating NOX4 expression through the activation of IL-6-JAK-STAT3 signal pathway. NOX4, as a VM-related gene in GBC, is over-expressed in GBC cells and GCAFs, which is related to aggression and unfavorable prognosis of GBC patients.
Chest X-ray image analysis and classification for COVID-19 pneumonia detection using Deep CNN
Authors: Gao Terry , Wang Grace
Published: August 2020

To speed up the discovery of COVID-19 disease mechanisms, this research developed a new diagnosis platform using a deep convolutional neural network (CNN) that is able to assist radiologists with diagnosis by distinguishing COVID-19 pneumonia from non-COVID-19 pneumonia in patients at Middlemore Hospital based on chest X-ray classification and analysis. Such a tool can save time in interpreting chest X-rays and increase the accuracy and thereby enhance our medical capacity for the detection and diagnosis of COVID-19. The research idea is that a set of X-ray medical lung images (which include normal, infected by bacteria, infected by virus including COVID-19) were used to train a deep CNN that can distinguish between the noise and the useful information and then uses this training to interpret new images by recognizing patterns that indicate certain diseases such as coronavirus infection in the individual images. The supervised learning method is used as the process of learning from the training dataset and can be thought of as a doctor supervising the learning process. It becomes more accurate as the number of analyzed images grows. In this way, it imitates the training for a doctor, but the theory is that since it is capable of learning from a far larger set of images than any human, it can have the potential of being more accurate.
Proteomic Analysis of the Protective Effect of Early Heat Exposure Against Chronic Heat Stress in Broilers
Authors: Kang Darae , Shim Kwan Seob
Published: August 2020

BackgroundThe increasing trend of global warming has affected the livestock industry through the heat stress caused to the animals. Among them, poultry are the most susceptible to heat stress, which results in serious production problems. Therefore, a better understanding of the mechanisms related to the thermal reactions and thermal resistance in poultry would be helpful toward resolving the production issues. In this study, whole proteome analysis was carried out to identify differentially expressed proteins in the liver tissue of broilers under chronic heat stress (35℃/24 h, each day between the broiler ages of 21–35 days). Additionally, the effect of early heat exposure (40℃/24 h, for 1 day only on chicks at 5 days of age) was determined.ResultsIn total, 277 differentially expressed proteins due to chronic heat stress were identified (132 downregulated and 145 upregulated). Of those, 95 proteins were regulated by early heat exposure (42 downregulated and 53 upregulated during chronic heat stress). Of the 95 proteins, 8 were related to actin metabolism. According to the KEGG analysis, the proteins were mainly involved in pathways for carbon metabolism and carbohydrate metabolism. Under chronic heat stress, the proteins involved in carbohydrate metabolism were expressed in such a way as to promote the metabolism of carbohydrates, which is the natural means to reduce body temperature but may well induce cell damage.ConclusionEarly heat exposure reduced the heat stress-induced expression changes of select proteins, indicating the adaptability of the animal to chronic heat stress. The determination of the differentially expressed proteins in the liver proteome under chronic heat stress and early heat exposure suggests that the liver of broilers has various physiological mechanisms for regulating homeostasis to aid heat resistance.