bluuebunny/crossref_metadata_2025 huggingface dataset:
Ang II Enhances Atrial Fibroblast Autophagy and Promotes Atrial Remodeling Through the AT1-ERK-mTOR Signaling Pathway
Authors: Xu Xudong , Chen Mengmeng , Qiu Hangyuan , Zhou Kuangshi , Zhu Jun , Cheng Hui , Wang Yunhe , Fu Guosheng , Jiang Ruhong , Jiang Chenyang
Published: August 2020

Background: Atrial remodeling is a common pathological change in atrial fibrillation (AF), while the mechanism of atrial remodeling remains unclear. In the present study, we investigated the autophagy and collagen secretion in atrial fibroblasts in response to renin-angiotensin system (RAS) activation and elucidated the relationship between atrial fibroblast autophagy and atrial remodeling. Methods: Right atrial tissues was obtained from patients that underwent cardiac valve replacement after signed the informed consent form. In vivo, subcutaneous perfusion of angiotensin II (Ang II) was used to mimic activation of the RAS and induce atrial remodeling. Electrical remodeling and AF induction were assessed by electrophysiology and programmed stimulation. In vitro, atrial fibroblasts were isolated and cultured. Autophagic flux changes were assessed by mCherry‑GFP‑LC3 adenovirus transfection. All samples were collected, collagen expression, autophagy changes and atrial remodeling were evaluated by western blot, masson’s trichrome staining, immunohistochemistry and immunoﬂuorescence mainly.Results: Atrial tissue samples from patients with atrial fibrillation showed more collagen deposition and enhanced autophagy than those with sinus rhythm. Chronic subcutaneous Ang II perfusion in mice promoted atrial remodeling and susceptible to AF induction. In cultured atrial fibroblasts, the expression of collagen I (COL-I) and collagen III (COL-III) and autophagy both increased when cells were treated with Ang II, and the autophagic flux was enhanced by Ang II. However, blocking autophagy reduced the expression of COL-I and COL-III. Besides, Ang II induced the phosphorylation of ERK and suppressed the phosphorylation of mTOR. In contrast, inhibition of the angiotensin II type 1 receptor (AT1) or ERK signaling pathway not only suppressed the autophagy induced by Ang II but also reduced COL-I and COL-III expression. Conclusions: In summary, these results suggest that Ang II promotes autophagy in atrial fibroblasts, which aggravates atrial remodeling and increases the susceptibility to AF induction. Autophagy may be a potential target for relieving atrial remodeling and AF after RAS activation.
Efficiency of Online Course of Medical Statistics in Nanjing Medical University During the COVID-19 Epidemic
Authors: Ni Senmiao , Chen Wensong , Yi Honggang , Zhao Yang , Tong Na , Chen Ran , Yu Hao , Liu Jiyong , Bai Jianling , Chen Feng
Published: August 2020

Background: To analyze the online course efficiency of a combined mode of Massive Open Online Course (MOOC) micro-video and E-learning platform in Nanjing Medical University during the COVID-19 epidemic. Methods: We developed a new questionnaire to assess the efficiency of online teaching of medical statistics in Nanjing Medical University. This investigation enrolled students participating in the online course of medical statistics from January 2020 to June 2020. The “Questionnaire Star” electronic questionnaire collection system was used to collect data. Results: In total, 1050 of the 1210 (86.78%) students completed the questionnaire, including 971 (92.48%) juniors. To be specific, 57.33% of the students majored in clinical medicine, 15.14% in pharmacy, 10.38% in pediatrics, 8.00% in medical imageology, and 6.29% in basic medicine. As to the question "Are you satisfied with the current online teaching method?", 354 (32.77%) students responded with "Agree" and "Strongly Agree", and 1012 (96.47%) thought they needed to consolidate what they had learned after returning to school. Most students reported their "Difficulties in the learning process" by "Learning motivation" and "Personal inertia" (59.90% and 58.29%, respectively).Conclusions: The online course of medical statistics was favored by most students, suggesting its efficiency an efficient alternative to classroom study during the COVID-19 pandemic. Yet there were still some problems, such as inconvenient communication between teachers and students, poor mastery of key knowledge, which should be resolved in classroom teaching at school.
Pan-cancer analysis of RNA expression of ANGIOTENSIN-CONVERTING ENZYME II (ACE2) and cellular proteases reveals high variability and possible impact on COVID-19 clinical outcomes
Authors: Elliott Andrew , Saul Michelle , Zeng Jia , Marshall John , Kim Edward , Nagasaka Misako , Lenz Heinz-Josef , Schwartzberg Lee , Spetzler David , Abraham Jim , Xiu Joanne , Stafford Phillip , Korn Wolgang
Published: August 2020

Patients with cancer demonstrate particularly poor outcomes from COVID-19. To provide information essential for understanding the biologic underpinnings of this association, we analyzed whole-transcriptome RNA expression data obtained from a large cohort of cancer patients to characterize expression of ACE2, TMPRSS2, and other proteases that are involved in viral attachment to and entry into target cells. We find substantial variability of expression of these factors across tumor types and identify subpopulations expressing ACE2 at very high levels. In some tumor types, especially in gastrointestinal cancers, expression of ACE2 and TMPRSS2 is highly correlated. Furthermore, we found infiltration with T-cell and natural killer (NK) cell infiltration to be particularly pronounced in ACE2-high tumors. These findings suggest that subsets of cancer patients exist with heightened susceptibility to SARS-CoV-2 infection in whom malignant tumors function as viral reservoir and possibly promote the frequently detrimental hyper-immune response in patients infected with this virus.
Antibiotic prescription in primary care from the perspective of family physicians: a qualitative study
Authors: Hosoglu Salih , Claßen Annika Yanina
Published: August 2020

