bluuebunny/crossref_metadata_2025 huggingface dataset:
Serum magnesium in diabetic retinopathy: the association needs investigation
Authors: Shivakumar Koushik , Rajalakshmi A.R. , Jha Kirti Nath , Nagarajan Swathi , Srinivasan A.R. , Lokesh Maran A.
Published: December 2021

Background:

Magnesium has an essential role in glucose metabolism, and hypomagnesaemia is common in diabetes mellitus. However, the relationship between serum magnesium and diabetic retinopathy is poorly understood.

Aim:

To determine the association between serum magnesium levels and retinopathy in type 2 diabetic patients with normal renal function and to correlate it with severity of retinopathy.

Methods:

This cross-sectional observational study was conducted in a semi-urban tertiary-care teaching hospital. Clinicodemographic profile and serum magnesium levels were determined in patients with type 2 diabetes mellitus (DM) with (group 1) and without (group 2) retinopathy. Serum magnesium levels were correlated with the presence and severity of retinopathy.

Results:

Of 104 type 2 DM patients, 50 had retinopathy. Younger age, longer duration of disease and poorer glycaemic control ( p < 0.05) were found to be associated with retinopathy. The mean serum magnesium levels in patients with retinopathy and those without retinopathy were 1.63 ± 0.30 mg/dL and 1.76 ± 0.22 mg/dL, respectively ( p = 0.029). Reduced serum magnesium was associated with elevated fasting sugars ( p = 0.019) and female gender ( p = 0.037). On comparative analysis of patients with sight-threatening diabetic retinopathy (STDR), non-STDR and no retinopathy by ANOVA test, patients with STDR had significantly lower serum magnesium (1.55 ± 0.33 mg/dL) ( p = 0.031).

Conclusion:

Serum magnesium levels were lower in patients with diabetic retinopathy. Patients with STDR had lower serum magnesium compared with those without STDR.

Serum magnesium, studied extensively for its role in glucose metabolism, was found to be lower in patients with diabetic retinopathy compared with those without retinopathy. Sight-threatening diabetic retinopathy had significantly lower levels of serum magnesium.
On-admission Serum High-Sensitivity C-Reactive Protein Level Independently Predicts In-Hospital Mortality and Adverse Cardiovascular Events in ST-elevation Acute Myocardial Infarction
Authors: Hartopo Anggoro Budi , Sukmasari Indah , Inggriani Maria Patricia , Rikl Thomas , Hayon Stefi Geovani Valentin , Rosqie Royhan , Puspitawati Ira
Published: December 2021

Background:

Inflammatory biomarkers are associated with adverse cardiovascular events during ST-elevation acute myocardial infarction (STEMI). We aimed to investigate the role of inflammatory biomarkers, high-sensitivity C-reactive protein (hs-CRP), and soluble ST-2 (sST2), for prediction of adverse cardiovascular events in STEMI.

Methods:

This was a prospective cohort study that consecutively enrolled patients with STEMI. Subjects were observed during hospitalization until discharge or fatal events happened. Adverse cardiovascular event was a compilation of cardiac mortality, acute heart failure, cardiogenic shock, reinfarction, and malignant ventricular arrhythmia. Blood samples were withdrawn on admission and inflammatory biomarkers (hs-CRP and sST2) were measured. The receiver operator characteristics curve and multivariable analysis were performed to determine which inflammatory biomarkers predict in-hospital adverse cardiovascular events and mortality.

Result:

Of 166 subjects, the in-hospital adverse cardiovascular events occurred in 41 subjects (24.6%) and mortality occurred in 16 subjects (9.6%). Subjects with in-hospital adverse cardiovascular events and mortality had a significantly higher hs-CRP level, but comparable sST2 level than subjects without events. The hs-CRP level was the most precise biomarkers to predict in-hospital adverse cardiovascular events (hs-CRP cut-off ≥2.75 mg/L) and mortality (hs-CRP cut-off ≥7 mg/L). Multivariable analysis indicated hs-CRP ≥2.75 mg/L as an independent predictor for in-hospital adverse cardiovascular events (adjusted odds ratio [OR]: 2.79, 95% confidence interval [CI]: 1.05-7.39, P = .039) and hs-CRP ≥7 mg/L for mortality (adjusted OR: 5.45, 95% CI: 1.13-26.18, P = .034) in STEMI.

Conclusion:

On admission, hs-CRP level independently predicted in-hospital adverse cardiovascular events, at cut-off level ≥2.75 mg/L, and mortality, at cut-off level ≥7 mg/L, in STEMI patients.
Surrounding Objects Detection and Tracking for Autonomous Driving Using LiDAR and Radar Fusion
Authors: Liu Ze , Cai Yingfeng , Wang Hai , Chen Long
Published: December 2021

Radar and LiDAR are two environmental sensors commonly used in autonomous vehicles, Lidars are accurate in determining objects’ positions but significantly less accurate as Radars on measuring their velocities. However, Radars relative to Lidars are more accurate on measuring objects velocities but less accurate on determining their positions as they have a lower spatial resolution. In order to compensate for the low detection accuracy, incomplete target attributes and poor environmental adaptability of single sensors such as Radar and LiDAR, in this paper, an effective method for high-precision detection and tracking of surrounding targets of autonomous vehicles. By employing the Unscented Kalman Filter, Radar and LiDAR information is effectively fused to achieve high-precision detection of the position and speed information of targets around the autonomous vehicle. Finally, the real vehicle test under various driving environment scenarios is carried out. The experimental results show that the proposed sensor fusion method can effectively detect and track the vehicle peripheral targets with high accuracy. Compared with a single sensor, it has obvious advantages and can improve the intelligence level of autonomous cars.
Optimal Design for Anti-Skid Control of Electric Vehicles by Fuzzy Approach
Authors: Li Chenming , Zhao Han , Huang Kang , Chen Ye-Hwa
Published: December 2021

