bluuebunny/crossref_metadata_2025 huggingface dataset:
What Lies Beneath: Clinical and Resource-use Characteristics of Institutionalized Older People. A Retrospective, Population-based Cohort Study in Catalonia
Authors: Amblàs-Novellas Jordi , Gonzàlez Sebastià J. Santaeugènia , Vela Emili , Clèries Montse , Contel Joan C.
Published: May 2020

Background Planning population care in a specific health care setting requires deep knowledge of the clinical characteristics of the target care recipients, which tend to be country specific. Our area virtually lacks any descriptive, far-reaching publications about institutionalized older people (IOP). We aimed to investigate the demographic and clinical characteristics of institutionalized older people (IOP) ≥65 years old and compare them with those of the rest of the population of the same age.Methods Retrospective analysis (total cohort approach) of clinical and resource-use characteristics of IOP and non-IOP older than 65 years in Catalonia (North-East Spain). Variables analysed included age and sex, diagnoses, morbidity burden—using Adjusted Morbidity Groups (GMA, Grupos de Morbilidad Ajustada)—, mortality, use of resources, and medications taken. All data were obtained from the administrative database of the local healthcare system.Results This study included 93,038, 78,458, 68,545 and 67,456 IOP from 2011, 2013, 2015 and 2017, respectively. In this interval, an increase in median age (83 vs. 87 years), in women (68.64% vs. 72.11%) and in annual mortality (11.74% vs. 20.46%) was observed. Compared with non-IOP (p<0.001 in all comparisons), IOP showed a higher annual mortality (20.46% vs. 3.13%), a larger number of chronic diseases (specially dementia: 46.47% vs. 4.58%), higher multimorbidity (15.2% vs. 4.2% with GMA of maximum complexity), and annual admissions to acute care (47.6% vs. 27.7%) and skilled nursing facilities (27.8% vs. 7.4%), mean length of hospital stay (10.0 vs. 7.2 days) and mean of medications taken (11.7 vs. 8.0). Conclusions There is a growing gap between the clinical and demographic characteristics of age-matched IOP and non-IOP, which overlaps with a higher mortality rate of IOP. The profile of resources utilization of IOP compared with non-IOP strongly suggests a deficiency of preventive actions and stresses the need to rethink the care model for IOP from a social and health care perspective.
Gaining favorable identities of Iranian EFL teachers: A single case study of transition from elementary schools to universities
Authors: Rostami Farzad , Yousefi Mohammad Hossein - , Amini Davood
Published: May 2020

Adopting the self-concept framework as a lens and interpretative case study as a methodological tool, the present study set out to examine how the professional identity of an elementary school teacher is socially (re) constructed while his transition from teaching at elementary schools to teach at universities. The design of the study was the intrinsic case study. The focal participant was an assistant professor of TEFL who has been teaching in elementary, middle, and high schools prior to starting his academic work ten years ago. For the purpose of the data collection, in-depth interview was conducted. Another source of the data was the participant's stories, as well as the diaries he had kept over the years. For the data analysis, thematic analysis was employed. Results indicate that the transition was seen to be in parallel with the transition from lower identity perception to higher identity perception. The transition can be best expressed in terms of identity promotion. The results indicate that the transitions were two main and noticeable ones. The data analyses also indicate that three themes, including personal-self, social self, and learners were the driving forces for the case's professional identity development. The study has a number of implications for teacher education, policymakers, and teachers.
Mood, Activity Participation, and Leisure Engagement Satisfaction (MAPLES): A randomised controlled pilot feasibility trial for low mood in acquired brain injury
Authors: Kusec Andrea , Murphy Fionnuala C. , Peers Polly V. , Lawrence Cara , Cameron Emma , Morton Claire , Bateman Andrew , Watson Peter , Manly Tom
Published: May 2020

Background: Acquired brain injury (ABI) affects approximately 79.3 million individuals annually and is linked with elevated rates of depression and low mood. Existing methods for treating depression in ABI have shown mixed efficacy. Behavioural Activation (BA) is a potentially promising intervention. Its premise is that individuals with low mood avoid planning and engaging in activities due to low expectations of a positive outcome. Consequently, their exposure to positive reinforcement is reduced, exacerbating low mood. BA aims to break this cycle by encouraging activity planning and engagement. It is unknown whether cognitive demands of traditional BA may undermine efficacy in ABI. Here we assess the feasibility and acceptability of two groups designed to increase activity engagement. In the Activity Planning Group (traditional BA) the importance of meaningful and positive activity will be discussed and participants encouraged to plan/engage in activities in everyday life. The Activity Engagement Group (experiential BA) instead focuses on engagement in positive experiences (crafts, games, discussion) within the group. The primary aims are to evaluate the feasibility and acceptability of the two groups in ABI. A secondary aim is to explore relative efficacy of the groups compared to an equivalent period of waitlist controls. Method: This study outlines a parallel-arm pilot feasibility trial for individuals with low mood and ABI that compares a traditional vs experiential BA group vs. waitlist controls. Adults (>18 years) will be recruited from local ABI services and randomised to condition. Feasibility and acceptability will be assessed via recruitment, retention, attendance, and participant feedback. Groups will be compared (pre- and post-intervention and 1 month follow-up) by assessing self-reported activity engagement. Secondary outcomes include self-report measures of depression, anxiety, post-traumatic distress related to the ABI, motivation, participation, and sense of control over one’s life. Ethics and Dissemination: The trial has been approved by the Health Research Authority of the NHS in the UK (East of England – Cambridge Central, REF: 18/EE/0305). Results will inform future research on interventions for mood in ABI and be disseminated broadly via peer-reviewed journals, conference presentations, and social media. Trial Registration: NCT03874650 Pre-results.Protocol Version: 2.1, March 5 2019Funding Source: Medical Research Council Cognition and Brain Sciences Unit Intramural funding (TM) and the Gates Cambridge Trust (AK).
lncRNA HOTAIR Overexpression Induced Downregulation of c-Met Signaling Promotes Hybrid Epithelial/Mesenchymal Phenotype in Hepatocellular Carcinoma Cells
Authors: Topel Hande , Bagirsakci Ezgi , Comez Dehan , Bagci Gulsun , Cakan-Akdogan Gulcin , Atabey Nese
Published: May 2020