Background Antibiotic consumption rates increase worldwide steadily. Turkey is now top on the list of global consumption and a prototype of excessive use of antibiotics. In the last two-decades, family physicians (FPs) have become key figures in the healthcare system. The aim of this study is to understand the reasons for inappropriate prescription and to elicit suggestions for ways of improving antibiotic use in primary care from doctors themselves.Methods This is a qualitative study using semi-structured interviews with key individuals. Fourteen FPs from different parts of Turkey participated in these interviews. They were questioned on major indications for antibiotic prescription, reasons for inappropriate antibiotic prescription, obstacles to decision making in antibiotic use and their suggestions for improving antibiotic use. The interviews were recorded, transcribed, and analyzed for common themes. Thematic coding was used in the formulation of themes.Results Interviewees emphasized the coercive factors that lead to inappropriate antibiotic prescription: patient expectations, defensive medical decision making, constraints due to workload and limited access to laboratories. The most powerful suggestions for improving the quality of antibiotic prescription were public campaigns, improvements in the diagnostic infrastructures of primary care centers and enhancing the social status of FPs. The FPs expressed strong concerns related to the complaints that patients make to administrative bodies. Conclusions Physicians in primary care work under immense pressure stemming mainly from workload, patient expectations and obstacles to diagnostic processes. Improving the social status of physicians, increasing public awareness and the facilitation of diagnostic procedures were the methods suggested for increasing antibiotic prescription accuracy.
A Novel Risk Scoring Tool to Predict Saphenous Vein Graft Occlusion in Patients with Type 2 Diabetes Mellitus After Cardiac Artery Bypass Graft Surgery
Authors: Cheng Yujing , Ma Xiaoteng , Liu Xiaoli , Zhao Yingxin , Sun Yan , Zhang Dai , Zhao Qi , Xu Yingkai , Zhou Yujie
Published: August 2020

Background: Coronary artery bypass grafting (CABG) success is reduced by graft occlusion. Patients with type 2 diabetes mellitus(T2DM) are more likely to develop graft occlusion. Understanding factors associated with graft occlusion may improve T2DM patient outcomes. The aim of this study was to develop a predictive risk score for saphenous vein graft (SVG) occlusion in T2DM patients after CABG.Methods: This retrospective cohort study enrolled 3716 CABG patients with T2DM from January 2012 to March 2013. The development cohort included 2477 patients and the validation cohort included 1239 patients. The baseline clinical data at index CABG was analyzed for their independent impact on graft occlusion in our study using Cox proportional hazards regression. The predictive risk scoring tool was weighted by beta coefficients from the final model. Concordance (c)-statistics and comparison of the predicted and observed probabilities of predicted risk were used for discrimination and calibration.Results: A total of 959 (25.8%) out of 3716 patients developed at least one SVG occlusion. Significant risk factors for occlusion were male sex, estimated glomerular filtration rate<90, smoking (currently), hyperuricemia, dyslipidemia, prior percutaneous coronary intervention (PCI), a rising number of lesion vessels, and SVG. On-pump surgery, and the use of angiotensin-converting enzyme inhibitors (ACEI)/angiotensin receptor blockers (ARB) and calcium channel blockers (CCB) were protective factors. The risk scoring tool with 11 variables was developed from the derivation cohort, which delineated each patient into risk quartiles. The c-statistic for this model was 0.71 in the validation cohort.Conclusions: An easy-to-use risk scoring tool that used common clinical variables was developed and validated. The scoring tool accurately estimated the risk of late SVG occlusion in T2DM patients after CABG.
Dynamic immunity gene and lncRNA regulatory cooperative pairs revealed prognostic signatures in the development of colon cancer
Authors: Wang Chun Jing , You Liu Ping , Wang Fujing , Cui Hao , Hu Yu Zhou , Li Sheng Long
Published: August 2020

Background: The pathological development of colon cancer is a complex progression that depends on multiple alterations of coding and non-coding genes. Colon cancer are challenged by the immune system and acquire features to evade its surveillance during the whole process of occurrence and development. Therefore, it is important to capture the immune regulatory events during the progression of colon cancer development and to identify reliable markers for predicting clinical outcomes in patients. Methods: Here, a standardized computational procedures was developed to evaluate immune cell populations-associated gene (immuneCPa gene)-lncRNA relationships in diverse stages (I, II, III and IV) of colon cancer based on genes and lncRNAs expression. Stage-specific immuneCPa genes and lncRNAs were identified in each colon cancer stage. Results: Dynamic stage-specific immuneCPa gene-lncRNA regulatory networks were constructed and characterized in colon cancer development. A immuneCPa gene-lncRNA activity profile across different stages revealed that lncRNAs were highly stage-selective in regulating immuneCPa genes in colon cancer. Specify scores of immune indicated that diverse kinds of immune cells were temporally-specific in colon cancer. NK CD56bright cell showed strongest stage common features in colon cancer. Further survival analysis indicated that some stage specific immuneCPa gene-lncRNA relationships may have the potential for predicting colon cancer prognosis. Conclusions: Collectively, our study leads to a novel starting point for future functional explorations, the identification of immune-related biomarkers, and lncRNA-based targeted therapy for colon cancer.
Diagnostic and Prognostic implications of AAGAB expression in human breast cancer
Authors: Zhang Cheng , Gong Chen , Liu Yang , Wang Changcai , Zeng Cheng , Yang Kai , Yin Dan
Published: August 2020

