bluuebunny/crossref_metadata_2025 huggingface dataset:
An Investigation of Spectrum of Diseases and Medication Use in Discharged Patients with Mental Disorders in the Inner Mongolia Autonomous Region
Authors: cao xue , Chen Lixia , Ma Jun , Liu Yongyi , Wang Qihui , Liu Linan
Published: July 2020

Objective We aim to investigate the inpatient status of patients with mental disorders who had been discharged from psychiatric hospitals in 2016 in the Inner Mongolia Autonomous Region, and through this, to provide theoretical basis for further improving the security system for patients with mental disorders in this region. Method: A two-phased stratified sampling method was used to collect data from selected hospitals. Results: A total of 1646 cases with valid data were obtained. The most common mental diseases were schizophrenia and bipolar disorder; atypical antipsychotic drugs played a dominant role (95.78%) among various antipsychotics, with risperidone being the most frequently used drug. Conclusion: We need to further improve the management of schizophrenia and bipolar disorder, as well as the hospital-community integration mode. Standardized training of residents and further education for clinicians should be enhanced to improve doctors’ clinical skills and promote drug prescribing in a scientific, rational and standardized manner.
Self-poisoning with pesticides in Jiangsu Province, China: a cross-sectional study on 24,602 subjects
Authors: Wang Boshen , Han Lei , Wen Jinbo , Zhang Juan , Zhu Baoli
Published: July 2020

Background
With an estimated > 800,000 suicide-related deaths and potentially several attempts for each death in the world. The purpose of this study was to determine the epidemiological characteristics of self-poisoning with pesticides within the Jiangsu province in China.
Methods
We evaluated the incidence of pesticide self-poisoning using the Routine Surveillance System by Jiangsu Provincial Center for Disease Control and Prevention.
Results
In recent years, Jiangsu Province has witnessed a decrease in pesticide self-poisoning cases and consequent deaths. Among all suicides by deliberate ingestion of pesticides, the proportion of cases were mainly in the age 40, accounting for 3.43% of all cases with pesticide suicide. The proportion of suicide due to pesticide poisoning in females was markedly higher than that in males (p < 0.001). Moreover, higher numbers of self-poisoning cases and deaths were reported in the farming season. Suicide using organophosphate and carbamate insecticides was most common, with 10,303 reported cases accounting for 42.02% of all suicides.
Conclusions
For national responses to be effective, the characteristics of pesticide suicides should be comprehensively investigated for the formulation of corresponding prevention strategies. Restriction of access to means plays an important role in suicide prevention, particularly in impulsive suicide cases. Implementation of these prevention strategies should result in an ongoing decline in the proportion of suicide.
Development of a Multi-Antigenic SARS-CoV-2 Vaccine Using a Synthetic Poxvirus Platform
Authors: Chiuppesi Flavia , Salazar Marcela d’Alincourt , Contreras Heidi , Nguyen Vu , Martinez Joy , Park Soojin , Nguyen Jenny , Kha Mindy , Iniguez Angelina , Zhou Qiao , Kaltcheva Teodora , Levytskyy Roman , Ebelt Nancy , Kang Tae , Wu Xiwei , Rogers Tom , Manuel Edwin , Shostak Yuriy , Diamond Don , Wussow Felix
Published: July 2020

Modified Vaccinia Ankara (MVA) is a highly attenuated poxvirus vector that is widely used to develop vaccines for infectious diseases and cancer. We developed a novel vaccine platform based on a unique three-plasmid system to efficiently generate recombinant MVA vectors from chemically synthesized DNA. In response to the ongoing global pandemic caused by SARS coronavirus-2 (SARS-CoV-2), we used this novel vaccine platform to rapidly produce fully synthetic MVA (sMVA) vectors co-expressing SARS-CoV-2 spike and nucleocapsid antigens, two immunodominant antigens implicated in protective immunity. Mice immunized with these sMVA vectors developed robust SARS-CoV-2 antigen-specific humoral and cellular immune responses, including potent neutralizing antibodies. These results demonstrate the potential of a novel vaccine platform based on synthetic DNA to efficiently generate recombinant MVA vectors and to rapidly develop a multi-antigenic poxvirus-based SARS-CoV-2 vaccine candidate.
L1 retrotransposons exploit RNA m6A modification as an evolutionary driving force
Authors: Hwnag Sung-Yeon , Jung Hyunchul , Mun Seyoung , Lee Sungwon , Baek S. Chan , Moon Hyungseok , Kim Baekgyu , Choi Yongkuk , Go Young-Hyun , Tang Wanxiangfu , Choi Jongsu , Choi Jung Kyoon , Cha Hyuk-Jin , Park Hye Yoon , Liang Ping , Kim V. Narry , Han Kyudong , Ahn Kwangseog
Published: July 2020

L1 retrotransposons can pose a threat to genome integrity. The host has evolved to restrict L1 replication. However, mechanisms underlying L1 propagation out of the host surveillance remains unclear. Here, we propose a novel survival strategy of L1, which exploits RNA m6A modification. We discover that m6A ‘writer’ METTL3 facilitates L1 retrotransposition, whereas m6A ‘eraser’ ALKBH5 suppresses it. The essential m6A cluster that is located on L1 5′ UTR serves as a docking site for eukaryotic initiation factor 3 (eIF3), enhances translational efficiency and promotes the formation of L1 ribonucleoprotein. Furthermore, through the comparative analysis of human- and primate-specific L1 lineages, we find that the most functional m6A motif-containing L1s have been positively selected and became a distinctive feature of evolutionarily young L1s. Thus, our findings demonstrate that L1 retrotransposons hijack RNA m6A modification system for its successful replication.
Chemical imaging of microstructure of chickpea seed tissue within a cellular dimension using synchrotron infrared microspectroscopy: A preliminary study
Authors: Feng Xin , Liu Na , Yu Peiqiang
Published: July 2020