Background: Epithelial-to-mesenchymal transition (EMT) and mesenchymal-to-epithelial transition (MET) are both reversible processes, and regulation of phenotypical transition is very important for progression of several cancers including hepatocellular carcinoma (HCC). Recently, it is defined that cancer cells can attain a hybrid epithelial/mesenchymal (hybrid E/M) phenotype. Cells with hybrid E/M phenotype comprise mixed epithelial and mesenchymal properties, they can be more resistant to therapeutics and also more capable of initiating metastatic lesions. However, the mechanisms regulating hybrid E/M in HCC are not well described yet. In this study, we investigated the role of the potential crosstalk between lncRNA HOTAIR and c-Met receptor tyrosine kinase, which are two essential regulators of EMT and MET, in acquiring of hybrid E/M phenotype in HCC. Methods: Expression of c-Met and HOTAIR were defined in HCC cell lines and patient tissues through HCC progression. lncRNA HOTAIR was overexpressed in SNU-449 cells and its effects on c-Met signaling were analyzed. c-Met was overexpressed in SNU-398 cells and its effect on HOTAIR expression was analyzed. Biological significance of HOTAIR/c-Met interplay was defined in means of adhesion, proliferation, motility behavior, invasion, spheroid formation and metastatic ability. Effect of ectopic HOTAIR expression on phenotype was defined with investigation of molecular epithelial and mesenchymal traits. Results: In vitro and in vivo experiments verified the pivotal role of lncRNA HOTAIR in acquisition of hybrid E/M phenotype through modulating expression and activation of c-Met and its membrane co-localizing partner Caveolin-1, and membrane organization to cope with the rate limiting steps of metastasis such as survival in adhesion independent microenvironment, escaping from anoikis and resisting to fluidic shear stress (FSS) in HCC. Conclusions: Our work provides the first evidence suggesting a role for lncRNA HOTAIR in the modulation of c-Met to promote hybrid E/M phenotype. The balance between lncRNA HOTAIR and c-Met might be critical for cell fate decision and metastatic potential of HCC cells.
Scaled-Up Nutrition Education on Pulse-Cereal Complementary Food Practice in Ethiopia: A Cluster-Randomized Trial
Authors: Teshome Getenesh Berhanu , Whiting Susan J. , Green Timothy J. , Mulualem Demelash , Henry Carol J.
Published: May 2020

Background: Improving children's weight status through nutrition education (NE) for mothers about using pulses in complementary feeding has been demonstrated in pilot studies, but no effect on stunting was reported. The aim of the study was to assess the impact of a 9-month pulse-nutrition education program on improving mothers' knowledge, attitude, and practices (KAP) towards pulses, as well as its effect on children's diet diversity, and nutritional status. The NE was delivered by Health Extension Workers (HEWs). Methods: A cluster randomized study was employed for the community-based interventional study. Twelve randomly selected villages in Sidama Zone, Southern Ethiopia were included in the study. A total of 772 mother-child pairs involved in the study; where 386 mother-child pairs in the intervention group received additional messages about pulse-cereal complementary food, and 386 pairs (the control) received only routine health education for 9 months. A survey on mothers’ KAP and anthropometric measurements of the children were taken at baseline, midline, and endline. ANOVA and descriptive statistics were used to analyzed data. Results: At baseline and endline, maternal KAP and the dietary diversity score of the children (mean age at endline 18.8 ± 2.9 mo) were assessed. Intervention mothers’ KAP improved (p<0.001) at midline and endline compared to that of the control group, as did frequency of pulse consumption and Dietary Diversity Score (DDS) among children. At 9 months, the prevalence of stunting, wasting, and underweight was significantly reduced in the intervention group compared to the control group (p=0.001). Conclusions: NE delivered by HEWs improved KAP of mothers regarding pulse consumption and dietary diversity of children led to improved nutritional status of the children. Training HEWs on the use of pulses for complementary food may be an effective way to improve the health of children in Ethiopian communities. Trial Registration: Clinicaltrials.gov #NCT02638571
Association between diet quality and food waste in Canadian families: a cross-sectional study
Authors: Carroll Nicholas , Wallace Angela , Jewell Kira , Darlington Gerarda , Ma David W.L. , Duncan Alison M. , Parizeau Kate , von Massow Michael , Haines Jess
Published: May 2020