Background: Alpha and gamma adaptin binding protein p34 (AAGAB) was previously reported as a novel on-treatment biomarker can improve prediction of response to neoadjuvant chemotherapy in breast cancer. However, the expression and prognostic value of AAGAB in breast cancer is unknown, the function of AAGAB in breast cancer remains to be elucidated. Methods: Herein we investigated the role of AAGAB in human breast cancer from the TCGA database, immunohistochemistry, Gene set enrichment analysis (GSEA) and immune infiltration analysis. Results: Increased AABAB expression in breast cancer was significantly associated with age, gender, race, ER status, PR status, N-stage, PAM50 classification and histological type (all p-values<0.05). Kaplan-Meier survival analysis showed that breast cancer patients with AAGAB-high had a worse prognosis than that with AAGAB-low (p=0.005). Univariate analysis using logistic regression revealed that age, pathological stage, and number of lymph nodes were significantly associated with poor overall survival (OS) (all p <0.05). AAGAB expression level was significantly correlated with cell purity, CD8 T cells, macrophages, CD4 T cells and dendritic cells. Functional annotations indicated that AAGAB is involved in the most significant signaling pathways including intra Golgi traffic and peroxisomal lipid metabolism pathways. Conclusions: Our study revealed that elevated AAGAB expression was significantly correlated with aggressive progression, poor survival in breast cancer patients. AAGAB may serve as a new biomarker and potential treatment target in breast cancer.
Effect of Insulin Resistance on Cardiac Mass in Elderly Normotensive People: A Cross-sectional Study
Authors: Kamal Amr , Mahmoud Dina , Hemida Kamel , Abdelaaty Talaat
Published: August 2020

Background

The increased left ventricular mass (LVM) is a well-known risk indicator for occurrences concerning cardiovascular disease. The risk of these changes in cardiac morphology is intensified for subjects with type 2 diabetes. While insulin resistance has been embroiled in the pathogenesis of ventricular (LV) hypertrophy, earlier research studies have produced contradictory findings which are constrained by comparison bias. The present study focuses on the independent effect of insulin resistance on LVM in the elderly normotensive population.
Methods

The study included 50 subjects excluding patients with myocardial infarction, heart failure, systemic hypertension and aortic stenosis. Group I included 30 patients with glucose intolerance, insulin resistance, or type 2 DM while Group II included 20 control subjects of matched age and sex. Participants involved in the study underwent clinical examination, laboratory investigation (including 75-g oral glucose tolerance test, HbA1c, Plasma insulin level, calculated HOMA-IR, Fasting Lipid profile, Serum albumin/ creatinine ratio) and echocardiography.
Results

LV mass index was significantly different between the 2 group being higher (142.07 ± 53.34) in the study group compared to (92.05 ± 9.42) in the control group, (P = 0.000). Waist circumference, HOMA-IR, FBS, HbA1c and systolic BP have significant positive correlations with LV mass index. However, only HOMA-IR has a significant independent positive correlation with LV mass index.
Conclusions

It is inferred from the present study that insulin resistance is associated with increased cardiac mass in normotensive elderly people.
Correlation Between Facet Tropism and Lumbar Disc Herniation
Authors: Ye Han , Xiaodong Wang , zepei Zhang , shrestha Deepak , Kepeng Li , Yang Song , Jun Miao
Published: August 2020

Purpose The relationship between facet tropism (FT) and lumbar disc herniation (LDH) is not clear. In the present study, MRI was used to assess the relationship between lumbar facet joint tropism and disc herniation. This paper is the first to assess the relationship between facet joint tropism and LDH from the sagittal view.
Methods 122 patients (154 segments) with lumbar disc herniation and 102 normal subjects (306 segments) who visited our hospital from 01-Jan-2020 to 01-Apr-2020 were included in this study. The axial and sagittal angles of facet joints were measured using an MRI scan. The difference of 10° in facet angles between left and right was defined as lumbar facet tropism. The relationship between the two was analyzed.
Results In the axial, 95/154 segments with lumbar disc herniation had FT whereas, 48/258 segments had FT in the normal segments(p<0.01). In the sagittal, 61/154 segments with lumbar disc herniation had FT and 48/306 had FT in the control(p<0.01).
Conclusion The proportion of FT is better in patients with lumbar disc herniation, and there is a significant correlation between FT and lumbar disc herniation.
How to make HIV vertical transmission prevention good value for money in settings with very low HIV prevalence? Using economic evaluation guiding policy in the Philippines
Authors: Uy Geovin Dexter Chua , Bayani Diana Beatriz Samson , Luz Alia Cynthia Gonzales , Teerawattananon Yot
Published: August 2020

