bluuebunny/crossref_metadata_2025 huggingface dataset:
Discectomy Combined with Annulus Fibrosus Repair for the Treatment of Lumbar Disc Herniation: A Bayesian analysis of Random Controlled Trials
Authors: Hu Jinlong , Bai Jianzhong , Shi Xueqiang , Fei Wenyong , Wang Hua
Published: April 2020

Objective To investigate clinical effects of discectomy combined with annulus fibrosus (AF) repair for the treatment of lumbar disc herniation. Methods We searched PubMed, Embase, Web of Science, CNKI and WanFang data for studies evaluating discectomy combined with AF repair and discectomy for the treatment lumbar disc herniation. Two reviewers selected studies, assessed quality, and extracted data. This meta-analysis was performed to calculate the weighted mean difference (WMD), risk ratios (RRs), and 95% confidence intervals (CIs). Results Six randomized controlled trials (RCTs) were included in the meta-analysis. The pooled results suggested that the recurrence rate and reoperation rate in the non-repair group versus those in the repair group [RR= 2.64, 95% confidence interval (CI) 1.09, 6.41], [RR=1.33, CI 0.85, 2.10], respectively. The rate of Visual analogue scale (VAS) relief in the repair group was significantly better than in non-repair group [WMD=0.23, CI 0.04, 0.42], and did not increase the incidence of postoperative complications. There were no significant differences between the two surgical procedures in the Oswestry disability index (ODI) reduction [WMD=-0.18, CI -1.50, 1.14], intraoperative blood loss [WMD = -1.23, CI -4.46, 2.00] and the length of the surgical incision [WMD = 0.08, CI -0.01, 0.18]. However, the operation time of the repair group was slightly longer than non-repair group [WMD =6.73, CI 2.80, 10.66]. Conclusion Discectomy combined with AF repair is superior to discectomy regarding postoperative recurrence rate and postoperative pain relief, but the operation time is slightly longer than the latter. There is no significant difference in reoperation rate, intraoperative blood loss, length of the surgical incision, postoperative complication rate, and reduction in ODI between the two surgical procedures.
Use of Immunostaining for the Diagnosis of Lymphovascular Invasion in Superficial Barrett’s Esophageal Adenocarcinoma
Authors: Hosono Isao , Miyahara Ryoji , Furukawa Kazuhiro , Funasaka Kohei , Sawada Tsunaki , Maeda Keiko , Yamamura Takeshi , Ishikawa Takuya , Ohno Eizaburo , Nakamura Masanao , Kawashima Hiroki , Yokoi Takio , Tsukamoto Tetsuya , Hirooka Yoshiki , Fujishiro Mitsuhiro
Published: April 2020

Background: The prevalence of Barrett’s esophageal adenocarcinoma (BEA) is increasing in Japan. Accurate assessment of lymphovascular invasion (LVI) after endoscopic resection or surgery is essential in evaluating treatment response. This study aimed to assess the usefulness of immunostaining in determining the extent of LVI in superficial BEA. Methods: We retrospectively included 41 patients who underwent endoscopic resection or surgery between January 2007 and July 2018. In all cases, 3-µm serial sections from paraffin-embedded resected specimens were used for hematoxylin and eosin (H-E) staining and immunostaining for D2-40 and CD31. Two specialized gastrointestinal pathologists (T.Y. and T.T), blinded to clinical information, independently evaluated the extent of LVI from these specimens. The LVI-positivity rate was evaluated with respect to the depth of invasion, changes in the positivity rate on immunostaining, pathological characteristics of patients with LVI, lymph node metastasis or relapse, and course after treatment. Results: H-E staining alone identified LVI in 7 patients (positivity rate: 17.1%). Depths of invasion were categorized based on extension to the submucosa (SM) or deeper. On immunostaining for D2-40 and CD31, additional positivity was detected in 2 patients with SM1 and 1 SM3, respectively; LVI was detected in 10 patients (positivity rate: 24.4%). LVI-positivity rates with invasion of the superficial muscularis mucosa (SMM)/lamina propria (LPM)/deep muscularis mucosa (DMM), SM 1, 2, and 3 were 0%, 75%, 28.6%, and 55.6%, respectively. Conclusions:Combined H-E staining and immunostaining is useful in diagnosing LVI in superficial BEA, particularly in endoscopically resected specimens.
Differential long-term retention of biological disease-modifying antirheumatic drugs in patients with rheumatoid arthritis by age group from the FIRST registry
Authors: Kawabe Akio , Nakano Kazuhisa , Kubo Satoshi , Asakawa Takeshi , Tanaka Yoshiya
Published: April 2020