Background: Higher diet quality has been associated with greater amounts of food waste among adults in the United States. This study aims to build on previous work by examining the association between diet quality and food waste, as assessed using detailed waste audits, among a sample of Canadian families.Methods: This cross-sectional study used data from 85 Canadian families with young children. Parent and children diet quality was assessed using the Healthy Eating Index-2015 (HEI-2015), calculated from 3-day food records. Household food waste was measured using detailed waste audits conducted over multiple weeks and these data were used to calculate daily per capita food waste. Linear regression was used to explore the association between parent and child HEI-2015 scores and daily per capita total avoidable and unavoidable food waste, as well as daily per capita avoidable and unavoidable food waste in the following categories: 1) fruits and vegetables, 2) milk, cheese and eggs, 3) meat and fish, 4) breads and cereals, 5) fats and sugars.Results: Parent HEI-2015 scores ranged from 37 to 92 (out of 100) and 81% of parents’ diets scored in the “Needs Improvement (51-80)” category. Parent and child diet quality scores were significantly correlated (r=0.61; P<0.0001) and 82% of children’s diets scored in the “Needs Improvement” category. On average, households produced 107 grams of avoidable food waste and 52 grams of unavoidable food waste per person per day. Fruits and vegetables were the highest contributor for both avoidable and unavoidable food waste. Both parent and child HEI-2015 scores were not significantly associated with total daily per capita avoidable or unavoidable food waste. However, parent HEI-2015 scores were positively associated with daily per capita avoidable fruit and vegetable waste (Unstandardized β= 1.05; 95%CI: 0.11, 1.99; P= 0.03) and daily per capita unavoidable fruit and vegetable waste (Unstandardized β= 0.60; 95%CI: 0.03, 1.17; P= 0.04), after adjusting for household income. Conclusion: This is the first study to explore the association between diet quality and food waste using detailed waste audits. Future research should explore effective strategies towards improving diet quality while simultaneously reducing food waste, especially of fruits and vegetables.
Associations between perceived environmental pollution and health-related quality of life in a Chinese adult population
Authors: Han Bingxue
Published: May 2020

Background Health-related quality of life (HRQoL) measures are being used in increasingly diverse populations. However, there have no known studies to date to examine the associations between perceived environmental pollution and HRQoL in a Chinese adult population. This study aimed to report the associations between air, water, noise pollution and HRQoL among Chinese populations.Methods A cross-sectional survey data was used from East Asian Social Survey 2010 with a sample of 3866 Chinese populations in environmental pollution. HRQoL was computed by SF-12 and reflected by physical and mental component summary score (PCS & MCS). Ordinary least regression analyses were used to examine associations between perceived environmental pollution and PCS and MCS scores. Models in SPSS PROCESS were selected to demonstrate the moderating and mediating effects.Results Only considering one pollutant, perceived air pollution and perceived water pollution had significant associations with PCS and MCS scores. Perceived noise pollution had significant associations with PCS scores. Perceived air×noise, air×water, noise×water, and air×noise×water pollution had significant associations with PCS and MCS scores. Conditional (moderated) mediation showed that there were no moderating effects and mediating effects of perceived one pollutant on another pollutant.Conclusions Co-occurring perceived environmental pollution were mainly associated with progressive increase in PCS and MCS scores among the Chinese adult population. These results suggested that some effective policies should be carried out to improve environmental quality across Chinese adult population.
Exome sequencing for diagnosis of congenital hemolytic anemia
Authors: MANSOUR-HENDILI Lamisse , Aissat Abdelrazak , Badaoui Bouchra , Sakka Mehdi , Gameiro Christine , Ortonne Valérie , Wagner-Ballon Orianne , Pissard Serge , Picard Véronique , Ghazal Khaldoun , Bahuau Michel , Guitton Corinne , Mansour Ziad , Duplan Mylène , Petit Arnaud , Chalumeau Nathalie Costedoat , Michel Marc , Bartolucci Pablo , Moutereau Stéphane , Funalot Benoît , Galactéros Frédéric
Published: May 2020

Background: Congenital hemolytic anemia constitutes a heterogeneous group of rare genetic disorders of red blood cells. Diagnosis is based on clinical data, family history and phenotypic testing, genetic analyses being usually performed as a late step. In this study, we explored 40 patients with congenital hemolytic anemia by whole exome sequencing: 20 patients with hereditary spherocytosis and 20 patients with unexplained hemolysis. Results: A probable genetic cause of disease was identified in 82.5% of the patients (33/40): 100% of those with suspected hereditary spherocytosis (20/20) and 65% of those with unexplained hemolysis (13/20). We found that several patients carried genetic variations in more than one gene (3/20 in the hereditary spherocytosis group, 6/13 fully elucidated patients in the unexplained hemolysis group), giving a more accurate picture of the genetic complexity of congenital hemolytic anemia. In addition, whole exome sequencing allowed us to identify genetic variants in non-congenital hemolytic anemia genes that explained part of the phenotype in 3 patients. Conclusion: The rapid development of next generation sequencing has rendered the genetic study of these diseases much easier and cheaper. Whole exome sequencing in congenital hemolytic anemia could provide a more precise and quicker diagnosis, improve patients’ healthcare and probably has to be democratized notably for complex cases. .
Comparing Clinical Outcomes of Piperacillin-Tazobactam Administration and Dosage Strategies in Critically Ill Adult Patients: A Systematic Review and Meta-Analysis
Authors: Fawaz Sarah , Barton Stephen , Nabhani-Gebara Shereen
Published: May 2020