Background: Preventing mother-to-child transmission of human immunodeficiency virus is important due to the impact of the disease to the women and their children’s health. Established guidelines have recommended strengthening the ability to detect and treat HIV as early as possible. This study attempts to explore cost-effective PMTCT interventions in a low incidence, low-middle income setting such as the Philippines that can be replicated in other similar country settings.Methods: The study utilized a model-based cost-effectiveness analysis through a decision tree analysis. The decision tree reflected the first ANC visit of a pregnant woman in the Philippines. Vertical transmission program was explored as ten possible PMTCT policy strategies including Do-nothing approach; status quo approach, which had 9% HIV testing, provision of tenofovir-based ART and neonatal prophylaxis, and automatic cesarean section; Eight universal screening policy strategies, which had 100% HIV testing and counselling, provision of tenofovir-based ART and neonatal prophylaxis with inclusion or exclusion of raltegravir for aggressive late antenatal care (ANC) HIV treatment on top of the ART given, breastfeeding or provision of substitute feeding, and normal delivery or cesarean section deliveryResults: Base case analysis revealed that policy strategy of universal HIV screening, with additional provision of raltegravir on those receiving late antiretroviral therapy, neonatal prophylaxis, and substitute feeding on normal delivery (urndnpsf) had the lowest ICER values among all policy strategies compared to status quo (₱291,170.26/QALY) and do nothing (₱291,710.26/QALY). Through universal screening coverage, at least 91% of the HIV cases in newborn may be averted. Cost of HIV test must be reduced by at least 45% to have a cost-effective PMTCT program. Alternatively, by performing group pre-test HIV counselling of at least three persons per session, the program will become cost-effective when compared to the unofficial Philippine threshold of ₱150,000/QALY.Conclusions: Model design on HIV testing among pregnant women allows exploration of costs and outcomes of PMTCT interventions that focused on a low prevalence, low-middle income setting. From the study, HIV testing can be a major cost constraint for PMTCT. Furthermore, by performing group pre-test HIV counselling instead of per individual, a cost-effective PMTCT program may be achieved.
Understory Species Diversity, Regeneration and Recruitment Potential of Sacred Groves in South West Nigeria
Authors: Onyekwelu J. C. , Lawal A. , Mosandl R. , Stimm B. , Agbelade A. D.
Published: August 2020

Background Global species extinction rates due to forest conversions are increasing. Ecologists, conservationists and governments have adopted various conservation methods. Sacred grove is one conservation option that has gained attention in recent time. We assessed understory species diversity, regeneration and recruitment potentials of four sacred groves in southwestern Nigeria. Overstory tree species were inventoried in eight 800m2 temporary sample plots, systematically laid along two transects of 1000m each. Understory tree species were assessed in 100m2 plots for saplings and 25m2 plots for seedlings in all sample plots. Results Shannon-Wiener diversity index (1.8-3.46 (overstory); 2.65-3.55 (understory)), number of species (32-58 (overstory); 39-78 (understory)) and tree density (309-417 individuals/ha (overstory); 775-1445 individuals/ha (understory)) were comparable and/or higher at the understories than the overstories. Dbh distribution curves showed highest stand density at the lowest class (10–20 cm) and decreased with increasing dbh, indicating good regeneration status and healthy ecosystem. Regeneration was considered good and fair, because in most cases, number of seedlings > saplings > overstory trees or number of seedlings > saplings ≤ overstory trees. The good regeneration status was further confirmed by the good species recruitment in the understory. Some tree species were found to be unique to some sacred groves while some species that were absent in protected forests existed in the groves. The presence of these unique tree species indicated the potential of sacred groves in conserving important tree species. The high regeneration could be attributed to strict access restrictions in the groves, and the taboos and myths feared by the people. However, the high influx of people into sacred groves for festivals and rituals, which results in trampling and burning of seedlings, is a threat to the diversity, regeneration and recruitment potentials of the groves.Conclusion High regeneration and recruitment status maintained in all the sacred groves in this study were achieved using taboos, cultural and traditional methods. These methods could be incorporated in managing forest reserves in Southwestern Nigeria.
Characterization and Distribution of Medicine Vendors in Nigeria: A study of Lagos and Kaduna States.
Authors: Daini Babajide Oluseyi , Okafor Emeka , Baruwa Sikiru , Adeyanju Oluwafunmito , Anyanti Jennifer
Published: August 2020

Background

In 2014, Nigeria issued the task-shifting/sharing policy for essential health services, which aimed to fill the human resource gap and improve the delivery of health services across the country. This study focuses on the characteristics, spread, and Family planning (FP) stocking practices of medicine vendors in Lagos and Kaduna, assessing the influence of health training on the provision and stocking of FP services and commodities by vendors.
Methods

We conducted a census of all patent and proprietary medicine vendor (PPMV) shops and followed up with a facility assessment among 10% of the mapped shops; utilizing an interviewer-administered questionnaire. Bivariate analysis was conducted using the chi-square test, and multiple logistic regression was used to estimate the adjusted odds ratio (OR) and confidence intervals (C.I) for the test of significance in the study.
Results

8,318 medicine shops were censused (76.2% Urban). There were 39 shops per 100,000 population in both states on average. About half (50.9%) were manned by a medicine vendor without assistance, 25.7% claimed to provide FP services to > 2 clients per week, and 11.4% were not registered with the regulatory body or any trade association. Also, 28.2% of vendors reported formal health training; with 56.3% of these health trained vendors relatively new in the business, opening within the last five years. Vendors utilized open drug markets as the major source of supply for FP products. Health training significantly increased the stocking of FP products and inhibited the utilization of open drug markets.
Conclusion