In this paper, a new fuzzy approach is applied to optimal design of the anti-skid control for electric vehicles. The anti-skid control is used to maintain the wheel speed when there are uncertainties. The control is able to provide an appropriate torque for wheels when the vehicle is about to skid. The friction coefficient and the moments of inertia of wheels and motor are considered as uncertain parameters. These nonlinear, bounded and time-varying uncertainties are described by fuzzy set theory. The control is deterministic and is not based on IF-THEN fuzzy rules. Then, the optimal design for this fuzzy system and control cost is proposed by fuzzy information. In this way, the uniform boundedness and uniform ultimate boundedness are guaranteed and the average fuzzy performance is minimized. Numerical simulations show that the control can prevent vehicle skidding with the minimum control cost under uncertainties.
Investigation on the Flow Behavior of Side Channel Pumps Based on Vortex Identification
Authors: Zhang Fan , Appiah Desmond , Chen Ke , Yuan Shouqi , Adu-Poku Kofi Asamoah , Zhu Lufeng
Published: December 2021

The momentum flow exchange between the impeller and side channel produces highly turbulent flows in side channel pumps. The turbulent flows feature complex patterns of vortex structures that are partly responsible for the dissipation of energy losses and unsteady pressure pulsations. The concept of turbulent flows in side channel pumps requires a reliable vortex identification criterion to capture and predict the effects of the vortex structures on the performance. For this reason, the current study presents the application of the new Ω-criterion to a side channel pump model in comparison with other traditional methods such as Q and λ2 criteria. The 3D flow fields of the pump were obtained through unsteady Reynolds-averaged Navier-Stokes (RANS) simulations. Comparative studies showed that the Ω-criterion identifies the vortex of different intensities with a standard threshold, Ω=0.52. The Q and λ2 criteria required different thresholds to capture vortex of different intensities thus leads to subjective errors. Comparing the Ω-criterion intensity on different planes with the entropy losses and pressure pulsation, the longitudinal vortex plays an important role in the momentum exchange development which increases the head performance of the pump. However, the rate of exchange is impeded by the axial and radial vortices restricted in the impeller. Therefore, the impeller generates the highest entropy loss and pressure pulsation intensities which lower the output efficiency. Finally, the findings provide a fundamental background to the morphology of the vortex structures in the turbulent flows which can be dependent upon for efficiency improvement of side channel pumps.
The mechanical properties and thermal conductivity of bamboo with freeze–thaw treatment
Authors: Wu Jieyu , Wang Xianke , Fei Benhua , Xu Xiang , Lian Caiping , Chen Hong
Published: December 2021

The aim of this research was to investigate the effect of freeze–thaw treatment on bamboo with different initial moisture content (water-saturated, air-dried and oven-dried). Bamboo (Phyllostachys pubescens) were treated with two freeze treatments and its microstructure, chemical composition, mechanical properties and thermal conductivity were characterized by field emission scanning electron microscopy (FE-SEM), Fourier-transform infrared spectroscopy (FT-IR), X-ray diffraction (XRD), mechanical testing machine and thermal conductivity tester, respectively. The results showed that the freeze–thaw treatment had little influence on the microstructure of bamboo, the chemical composition content and the cellulose crystalline structure of bamboo were also not altered. The crystallinity index was found to increase with the increase of initial moisture content. The bending strength and elastic modulus of the treated bamboo increased, the extent of the increase was dependent on the initial moisture content and the freezing temperature. The thermal conductivity of the treated bamboo increased remarkably, which might be possibly determined by the cellulose crystallinity, moisture content, and density of bamboo.
Fyn kinase regulates dopaminergic neuronal apoptosis in animal and cell models of high glucose (HG) treatment
Authors: Tan Changhong , Liu Xi , Zhang Xiaoshuai , Peng Wuxue , Wang Hui , Zhou Wen , Jiang Jin , Mo Lijuan , Chen Yangmei , Chen Lifen
Published: December 2021

Background

High glucose (HG) is linked to dopaminergic neuron loss and related Parkinson’s disease (PD), but the mechanism is unclear.

Results

Rats and differentiated SH-SY5Y cells were used to investigate the effect of HG on dopaminergic neuronal apoptotic death. We found that a 40-day HG diet elevated cleaved caspase 3 levels and activated Fyn and mTOR/S6K signaling in the substantia nigra of rats. In vitro, 6 days of HG treatment activated Fyn, enhanced binding between Fyn and mTOR, activated mTOR/S6K signaling, and induced neuronal apoptotic death. The proapoptotic effect of HG was rescued by either the Fyn inhibitor PP1 or the mTOR inhibitor rapamycin. PP1 inhibited mTOR/S6K signaling, but rapamycin was unable to modulate Fyn activation.