Background: Recently, continuous administration of piperacillin-tazobactam has been proposed as a valuable alternative to traditional intermittent administration especially in critically ill patients. However, antibiotic dosing remains a challenge for clinicians as antibiotic dosing regimens are usually determined in non-critically ill hospitalized adult patients. The aim was to conduct a systematic review to identify and highlight studies comparing clinical outcomes of piperacillin tazobactam dosing regimens, continuous/prolonged infusion vs intermittent infusion in critically ill patients. Meta-analyses were performed to assess the overall effect of dosing regimen on clinical efficacy. Methods: Studies were identified systematically through searches of PubMed and Science Direct, in compliance with PRISMA guidelines. Following the systematic literature review, meta-analyses were performed using Review Manager. Results: Twenty-three studies were included in the analysis involving 3828 critically ill adult participants in total (continuous/prolonged infusion = 2197 and intermittent infusion = 1631) from geographically diverse regions. Continuous/prolonged resulted in significantly: higher clinical cure rates (Odds Ratio 1.56, 95% Confidence Interval 1.28-1.90, P = 0 .0001), lower mortality rates (Odds Ratio 0.68, 95% Confidence Interval 0.55-0.84, P = 0 .0003), higher microbiological success rates (Odds Ratio 1.52, 95% Confidence Interval 1.10-2.11, P = 0.01) and decreasing the length of hospital stay (Odds Ratio -1.27, 95% Confidence Interval -2.45—0.08, P = 0.04) in critically ill patients.Conclusion: Results from this study show that there is a significant level of evidence that clinical outcome in critically ill patients is improved in patients receiving piperacillin-tazobactam via continuous/prolonged infusion. However, more rigorous scientific studies in critically ill patients are warranted to reach a sufficient level of evidence and promote further implementation of C/PI as a dosing strategy.
Human bone marrow mesenchymal stem cells-derived exosomes stimulate cutaneous wound healing mediates through TGF-β/Smad signaling pathway
Authors: Jiang Tiechao , Wang Zhongyu , Sun Ji
Published: May 2020

Background: Cutaneous wound healing represents a morphogenetic response to injury, and is designed to restore anatomic and physiological function. Human bone marrow mesenchymal stem cells-derived exosomes (hBM-MSCs-Ex) is a promising source for cell-free therapy and skin regeneration. Methods: In this study, we investigated the cell regeneration effects and its underlying mechanism of hBM-MSCs-Ex on cutaneous wound healing in rats. In vitro studies , w e evaluated the role of hBM-MSCs-Ex in the two type s of skin cell s : human keratinocytes (HaCaT) and human dermal fibroblasts (HDFs) for the proliferation . For in vivo studies , we used a full-thickness skin wound model to evaluate the effects of hBM-MSCs-Ex on cutaneous wound healing in vivo . Results: The results demonstrated that hBM-MSCs-Ex promote both two type s of skin cell s growth effectively and accelerate the cutaneous wound healing. Interestingly , we found that hBM-MSCs-Ex significantly down-regulated TGF-β1, Smad2, Smad3, and Smad4 expression, while up-regulated TGF-β3 and Smad7 expression in the TGF-β/Smad signaling pathway . Conclusions: Our findings indicated that hBM-MSCs-Ex effectively promote the cutaneous wound healing through inhibiting the TGF-β/Smad signal pathway . The current result s providing a new sight for the therapeutic strategy for the treatment of cutaneous wounds.
Changes in the vaginal microbiota associated with primary ovarian failure
Authors: Wang Juan , Xu Jieying , Han Qixin , Chu Weiwei , Lu Gang , Chan Wai-Yee , Qin Yingying , Du Yanzhi
Published: May 2020

Background: Primary ovary failure (POF) is defined as follicular failure in women of reproductive age. Although many factors are speculated to contribute to the occurrence of POF, the exact aetiology is unclear. Alterations in the microbiome of women with POF are poorly studied; Methods: This study investigated the vaginal microbiota of 22 patients with POF and 29 healthy individuals. High-throughput Illumina Miseq sequencing targeting the V3-V4 region of the 16S ribosomal RNA (rRNA) gene was used to evaluate the relationships between vaginal flora and clinical characteristics of POF. Results: Different from before, we found that the diversity and richness of the vaginal flora of patients with POF was significantly different from that of healthy controls. Comparison of the flora of patients with POF with that of menopausal women revealed that the relative abundance of Lactobacillus was significantly reduced in the latter, and women with reduced relative abundance of Lactobacillus in microbiota community decreased the pregnancy success rate at term. The result suggests the present study enabled identification of microbiota associated with POF, further investigations of differences in the microbiota in the context of POF will improve our understanding of the pathogenesis of the disease which involve modification of the vaginal microbiota. Conclusion: The present study identified the microbiota associated with POF. Further investigations on the differences in the microbiota in the context of POF will improve our understanding of the pathogenesis of the disease which involves modification of the vaginal microbiota.
The fraction of Nitrous Oxide in oxygen for facilitating Lung collapse During One-Lung Ventilation with double lumen tube
Authors: liang chao , Lv Yuechang , Shi Yu , Cang Jing , Xue Zhanggang
Published: May 2020