PPMVs have continued to grow progressively in the last five years, becoming the most proximal health facility for potential clients for different health services (especially FP services) across both Northern and Southern Nigeria. Now comprised of a considerable mass of health trained personnel, able to deliver high-quality health services and complement existing healthcare infrastructure, if trained. However, restrictions on services within the PPMV shop and lack of access to quality health commodities and consumables have resulted in poor practices among PPMVs. There is therefore a need to identify, train, and provide innovative means of improving access to quality-assured products for this group of health workers.
New-onset Atrial Fibrillation In Sepsis No Correlation With Inflammatory Cytokines in Real-life Clinical Setting
Authors: Li Zhuanyun , Li Dandan , Chai Yage , Li Jiming , Peng Peng , Yang Jianzhong
Published: August 2020

Background

New-onset atrial fibrillation(new-onset AF) is one of the most common tachyarrhythmia in critically ill patients and is associated with increased morbidity and mortality. Unfortunately, risk factors for new-onset AF in sepsis have not been clearly elucidated. This study aims to determine the association of new-onset AF with circulating inflammatory cytokine concentrations.
Methods

This is a retrospective analysis of the relationship between new-onset AF in sepsis and inflammatory cytokine concentrations. The study included patients with sepsis diagnosed in the Emergency Intensive Care Unit(EICU) of The First Affiliated Hospital of Xinjiang Medical University. This study was conducted on data submitted from June 2016 through May 2019. The patients were classified based on the new-onset AF into Control group(n = 100)、Non New-onset AF in sepsis group(n = 182)、New-onset AF in sepsis group(n = 89). We aimed to investigate whether new-onset AF in sepsis can be explained by increased circulating inflammatory cytokine concentrations.
Results

Unadjusted analysis of the 371 observations from the retrospective cohort study demonstrated that serum cytokine concentrations do not correlate with new-onset AF in sepsis, despite the fact that cytokines predict mortality and correlate with organ dysfunction and sepsis severity (APACHEⅡ and SOFA scores). On multivariable analysis, the present study shows that hypertension, BMI, fibrinogen and hs-Troponin-T strongly correlated with the new-onset AF in sepsis. Besides, none of the cytokine concentrations correlated with any of the hs-Troponin-T or fibrinogen.
Conclusions

Our study shows that risk factors for new-onset AF in sepsis are mainly factors that are associated with the pre-admission comorbidity, coagulation, cardiac biomarkers. none of the measured inflammatory cytokines correlates with new-onset AF in sepsis.
Dynamic plasma extracellular vesicle long RNA profiling changes during the peri-operative period
Authors: hua qing , xu wenhao , shen xuefang , tian xi , Wang Peng , Zhang hailiang , Li yan , xu pingbo
Published: August 2020

Background: Surgery remains the most important treatment strategy for solid tumors, such as colorectal cancer (CRC); However, a number of studies have suggested that surgical stress contributes to tumor recurrence or distant metastases. Extracellular vesicles (EVs), which contain a rich variety of RNAs with specialized functions and clinical applications, have been shown to be an indicator for diagnosis and prognosis of cancers. The effect of surgical stress on the landscape and characteristics of EV long RNA (exLR) in human blood, however, remains largely unknown.Methods: We present an optimized strategy for exLR sequencing (exLR-seq) the plasma from three patients with CRC at 4 time points (before surgery [T0], after extubation [T1], 1 day after surgery [T2], and 3 days after surgery [T4]). The “Limma” R package was used to evaluate the dynamic changes of mRNAs and long non-coding (lnc)RNAs from EVs. We also constructed a protein–protein interaction (PPI) network of hub genes and predicted biological processes, cellular components, and molecular functions of gene ontology (GO) functional analysis and the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway. Results: We observed a sufficient number of exLRs, including 12,924 mRNAs and 2196 lncRNAs. Both mRNAs and lncRNAs underwent dynamic changes during the peri-operative period. Compared with T0, there were 110 mRNAs differentially expressed after extubation, 60 differentially expressed genes（DEGs）1 day after surgery, and 50 DEGs 3 days after surgery. A total of 11 genes changed at all 3 time points and were related to regulation of the membrane potential, receptor complex, and passive transmembrane transporter activity. In addition, 22 lncRNAs were differentially expressed after extubation (T1). Nineteen lncRNAs were differentially expressed between T0 and T2, and 38 lncRNAs were differentially expressed between T0 and T3. In addition, we found that only 3 lncRNAs changed at 3 time points. Interestingly, blood exLRs reflected the tissue origins and relative fractions of different immune cell types. EVs from CD8+ T，CD4+ memory T, and NK cells decreased after surgery and the absolute quality of EVs from immune cells decreased as well. Conclusion: In summary, this study demonstrated abundant exLRs in human plasma and the dynamic changes of these exLRs and exLRs originating from CD8+ T and CD4+ memory T cells were reduced during the peri-operative period.
Analysis of the Karst Development Law Based on Multiple Exploration Technologies of Cambrian Limestone
Authors: Guo J.W. , Zhang B. , Wang X. Y.
Published: August 2020