The authors have withdrawn this preprint due to author disagreement.
Climate Change and Trend Analysis of Temperature in Addis Ababa, Ethiopia
Authors: Alemu Zinabu Assefa , Dioha Michael O.
Published: July 2020

Background: This paper presents the trend analysis of temperature in Addis Ababa City and the effect of climate change in the study area. The analysis is based on the temperature variation in the capital city of Addis Ababa over two stations - Bole and Entoto. Methods: The Mann-Kendall trend test and Sen’s slope estimate were employed to find the nature of the temperature trend and significance level in Addis Ababa city. Results: It was found that the Mann-Kendall statistic (Z) value for minimum, maximum and average temperatures for Bole station are 5.99, 3.32, and 6.14 respectively. The positive Kendall’s Z value shows an upward trend and implies an increasing trend over time. This indicates that there is a significant increase in the trend at a 5% level of significance since the p-value is less than the significant level (p-values (0.0001) < 0.05). Whereas for Entoto station, the Mann-Kendall statistic (Z) results are 1.64 for minimum, 0.85 for the maximum, and 1.40 for average temperature, and this positive value show an indicator of an increasing trend. However, the increase is not significant at 5% significant level since the p-value is greater than the significant level (p-value (0.219) > 0.05). Conclusions: From both the Mann-Kendall trend test result and Sen’s Slope estimator, it can be concluded that there is the tendency of temperature increments in Bole station. This could be due to the influence of climate change and can lead to weather extremes in the capital city. Therefore, the study recommend that the variability of temperature needs further monitoring technique, and there is a need to consider the increasing temperature trend to minimize its effects on human health.
LncRNA APOC1P1-3 promoting anoikis-resistance of breast cancer cells
Authors: Lu Qi , Wang Li , Zhu Ping , Li Luying , Wang Xue , Jin Youping , Zhi Xiuling , Yu Jerry , Li Xin , Qin Xingjun , Zhou Ping
Published: July 2020

Background

Anoikis resistance plays a critical role in the tumor metastasis by allowing survival of cancer cells in the systemic circulation. We previously showed that long non-coding RNAs APOC1P1-3 (lncRNA APOC1P1-3) inhibits breast cancer cell apoptosis. However, its role in the anoikis resistance remains unclear.
Methods

We induced anoikis resistance in two breast cancer cell lines (MCF-7 and MDA-MB-231) under anchorage-independent culture condition and studied the effects of lncRNA APOC1P1-3 on the apoptosis. The Dual-Luciferase activity assay were used to whether miRNA-188-3P can specifically bind to lncRNA APOC1P1-3. We further explored the role of APOC1P1-3 in the lung metastasis by injecting MDA-MB-231 and MDA-MB-231-APOC1P1-3-knock-down cells in the female BALB/c nude mice.
Results

We found that it suppressed early apoptosis of these cells by gain or loss of their function, respectively. We further explored its mechanism related to anoikis resistance, and found this molecule promoted the resistance via activating Caspase 3, 8, 9 and PARP. Moreover, it was specifically binding to the target miRNA-188-3p to block its inhibition of Bcl-2 (an anti-apoptosis protein). These findings suggest that lncRNA APOC1P1-3 plays an important role in the development of breast cancer metastasis via anoikis resistance.
Conclusions

This study demonstrates that lncRNA APOC1P1-3 can promote the anoikis resistance of breast cancer cells and specifically bind to miRNA-188-3p acting as a “sponge” to block the inhibition of anti-apoptotic protein Bcl-2.
LAMP: disease classification derived from layered assessment on modules and pathways in the human gene network
Authors: Mi Zhilong , Guo Binghui , Yang Xiaobo , Yin Ziqiao , Zheng Zhiming
Published: July 2020

Background: Classification of diseases based on genetic information is of great significance as the basis for precision medicine, increasing the understanding of disease etiology and revolutionizing personalized medicine. Much effort has been directed at understanding disease associations by constructing disease networks, and classifying patient samples according to gene expression data. Integrating human gene networks overcomes limited coverage of genes. Incorporating pathway information into disease classification procedure addresses the challenge of cellular heterogeneity across patients. Results: In this work, we propose a disease classification model LAMP, which concentrates on the layered assessment on modules and pathways. Directed human gene interactions are the foundation of constructing the human gene network, where the significant roles of disease and pathway genes are recognized. The fast unfolding algorithm identifies 11 modules in the largest connected component. Then layered networks are introduced to distinguish positions of genes in propagating information from sources to targets. After gene screening, hierarchical clustering and refined process, 1726 diseases from KEGG are classified into 18 categories. Also, it is expounded that diseases with overlapping genes may not belong to the same category in LAMP. Within each category, entropy is applied to measure the compositional complexity, and to evaluate the prospects for combination diagnosis and gene-targeted therapy for diseases.Conclusions: In this work, by collecting data from BioGRID and KEGG, we develop a disease classification model LAMP, to support people to view diseases from the perspective of commonalities in etiology and pathology. Comprehensive research on existing diseases can help meet the challenges of unknown diseases. The results provide suggestions for combination diagnosis and gene-targeted therapy, which motivates clinicians and researchers to reposition the understanding of diseases and explore diagnosis and therapy strategies.
Time Course of Renal Ischemia/Reperfusion and Distance Organ; Lung Dysfunction in Male and Female Rats
Authors: Azarkish Fariba , Parvar Ali Atash Ab , Nematbakhsh Mehdi , dehghani aghdas , Parvar Ali Atash Ab
Published: July 2020