Background: The ideal fraction of nitrous oxide (N2O) in oxygen (O2) for rapid lung collapse remains unclear. Accordingly, this prospective trial aimed to determine the 50% effective concentration (EC50) and 95% effective concentration (EC95) of N2O in O2 for rapid lung collapse. Methods: This study included 38 consecutive patients undergoing video-assisted thoracoscopic surgery (VATS). The lung collapse score (LCS) of each patient during one-lung ventilation was evaluated by the same surgeon. The first patient received 30% N2O in O2, and the subsequent N2O fraction in O2 was determined by the LCS of the previous patient using the Dixon up-and-down method. The testing interval was set at 10%, and the lowest concentration was 10% (10%, 20%, 30%, 40%, or 50%). The EC50 and EC95 of N2O in O2 for rapid lung collapse were analyzed using a probit test.Results: According to the up-and-down method, the N2O fraction in O2 at which all patients exhibited successful lung collapse was 50%. The EC50 and EC95 of N2O in O2 for rapid lung collapse were 27.7% (95% confidence interval 19.9%–35.7%) and 48.7% (95% confidence interval 39.0%–96.3%), respectively.Conclusions: In patients undergoing VATS, the EC50 and EC95 of N2O in O2 for rapid lung collapse were 27.7% and 48.7%, respectively.
Positive results for patients with COVID-19 discharged form hospital in Chongqing, China
Authors: Deng Wang , Guang Tian-wen , Yang Mei , Li Jian-rong , Jiang De-peng , Li Chang-yi , Wang Dao-Xin
Published: May 2020

Background: Since December 2019,more than 80 thousand patients with coronavirus disease 2019 (COVID-19) has been confirmed in China. With the increasing number of recovered patients, more attention should be paid to the follow-up of patients. Methods: In the study, 576 patients with COVID-19 discharged from hospital in Chongqing, China from January 24, 2020, to March 10, 2020 were evaluated by viral nucleic acid tests for severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) to determine if they could be released from quarantine. Among the 576 patients, 61 patients (10.6%) had positive results for SARS-CoV-2. We aimed to analyze the demographics, clinical characteristics and treatment of 61 patients.Results: These positive patients were characterized by older age, chronic medical illness and mild conditions. Asymptom and normalities on chest radiograph were found in most of the positive patients with COVID-19. Also, they showed positive results by stool or sputum specimen with negative results by nasal and throat swab. The median duration of positive result for SARS-CoV-2 was varied from 3 days to 35 days after hospital discharge with no family member infection.Conclusions: Multi-site screening of SARS-CoV-2 including nasal and throat swab, stool and sputum samples could be considered to improve the diagnosis, treatment and infection control in patients with COVID-19. Our findings provide the important information and clinical evidence for the improved management of patients recovered from COVID-19
Modified FOLFIRINOX as a second-line therapy following gemcitabine plus nab-paclitaxel therapy in metastatic pancreatic cancer
Authors: Sawada Masashi , Kasuga Akiyoshi , Mie Takafumi , Furukawa Takaaki , Taniguchi Takanobu , Fukuda Koshiro , Yamada Yuto , Takeda Tsuyoshi , Kanata Ryo , Matsuyama Masato , Sasaki Takashi , Ozaka Masato , Sasahira Naoki
Published: May 2020

Background There is no established second-line treatment after failure of gemcitabine plus nab-paclitaxel (GnP) therapy for metastatic pancreatic cancer (MPC). This study aimed to evaluate the efficacy and tolerability of the modified FOLFIRINOX (mFFX) as a second-line therapy for MPC and investigate prognostic factors for survival. Methods From 2015–2019, we retrospectively reviewed the medical records of patients receiving mFFX for MPC after failure of GnP therapy. Patients were treated every 2 weeks with mFFX (intravenous oxaliplatin 85 mg/m 2 , intravenous irinotecan 150 mg/m 2 , and continuous infusion of 5-fluorouracil 2,400 mg/m 2 for 46 hours without bolus infusion) until disease progression, patient refusal, or unacceptable toxicity. Results In total, 104 patients received mFFX. The median overall survival (OS) was 7.0 months (95% confidence interval [CI]: 6.2-9.8) and the progression-free survival (PFS) 3.9 months (95% CI 2.8-5.0). The objective response rate was 10.6% and the disease control rate 56.7%. The median relative dose intensities of oxaliplatin, irinotecan, and infusional 5-FU were 80.0% (range 21.5-100%), 77.2% (range 38.1-100%), and 85.9% (range 36.9-100%), respectively. Grade 3-4 toxicities were reported in 57 patients (54.8%), including neutropenia, leukopenia, anemia, febrile neutropenia, and peripheral sensory neuropathy. Glasgow prognostic score and carcinoembryonic antigen level were independently associated with survival. Our prognostic model using these parameters could classify the patients into good (n = 38), intermediate (n = 47), and poor (n = 19) prognostic groups. The median OS and PFS time was 14.7 (95% CI 7.6-16.3) and 7.6 months (95% CI 4.1-10.5) for the good prognostic factors, 6.5 (95% CI 5.5-10.0) and 3.6 months (95% CI 2.7-4.8) for the intermediate prognostic factors and 5.0 (95% CI 2.9-6.6) and 1.7 months (95% CI 0.9-4.3) for the poor prognostic factors, respectively. Conclusions The mFFX showed to be a tolerable second-line treatment for MPC after GnP failure. Our prognostic model might be useful for deciding whether mFFX is indicated in this setting.
Genetic deletion of microRNA-22 blunts the inflammatory transcriptional response to status epilepticus and exacerbates epilepsy in mice
Authors: Silva Luiz FA , Reschke Cristina R , Nguyen Ngoc T , Langa Elena , Rodriguez Amaya Sanz , Temp Fernanda R. , Freitas Mayara L. , Gerbatin Rogerio R , Conroy Ronan M , Brennan Gary P , Engel Tobias , Henshall David C
Published: May 2020