Conclusions

HG induces dopaminergic neuronal apoptotic death via the Fyn/mTOR/S6K pathway.
Genetic association tests in family samples for multi-category phenotypes
Authors: Wang Shuai , Meigs James B. , Dupuis Josée
Published: December 2021

Background

Advancements in statistical methods and sequencing technology have led to numerous novel discoveries in human genetics in the past two decades. Among phenotypes of interest, most attention has been given to studying genetic associations with continuous or binary traits. Efficient statistical methods have been proposed and are available for both types of traits under different study designs. However, for multinomial categorical traits in related samples, there is a lack of efficient statistical methods and software.

Results

We propose an efficient score test to analyze a multinomial trait in family samples, in the context of genome-wide association/sequencing studies. An alternative Wald statistic is also proposed. We also extend the methodology to be applicable to ordinal traits. We performed extensive simulation studies to evaluate the type-I error of the score test, Wald test compared to the multinomial logistic regression for unrelated samples, under different allele frequency and study designs. We also evaluate the power of these methods. Results show that both the score and Wald tests have a well-controlled type-I error rate, but the multinomial logistic regression has an inflated type-I error rate when applied to family samples. We illustrated the application of the score test with an application to the Framingham Heart Study to uncover genetic variants associated with diabesity, a multi-category phenotype.

Conclusion

Both proposed tests have correct type-I error rate and similar power. However, because the Wald statistics rely on computer-intensive estimation, it is less efficient than the score test in terms of applications to large-scale genetic association studies. We provide computer implementation for both multinomial and ordinal traits.
Weighted gene coexpression correlation network analysis reveals a potential molecular regulatory mechanism of anthocyanin accumulation under different storage temperatures in ‘Friar’ plum
Authors: Li Xueling , Cheng Yudou , Wang Meng , Cui Sujuan , Guan Junfeng
Published: December 2021

Background

Flesh is prone to accumulate more anthocyanin in postharvest ‘Friar’ plum (Prunus salicina Lindl.) fruit stored at an intermediate temperature. However, little is known about the molecular mechanism of anthocyanin accumulation regulated by storage temperature in postharvest plum fruit.

Results

To reveal the potential molecular regulation mechanism of anthocyanin accumulation in postharvest ‘Friar’ plum fruit stored at different temperatures (0 °C, 10 °C and 25 °C), the fruit quality, metabolite profile and transcriptome of its flesh were investigated. Compared to the plum fruit stored at 0 °C and 25 °C, the fruit stored at 10 °C showed lower fruit firmness after 14 days and reduced the soluble solids content after 21 days of storage. The metabolite analysis indicated that the fruit stored at 10 °C had higher contents of anthocyanins (pelargonidin-3-O-glucoside, cyanidin-3-O-glucoside, cyanidin-3-O-rutinoside and quercetin-3-O-rutinose), quercetin and sucrose in the flesh. According to the results of weighted gene coexpression correlation network analysis (WGCNA), the turquoise module was positively correlated with the content of anthocyanin components, and flavanone 3-hydroxylase (F3H) and chalcone synthase (CHS) were considered hub genes. Moreover, MYB family transcription factor APL (APL), MYB10 transcription factor (MYB10), ethylene-responsive transcription factor WIN1 (WIN1), basic leucine zipper 43-like (bZIP43) and transcription factor bHLH111-like isoform X2 (bHLH111) were closely related to these hub genes. Further qRT–PCR analysis verified that these transcription factors were specifically more highly expressed in plum flesh stored at 10 °C, and their expression profiles were significantly positively correlated with the structural genes of anthocyanin synthesis as well as the content of anthocyanin components. In addition, the sucrose biosynthesis-associated gene sucrose synthase (SS) was upregulated at 10 °C, which was also closely related to the anthocyanin content of plum fruit stored at 10 °C.

Conclusions

The present results suggest that the transcription factors APL, MYB10, WIN1, bZIP43 and bHLH111 may participate in the accumulation of anthocyanin in ‘Friar’ plum flesh during intermediate storage temperatures by regulating the expression of anthocyanin biosynthetic structural genes. In addition, the SS gene may play a role in anthocyanin accumulation in plum flesh by regulating sucrose biosynthesis.
Morphometric assessment of spleen dimensions and its determinants among individuals living in Arba Minch town, southern Ethiopia
Authors: Demissie Solomon , Mergu Prasad , Hailu Tadiwos , Abebe Getachew , Warsa Mengistu , Fikadu Teshale
Published: December 2021

Introduction

The spleen is a vital lymphoid soft organ that demands constant attention from the clinical point of view. It is a multi-dimensional organ that enlarges in its all dimensions during some disease condition. The detection of the spleen by palpation is not an indicator of an enlarged spleen because normal spleen may be palpable. Therefore, this study aimed to assess the morphometry of spleen dimensions and its determinants among individuals living in Arba Minch town by sonographic examinations.

Methods and materials

Community-based cross-sectional study was conducted in Arba Minch town from February 1 to March 30, 2020. Seven hundred and eight study participants were selected using a multi-stage systematic random sampling technique. Data were checked for completeness, edited, coded and entered into Epi-Data version 3.1 and exported to STATA software version 16 for analysis.

Result

The mean splenic length, width, thickness and volume were 10.24 cm, 4.79 cm, 3.93 cm, and 109.34 cm3, respectively. The mean spleen length, width, thickness and volumes among males were 10.64 cm, 4.92 cm, 4.05 cm and 119.81 cm3 and among females were 9.75 cm, 4.63 cm, 3.78 cm and 96.50 cm3 respectively. As age increased by one year the mean spleen length, width, thickness and volume was decreased by 0.032 cm, 0.018 cm 0.004 cm and 0.012 cm respectively. As height increased by 1 cm the mean spleen width and volume were increased by 0.096 cm and 0.052 cm respectively. As we go from male to female the mean spleen length decreased by 0.294 cm.