Background. The effectiveness and safety of biological disease-modifying antirheumatic drugs (bDMARDs) by age group (<65, 65–74, and ≥75 years) are uncertain. We examined retention rates reflecting the effectiveness and safety of bDMARDs in actual clinical practice for clarifying optimal therapeutic strategies for rheumatoid arthritis (RA) by age groups.Methods. Data of patients who were treated with tumor necrosis factor inhibitors (TNFi), abatacept (ABA), and tocilizumab (TCZ) between February 2011 and April 2017 were retrospectively collected from an observational registry of RA patients. A total of 1,362 patients were enrolled, of which 695 were aged <65 years, 402 were aged 65–74 years, and 265 were aged ≥75 years. Primary outcome was the drug retention rate in adjusted data using inverse probability of treatment weighting based on generalized propensity scores.Results. In patients aged <65 years, three-year retention rates of TNFi, ABA, and TCZ were 43%, 47%, and 69%, respectively (ABA versus TCZ, p = 0.017; TNFi versus TCZ, p = 0.002). In patients aged 65–74 years, three-year retention rates of TNFi, ABA, and TCZ were 44%, 53%, and 60%, respectively (TCZ versus TNFi, p = 0.034). In patients aged ≥75 years, three-year retention rates for TNFi, ABA, and TCZ were 38%, 63%, and 58%, respectively (ABA versus TNFi, p = 0.017).Conclusions. We found that the effectiveness and safety of TCZ were maximal in patients aged <75 years and that patients aged ≥75 years might be suitable candidates for TCZ and ABA therapy. The use of therapeutic strategies appropriate to each age group might improve the outcomes of bDMARD therapy for RA.
Human umbilical cord-derived mesenchymal stem cells ameliorate insulin resistance via PTEN-mediated crosstalk between the PI3K/Akt and Erk/MAPKs signaling pathways in the skeletal muscles of db/db mice
Authors: Chen Guang , Fan Xiao-yan , Zheng Xiao-peng , Jin Yue-lei , Liu Ying , Liu Shuang-chun
Published: April 2020

Background: Globally, 1 in 11 adults have diabetes mellitus and 90% of the cases are type 2 diabetes mellitus. Asia is the epicenter of this global type 2 diabetes mellitus epidemic. Type 2 diabetes mellitus and its complications have contributed significantly to the burden of mortality and disability worldwide. Insulin resistance is a central defect in type 2 diabetes mellitus, and although multiple drugs have been developed to ameliorate insulin resistance, the limitations and accompanying side effects cannot be ignored. Thus more effective methods are required to improve insulin resistance. Methods: In the current study, db/m and db/db mice were injected with human umbilical cord-derived mesenchymal stem cells (HUC-MSCs) via tail vein injection, intraperitoneal injection and skeletal muscle injection. Body weight, fasting blood glucose and the survival rates were monitored. Furthermore, the anti-insulin resistance effects and potential mechanisms of transplanted HUC-MSCs were investigated in db/db mice in vivo. Results: The results showed that HUC-MSC transplantation by skeletal muscle injection was safer compared with tail vein injection and intraperitoneal injection, and the survival rate reached 100% in the skeletal muscle injection transplanted mice. HUC-MSCs can stabilize localization and differentiation in skeletal muscle tissue and significantly ameliorate insulin resistance. Potential regulatory mechanisms are associated with downregulation of inflammation; regulating the balance between PI3K/Akt and ERK/MAPK signaling pathway via PTEN, but was not associated with the IGF-1/IGF-1R signaling pathway. Conclusions: These results suggest HUC-MSC transplantation may be a novel therapeutic direction to prevent insulin resistance and increase insulin sensitivity, and skeletal muscle injection was the safest and most effective way.
Development of a convenient detection method for Trichomonas vaginalis based on loop-mediated isothermal amplification targeting adhesion protein 65
Authors: Li Yuhua , Wang Shuai , Li Haoran , Song Xiaoxiao , Zhang Hao , Duan Yujuan , Luo Chengyang , Wang Bingli , Ji Sifan , Xie Qing , Zhang Zhenchao
Published: April 2020