MicroRNAs perform important roles in the post-transcriptional regulation of gene expression. Sequencing as well as functional studies using antisense oligonucleotides, indicate important roles for microRNAs during the development of epilepsy through targeting transcripts involved in neuronal structure, gliosis and inflammation. MicroRNA-22 (miR-22) has been reported to protect against the development of epileptogenic brain networks through suppression of neuroinflammatory signalling. Here, we used mice with a genetic deletion of miR-22 to extend these insights. Mice lacking miR-22 displayed normal behaviour and brain structure and developed similar status epilepticus after intraamygdala kainic acid compared to wildtype animals. Continuous EEG monitoring after status epilepticus revealed an accelerated and exacerbated epilepsy phenotype whereby spontaneous seizures began sooner, occurred more frequently and were of longer duration in miR-22-deficient mice. RNA sequencing analysis of the hippocampus during the period of epileptogenesis revealed a specific suppression of inflammatory signalling in the hippocampus of miR-22-deficient mice. Taken together, these findings indicate a role for miR-22 in establishing early inflammatory responses to status epilepticus. Inflammatory signalling may serve anti-epileptogenic functions and cautions the timing of anti-inflammatory interventions for the treatment of status epilepticus.
Male sex is strongly associated with IgE-sensitization to airborne but not food allergens: results up to age 24 years from the BAMSE birth cohort
Authors: Melén Erik , Bergström Anna , Kull Inger , Almqvist Catarina , Andersson Niklas , Asarnoj Anna , Borres Magnus P , Georgellis Antonis , Pershagen Göran , Westman Marit , Hage Marianne van , Ballardini Natalia
Published: May 2020

Background Up to half of the population in high-income countries has allergen-specific IgE antibodies. However, data regarding sex differences of IgE-sensitization from childhood to adulthood is limited. Objective To explore IgE-sensitization to common foods and airborne allergens in relation to sex over time in a population-based birth cohort followed up to young adulthood. Methods The Swedish population-based birth cohort BAMSE includes 4,089 subjects who have been followed regularly with questionnaires and clinical investigations. A recent 24-year follow-up included 3,069 participants (75%). Sera collected at 4, 8, 16 and 24 years were analyzed for IgE-antibodies to 14 common foods and airborne allergens. Results At 24 years sensitization to foods had decreased compared to previous follow-ups affecting 8.4%, while sensitization to airborne allergens was more common, affecting 42.2%. Male sex was associated with IgE-sensitization to airborne allergens at all ages (overall OR: 1.68, 95% CI 1.46 - 1.94) while there was no statistically significant association between sex and sensitization to food allergens (overall OR: 1.10, 95% CI 0.93 - 1.32). Levels of allergen-specific IgE did not differ significantly between males and females for any of the tested foods or airborne allergens at any age, following adjustment for multiple comparisons. Conclusion IgE-sensitization to airborne allergens increases with age up to young adulthood, whereas sensitization to food allergens seems to level off. Male sex is strongly associated with IgE-sensitization to airborne allergens from early childhood up to young adulthood. In contrast, there is little evidence for associations between sex and IgE-sensitization to foods.
Segmental motion at the peak of the ossification foci is independent risk factor except for mal-alignment and thick ossification foci for poor outcome after laminoplasty for cervical ossification of the posterior longitudinal ligament: analyses in patients with positive K-line, lordotic alignment and lower canal occupying ratio
Authors: Saito Junya , Koda Masao , Furuya Takeo , Maki Satoshi , Ijima Yasushi , Kitamura Mitsuhiro , Miyamoto Takuya , Orita Sumihisa , Inage Kazuhide , Hasue Fumio , Fujiyoshi Takayuki , Kamiya Koshiro , Ikeda Yoshikazu , Nakajima Fumitake , Hashimoto Mitsuhiro , Noguchi Hiroshi , Takahashi Hiroshi , Yamazaki Masashi , Ohtori Seiji
Published: May 2020

Purpose: To elucidate the independent preoperative factors that have a significant impact on poor surgical outcome after laminoplasty for K-line (+) ossification of the posterior longitudinal ligament (OPLL). Analyses in K-line (+) patient population can exclude the influence by mal-alignment and thick OPLL, both of which are well known two major factors have significant impact on clinical outcome.Methods: The present study included 72 patients (50 male and 22 female) who underwent laminoplasty for K-line (+) cervical OPLL and were followed-up for at least one year. Recovery of Japanese Orthopedic Association score (JOA score) for cervical myelopathy was used as the measure of clinical outcome. For radiographic assessment, the type of OPLL, the maximum OPLL occupation ratio, the C2-C7 angle and the segmental range of motion at the peak of OPLL (segmental ROM) were assessed. To elucidate the factors that are significantly associated with a poor clinical outcome after laminoplasty for K-line (+) OPLL, statistical analyses were conductedResults: The mean preoperative JOA score was 8.9 points and improved to 12.8 points after surgery. The recovery of JOA score was 47 ± 35 %. Stepwise logistic regression following univariate analyses revealed that preoperative segmental ROM at the peak of OPLL is an independent factor associated with a poor outcome (p = 0.04, odds ratio = 1.15).Conclusions: Large preoperative segmental ROM at the peak of the OPLL is an independent factor that has significant impact on poor surgical outcome after laminoplasty for K-line (+) OPLL.
"Who is Watching the Watchdog?": Ethical Perspectives of Sharing Health-related Data for Precision Medicine in Singapore
Authors: Lysaght Tamra , Ballantyne Angela , Xafis Vicki , Ong Serene , Schaefer Gerald Owen , Ling Jeffrey , Newson Ainsley J , Khor Ing Wei , Tai E Shyong
Published: May 2020