Conclusion

The spleen dimensions were higher in males than females. Splenic length was determined by age & sex, the spleen width was determined by age & height, the spleen volume was determined by age & height and the spleen thickness was determined by age.
METTL14 gene polymorphisms decrease Wilms tumor susceptibility in Chinese children
Authors: Zhuo Zhenjian , Hua Rui-Xi , Zhang Huizhu , Lin Huiran , Fu Wen , Zhu Jinhong , Cheng Jiwen , Zhang Jiao , Li Suhong , Zhou Haixia , Xia Huimin , Liu Guochang , Jia Wei , He Jing
Published: December 2021

Background

Wilms tumor is a highly heritable malignancy. Aberrant METTL14, a critical component of N6-methyladenosine (m6A) methyltransferase, is involved in carcinogenesis. The association between genetic variants in the METTL14 gene and Wilms tumor susceptibility remains to be fully elucidated. We aimed to assess whether variants within this gene are implicated in Wilms tumor susceptibility.

Methods

A total of 403 patients and 1198 controls were analyzed. METTL14 genotypes were assessed by TaqMan genotyping assay.

Result

Among the five SNPs analyzed, rs1064034 T > A and rs298982 G > A exhibited a significant association with decreased susceptibility to Wilms tumor. Moreover, the joint analysis revealed that the combination of five protective genotypes exerted significantly more protective effects against Wilms tumor than 0–4 protective genotypes with an OR of 0.69. The stratified analysis further identified the protective effect of rs1064034 T > A, rs298982 G > A, and combined five protective genotypes in specific subgroups. The above significant associations were further validated by haplotype analysis and false-positive report probability analysis. Preliminary mechanism exploration indicated that rs1064034 T > A and rs298982 G > A are correlated with the expression and splicing event of their surrounding genes.

Conclusions

Collectively, our results suggest that METTL14 gene SNPs may be genetic modifiers for the development of Wilms tumor.
The identification of gene signatures in patients with extranodal NK/T-cell lymphoma from a pair of twins
Authors: Wang Yang , Tan Huaicheng , Yu Ting , Ma Xuelei , Chen Xiaoxuan , Jing Fangqi , Zou Liqun , Shi Huashan
Published: December 2021

Background

There is no unified treatment standard for patients with extranodal NK/T-cell lymphoma (ENKTL). Cancer neoantigens are the result of somatic mutations and cancer-specific. Increased number of somatic mutations are associated with anti-cancer effects. Screening out ENKTL-specific neoantigens on the surface of cancer cells relies on the understanding of ENKTL mutation patterns. Hence, it is imperative to identify ENKTL-specific genes for ENKTL diagnosis, the discovery of tumor-specific neoantigens and the development of novel therapeutic strategies. We investigated the gene signatures of ENKTL patients.

Methods

We collected the peripheral blood of a pair of twins for sequencing to identify unique variant genes. One of the twins is diagnosed with ENKTL. Seventy samples were analyzed by Robust Multi-array Analysis (RMA). Two methods (elastic net and Support Vector Machine-Recursive Feature Elimination) were used to select unique genes. Next, we performed functional enrichment analysis and pathway enrichment analysis. Then, we conducted single-sample gene set enrichment analysis of immune infiltration and validated the expression of the screened markers with limma packages.

Results

We screened out 126 unique variant genes. Among them, 11 unique genes were selected by the combination of elastic net and Support Vector Machine-Recursive Feature Elimination. Subsequently, GO and KEGG analysis indicated the biological function of identified unique genes. GSEA indicated five immunity-related pathways with high signature scores. In patients with ENKTL and the group with high signature scores, a proportion of functional immune cells are all of great infiltration. We finally found that CDC27, ZNF141, FCGR2C and NES were four significantly differential genes in ENKTL patients. ZNF141, FCGR2C and NES were upregulated in patients with ENKTL, while CDC27 was significantly downregulated.

Conclusion

We identified four ENKTL markers (ZNF141, FCGR2C, NES and CDC27) in patients with extranodal NK/T-cell lymphoma.
Predictors for HIV testing among Chinese workers in infrastructure construction enterprises in Kenya
Authors: Zhou Wenjuan , Deng Wenyu , Luo Junfei , Bai Yin , He Zeyi , Wang Honghong
Published: December 2021

Background

There are increasing Chinese migrants in sub-Saharan Africa currently. Most of them are engaged in infrastructure construction. Research has shown that they stay at particular risk of HIV and are recommended for HIV testing. However, their HIV testing behavior, and its relevant factors, have not been researched among them by now. This study describes the recent HIV testing behavior and relevant factors among Chinese migrant workers in Kenya.

Methods

A cross-sectional survey was conducted among 110 male Chinese workers from six different Chinese infrastructure construction enterprises in Kenya. Furthermore, a two-stage cluster random sampling method was used to select participants. We used a questionnaire that included HIV testing history, demographic characteristics, and putative multilevel facilitators of HIV testing. Logistic regression was used to explore the predictors of recent HIV testing behavior among Chinese migrant workers in Kenya.