Background

Renal ischemia/reperfusion injury (IRI) may influence distance organ such as lung. The severity of IRI induced - lung injury can be affected by gender. The aim of this study was to determine the role of gender in IRI induced- lung injury in different of renal reperfusion time.
Methods

80 male and female Wistar rats were assigned into 8 groups; 4 groups in each gender including sham, renal ischemia (ISC) for 45 min by clamping renal vessels followed by 3 hr, 24 hr or 48 hr reperfusion.blood samples were obtained for measuring the serum level of blood urea nitrogen (BUN), creatinine (Cr), nitrite, and malondialdehyde (MDA). The kidneys and lung tissues were removed and used for MDA and nitrite measurements and the histological changes evaluation.the percentage of lung water content was calculated.
Results

In both genders, the rise in Cr and BUN reached the peak at 24 h reperfusion. In 3 h reperfusion female rats, lead to significant increase in serum level of nitrite compared with males. In male rats subjected to 3 h reperfusion, the renal MDA level increased but not seen in females. The enhanced lung tissues damages were depended to reperfusion time in both genders. The water content of lung was reduced in 3 h of reperfusion groups.
Conclusions

IRI caused kidney and lung dysfunction depends on reperfusion time. Considering gender difference, female gender may be more sensitive to alteration of nitrite level compared with males. It seems that the effect of IRI is more rapid in males than females.
Long-term Experience with Triheptanoin in 12 Austrian Patients with Long-chain Fatty Acid Oxidation Disorders
Authors: Zöggeler Thomas , Stock Katharina , Jörg-Streller Monika , Spenger Johannes , Konstantopoulou Vassiliki , Hufgard-Leitner Miriam , Scholl-Bürgi Sabine , Karall Daniela
Published: July 2020

BackgroundLong-chain fatty acid oxidation disorders (LC-FAOD) are a group of rare inborn errors of metabolism with autosomal recessive inheritance that may cause life-threatening events. Treatment with triheptanoin, a synthetic seven-carbon fatty acid triglyceride compound with an anaplerotic effect, seems beneficial, but clinical experience is limited. We report our long-term experience in an Austrian cohort of LC-FAOD patients.MethodsWe assessed clinical outcome by reviewing medical records of 12 Austrian LC-FAOD patients.ResultsFor 12 Austrian LC-FAOD patients at three metabolic centers, triheptanoin was started shortly after birth in 3/12, and between 7.34 and 353.3 (median 44.5; mean 81.1) months of age in 9/12 patients. For 11 pediatric patients, mean duration of triheptanoin intake was 5.28 (median 3.87, range 1.18 to 15.72) years and triheptanoin was well tolerated. Total hospitalization days per year before and after triheptanoin treatment decreased by 82.3% from 27.1 (range 11-65) days per year to 4.8 (range 0-13) days per year, and hospitalization days in the one year pre- compared to the one year post-triheptanoin decreased by 69.8% from 27.1 (range 4-75) days to 8.2 (range 0-25) days. All patients are in good clinical condition, show normal psychomotor development and no impairment in daily life activities.ConclusionIn this retrospective observational study in an Austrian LC-FAOD cohort, triheptanoin data show improvement in disease course. Triheptanoin appears to be a safe and beneficial treatment option in LC-FAOD. For further clarification, additional prospective randomized controlled trials are needed.
Computation offloading through mobile vehicles in IoT-edge-cloud network
Authors: Long Jun , Luo Yueyi , Zhu Xiaoyu , Luo Entao , Huang Mingfeng
Published: July 2020

With the developing of Wireless Sensor Networks (WSNs), more and more sensing devices are widely deployed in the smart city. These sensing devices generate various kinds of tasks, which need to be sent to cloud to process. Usually, the sensing devices do not equip with wireless modules, because it is neither economical nor energy saving. Thus, it is a challenging problem to find a way to offload tasks for sensing devices. However, many vehicles are moving around the city, which can communicate with sensing devices in an effective and low-cost way. In this paper, we propose a computation offloading scheme through mobile vehicles in IoT-edge-cloud network. The sensing devices generate tasks and transmit the tasks to vehicles, then the vehicles decide to compute the tasks in the local vehicle, MEC server or cloud center. The computation offloading decision is made based on the utility function of the energy consumption and transmission delay, and the deep reinforcement learning technique is adopted to make decisions. Our proposed method can make full use of the existing infrastructures to implement the task offloading of sensing devices, the experimental results show that our proposed solution can achieve the maximum reward and decrease delay.
Association Between Glucose Variability And Postoperative Delirium In Acute Aortic Dissection Patients: An Observational Study
Authors: Lin Yan-Juan , Lin Ling-Yu , Peng Yan-Chun , Zhang Hao-Ruo , Chen Liang-wan , Huang Xi-Zhen , Chen Qiong
Published: July 2020