Background: Trichomoniasis resulting from Trichomonas vaginalis ( T. vaginalis ) has been considered as a commonly seen disease with the transmission way of sex. At present, the detection methods of T. vaginalis mainly include wet mount microscopy, culture, PCR, immunofluorescence and ELISA. However, all of these detection methods exist shortcomings. Methods: In this study, a loop-mediated isothermal amplification (LAMP) assay that targeted the species-specific sequence of adhesion protein 65 (AP65) gene had been conducted to detect T. vaginalis . The optimum reaction system and conditions were optimized in this rapid detection method. Results: The results of sensitivity analysis showed that the LAMP assay targeting the AP65 gene was 1000 times more sensitive than the nested PCR targeting the actin gene commonly used for detection of T. vaginalis , and the detecting limitation of the former was 10 trichomonad. Moreover, the amplification of the target gene AP65 by LAMP assay exhibited high specificity and the product was exclusively from T. vaginalis . The detection technique of LAMP did not exhibit cross-reactivity with the common pathogens of Trichinella spiralis , Toxoplasma gondii , Escherichia coli , Candida albicans , Staphylococcus aureus , Haemophilus . Conclusions: According to the present study, the LAMP assay with the target of AP65 gene, was suitable for the early diagnosis of T. vaginalis infections. Consequently, the LAMP assay was proposed by the current study as a point-of-care examination and an alternative molecular tool which exhibited the potential value in the treatment, control and prevention of trichomoniasis transmission and relevant complication.
Smoking is associated with pneumonia development in lung cancer patients
Authors: Heo Jung Won , Yeo Chang Dong , Park Chan Kwon , Kim Sung Kyoung , Kim Ju Sang , Kim Jin Woo , Kim Seung Joon , Lee Sang Haak , Kang Hye Seon
Published: April 2020

Background: Various host factors can promote pneumonia susceptibility of lung cancer patients. However, data about risk factors for pneumonia in lung cancer patients receiving active treatments such as chemotherapy, radiotherapy, and surgical intervention are limited. Thus, the purpose of this study was to identify risk factors for pneumonia development in lung cancer patients. Methods: The present study used a lung cancer cohort of the Catholic Medical Center at the Catholic University of Korea from January 2015 to December 2018. Pneumonia was defined by the presence of a new or progressive infiltration on chest imaging together with any of the following: new onset purulent sputum, change in character of chronic sputum, and fever. We ruled out noninfectious infiltration such as drug or radiation toxicity and hydrostatic pulmonary edema. We especially excluded those if computed tomography revealed sharp demarcation consolidation or ground glass opacity limited radiation field. Results: A total of 413 patients were enrolled in this study. Pneumonia occurred in 118 (28.6%) patients. The pneumonia group had significantly worse overall survival (OS) than the non -pneumonia group (456.7 ± 35.0 days vs. 813.4 ± 36.1 days, log rank p < 0.001). In patients with pneumonia, OS was shorter in ex-smokers and current smokers than in never smokers (592.0 ± 101.0 days vs. 737.0 ± 102.8 days vs. 1357.0 days, log rank p < 0.001). Age (hazard ratio [HR]: 1.046; 95% confidence interval [CI]: 1.019­–1.074; p = 0.001), clinical stage IV (HR: 1.759; 95% CI: 1.004–3.083; p = 0.048), neutropenia (HR: 2.620; 95% CI: 1.562–4.396; p < 0.001], and smoking (HR: 2.040; 95% CI: 1.100–3.784; p = 0.024) were independent risk factors of pneumonia development in lung cancer patients in multivariate analysis. In subgroup analysis for patients treated with chemotherapy, age (HR: 1.043; 95% CI: 1.012–1.074; p = 0.006), neutropenia (HR: 3.199; 95% CI: 1.826–5.605; p < 0.001), and smoking (HR: 2.125; 95% CI: 1.071–4.216; p = 0.031) were independent risk factors of pneumonia development. Conclusions: Smoking and neutropenia were risk factors affecting pneumonia development in the total group and subgroup of patients with lung cancer.
Effects of Virtual Reality Associated With Serious Games for Upper Limb Rehabilitation in Patients With Multiple Sclerosis. a Randomized Controlled Trial
Authors: Cuesta-Gómez Alicia , Baeza Patricia Sanchez-Herrera , Oña-Simbaña Edwin Daniel , Martínez-Medina Alicia , Ortiz-Comino Carmen , de Quirós Carlos Balaguer-Bernaldo , Jardón-Huete Alberto , Cuerda Roberto Cano-de la
Published: April 2020