Result

Of the 110 participants, 30 (27.27%) were tested for HIV in the recent year. All participants were male, and the majority were married (73.2%). The mean age was 37.49 years (SD = 9.73; range: 23 to 63), and a considerable proportion refused to answer questions about transactional sexual behaviors in the last year. Most were able to obtain HIV-related information (91.8%) and were exposed to HIV-related information in the last year (68.2%), but only 47.6% had sufficient HIV knowledge. Nearly one-fifth of them believed that selling sex and paying for sex is acceptable. Multiple logistic regression analysis indicated that participants who could accept the ‘pay for sex’ (OR: 2.74; 95% CI: 1.02, 7.36) and exposed to HIV related information (OR: 4.75; 95% CI: 1.29, 17.44) were more likely to test for HIV in the recent 1 year.

Conclusion

Higher current HIV test rates were associated with a more open sexual attitude towards paying for sex and being exposed to HIV-related information in the last year among Chinese workers in Kenya. More specific attention to HIV should be attached to this population to increase the rate of HIV testing among them.
Validation of the risk stratification score in idiopathic pulmonary fibrosis: study protocol of a prospective, multi-centre, observational, 3-year clinical trial
Authors: Manzetti Gian Marco , Hosein Karishma , Cecchini Matthew J. , Kwan Keith , Abdelrazek Mohamed , Zompatori Maurizio , Rogliani Paola , Mura Marco
Published: December 2021

Background

Idiopathic pulmonary fibrosis (IPF) is characterized by a poor prognosis, with a progressive decline in lung function and considerable variability in the disease’s natural history. Besides lung transplantation (LTx), the only available treatments are anti-fibrosing drugs, which have shown to slow down the disease course. Therefore, predicting the prognosis is of pivotal importance to avoid treatment delays, which may be fatal for patients with a high risk of progression. Previous studies showed that a multi-dimensional approach is practical and effective in the development of a reliable prognostic score for IPF. In the RIsk Stratification scorE (RISE), physiological parameters, an objective measure of patient-reported dyspnea and exercise capacity are combined to capture different domains of the complex pathophysiology of IPF.

Methods

This is an observational, multi-centre, prospective cohort study, designed to reflect common clinical practice in IPF. A development cohort and a validation cohort will be included. Patients newly diagnosed with IPF based on the ATS/ERS criteria and multi-disciplinary discussion will be included in the study. A panel of chest radiologists and lung pathologists will further assess eligibility. At the first visit (time of diagnosis), and every 4-months, MRC dyspnea score, pulmonary function tests (FEV1, FVC and DLCO), and 6-min walking distance will be recorded. Patients will be prospectively followed for 3 years. Comorbidities will be considered. The radiographic extent of fibrosis on HRCT will be recalculated at a 2-year interval. RISE, Gender-Age-Physiology, CPI and Mortality Risk Scoring System will be calculated at 4-month intervals. Longitudinal changes of each variable considered will be assessed. The primary endpoint is 3-year LTx-free survival from the time of diagnosis. Secondary endpoints include several, clinically-relevant information to ensure reproducibility of results across a wide range of disease severity and in concomitance of associated pulmonary hypertension or emphysema.

Discussion

The objective of this study is to validate RISE as a simple, straightforward, inexpensive and reproducible tool to guide clinical decision making in IPF, and potentially as an endpoint for future clinical trials.

Trial registration: U.S National Library of Medicine Clinicaltrials.gov, trial n. NCT02632123 “Validation of the risk stratification score in idiopathic pulmonary fibrosis”. Date of registration: December 16th, 2015.
Association between body mass index and newly diagnosed drug-resistant pulmonary tuberculosis in Shandong, China from 2004 to 2019
Authors: Song Wan-mei , Guo Jing , Xu Ting-ting , Li Shi-jin , Liu Jin-yue , Tao Ning-ning , Liu Yao , Zhang Qian-yun , Liu Si-qi , An Qi-qi , Li Yi-fan , Yu Chun-bao , Dong Ji-hua , Li Huai-chen
Published: December 2021

Background

Drug-resistant tuberculosis (DR-TB), obesity, and malnutrition are growing public health problems in the world. However, little has discussed the impact of different BMI status on the emergence of TB drug resistance. We aimed to explore the drug-resistant profiles of DR-TB and its clinical predictors among underweight, overweight or obesity population.

Methods

8957 newly diagnosed TB cases with drug susceptibility results and BMI data in Shandong China, from 2004 to 2019 were enrolled. Multivariable and univariable logistic regression models were applied to investigate the impact of BMI on different drug-resistance. Clinical predicators and drug-resistant profiles of DR-TB among obesity, underweight, normal TB group were also described.

Results

Among 8957 TB cases, 6417 (71.64%) were normal weight, 2121 (23.68%) were underweight, 373 (4.16%) were overweight, and 46 (0.51%) were obese. The proportion of drug resistance and co-morbidity among normal weight, underweight, overweight, obese TB groups were 18.86%/18.25%/20.38%/23.91% (DR-TB), 11.19%/11.74%/9.65%/17.39% (mono-resistant tuberculosis, MR-TB), 3.41%/3.06%/5.36%/0.00% (multidrug resistant tuberculosis, MDR-TB), 4.21%/3.39%/5.36%/6.52% (polydrug resistant tuberculosis, PDR-TB), 10.57%/8.44%/19.57%/23.91% (co-morbidity), respectively. Compared with normal weight group, underweight were associated with lower risk of streptomycin-related resistance (OR 0.844, 95% CI 0.726–0.982), but contributed to a higher risk of MR-TB (isoniazid) (odds ratio (OR) 1.347, 95% CI 1.049–1.730; adjusted OR (aOR) 1.31, 95% CI 1.017–1.686), P < 0.05. In addition, overweight were positively associated with MDR-TB (OR 1.603, 95% CI 1.002–2.566; aOR 1.639, 95% CI 1.02–2.633), isoniazid + rifampicin + streptomycin resistance (OR 1.948, 95% confidence interval (CI): 1.061–3.577; aOR 2.113, 95% CI 1.141–3.912), Any isoniazid + streptomycin resistance (OR 1.472, 95% CI 1.013–2.14; aOR 1.483, 95% CI 1.017–2.164), P < 0.05.