Background: Blood glucose variability is associated with poor prognosis after cardiac surgery, but the relationship between glucose variability and postoperative delirium in patients with acute aortic dissection is unclear. The study aims to investigate the association of blood glucose variability with postoperative delirium in acute aortic dissection patients.Methods: We prospectively analyzed 257 patients including 103 patients with delirium. The patients were divided into two groups according to whether delirium was present. The outcome measures were postoperative delirium, the length of the Intensive Care Unit stay, and the duration of hospital stay. Multivariable Cox competing risk survival models was used to assess.Results: A total of 257 subjects were enrolled, including 103 patients with delirium. There were statistically significant differences between the two groups in age, body mass index, first admission blood glucose, white blood cell counts, Acute Physiology and Chronic Health Evaluation II score, hypoxemia, mechanical ventilation duration, and the length of Intensive Care Unit stay (P<0.05). The median of the mean of blood glucose and the standard deviation of blood glucose were higher in the delirium group than in the non-delirium group, and the difference was statistically significant (P<0.05). In model 1, the adjusted hazard ratio of the standard deviation of blood glucose was 1.436 (P<0.05). In Model 2, the standard deviation of blood glucose (AHR=1.418, 95% CI=1.195-1.681, P<0.05) remained significant after adjusting for confounders (P<0.05). The area under the curve of the standard deviation of blood glucose was 0.763 (95% CI=0.704-0.821, P<0.01). The sensitivity was 81.6%, and the specificity was 57.8%. Conclusions: Glucose variability is associated with the risk of delirium in patients after aortic dissection surgery, and high glycemic variability increases the risk of postoperative delirium.
Students Perception Towards Challenges and Difficulties to Established E-learning Medical Education in a High Burden Developing Country
Authors: GISMALLA MOHAMED Daffalla Awadalla , Mohamed Mohamed Soud , Mohamed Mohammed NaserEldeen , Elhassan Moawia Mohamed Ali , Ibrahim Omaima
Published: July 2020

Background After World Health organization declaration of COVID-19 as a worldwide pandemic. Medical education, as well as general education, was stopped and ceased in developing countries which affect the education process, while in developed countries it was changed to E-learning models. This study aimed to highlight challenges and difficulties of E-learning beside the perception of students towards the effect of COVID-19 in medical education.Methods This is a cross-sectional survey study which conducted during 10-25 May 2020 to determine the perception of medical student regard the e-learning, COVID Pandemic related difficulties to reestablish the educational process. An online-based questionnaire was developed, and a pilot study was performed. Yes/No questions, four response questions in a form of strongly agree, agree, disagree, and strongly disagree (modified Likert scale) and open questions were used. Data were entered and analyzed using SPSS (Statistical Package for Social Science); version 24. Chi‑square distribution was applied to assess the statistical significance of variables' < 0.05 was considered as statistically significant.Results This study revealed closure of the university is mandatory to prevent the spread of COVID-19, however, continuing education through E-learning tools is a crucial step. Additionally, it demonstrates the challenges and difficulties to establish E-learning such as internet service, facilities, technical support, live sessions, interactions and exam conductions.Conclusion Students are willing to continue their learning and educational process. However, there are challenges and difficulties which need more analysis to overcome it.
Landscape Disturbance Impacts on Attalea Butyracea Palm Distribution in Central Panama: Implications for Chagas Disease Transmission
Authors: Mertzlufft Caitlin , Madden Marguerite , Gottdenker Nicole , Runk Julie Velasquez , Saldaña Azael , Tanner Susan , Calzada Jose , Yao Xiaobai
Published: July 2020

Background: Chagas disease is a vector-borne zoonotic disease endemic to Latin America. In Panama, Attalea butyracea palm trees are the preferred habitat of the region’s primary Chagas disease vector (Rhodnius pallescens). Close proximity of these palms to human dwellings is linked to increased risk of Chagas disease transmission. However, these palms thrive in disturbed habitats associated with human settlement and agriculture. This study examines the relationship between landscape disturbance and mature A. butyracea spatial distribution, density, and proximity to susceptible populations and vector movement corridors in a heterogeneous tropical region in central Panama. Presence of A. butyracea does not guarantee corresponding presence of R. pallescens, but as the vectors’ preferred habitat, quantifying A. butyracea response to disturbance may provide new insight into Chagas disease transmission risks in changing landscapes. Methods: We remotely identified the locations of over 50,000 mature A. butyracea palms using high-resolution WorldView2 satellite imagery. A local Getis-Ord Gi* spatial analysis identified significant clusters of aggregated palms. Associations between palm and cluster abundance and a landscape disturbance gradient, derived from official Panama landcover data, were tested using Chi-square tests for Homogeneity and Z-test for proportions. Kruskall-Wallace non-parametric analysis of variance tests were run to assess whether palm cluster area varied by disturbance level, or whether disturbance influenced average proximity of palms and palm clusters to susceptible populations or vector movement corridors.Results: Our findings indicate a regional relationship between landscape disturbance and A. butyracea occurrence. We observe a significant increase in both individual and clustered A. butyracea in secondary forest, but a reduction in palms in agricultural settings. Notably, we do not detect evidence of any thinning in abundance of palms in residential settings. All but one household in our study area is within vector flight distance of potential vector habitat in palm crowns.Conclusions: We observe probable anthropogenic thinning of A. butyracea palms in agricultural, but not residential, settings. Even in heavily deforested regions, significant concentrations of mature palms remain in close proximity to human establishments. The potential of A. butyracea palms as a source of infectious Chagas disease vectors in this region warrants further study.
Thoracoscopic Lobectomy for Congenital Cystic Lung Disease in Infants
Authors: Huang Jinxi , Zhou Chaoming , Chen Qiang , Wu Dianming , Hong Junjie , Hong Songming
Published: July 2020