Background: Dexterity and activities of daily living limitations on the upper limb (UL) represent one of the most common problems in patients with multiple sclerosis (MS). The aim of this study was to evaluate the effectiveness of the specially developed Serious Games that make use of the Leap Motion Controller (LMC) as main user interface for improving UL grip muscle strength, dexterity, fatigue, quality of life, satisfaction and compliance. Methods: A single-blinded randomized controlled trial was conducted. The sample was randomized into two groups: an experimental group who received treatment based on serious games designed by the research team using the developed LMC based Serious Games for the UL plus conventional rehabilitation, and a control group who received the same conventional rehabilitation for the UL. Both groups received two 60 min sessions per week over a ten-week period. Grip muscle strength, coordination, speed of movements, fine and gross UL dexterity, fatigue, quality of life, satisfaction and compliance were assessed in both groups pre-treatment, post-treatment and in a follow-up period of one month without receiving any treatment. Results : In the experimental group compared to the control group, significant improvements were observed in the post-treatment assessment for coordination, speed of movements, fine and gross UL dexterity. Also, significant results were found in the follow-up in coordination, speed of movements, fine and gross for the more affected side. Conclusions: An experimental protocol using an LMC based Serious Games designed for UL rehabilitation showed improvements for unilateral gross manual dexterity, fine manual dexterity, and coordination in MS patients with high satisfaction and excellent compliance.
Examining the accuracy of trackways for predicting gait selection and speed of locomotion
Authors: Marmol-Guijarro Andres , Nudds Robert , Folkow Lars , Codd Jonathan
Published: April 2020

Background Using Froude numbers (Fr) and relative stride length (stride length: hip height), trackways have been widely used to determine the speed and gait of an animal. This approach, however, is limited by the ability to estimate hip height accurately and by the lack of information related to the substrate properties when the tracks were made, in particular for extinct fauna. By studying the Svalbard ptarmigan moving on snow, we assessed the accuracy of trackway predictions from a species-specific model and two additional Fr based models by ground truthing data extracted from videos as the tracks were being made. Results The species-specific model accounted for more than 60% of the variability in speed for walking and aerial running, but only accounted for 19% when grounded running, likely due to its stabilizing role while moving faster over a changing substrate. The error in speed estimated was 0-35% for all gaits when using the species-specific model, whereas Fr based estimates produced errors up to 55%. The highest errors were associated with the walking gait. The transition between pendular to bouncing gaits fell close to the estimates using relative stride length described for other extant vertebrates. Conversely, the transition from grounded to aerial running appears to be species specific and highly dependent on posture and substrate. Conclusion Altogether, this study highlights that using trackways to derive predictions on the locomotor speed and gait, using stride length as the only predictor, are problematic as accurate predictions require information from the animal in question.
Impact of an Infectious Disease Specialist-Led Postprescription Carbapenem Intervention on Prescribing Behavior in a Japanese Tertiary Hospital: a Before-After Study
Authors: MATONO Takashi , Umeda Yuichi , Uchida Moritsugu , Koga Hidenobu , Kanatani Naoya , Furuno Yoshimi , Yamashita Tomonori , Nakamura Kenichi
Published: April 2020