Conclusions

The higher risk of MDR-TB, isoniazid + rifampicin + streptomycin resistance, Any isoniazid + streptomycin resistance, and co-morbidity among overweight population implies that routine screening for drug sensitivity and more attention on co-morbidity among overweight TB cases may be necessary. In addition, underweight TB cases have a higher risk of isoniazid resistance. Our study suggests that an in-depth study of the interaction between host metabolic activity and infection of DR-TB may contribute more to novel treatment options or preventive measures, and accelerate the implementation of the STOP TB strategy.
The accuracy of acetabular cup placement in primary total hip arthroplasty using an image-free navigation system
Authors: Naito Yohei , Hasegawa Masahiro , Tone Shine , Wakabayashi Hiroki , Sudo Akihiro
Published: December 2021

Background

Intraoperative navigation systems have been shown to improve the accuracy of acetabular component insertion in total hip arthroplasty (THA). The purpose of this study was to investigate the accuracy of cup orientation in primary THA using an image-free navigation system.

Methods

A total of 107 consecutive cementless THAs using an image-free navigation system were performed from February 2017 to March 2020 (the navigation group). As a control group, 77 retrospective consecutive cases who underwent THAs with manual implant-techniques between February 2012 and April 2017 were included. Postoperative cup radiographic inclination and radiographic anteversion relative to the functional pelvic plane were assessed using a 3D-template system after computed tomography (CT) examination.

Results

The mean absolute errors of the postoperative measured angles from the target angles in inclination were 3.4° ± 3.0° in the navigation group and 8.4° ± 6.6° in the control group (p < 0.001). The mean absolute errors in anteversion were 5.1° ± 3.6° in the navigation group and 10.8° ± 6.5° in the control group (p < 0.001). The percentage of cups inside the Lewinnek safe zone was 93% in the navigation group and 44% in the control group (p < 0.001). The mean absolute values of navigation error were 3.3° ± 2.8° in inclination and 5.8° ± 4.9° in anteversion. Among the cases of osteoarthritis, the inclination error was significantly higher in Crowe group 2 to 4 than in Crowe group 1 (5.1° ± 3.5° and 3.0° ± 2.5°, respectively, p < 0.05). The percentage of hips with inclination error over 10° in Crowe group 2 to 4 was significantly higher than in Crowe group 1 (17 and 1%, respectively, p < 0.05).

Conclusions

The image-free navigation system improved the accuracy of cup orientation. The accuracy of cup position was less in Crowe group 2 to 4 than in Crowe group 1.
Modified bladder outlet obstruction index for powerful efficacy prediction of transurethral resection of prostate with benign prostatic hyperplasia
Authors: Liu Hongming , Tian Ye , Luo Guangheng , Su Zhiyong , Ban Yong , Wang Zhen , Sun Zhaolin
Published: December 2021

Background

The correlation between modified bladder outlet obstruction index (MBOOI) and surgical efficacy still remains unknown. The purpose of the study was to investigate the clinical value of the MBOOI and its use in predicting surgical efficacy in men receiving transurethral resection of the prostate (TURP).

Methods

A total of 403 patients with benign prostate hyperplasia (BPH) were included in this study. The International Prostate Symptom Score (IPSS), quality of life (QoL) index, transrectal ultrasonography, and pressure flow study were conducted for all patients. The bladder outlet obstruction index (BOOI) (PdetQmax–2Qmax) and MBOOI (Pves–2Qmax) were calculated. All patients underwent TURP, and surgical efficacy was accessed by the improvements in IPSS, QoL, and Qmax 6 months after surgery. The association between surgical efficacy and baseline factors was statistically analyzed.

Results

A comparison of effective and ineffective groups based on the overall efficacy showed that significant differences were observed in PSA, Pves, PdetQmax, Pabd, BOOI, MBOOI, TZV, TZI, IPSS-t, IPSS-v, IPSS-s, Qmax, and PVR at baseline (p < 0.05). Binary logistic regression analysis suggested that MBOOI was the only baseline parameter correlated with the improvements in IPSS, QoL, Qmax, and the overall efficacy. Additionally, the ROC analysis further verified that MBOOI was more optimal than BOOI, TZV and TZI in predicting the surgical efficacy.

Conclusion

Although both MBOOI and BOOI can predict the clinical symptoms and surgical efficacy of BPH patients to a certain extent, however, compared to BOOI, MBOOI may be a more useful factor that can be used to predict the surgical efficacy of TURP.

Trial registration retrospectively registered.
The impact of a multilevel interactive nursing quality control and audit application on nursing quality management
Authors: Pei-Ying K. O. , Chen-Shie H. O. , Pei-Hung L. I. A. O.
Published: December 2021

Background

This study aims to investigate the effects of a nursing quality control and audit application (app) on the autonomous learning of nursing staff and nursing quality management by nursing supervisors. A multilevel interactive app is developed to assist nursing staff in conducting online autonomous learning and nursing supervisors in identifying problems and creating nursing quality improvement plans. The app could also present the different evaluation results of wards in visual charts for supervisors to review.