Background: Congenital cystic lung disease is a congenital disease with abnormal development of the trachea, pulmonary parenchyma and pulmonary vessels. Congenital cystic adenomatoid malformation and pulmonary sequestration are the two main types. With the development of endoscopic technology, congenital pulmonary dysplasia has been alleviated in an increasing number of infants through thoracoscopic surgery. However, the timing of the operation is controversial.Methods: Seventy-two infants with congenital cystic lung disease who underwent thoracoscopic lobectomy from March 2017 to April 2020 were selected as subjects. The data were summarized and analysed, including preoperative complications, operative situation, postoperative recovery, postoperative hospital stay time, etc. All children were followed regularly.Results: Seventy-two patients were aged 3 to 7 months, with an average age of 5.40±2.02 months: 44 were male, and 28 were female, with an average weight of 6.95±1.96 kg. Preoperative condition: 48 patients were observed and operated on when they were between 5 and 7 months old. Twenty-four patients were diagnosed with pneumonia, and thoracoscopic surgery was performed after anti-infective therapy. All children were diagnosed with congenital cystic pulmonary disease with a CT scan before the operation. Postoperative pathological diagnosis showed 50 cases of congenital cystic adenomatoid malformation, 16 cases of intralobar pulmonary sequestration, and 6 cases of both congenital cystic adenomatoid malformation and intralobar pulmonary sequestration. Anaesthesia was performed by artificial pneumothorax or bronchial occlusion. The average operative time was 92.17±19.65 min, and the average length of postoperative ventilator assistance was 28.18±11.01 hours. Complications: 3 cases of pneumothorax after the operation and 5 cases of atelectasis, and the incidence of pneumonia was 33%. No bleeding, bronchial pleural fistula or other serious complications were observed. All children were followed for 3 months to 2 years. The growth and development of all the children were not different from those of normal children.Conclusions: In this study, preoperative pneumonia accounted for 23.6% of children. Thoracoscopic lobectomy was effective and feasible for children with congenital cystic lung disease from 3 to 7 months of age.
Is There A Renoprotective Value to Leukodepletion During Heart Valve Surgery? A Randomized Controlled Trial (ROLO)
Authors: KHOSHBIN Espeed , SPENCER Sally , SOLOMON Laurence , TANG Agustine , CLARK Stephen , STOKES Elizabeth , WORDSWORTH Sarah , DABNER Lucy , EDWARDS Julia , REEVES Barnaby , ROGERS Chris
Published: July 2020

Background: Acute Kidney Injury (AKI) adversely affects outcomes after cardiac surgery. A major mediator of AKI is the activation of leukocytes through exposure to the cardiopulmonary bypass circuit. We evaluate the use of leukodepletion filters throughout bypass to protect against post-operative AKI by removing activated leukocytes during cardiac surgery. Methods: This is a single-centre, double-blind, randomized controlled trial comparing the use of leukodepletion versus a standard arterial filter throughout bypass. Elective adult patients undergoing heart valve surgery with or without concomitant procedures were investigated. The primary clinical outcome measured was the development of AKI according to the KDIGO criteria. Secondary measures included biomarkers of renal tubular damage (urinary Retinol Binding Protein and Kidney Injury Molecule-1), glomerular kidney injury (urinary Micro Albumin and serum Cystatin C) and urinary Neutrophil Gelatinase Associated Lipocalin, as well as the length of hospital stay and quality of life measures through EQ-5D-5L questionnaires. Results: The ROLO trial randomized 64 participants with a rate of recruitment higher than anticipated (57% achieved, 40% anticipated). The incidence of AKI was greater in the leukodepletion filter group (44% versus 23%, risk difference 21%, 95% CI -2% to 44%). This clinical finding was supported by biomarker levels especially by a tendency toward glomerular insult at 48 hours, demonstrated by a raised serum Cystatin C (mean difference 0.11, 95% CI 0.00 to 0.23, p=0.068) in the leukodepleted group. There was however no clear association between the incidence or severity of AKI and length of hospital stay. On average, health related quality of life returned to pre-operative levels in both groups within 3 months of surgery. Conclusions: Leukocyte depletion during cardiopulmonary bypass does not significantly reduce the incidence of AKI after valvular heart surgery. Other methods to ameliorate renal dysfunction after cardiac surgery need to be investigated.Trial registration: The trial was registered by the International Standard Randomized Controlled Trial Number Registry ISRCTN42121335. Registered on the 18 February 2014. The trial was run by the Bristol Clinical Trials and Evaluation Unit. This trial was financially supported by the National Institute of Health Research (Research for Patient Benefit), award ID: PB-PG-0711-25090.
WITHDRAWN: Combination of Paeoniflorin and Calycosin-7-glucoside Promotes Ischemic Stroke Recovery via the PI3K/AKT Signaling Pathway
Authors: Wang shengxin , Yan Xiangli , He Yingying , Zheng Haozhen , Wang PengCheng , Shi Xuguang , Tan Yongheng , Wang Lisheng
Published: July 2020