Background: There are a few infectious disease (ID) specialists in Japan. A solution to promote the implementation of antimicrobial stewardship activities under these resource-limited settings is required.Methods: We compared carbapenem consumption between a 24-month baseline and 12-month intervention periods. During the intervention period, an ID specialist provided daily advises through a chart review and ID consultation service to prescribers against all prolonged carbapenem use (≥ 14 days). Additionally, we send an aggregated table containing the weekly point prevalence amount of each departmental carbapenem use for 7–13 and ≥ 14 days through e-mail to all doctors.Results: Among the 1,241 carbapenem courses during the intervention period, the ID specialist provided a total of 96 instances of feedback regarding carbapenem use for ≥ 14 days, and the feedback acceptance rate was 76%. After the initiation of the intervention, the trend in monthly carbapenem consumption changed (coefficient: -0.62; 95% CI: -1.15 to -0.087, p = 0.024), and its consumption decreased (coefficient: -0.098; 95% CI: -0.16 to -0.039, p = 0.002) without an increase in the consumption of broad-spectrum antimicrobials or in-hospital mortality. Interestingly, the monthly number of carbapenem courses, but not the duration of carbapenem use, significantly decreased (coefficient: -3.02; 95% CI: -4.63 to -1.42, p = 0.001). The carbapenem-related annual estimated savings after the intervention was $83,745, with a 22% cost reduction.Conclusions: Our ID specialist-led daily intervention with weekly feedback regarding long-term carbapenem use was effective in reducing antimicrobial consumption. Such feedback may be useful in changing the prescribing behavior and promoting appropriate antimicrobial usage even in resource-limited settings.
Methylated Septin9: biomarker for diagnosis of cervical cancer in cervical scrapings and for prediction of pelvic lymphatic metastasis in plasma
Authors: Bu Qiaowen , Wu Heng-ying , Wang San-feng , Ma Jian , Lei Wen , Li Yu-han , Zhou Wei-ping , Li Hai-ping , Deng Hua , Luo Jia-qi , He Lu-lu , Zhang Liang , Luo Xi-ping
Published: April 2020

BackgroundAberrant Septin9 methylation in cervical cancer has been rarely studied. In this study we aimed to identify its diagnostic value of cervical cancer in cervical scrapings, and its predictive potential in plasma for pelvic nodal metastasis of cervical cancer.MethodsThe statuses of methylated Septin9 in fresh cervical lesions were first evaluated by using quantitative methylation-specific PCR(qMS-PCR). Subsequently 248 samples of cervical scrapings were collected to explore Septin9 methylation in different severities of cervical lesions; and the relationship between Septin9 methylation in plasma and pelvic nodal metastasis of cervical cancer was further evaluated.ResultsMethylated Septin9 was detected in all cancerous tissues, but not in cervicitis controls (P < 0.0001). The degrees of Septin9 methylation increased with growing severity of cervical lesions in cervical scrapings (P < 0.0001). Methylation analysis of Septin9 demonstrated a satisfactory specificity and area under the curve(AUC) in cervical cancer detection, at an equivalent sensitivity relative to any other test. And methylated Septin9 also yielded a high specificity and AUC in detecting high-grade squamous intraepithelial lesion or cervical cancer(≥ HSIL). Plasma-based Septin9 methylation had a high discriminatory power in predicting pelvic nodal metastasis, with an optimal specificity of 81.48%; additionally an increasing sensitivity from 50% to nearly 80% was found when combined with squamous cell carcinoma antigen(SCC-Ag). ConclusionsIn conclusion, we demonstrated methylated Septin9 to be an innovative diagnostic biomarker for cervical cancer in cervical scrapings and its non-invasive predictive potential in plasma for pelvic nodal metastasis of cervical cancer.
Macro- and individual-level influence factors of depression: multilevel cross-provinces comparison in China
Authors: Wu Nianwei , Gao Bo
Published: April 2020