Methods

A single-group pre- and post-test design was applied. Data were collected from 131 nurses between October 2019 and October 2020 to analyze the differences between nursing staffs’ willingness to engage in autonomous learning and the integrity of nursing quality improvement plan writing before and after the intervention. The structured questionnaires included open-ended questions that cover aspects of nursing quality control, the audit app, and the information acceptance intention of nurses.

Results

The participants’ age and job title are negatively correlated with the app’s usability, while the ability to use 3C (Computer, Communication, and Consumer Electronics products including mobile phones and laptops) equipment is positively correlated with the willingness to use the app. Nurses’ satisfaction with the convenience of the online autonomous learning method is 92%, which indicates that the app could improve their willingness to learn. Following the intervention of the app, nursing supervisors’ satisfaction with the integrity of nursing quality improvement plan writing increased from 41 to 88%.

Conclusions

Using information technology products to assist in nursing quality management in clinical practice has a significant effect on nurses’ load reduction and head nurses’ satisfaction. Multilevel interactive nursing quality control and audit apps can improve nursing staff’s willingness to learn independently, nursing quality, and the integrity of plan writing. Thus, nursing quality control and audit apps can be considered as suitable nursing quality control tools.
Immediate IUD insertion after second trimester abortion: implications for service delivery
Authors: Somefun O. , Constant D. , Endler M.
Published: December 2021

Background

The availability of modern contraception including long-acting reversible contraceptives (LARC), is a fundamental component of postabortion care. Findings from a recent randomized controlled trial (RCT) in South Africa comparing immediate to delayed insertion of the copper intrauterine device (IUD) after medical abortion (MA) at 17-20 gestational weeks showed that immediate insertion resulted in higher IUD use at 6 weeks postabortion, but that expulsion rates were significantly higher than for delayed insertion. This study aims to explore barriers, facilitators, and context-specific factors relevant to the implementation of immediate IUD provision after second trimester medical abortion.

Methods

We performed a qualitative study alongside the RCT in which we conducted in-depth interviews with 14 staff providing healthcare to study participants and 24 study participants. Research questions explored barriers and facilitators to implementation of immediate IUD insertion, contraceptive decision-making, and the impact of context and supplementary trial activities on service provision. Interviews were recorded and transcribed, with translation into English if needed. We performed a triangulated thematic analysis at the level of the transcribed interview text.

Results

Contraceptive counselling at the abortion facility by a study nurse improved knowledge, corrected misconceptions, and increased demand for the IUD postabortion. Women expressed a clear preference for immediate insertion. Convenience, protection from pregnancy and privacy issues were paramount and women expressed preference for engagement with staff who knew their abortion history, and with whom they had an established connection. Doctors and nurses were generally in favour of immediate insertion and said it could be incorporated into standard care if women wanted this. This contrasted with the need for interventions by the research team to reinforce adherence by staff to provide contraception as allocated during the trial.

Conclusions

Women and staff favour immediate IUD insertion after second trimester medical abortion, but service delivery may require structures that ensure timely insertion postabortion, continuity of care, communication that mitigates loss to follow-up and training of staff to ensure competence.
Trends of chronic illness in emergency department admissions among elderly adults in a tertiary hospital over ten years
Authors: Hu Zhongxun , Siddiqui Fahad Javaid , Fan Qiao , Lian Sherman W. Q. , Liu Nan , Ong Marcus E. H.
Published: December 2021

Background

This study aimed to determine to what extent an aging population and shift to chronic illness has contributed to emergency admissions at a tertiary care hospital over ten years.

Methods

This was a retrospective observational study performed using a database of all emergency admissions from the Emergency Department (ED) at a single tertiary hospital in Singapore during a ten-year period (January 1st, 2008 to December 31st, 2017). Emergency admissions were defined as ED visits with inpatient admission as the disposition. This study analyzed the trends of demographics, pre-existing comorbidities, chronic conditions or ambulatory care sensitive conditions (ACSC) of all patients who underwent emergency admissions in Singapore General Hospital.

Results

A total of 446,484 emergency records were included. For elderly patients, the proportions of them had pre-existing multimorbidity at the time of undergoing emergency admissions were found to be lower at the end the 10-year study period relative to the beginning of the study period. The proportions of emergency admissions whose ED primary diagnoses were categorized as chronic conditions and certain chronic ACSC including chronic obstructive pulmonary disease, congestive heart failure, diabetes complications, and epilepsy also decreased for elderly patients over the 10-year study period.

Conclusions

In Singapore, despite a rapidly aging population, there have been surprisingly lower proportions of chronic conditions, pre-existing comorbidities, and chronic ACSC among the elderly emergency admissions. This is possibly consistent with an overall improved management of the chronic conditions among the elderly population. Future studies should include similar studies at the national level and comparison with other healthcare settings in different countries.
A review of simulation models for the long-term management of type 2 diabetes in low-and-middle income countries
Authors: Mukonda Elton , Cleary Susan , Lesosky Maia
Published: December 2021

Introduction

The burden of type 2 diabetes is steadily increasing in low-and-middle-income countries, thereby posing a major threat from both a treatment, and funding standpoint. Although simulation modelling is generally relied upon for evaluating long-term costs and consequences associated with diabetes interventions, no recent article has reviewed the characteristics and capabilities of available models used in low-and-middle-income countries. We review the use of computer simulation modelling for the management of type 2 diabetes in low-and-middle-income countries.