Background
Paeoniflorin (PF) and calycosin-7-glucoside (CG) play a role in protecting against brain damage following cerebral ischemia. However, the mechanism of action of PF in combination with CG (PF + CG) against ischemia/reperfusion injury remains unclear.
Methods
The aim of this study was to investigate the protective role of PF + CG on ischemia/reperfusion injury in vivo and in vitro, as well as its potential mechanism of action indicating that PF + CG attenuates middle cerebral artery occlusion (MCAO) /oxygen-glucose deprivation reperfusion (OGD/R) injury via the PI3K/AKT pathway. MCAO rat model was prepared by modified suture method, and behavioral scoring, cerebral infarction area, brain tissue water content measurement, using PI3K, p-PI3K, AKT, p-AKT, Bcl-2, Bax, GSK-3β protein expression as indicators, observe the effect of PI3K / AKT signaling pathway inhibitor LY294002 on the anti-ischemia-reperfusion effect of PF + CG. Oxygen deprivation method was used to prepare the OGD/R model, CCK-8 was used to determine the survival rate of HT22 cells, the contents of SOR, ROS, MDA, and LHD were determined, and apoptosis was detected by flow cytometry and mitochondrial membrane potential, using PI3K, p-PI3K, AKT, p-AKT, Bcl-2, Bax, GSK-3β protein expression as indicators, observe the effect of PI3K/AKT signaling pathway inhibitor LY294002 on the anti- oxidative and glucose deprivation effect of PF + CG.
Results
The animal studies showed that PF + CG significantly decreased neurobehavioral deficits, cerebral infarct volume, and brain edema; ameliorated histopathological damage in model rats; increased levels of PI3K, AKT, p-PI3K, p-AKT, and Bcl-2; and reduced BAX and GSK-3β expression. After treatment with PF + CG, the morphology and number of cells in brain tissue were restored to normal, demonstrating a therapeutic effect in cerebral ischemia-reperfusion injury. Results of further studies revealed that, in vitro, PF + CG has a therapeutic effect to enhance cell vitality; elevate levels of superoxide dismutase (SOD); reduce levels of reactive oxygen species (ROS), lactate dehydrogenase (LDH), and malondialdehyde (MDA); decrease apoptosis rate; increase levels of PI3K, AKT, p-PI3K, p-AKT, and Bcl-2; and reduce BAX and GSK-3β expression.
Conclusion
These results demonstrate that PF + CG has a positive therapeutic effect on ischemia/reperfusion and OGD/R injury, and the mechanism is attributed to activation of the PI3K/AKT signaling pathway.
Lacrimal Sac Bacteriology and Susceptibility Pattern in Infants with Congenital Nasolacrimal Duct Obstruction in the 1st Year of Life: A Cross-Sectional Study
Authors: Zheng Xiaoyu , Choy Bonnie Nga Kwan , Zhou Mingming , Shi Caiping , Zhao Zhengyan
Published: July 2020

Background
Congenital nasolacrimal duct obstruction (CNLDO) is one of the main causes of epiphora in infants, and antibiotics are usually used as a conservative therapy in the first year. Yet, little is known about the bacteriology of the occluded lacrimal drainage system in this group of patients. The aim of this study was to evaluate the microbiology of lacrimal sac (LS) in Chinese children with CNLDO in their first year of life.
Methods
Patients with CNLDO between May 1, 2017 and August 31, 2018 at a tertiary care children’s hospital were enrolled. The study recruited infants who received lacrimal probing under 1 year old, and refluxed discharge from LS was collected. Samples were cultured and susceptibility test was performed for positive culture.
Results
Thirty-two patients with CNLDO were included. The ratio of male to female was 1.5 : 1. The mean age was 6.6 ± 2.3 (1.7–12) months. Positive cultures was identified in 87.5% of the sample, and presented 38 strains of bacteria. Mixed infection was identified in 10 (35.7%) children. Gram-positive bacteria accounted for 60.5% of all the strains, with Streptococcus (50%) being the most frequent species, whereas Haemophilus (21.1%) and Neisseriae (13.2%) were most common isolates for Gram-negative organisms. Methicillin-resistant Staphylococcus aureus (MRSA) was detected in 2 infants whose symptoms resolved by a routine probing. No difference of bacteriology pattern was detected between patients under 6 months old and those beyond. The pathogens were highly sensitive to chloramphenicol (88%) and levofloxacin (84%), but resistant to erythromycin (40%) and sulfamethoxazole (32%).
Conclusions
Infants with CNLDO under 1 year of age presented predominance of Streptococcus as Gram-positive organism, and Haemophilus as Gram-negative organism. Levofloxacin was an active topical antibiotic agent with few chance of resistance. These findings could help clinicians choose optimal medicine for CNLDO as the conservative treatments.
The Effect of Foetal And Early Childhood Growth on Metabolic Derangements of Sri Lankan Children
Authors: Wickramasinghe Vithanage Pujitha , Arambepola C.
Published: July 2020

Background
Studies have shown that accelerated postnatal growth plays a significant role on the onset of adult metabolic diseases. The aim of this study was to identify the effects of intrauterine and later growth on metabolic derangements among children in Colombo, Sri Lanka
Materials:
A school-based cross-sectional study was conducted among 5–15 year old children selected using a two-stage probability-proportionate-to-size cluster sampling technique. Birthweight (BW) was extracted from records to denote prenatal growth; and body mass index (BMI) and fat mass (FM) measured to denote the current growth of children. As metabolic parameters, fasting and random blood glucose, lipid profile and blood pressure (BP) were measured. The sample was stratified by age (5–10 years and 11–15 years); and each age group further categorized into tertiles of BW and BMI. Based on these two parameters, metabolic parameters were evaluated within each age category.
Results
The sample comprised 833 (494 boys). Metabolic parameters did not significantly differ by sex or across BW tertiles of each BMI tertile. However, significant increases were noted in all except FBS across the BMI tertiles of each BW tertile. Children belonging to the lowest BW and highest BMI tertiles had worst metabolic profiles, while those in the lowest BW as well as BMI tertile were protected. Changes were more significant in the older age category. Irrespective of BW, fat deposition rather than nutritional growth seemed to move children to higher BMI tertiles.
Conclusion
Poor prenatal growth is not the sole risk factor for abnormal metabolic profile found in childhood. Those who gain weight during early childhood are at higher risk than those who remain small. This favours the accelerated postnatal growth hypothesis.
Cognitive development of children with Kawasaki Disease and the parenting stress of their caregivers
Authors: Wang Liang-Jen , Tsai Zi-Yu , Chang Ling-Sai , Kuo Ho-Chang
Published: July 2020