Coal mine floor limestone aquifers are a major source of water inrush from the coal seam floor and a serious threat to the safety of coal mining. In order to reduce and avoid the occurrence of water inrush within the coal mine, we use multiple detection techniques, which are geophysical exploration technology , drilling technology, water inrush accidents and tracer test, to develop a multi-faceted exploration of karst development and analyze its development characteristics in the Chaochuan mine No. 1 well of Pingdingshan Coal Co.Ltd, Henan Province, China. The results show that, the Cambrian limestone (CL) karst water is poor; there is a certain hydraulic connection. Near faults F5, F1, and SF28, the area is less water-rich area, the water is weak, and the deep karst water forms a closed area; 61.54 % of shallow water inrush accidents in the Taiyuan limestone and CL karsts were caused by large tectonic and nearby shallow faults. The karst vertical zonation is shallow; the shallow water level decreased more in the West Wing of the No. 1 well than in the East Wing at elevations above 140 m and below -150 m. The F125 level decline is greater than that of the east, and the west fault is more than 170 m due to the hydraulic connection intrusive barrier wings of the karst water. the East Wing below -150 m F125 fault was weak and uneven on both sides of the hydraulic connection.
Overexpression of Agrin promotes tumor proliferation and correlates with poor prognosis in cholangiocarcinoma
Authors: He Meimei , Ji Shasha , Tu Junxue , Lou Dan
Published: August 2020

Background

Agrin exists as a shorter Type II Transmembrane form with an internal signal peptide, and is closely correlated with the activation of multiple intercellular signaling pathways. The aim of the present study was to investigate the role of Agrin in the development of cholangiocarcinoma (CCA).
Methods

RT-qPCR and western blotting were performed to detect the expressional level of target genes, including Agrin, in CCA tissues or cell lines. The correlation between Agrin, and tumor characteristics and prognosis, was analyzed using independent sample t-test, the Kaplan-Meier method and Cox proportional hazard model, respectively. Proliferation, migration, invasion and tumorigenesis in CCA cells was determined by CCK8 assay, cell cycle detection, Transwell assay and nude mouse tumorigenicity assay, respectively.
Results

Agrin was significantly upregulated in CCA tissues, as compared to the adjacent non-tumor tissues, and was correlated with poorer tumor characteristics such as portal vein tumor thrombus, intrahepatic metastasis and poor survival. The Agrin overexpression in CCA cell lines clearly promoted proliferation, colony formation, migration, invasion and cell cycle progression, but Agrin knockdown had the opposite effect. Furthermore, CCA cells with inhibitory Agrin expression presented with less and smaller tumors, as compared with the control group in vivo. Mechanistic analysis indicated that Agrin was able to activate the Hippo signaling pathway and induce yap to enter the cell nucleus.
Conclusions

We found that Agrin promotes the CCA progression via activating the Hippo signaling pathway, which could be a potentially promising target for CCA treatment.
Epidemic Dynamics of COVID-19 Based on SEAIUHR Model Considering Asymptomatic Cases in Henan Province, China
Authors: Li Chunyu , Zhu Yuchen , Qi Chang , Liu Lili , Zhang Dandan , Wang Xu , She Kaili , Jia Yan , Liu Tingxuan , Xiong Momiao , Li Xiujun
Published: August 2020

Background

New coronavirus disease (COVID-19), an infectious disease caused by a type of novel coronavirus, has emerged in various countries since the end of 2019 and caused a global pandemic. Many infected people went undetected because their symptoms were mild or asymptomatic, but the proportion and infectivity of asymptomatic infections remained unknown. Therefore, in this paper, we analyzed the proportion and infectivity of asymptomatic cases, as we as the prevalence of COVID-19 in Henan province.
Methods

We constructed SEAIUHR model based on COVID-19 cases reported from 21 January to 26 February 2020 in Henan province to estimate the proportion and infectivity of asymptomatic cases, as we as the change of effective reproductive number, \({R}_{t}\). At the same time, we simulated the changes of cases in different scenarios by changing the time and intensity of the implementation of prevention and control measures.
Results

The proportion of asymptomatic cases among COVID-19 infected individuals was 42% and infectivity of asymptomatic cases was 10% of that symptomatic ones. The basic reproductive number\({R}_{0}\)=2.73, and \({R}_{t}\) dropped below 1 on 1 February under a series of measures. If measures were taken five days earlier, the number of cases would be reduced by 2/3, and after 5 days the number would more than triple.
Conclusions

In Henan Province, the COVID-19 epidemic spread rapidly in the early stage, and there were a large number of asymptomatic infected individuals with relatively low infectivity. However, the epidemic was quickly brought under control with national measures, and the earlier measures were implemented, the better.
Personalized hypertension management based on serial assessment and telemedicine: a cluster randomize controlled trial protocol in Anhui, China
Authors: Xiao Siyi , Shen Xingrong , Liu Rong , Tong Guixian , Liu Tongzhu , Wang Debin
Published: August 2020