Methods

A search for studies reporting computer simulation models of the natural history of individuals with type 2 diabetes and/or decision models to evaluate the impact of treatment strategies on these populations was conducted in PubMed. Data were extracted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and assessed using modelling checklists. Publications before the year 2000, from high-income countries, studies involving animals and analyses that did not use mathematical simulations were excluded. The full text of eligible articles was sourced and information about the intervention and population being modelled, type of modelling approach and the model structure was extracted.

Results

Of the 79 articles suitable for full text review, 44 studies met the inclusion criteria. All were cost-effectiveness/utility studies with the majority being from the East Asia and Pacific region (n = 29). Of the included studies, 34 (77.3%) evaluated the cost-effectiveness of pharmacological interventions and approximately 75% of all included studies used HbA1c as one of the treatment effects of the intervention. 32 (73%) of the publications were microsimulation models, and 29 (66%) were state-transition models. Most of the studies utilised annual cycles (n = 29, 71%), and accounted for costs and outcomes over 20 years or more (n = 38, 86.4%).

Conclusions

While the use of simulation modelling in the management of type 2 diabetes has been steadily increasing in low-and-middle-income countries, there is an urgent need to invest in evaluating therapeutic and policy interventions related to type 2 diabetes in low-and-middle-income countries through simulation modelling, especially with local research data. Moreover, it is important to improve transparency and credibility in the reporting of input data underlying model-based economic analyses, and studies.
Respiratory obstruction due to tonsillar lymphoglandular polyp in a brachycephalic dog: a case report
Authors: Gabriel Leah , Aryazand Yazdan , Buote Nicole
Published: December 2021

Background

Respiratory distress is one of the most common afflictions of brachycephalic dogs. Dogs in respiratory distress usually present to the emergency service with a constellation of clinical signs including but not limited to: stertorous breathing, dyspnea, gagging, cyanotic mucus membranes, hyperthermia, and commonly a history of gastrointestinal signs. While Brachycephalic Obstructive Airway Syndrome is the most common cause of respiratory distress in dogs with brachycephalic conformation, any condition eliciting an inflammatory response in the oropharynx, can result in obstruction. There is no previous report of respiratory obstruction leading to emergency tonsillectomy caused by tonsillar polyps.

Case presentation

A 9-month-old male intact English bulldog presented to the emergency service in severe respiratory distress. Due to continued severe dyspnea and cyanosis the patient was induced with propofol (Propofol, Hospira) 4 mg/kg intravenously titrated to effect and tracheal intubation performed. Intubation was noted to be difficult due the presence of two, large, inflamed masses in the oropharynx region. The remainder of his physical exam was unremarkable. Minimum database blood work and chest radiographs revealed only minor abnormalities. The patient was placed under anesthesia and the masses were transected sharply using a carbon dioxide (CO2) laser (Aesculight, Bothell, WA, USA). Anesthesia and recovery were uneventful, and the patient was discharged the following day. Histopathology results of the masses revealed them to be benign lymphoglandular polyps.

Conclusions

This is the first report of bilateral tonsillar polyps causing life-threatening respiratory obstruction in a dog. Both masses were excised safely and completely with the CO2 laser. Difficulties inherent to oropharyngeal surgery include the hemorrhage, small working space, tissue swelling and difficult visualization. Surgical excision of these polyps alleviated all emergent and chronic clinical signs, and the patient’s remains healthy 12-months post-treatment.
CircTUBGCP3 facilitates the tumorigenesis of lung adenocarcinoma by sponging miR-885-3p
Authors: Yang Yang , Fan Xin , Nie Yunfei , Liu Donglei , Zhu Dengyan , Wu Kai , Zhang Yuan , Li Wenhua , Tian Xiangyu , Wang Huaqi , Fan Yuxia
Published: December 2021

Background

Circular RNAs (circRNAs) act pivotal roles in the progression of multiple malignancies. However, the underlying mechanisms by which hsa_circ_0007031 (circTUBGCP3) contributes to lung adenocarcinoma (LAC) remain largely unknown.

Methods

The association of circTUBGCP3 expression with clinicopathological characteristics and prognosis in patients with LAC was determined by RT-qPCR and fluorescence in situ hybridization. The in vitro functional experiments as well as a subcutaneous tumorigenesis model were executed to estimate the role of circTUBGCP3 in LAC cells. The interaction between circTUBGCP3 and miR-885-3p was confirmed by RNA immunoprecipitation, luciferase gene report and RT-qPCR assays. The effects of circTUBGCP3 on miR-885-3p-mediated Wnt10b/β-catenin signaling were evaluated by Western blot.

Results

The upregulation of circTUBGCP3 or downregulation of miR-885-3p was associated with the pathological stage and poor survival in patients with LAC. Restored expression of circTUBGCP3 facilitated the growth and invasion of LAC cells, but knockdown of circTUBGCP3 harbored the opposite effects. In mechanism, circTUBGCP3 could act as a sponge of miR-885-3p, which suppressed the cell proliferation and colony formation and attenuated the tumor-promoting effects of circTUBGCP3. Wnt10b as a target of miR-885-3p could be upregulated be circTUBGCP3 and indicate poor survival in patient with LAC.

Conclusions

Our findings demonstrated that circTUBGCP3 promoted LAC progression by sponging miR-885-3p, and might represent a prognostic factor for LAC.