Background

Kawasaki disease (KD) is an acute form of febrile vasculitis that occurs in early childhood. The multi-systemic vasculitis common in KD patients may influence blood perfusion in the brain, and thus caregivers of KD children may feel stress with regard to caring for them. Intravenous immunoglobulin (IVIG) infusion is the standard treatment for acute KD, and the most serious complication of KD is coronary artery aneurysms (CAL). This study aimed to investigate the relationships between KD heterogeneity and the risk of patients’ cognitive impairment or caregivers’ parenting stress.
Methods

This cross-sectional study consisted of 176 patients with KD (mean age: 5.5 years, 60.8% male) and 85 healthy children (mean age: 6.4 years, 54.1% male). Based on the children’s age, each KD patient and control subject was administered an assessment using the Mullen Scales of Early Learning or the Wechsler Intelligence Scale, and parenting function of their caregivers was assessed using the Parenting Stress Index-Short Form (PSI).
Results

We observed no significant differences in any developmental index, cognitive function, or parenting stress between KD patients and controls. Among the KD children, IVIG administration nor CAL was associated with children’s cognitive scores. However, the caregivers of patients who had CAL suffered from greater PSI total scores than those of patients without CAL (p = 0.019). Furthermore, the caregivers who had education levels of a master’s degree or above showed less parenting stress than those who had an education level of college (p = 0.010) or lower (p = 0.021).
Conclusion

No significant differences in developmental index, cognitive function or parenting stress between KD patients and controls. In KD patients, neither IVIG response nor CAL appear to have a relationship with development milestones or cognitive function. However, caregivers’ education is associated to parenting stress, and caregivers of KD patients who developed CAL may feel stress about the unpredictable sequela caused by CAL for their children. Such caregivers may require support to fulfill their parenting roles.
Human levator veli palatini muscle: A novel source of mesenchymal stem cells for use in the rehabilitation of patients with congenital craniofacial malformations
Authors: Bueno Daniela Franco , Kabayashi Gerson Shigueru , Pinheiro Carla Cristina Gomes , Tanikawa Daniela Y S , Raposo-Amaral Cassio Eduardo , Rocha Diogenes Laercio , Ferreira José Ricardo Muniz , Hokugo Ashigue , Jarrahy Reza , Zuk Patricia A , Bueno Maria Rita Passos
Published: July 2020

Background. Bone reconstruction in congenital craniofacial differences, which affect about 2-3% of newborns, has long been the focus of intensive research in the field of bone tissue engineering. The possibility of using mesenchymal stem cells in regenerative medicine protocols has opened a new field of investigation aimed at finding optimal sources of multipotent stem cells that can be isolated via non-invasive procedures. Here we analysed whether levator veli palatini muscle fragments, which can be readily obtained in non-invasive manner during surgical rehabilitation of cleft p­­atients during palatoplasty, represent a novel source of MSCs with osteogenic potential. Methods. We obtained levator veli palatini muscle fragments, in non-invasive procedure during surgical rehabilitation of 5 unrelated cleft palate patients (palatoplasty surgery). The levator veli palatini muscle fragments was used to obtain the mesenchymal cells using pre-plating technique in a clean rooms infrastructure and all procedures were performed at good practices of manipulation conditions. To prove that levator veli palatini muscle are mesenchymal stem cells they were induced to flow cytometry analysis and to differentiation into bone, cartilage, fat and muscle. To demonstrate the osteogenic potential of these cells in vivo a bilateral full thickness calvarial defect model was made in immunocompentent rats.Results. Flow cytometry analysis showed that the cells were positive for mesenchymal stem cell antigens (CD29, CD73, CD90), while negative for hematopoietic (CD45) or endothelial cell markers (CD31). Moreover, these cells were capable of undergoing chondrogenic, adipogenic, osteogenic and skeletal muscle cell differentiation under appropriate cell culture conditions characterizing them as mesenchymal stem cell. Defects treated with CellCeramTM scaffolds seeded with levator veli palatini muscle cells showed significantly greater bone healing compared to defects treated with acellular scaffolds. Conclusion. We have demonstrated that cells derived from levator veli palatini muscle have phenotypic characteristics similar to other mesenchymal stem cells, both in vitro and in vivo. Our ﬁndings suggest that these cells may have clinical relevance in the rehabilitation of patients with cleft palate and other craniofacial anomalies characterized by significant bone deficit.
Pathogenesis Clues from the Early Clinical Presentation of 300 Hospitalized COVID-19 Patients
Authors: Yu Feng , Deng Xuemei , Ni Li , Li Wei , Yan Ping , Huang Mian , wang xiongbiao
Published: July 2020