Background: Rapid social change has given rise to a general increase in psychological pressure, which lead to more and more Chinese people suffering from depression over the past 30 years. However, few literatures reported the influence of macro factors on depression of Chinese .The effects of macro-level and individual-level on depression of Chinese respondents aged 16-97 years were examined in this study. Methods: We conducted a multilevel analysis of the 2018 longitudinal follow up of the Chinese Family Panel Studies (CFPS), with 19072 respondents nested within the 25 Chinese provinces. Data for macro-level are extracted from National Bureau of Statistics of China, including three predictors: gross regional product (GRP) per capita, expenditure for social security and employment (ESSE) and rural and urban household income inequality. Depression is measured with the eight-item short version of the Center for Epidemiologic Studies Depression Scale (CES-D8). Result: We found that respondents who were female,30-59 years, divorced or widowed, less educated, rural residents, less body mass index (BMI) or had lower household income tended to report higher levels of depressive symptoms. After adjustment for individual-level features, a significant macro effect of provinces survives. The respondents who lived in province that were higher GRP, higher ESSE or smaller rural and urban household income inequality reported lower levels of depressive symptoms. Conclusions: Our results have demonstrated that depression is not fully explained by individual features. Economic social factors appear to have an impact on depression and have to be considered when planning for improved public depression. Meanwhile, our research also provides a reference for some provinces to further investigation and improvement of depression. Keywords: China; Individual-level; Macro-level; Influence factors; Depression; Multilevel analysis
Association between social trust and the risk of cardiovascular disease in Korean adults aged 50 years or older: a nationwide retrospective cohort study
Authors: Hwang Seo Eun , Choi Seulggie , Kim Kyuwoong , Lee Jong-Koo , Oh Juhwan , Park Sang Min
Published: April 2020

Background
Although social capital has been shown to be one of the important social determinants of health, the association between social trust and the risk of cardiovascular disease (CVD) is not clear yet. We aimed to investigate the association of social trust with CVD risk using a large Korean population.
Methods
The study data was derived from the Korean National Health Insurance Service database. Community-level social trust was determined from the Koran Community Health Survey. The study population consisted of 2,156,829 participations. According to social trust index measured in the area of residence during 2011, participants were followed-up from 1 January 2012 to 31 December 2016. Multivariate Cox proportional hazards regression was used to determine the adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for CVD risk according to quintiles of social trust.
Results
Compared to participants with the lowest quintile of social trust, those within the highest quintile had lower risk for CVD (aHR 0.91, 95% CI = 0.89 to 0.93), CHD (aHR 0.92, 95% CI = 0.89 to 0.95), and stroke (aHR 0.90, 95% CI = 0.87 to 0.93). The risk-reducing association of high social trust on CVD risk was preserved after additional adjustments for lifestyle behaviors including smoking, alcohol intake, and physical activity.
Conclusion
Higher social trust was associated with reduced risk of CVD even after considering lifestyle behaviors. Social trust in a community level is an important determinant of CVD and enhancing social trust may lead to reduced risk of CVD.
Seedling growth, root development and nutrient use efficiency of Cypress clones in response to calcium fertilizer
Authors: Zhang Zhen , Jin Guoqing , Zhou Zhichun
Published: April 2020