Background: Despite tremendous investment worldwide, hypertension treatment and control rates remain low, suggesting that contemporary population-based hypertension management may have reached its efficacy ceiling. The complexity and long-term dynamics of influencing factors make personalized management inevitable and challenging. This protocol describes Personalized Hypertension Management in Anhui, China (PHMA), a project that uses a package of innovative approaches in tailoring interventions to individual patient’s dynamic complications and contexts.Methods/design: PHMA strives to reduce hypertension harms by eight proven “objective behaviors” (e.g., self-monitoring and reporting, healthy diet, physical exercise/activities). These objective behaviors are promoted through five intervention measures: support for self- monitoring, supervised machine communications, daily education or reminder messages, weekly blood pressure notification, and quarterly signed feedback. PHMA uses ten categories and over 300 variables in selecting and refining intervention procedures and content for individual patients. Efficacy of the intervention package is evaluated using a cluster randomized controlled trial design involving a total of 60 site communities and 3352 hypertension patients. Primary measure for the evaluation is systolic and diastolic blood pressure; while secondary evaluation measures include quality of life (EQ5D-5L), occurrence of hypertension-related complications (such as cerebral hemorrhage, coronary heart disease, myocardial or cerebral infarction), healthcare utilization and scores of objective behaviors.Discussion: PHMA uses novel, low cost and sustainable approaches to tailor interventions to the dynamic conditions and contexts of individual patients. Unlike contemporary approaches to hypertension management which are mainly population based, each participant patient in PHMA applies a unique intervention package and all messages, feedbacks and other materials sent out to individual patients are different from each other. PHMA is the first project that adopts so comprehensive tailoring and if proved effective, it should have important implications for future research, practice and policy-making.Trial registration: ISRCTN10999269. July 17, 2020; https://doi.org/10.1186/ISRCTN10999269
Causal Effect Between Total Cholesterol and Hdl Cholesterol as Risk Factors for Chronic Kidney Disease: A Mendelian Randomization Study
Authors: Miao Liu , Min Yan , Zhu Chuan-Meng , Chen Jian-Hong , Qi Bin , Wang Yong , Li Jian-Fei , Li Rong-Shan
Published: August 2020

Background

While observational studies show an association between serum lipid levels and cardiovascular disease (CVD), intervention studies that examine the preventive effects of serum lipid levels on the development of CKD are lacking.
Methods

To estimate the role of serum lipid levels in the etiology of CKD, we conducted a two-sample Mendelian randomization (MR) study on serum lipid levels. Single nucleotide polymorphisms (SNPs), which were significantly associated genome-wide with plasma serum lipid levels from the GLGC and CKDGen consortium genome-wide association study (GWAS), including total cholesterol (TC, n = 187365), triglyceride (TG, n = 177861), HDL cholesterol (HDL-C, n = 187167), LDL cholesterol (LDL-C, n = 173082), apolipoprotein A1 (ApoA1, n = 20687), apolipoprotein B (ApoB, n = 20690) and CKD (n = 117165), were used as instrumental variables. None of the lipid-related SNPs was associated with CKD (all P > 0.05).
Results

MR analysis genetically predicted the causal effect between TC/HDL-C and CKD. The odds ratio (OR) and 95% confidence interval (CI) of TC within CKD was 0.756 (0.579 to 0.933) (P = 0.002), and HDL-C was 0.85 (0.687 to 1.012) (P = 0.049). No causal effects between TG, LDL-C- ApoA1, ApoB and CKD were observed. Sensitivity analyses confirmed that TC and HDL-C were significantly associated with CKD.
Conclusions

The findings from this MR study indicate causal effects between TC, HDL-C and CKD. Decreased TC and elevated HDL-C may reduce the incidence of CKD but need to be further confirmed by using a genetic and environmental approach.
Altered dynamic functional network connectivity in levodopa-induced dyskinesia of Parkinson's disease
Authors: Si Qianqian , Yuan Yongsheng , Gan Caiting , Wang Min , Wang Lina , Ma Kewei , Zhang Kezhong
Published: August 2020

Background

Traditional measures of static functional connectivity may not completely reflect the dynamic neural activity of levodopa-induced dyskinesia (LID) in Parkinson's disease (PD). This study was aimed to investigate the dynamic changes of large-scale functional network connectivity in the temporal domain in PD patients with and without LID.
Methods

Using dynamic functional network connectivity (dFNC) analysis, we evaluated 41 PD patients with LID (LID group) and 34 PD patients without LID (No-LID group), on and off their levodopa medications. Group spatial independent component analysis, sliding-window approach and k-means clusters were employed.
Results

In OFF phase, we found no differences between PD subgroups in temporal properties. In ON phase, compared than No-LID group, LID group occurred more frequently and dwelled longer in strongly connected State 1, characterized by strong connections between visual network (VIS) and other networks. When switching from OFF to ON phase, LID group occurred more frequently and dwelled longer in State 2 and occurred less frequently and dwelled shorter in State 3 (both states were strongly connected), while No-LID group occurred more frequently and dwelled longer in State 5 (weakly connected). Additionally, correlation analysis further demonstrated that the severity of dyskinesia was only associated with frequency of occurrence and dwell time in State 2, dominated by inferior frontal cortex in cognitive executive network (CEN), strongly connecting with sensorimotor network (SMN) and VIS.
Conclusions

Using dFNC analysis, we found that compared to those without LID, PD patients with LID may be involved in the superexcitation of VIS, as well as interconnections between CEN and SMN, VIS, having impact on inhibition of motor circuits. The dFNC analysis might provide new insights into the neural mechanisms of LID in PD.
Discrimination of Quarry Blasts from Micro Earthquakes in the Surendranagar region of Saurashtra Horst, Northwestern India
Authors: Dixit Mayank , Roy Ketan Singh , Shastri Arpan
Published: August 2020