Background: We aimed to examine the ethical concerns Singaporeans have about sharing health-data for precision medicine (PM) and identify suggestions for governance strategies. Just as Asian genomes are under-represented in PM, the views of Asian populations about the risks and benefits of data sharing are under-represented in prior attitudinal research. Methods: We conducted seven focus groups with 62 participants in Singapore from May to July 2019. They were conducted in three languages (English, Mandarin and Malay) and analysed with qualitative content and thematic analysis. Results: Four key themes emerged: nuanced understandings of data security and data sensitivity; trades-offs between data protection and research benefits; trust (and distrust) in the public and private sectors; and governance and control options. Participants were aware of the inherent risks associated with data sharing for research. Participants expressed conditional support for data sharing, including genomic sequence data and information contained within electronic medical records. This support included sharing data with researchers from universities and healthcare institutions, both in Singapore and overseas. Support was conditional on the perceived social value of the research and appropriate de-identification and data security processes. Participants suggested that a data sharing oversight body would help strengthen public trust and comfort in data research for PM in Singapore. Conclusion: Maintenance of public trust in data security systems and governance regimes can enhance participation in PM and data sharing for research. Contrary to themes in much prior research, participants demonstrated a sophisticated understanding of the inherent risks of data sharing, analysed trade-offs between risks and potential benefits of PM, and often adopted an international perspective.
Safety studies and viral shedding of intramuscular administration of oncolytic vaccinia virus TG6002 in healthy Beagle dogs
Authors: Béguin Jérémy , Nourtier Virgine , Gantzer Murielle , Cochin Sandrine , Foloppe Johann , Balloul Jean Marc , Laloy Eve , Tierny Dominique , Klonjkowski Bernard , Quemeneur Eric , Maurey Christelle , Erbs Philippe
Published: May 2020

Background
Cancer is a leading cause of mortality for both humans and dogs. As spontaneous canine cancers appear to be relevant models of human cancers, the development of new therapeutic approaches can benefit both species. Oncolytic virotherapy is a promising therapeutic approach for the treatment of cancer. TG6002 is a recombinant oncolytic vaccinia virus deleted in the thymidine kinase and ribonucleotide reductase genes and armed with the suicide gene FCU1 that encodes a protein which catalyses conversion of the non-toxic 5-fluorocytosine into the toxic metabolite 5-fluorouracil. Previous studies have shown the ability of TG6002 to infect and replicate in canine tumor cell lines and its oncolytic potency in cell lines, xenograft models and canine mammary adenocarcinoma explants. Moreover, 5-fluorouracil synthesis has been confirmed in fresh canine mammary adenocarcinoma explants infected with TG6002 with 5-fluorocytosine. This study aims to assess the safety profile and viral shedding after unique or repeated intramuscular injections of TG6002 in healthy Beagle dogs.
Results
The maximal tolerated dose of TG6002 by intramuscular route was 5 × 107 PFU/kg. Repeated intramuscular administrations of TG6002 at the dose of 5 × 107 PFU/kg seem feasible with no particular adverse events. No clinical or biological adverse effect was observed in the course of the study. Residual TG6002 in blood, saliva, urine and feces of treated dogs was not detected by infectious titer assay and by qPCR, ensuring the safety of the virus for the dogs and their environment.
Conclusions
These results establish the good tolerability of TG6002 in healthy dogs with undetectable viral shedding after multiple injections. This study supports the initiation of further studies in canine cancer patients to evaluate the oncolytic potential of TG6002 and provides critical data for clinical development of TG6002 as human cancer therapy.
Efficacy of Melatonin on Postoperative Outcomes after Hysterectomy: A Randomized, Double-blind, Placebo-controlled Trial
Authors: Laosuwan Prok , Dechaworawut Kamolwan , Rodanant Oraluxna , Charuluxananan Somrat
Published: May 2020

Background: Melatonin became a part of multimodal analgesia in several recent studies because of its analgesic, anxiolytic and anti-inflammatory properties. Incidence of anxiety and pain in patients who underwent hysterectomy are not low. Moreover, preoperative anxiety was related to postoperative pain. The hypothesis of this study was whether melatonin could improve pain and other postoperative conditions after hysterectomy.Methods: A randomized, double-blinded, placebo-controlled trial recruitment of 54 patients, aged between 18 and 65 years old, planned to undergo hysterectomy, with or without oophorectomy under spinal anesthesia. The patients were allocated to receive 4 mg prolonged-release melatonin at night before surgery and in the morning before surgery or 2 doses of placebo at the same time point. Morphine consumption within 24 hours with patient-controlled analgesia machine and visual analog scale (VAS) pain score were recorded. In addition, quality of sleep, Thai standard anxiety level score, fatigue, general well-being and satisfaction score were measured by a blinded assessor and analyzed.Results: Mean of cumulative dose of morphine consumption in melatonin and placebo group were 33.04 ±10.42 and 42.63 ±8.21 mg, respectively. (p < 0.001) Mean of postoperative VAS pain scale was lower in the melatonin group at recovery room arrival (T0) (23.41 vs 8.07, p = 0.01). However, there was not a significant difference between postoperative groups at 1(T1), 6 (T6) and 24 h (T24). Fatigue and general well-being score in the melatonin group were better than the placebo group.Conclusion: Prolonged-release formulation of melatonin decreased pain intensity in post anesthetic care room and lowered doses of postoperative morphine within 24 hours after surgery. Postoperative fatigue, general well-being and satisfaction scores were better in the treatment group. However, there was no anxiety and sleep quality improvement. Melatonin may be an additional choice of multimodal analgesia for hysterectomy. Clinical trial registration: TCTR20140516001, Registered 16 May, 2014, http://www.clinicaltrials.in.th/index.php?tp=regtrials&menu=trialsearch&smenu=fulltext&task=search&task2=view1&id=1076, Efficacy of melatonin on postoperative outcomes after hysterectomy: a randomised, doubl-blinded, placebo-controlled trial
A Novel Automobile Antenna for Vehicles Communication of Iot Systems in 5g Network
Authors: Luo Wei , Chen Wuquan , Feng Yulu , Yang Yuqi
Published: May 2020