Background:
Cypress (Cupressus funebris Endl.) is an important tree species in the subtropics of China, it is also a major tree species for afforestation and forest land restoration under infertile site conditions. Cypress is considered to be a calcicolous tree, whose there are growth and development can be promoted significantly by exchangeable Calcium (Ca2+) in the soil. However, most of the subtropical regions have infertile acidic soils, in which Ca2+ gradually becomes a limiting element for cypress growth.
Results:
In this study, different concentrations of Ca2+ fertilizer were added under fertile and infertile soil conditions. Cypress clones responded differently to Ca2+ addition in different soil conditions. In the infertile soil, the addition of 3 g•kg− 1 Ca2+ advanced and prolonged the fast-growing period of seedling height growth, increased plant height and dry biomass, promoted the development of fine roots ≤ 1.5 mm in diameter, and improved accumulation efficiencies of nitrogen (N), phosphorous (P) and Ca by the roots in cypress clones; however, the addition of 6 g•kg− 1 Ca2+ inhibited height growth and root development of cypress. In the fertile soil, Ca2+ addition delayed and shortened the fast-growing period for cypress height growth, but plant height and dry biomass did not differ significantly between treatments; Ca2+ addition also inhibited the development of fine roots. The clone with fast height growth had a larger proportion of roots with a diameter ≤ 1.5 mm and achieved higher N accumulation efficiency, while Ca accumulation efficiency showed genotypic differences only in the fertile soil.
Conclusions:
An appropriate level of Ca2+ can be added to infertile soil to promote cypress seedling growth, and clones with fast height growth and developed fine roots can be selected for cultivation and promotion in the fertile soil without Ca2+ application.
Effect of mesenchymal stem cells combined with chondroitin sulfate in osteoarthritis
Authors: Pérez-Castrillo Saúl , González-Fernández María Luisa , Álvarez-Suárez Jessica , Sánchez-Lázaro Jaime , Esteban-Blanco Marta , Gutiérrez-Velasco Laura , González-Cubero Elsa , VILLAR-SUÁREZ VEGA
Published: April 2020

Introduction: Osteoarthritis (OA) is a degenerative joint disease affecting the whole joint structure. Many authors have focused on the factors responsible for the development of inflammatory processes involved in OA. Adipose tissue-derived mesenchymal stem cells (ASCs) represent a promising alternative of cell-based therapy strategy in the treatment of OA which could be combined with any drugs. Chondroitin sulfate plays a protective role in the joint based on the decrease of pro-inflammatory cytokines, thus having an important role in the activation and inhibition of metabolic pathways in chondrocytes.Aims: In this study, the effectiveness of chondroitin sulfate and ASCs in the treatment of knee OA have also been evaluated.Materials: Cytokines and factors which are involved in OA as well as specific cartilage gene expression after adding ASCs and chondroitin sulfate have been discussed in detail.Results: Our results show a decrease in the expression of all genes related to the pro-inflammatory cytokines analysed. Although there was no increase in the expression of the specific genes of the cartilage matrix, such as collagen type II and aggrecan.Conclusions: This study show the effectiveness of association of ASCs and chondroitin sulfate for the treatment of OA.
PLAC8 promotes adriamycin resistance via blocking autophagy in breast cancer
Authors: chen yongxia , jia yunlu , mao misha , Gu Yifeng , Xu Chenpu , Yang Jingjing , Hu Wenxian , Shen Jun , Hu Dengdi , Chen Cong , Li Zhaoqing , Chen Lini , Ruan Jian , Shen Peng , zhou jichun , wei qun , wang linbo
Published: April 2020