Background: The global spread of the 2019 coronavirus disease (COVID-19) has lasted more than half a year. Except for the gene sequence and viral structure of SARS-CoV-2, its clinical characteristics, pathological mechanisms and corresponding measures have not been fully revealed. We aimed to speculate about the possible pathological mechanism from the early clinical manifestations of patients with COVID-19. Methods: The onset symptoms, laboratory examinations and CT findings on admission of 300 patients in two wards of Wuhan Third Hospital from January 28 to March 15 were analyzed retrospectively. Results: There was no difference in incidence between men and women, but women were hospitalized later after onset. Upper respiratory symptoms and sputum were rare. The incidence of fever was 71%. Blood lymphocyte counts were decreased significantly on admission and were related to the severity of the disease. In moderate patients without hypoxia, thrombocytopenia occurred in 12.37%, CRP rose in 64.43%, BUN was elevated in 20.62%, creatinine rose in 17.53%, D-dimer was elevated in 74.74%, and creatine kinase and α-hydroxybutyrate dehydrogenase were elevated in 45.36% and 54.12% of patients, respectively. Early CT showed a small amount of infiltration in the subpleural and lateral zones of the lung and thickening of the interlobular septum. Approximately 5 days later, infiltration was worse in some of the patients, and the proportion of involvement of the affected lung was negatively correlated with the lymphocyte count. Conclusions: There was no sex difference in patients with SARS-CoV-2 infection. Alveolar cells and T lymphocytes may be the main targets of the virus, and apoptosis may be the primary mechanism of pathogenesis. The virus entering the lung may be transmitted through lymph or blood vessels rather than directly dispersing through the respiratory tract. Early damage to multiple organs may be caused by the immune response.
Assessment of self-medication practices in the context of Covid-19 outbreak in Togo
Authors: Sadio Arnold J , Gbeasor-Komlanvi Fifonsi A , KONU Rodion Y , Bakoubayi Akila W , Tchankoni Martin K , Bitty-Anderson Alexandra , Gomez Iris M , Denadou Claudia P , Anani Joël , Kouanfack Harold R , Kpeto Innocent K , Salou Mounerou , Ekouevi Didier K
Published: July 2020

Background: To date, there is no effective treatment for Covid-19 which is a pandemic due to a new coronavirus called SARS-CoV-2. In Togo where four people in five practice self-medication, the absence of a cure for Covid-19 and its constant progression requires an assessment of self-medication patterns in the context of the pandemic. This study aimed to estimate the prevalence of self-medication to prevent Covid-19 and its associated factors in Lomé, Togo. Methods: A cross-sectional study was conducted in Lomé, capital city of Togo, from April 23rd to May 8th, 2020 in a random sample of participants from five sectors: healthcare, air transport, police, road transport and informal. Participants were invited to give information about their self-medication practices to prevent Covid-19 within the two weeks preceding the survey. Results: A total of 955 participants (71.6% of men) with a median age of 36 (IQR 32–43) were included. Around 22.1% were in the air transport sector, 20.5% in police, and 38.7% in the health sector. The overall prevalence of self-medication to prevent Covid-19 was 34.2% (95CI%: 31.2-37.3%). Most commonly used products were vitamin C (27.6%) and traditional medicine (10.2%). Only 2.0% of participants reported using Chloroquine/Hydroxychloroquine. Female sex (aOR=1.90; p<0.001), working in the health sector (aOR=1.89; p= 0.001), secondary education level (aOR= 2.28; p= 0.043) and university education level (aOR= 5.11; p<0.001) were associated with self-medication. Conclusion: Prevalence of self-medication was high in high-risk populations in Lomé. Intensifying awareness campaigns is crucial to fight misinformation about alleged Covid-19 prevention products on social media.
Preservation of Swallowing in Resected Oral Cavity Squamous Cell Carcinoma: Examining Radiation Volume Effects (PRESERVE): Study Protocol for a Randomized Phase II Trial
Authors: Lang Pencilla , Contreras Jessika , Kalman Noah , Paterson Claire , Bahig Houda , Billfalk-Kelly Astrid , Brennan Sinead , Rock Kathy , Read Nancy , Venkatesan Varagur , Sathya Jinka , Mendez Lucas C. , MacNeil S. Danielle , Nichols Anthony C. , Fung Kevin , Mendez Adrian , Winquist Eric , Kuruvilla Sara , Stewart Paul , Warner Andrew , Mitchell Sylvia , Theurer Julie A. , Palma David
Published: July 2020

Background Patients with resected oral cavity squamous cell carcinoma (OCSCC) are often treated with adjuvant radiation (RT) ± concomitant chemotherapy based on pathological findings. Standard RT volumes include all surgically dissected areas, including the tumour bed and dissected neck. RT has significant acute and long-term toxicities including odynophagia, dysphagia, dermatitis and fibrosis. The goal of this study is to assess the rate of regional failure with omission of radiation to the surgically dissected pathologically node negative (pN0) hemi-neck(s) compared to historical control, and to compare oncologic outcomes, toxicity, and quality of life (QoL) profiles between standard RT volumes and omission of RT to the pN0 neck. Methods This is a multicentre phase II study randomizing ninety patients with T1-4 N0-2 OCSCC with at least one pN0 hemi-neck in a 1:2 ratio between standard RT volumes and omission of RT to the pN0 hemi-neck(s). Patients will be stratified based on overall nodal status (nodal involvement vs. no nodal involvement) and use of concurrent chemotherapy. The primary endpoint is regional failure in the pN0 hemi-neck(s); we hypothesize that a 2-year regional recurrence of 20% or less will be achieved. Secondary endpoints include overall and progression-free survival, local recurrence, rate of salvage therapy, toxicity and QoL. Discussion This study will provide an assessment of omission of RT to the dissected pN0 hemi-neck(s) on oncologic outcomes, QoL and toxicity. Results will inform the design of future definitive phase III trials. Trial Registration: Clinicaltrials.gov identifier: NCT03997643. Date of registration: June 25, 2019, Current version: 2.0 on July 11 2020. URL: https://clinicaltrials.gov/ct2/show/NCT03997643