AbstractThe Internet of vehicles (IoV) is an important part of mobile communication system with the development of Internet of things (IoT). A novel multiband automobile antenna is proposed, which can cover all frequency bands for the long-term evolution (LTE), the 5th generation wireless systems (5G), the wireless local area network (WLAN) and the dedicated short-range communication (DSRC) (from 690 MHz to 944 MHz and from 1.46 GHz to 6 GHz). The antenna is designed based on the monopole antenna, and the impedance matching performance of the antenna is improved by loading the toothed capacitor and the impedance matching disc. The simulation results show that the automobile antenna achieves good impedance matching in the working bandwidth and obtains omnidirectional radiation pattern in the horizontal direction. The electric field distribution of the antenna placed on the vehicle roof is simulated to evaluate the network performance of the antenna system in the urban environment. The transmission coefficient of the transceiver system using the automobile antenna is also analyzed based on the electromagnetic simulation results and statistical model. The blind area of mobile communication system is effectively covered with the automobile antenna, which could be used to connect the LTE cell and the IoV system.
Emergency Demand Response in Edge Computing
Authors: Song Zhaoyan , Zhou Ruiting , Zhao Shihan , Qin Shixin , Lui John C.S. , Li Zongpeng
Published: May 2020

A cloudlet is a small-scale cloud datacenter deployed at the network edge to support mobile applications in proximity with low latency. While an individual cloudlet operates on moderate power, cloudlet clusters are well-suited candidates for emergency demand response (EDR) scenarios due to substantial electricity consumption and job elasticity: mobile workloads in the edge often exhibit elasticity in their execution. To efficiently carry out edge EDR via cloudlet cluster control, two fundamental problems need to be addressed: how to incentivize the participation of cloudlet clusters, and how to schedule and allocate workloads in each cluster to satisfy EDR requirements. We propose a two-stage control scheme, consisting of: i) an auction mechanism to motivate clusters' voluntary energy reduction and select participants with the minimum social cost; ii) an online task scheduling algorithm for chosen clusters to dispatch workloads to guarantee target EDR power reduction. Using the primal-dual optimization theory, we prove that our control scheme is truthful, individually rational, runs in polynomial time and achieves near-optimal performance. Large-scale simulation studies based on real-world data also confirm the efficiency and superiority of our scheme over state-of-the-art algorithms.
Using metagenomic analysis to assess the effectiveness of oral health promotion interventions in reducing risk for pneumonia among patients with stroke in acute phase: study protocol for a randomized controlled trial
Authors: Wu Juncang , Dai Yuanchang , Lo Edward C.M. , Qi Yinliang , Zhang Ya , Li Quanli , Dai Ruoxi
Published: May 2020

Background:The prevalence of pneumonia complicating stroke in acute phase has a poor prognosis and higher risk for death. Oral opportunistic pathogens have been reported to be associated with pneumonia among people with compromised health. Oral health promotion is effective in reducing dental plaque among patient with stroke, which is considered as reservoirs for oral opportunistic pathogens. This study evaluates the effectiveness of oral health promotions in reducing prevalence of pneumonia via its effects on composition and relative abundance of oral opportunistic pathogens.Methods/Design:This study is a randomized, single-blind, parallel trial of 6 months duration. The study is being conducted at one of the largest medical teaching hospitals in Hefei, China. A total of 166 patients with stroke and free from any post-stroke complication will be recruited. After enrollment, patients will be randomized to one of the groups: (1) oral hygiene instruction (OHI), or (2) OHI, 6-month use of powered toothbrushing, and 0.2% chlorhexidine gluconate mouth rinse (10 ml twice daily). The primary outcome is the prevalence of pneumonia complicating stroke. Patients will be monitored closely for any occurrence of pneumonia over the entire period of this trial. Oral rinse samples will be collected at baseline and multiple follow-up reviews (3, 5, 7 days, and 1, 3, 6 months after baseline). Next generation sequencing will be employed to detect composition and relative abundances of the microorganism in the oral rinse samples. Questionnaire interviews and clinical oral examinations will be conducted at baseline, and 1, 3, 6 months after baseline.DiscussionThe findings of this trial will provide evidence whether oral health promotion intervention is effective in reducing prevalence of pneumonia complicating stroke via its effect on oral microbiome. The analysis of the outcomes of this trial is empowered by metagenomic analysis at 16 S rRNA level, which is more sensitive and comprehensive to help us detect how oral health promotion inventions affect oral microbiome in terms of its composition, relative abundance, and interactions between species, which all may contribute to the occurrence of pneumonia complicating stroke.Trial registration: ClinicalTrials.gov, NCT04095780, registered on 09/19/2019