The complex and covert phenomenon undergoing in the earth’s interior is revealed by the seismic waves propagating to the surface. The main objective of this study is to uphold the difference in the nature of waves transmitted due to quarry blasts and earthquakes and differentiate the tremors caused by the two. A total of ~1300 ground motions recorded at different broadband seismic stations of Saurashtra, Gujarat, observed from 2012 to 2016 of magnitude greater than or equal to 1.4 were considered for the study. These recordings have been obtained from the seismic network established and maintained by Seismic Data Analysis Center (SeiDAC), Institute of Seismological Research (ISR), Gandhinagar, Gujarat. In this investigation, ground motions of frequency greater than 1Hz were considered and statistical method (maximum of P to S (P/S) waves amplitude ratio) was applied for four mutually exclusive frequency bands such as 2 to 4, 4 to 6, 6 to 8, 8 to 10 and a common bin from 1 to 10 Hz. The outcome of this investigation suggested that ~10% of the examined ground motion records were caused due to quarry blasts and the rest as a consequence of earthquakes. Application of the coda decay rate method revealed that the coda decay rate Qc־¹ is significantly higher for quarry blasts than earthquakes of lower frequencies (1.5 and 3.0 Hz). The spectrogram analysis affirms the distinction between quarry blasts and earthquakes in terms of varying frequency content. The detailed investigation brought forward an intriguing remark about mining-induced seismicity as more seismic activity was observed during the daytime when compared with the after-dark recordings. The findings of this investigation may contribute to the existing knowledge base on earthquakes in addition to creating a distinction between the natural and manmade earthquakes.
Comparative Prospective Study of the Performance of Chest Pain Scores and Clinical Assessment in an Emergency Department Cohort in Singapore
Authors: Mingwei Ng , Tan Hong Jie Gabriel , Gao Fei , Tan Jack Wei Chieh , Lim Swee Han , Ong Marcus Eng Hock , Ponampalam R
Published: August 2020

Background Chest pain scores allow emergency physicians to identify low-risk patients for whom discharge can be safely expedited. While their utility have been extensively studied and validated in Western cohorts, data in patients of Asian heritage is lacking. This study aimed to determine the accuracy of HEART, EDACS and GRACE in risk-stratifying which emergency patients with chest pain or angina-equivalent symptoms are at risk of major adverse cardiovascular events (MACE) within 30 days (composite of all-cause mortality, acute myocardial infarction, and coronary revascularization). This single-centre prospective cohort-study enrolling 1200 patients was conducted by a large urban tertiary centre in Singapore. The chest pain scores were reported prior to disposition by research assistants blinded to the physician’s clinical assessment. Outcome adjudication was performed by an independent blinded cardiologist and emergency physician, while a second cardiologist adjudicated in the case of discrepancies. \Results Of 1200 patients enrolled, 5 withdrew consent and were excluded from analyses. 135 patients (11.3%) suffered MACE within 30 days. HEART, which ruled-out acute coronary syndrome in 52.8% of patients with 88.1% sensitivity, and EDACS, which ruled-out acute coronary syndrome in 57.5% of patients with 83.7% sensitivity, proved comparable to clinical judgment which ruled-out acute coronary syndrome in 73.0% of patients with 85.5% sensitivity. GRACE was weaker – ruling-out acute coronary syndrome in 79.2% of patients but with a dismal sensitivity of 45.0%. The correlation-statistic for HEART (79.4%) was also superior to EDACS (69.9%) and GRACE (69.2%). Conclusions HEART more accurately identified low-risk chest pain patients in an Asian emergency department who were suitable for expedited discharge and demonstrated comparable performance characteristics to clinical judgment. This has major implications on the use of chest pain scores to safely expedite disposition decisions for low-risk chest pain patients in the emergency department.
Traumatic Internal Mammary Injury— A Literature Review and Guide for Management
Authors: Wu Yu-Tung , Liao Chien-Hung , Liao Chien-An , Fu Chih-Yuan , Hsieh Chi-Hsun
Published: August 2020

BackgroundTraumatic internal mammary artery (IMA) injury is a rare but clinically significant injury since it is linked to various troublesome conditions. In this review, we aim to provide a complete description and a practical strategy for managing this injury.MethodsPubMed, Embase, and the Web of Science were searched from 1960 to 2019. We also reviewed IMA injuries in our hospital. Only traumatic IMA injuries were included. The demographics, diagnostic procedures, treatments and outcomes were recorded and analyzed.ResultsThere were a total of 72 IMA injury cases, including 4 in our hospital. The injuries were predominantly in males (79.2%), were on the left side (66.7%), were considered blunt injuries (63.9%), and featured mediastinal hematoma (62.5%). Computed tomography (CT) has been used to diagnose IMA injuries in recent years. Most patients could be managed by nonsurgical treatments (61.2%). The outcome for IMA injury is very good, with low morbidity and mortality rates.ConclusionsIdentifying traumatic IMA injuries requires alertness from the physicians. An appropriate management chosen according to the patient’s individualized condition could lead to a satisfying result.Trial registration: not applicable