Background
Adriamycin (ADM) is currently one of the most effective chemotherapeutic agents in breast cancer treatment. However, growing resistance to ADM can lead to treatment failure and poor outcome. The underlying molecular mechanisms in ADM resistance in breast cancer remains unclear. PLAC8 is reported as a novel highly-conserved protein and functions as an oncogene or tumor suppressor in various tumors.
Methods
Here, we analyzed the expression profile of PLAC8 in breast cancer tissues and breast cancer cell lines, and explored the correlation of PLAC8 expression levels with patients’ outcomes and ADM response. One ADM resistant MCF-7 breast cancer cell (MCF-7/ADM) and its parental cell was used as in vitro models to identify the underlying mechanism of PLAC8 and ADM resistance. Breast cancer cells were transfected with PLAC8 knockdown and overexpression vectors, and MTT and colony formation assays were performed to test the cell response to ADM. Then, we tested the effect of PLAC8 on autophagy pathway by flow cytometry and immunofluorescence analysis, and the change of main autophagy-correlated factors expressions: LC3 and p62. Next, combining treatment of autophagy inhibitor/inducer and PLAC8 downregulation/upregulation revealed the participation of PLAC8 in autophagy pathway to synergistically regulate ADM resistance in breast cancer.
Results
Here, higher PLAC8 expression was correlated with poorer outcome and aggressive phenotype in breast cancer, and breast cancer patients with higher PLAC8 expression showed potential ADM resistance. PLAC8 expression level was also significantly elevated in ADM resistant MCF-7 breast cancer cells (MCF-7/ADM), compared to parental MCF-7 cells. In vitro experiments further confirmed that PLAC8 inhibition by siRNA or enforced overexpression by infecting pcDNA3.1(C)-PLAC8 plasmid correspondingly decreased or increased the ADM resistance. Subsequently, we demonstrated that ectopic PLAC8 expression in MCF-7/ADM cell blocked the accumulation of the autophagy-associated protein LC3II, and resulted in cellular accumulation of p62. Rapamycin-triggered autophagy significantly increased cell response to ADM, while the autophagy inhibitor 3-MA enhanced ADM resistance. Actually, 3-MA and PLAC8 could synergistically enhance ADM resistance via blocking the autophagy process. Additionally, the downregulation of p62 by siRNA attenuated the activation of autophagy and PLAC8 expression in breast cancer cells.
Conclusion
Our findings suggest that PLAC8, through participation of p62, inhibits autophagy and consequently results in ADM resistance in breast cancer. PLAC8/p62/autophagy pathway may act as novel therapeutic targets in breast cancer treatment and has potential clinical application in overcoming ADM resistance.
Comparative clinical characteristics among different age group of adult COVID-19 Patients
Authors: Peng Yating , Zhou Aiyuan , Liao Xin , Deng Dingding , Huang Peng , Liu Wenlong , Jiang Mingyan , Xiang Xudong , Shuang Qingcui , Cai Shan , Chen Ping , Liao Xucai
Published: April 2020

Introduction: Coronavirus disease (COVID-19) is a global infectious disease with a large burden of illness and high healthcare costs.Objectives: This study aimed to compare clinical features among adult COVID-19 patients in different age groups.Methods: Laboratory-confirmed adult COVID-19 infection cases between Dec 31, 2019 to March 8, 2020 obtained from Neighboring Cities. Patients were divided into five age groups: age＜30, 30-40, 40-50, 50-65, ≥65 y (elderly). Age, sex, history of chronic disease and epidemiology, symptoms, laboratory tests, and outcomes were compared among different age groups. Binary logistic regression analysis was conducted to evaluate associated factors for severe or critical type.Results: We studied 299 cases. Median (IQR) age was 44 (34,54) and 158 (53%) were male. Percent of bilateral involvement on chest radiographs was increased significantly with older age (p = 0.005). 53.3% of 30-40 years, 50% of 40-50 years, 36.6% of ＜30 years and 36.2% of 50-60 years were imported case, none of the elderly were imported case. Among all the observed symptoms, only symptom of dyspnea was significantly different between the elderly group and other groups (p < 0.001). Proportion of severe or critical type was 2.4%, 5.3%, 9.5%, 14.5%, and 35% in patients with age＜30, 30-40, 40-50, 50-65, ≥65 (p < 0.001), respectively. At this point, ICU admission rate, ARDS and shock rate and on medical treatment rate was increased especially in patients ≥65 years. 285 patients (95.3%) were cured and discharged, 12 patients (4.0%) were still on medical treatment in hospital. There were 2 (0.67%) deaths; these occurred among persons ≥65 y (p < 0.001). Old age, high HR on admission, high respiratory rate on admission, and history of chronic heart disease were independently associated with severe or critical .Conclusions: Proportion of severe or critical type increased with old age groups. Adults with old age and high HR, R rate in admission and history of chronic heart disease were associated with severe or critical type in COVID-19.
Rate and Neonatal Outcomes Among Instrument Assisted Vaginal Birth in 12 Public Hospitals in Nepal
Authors: Thakur Nishant , Sunny Avinash K , Gurung Rejina , Basnet Omkar , Litorp Helena , KC Ashish
Published: April 2020

Background Instrument assisted vaginal birth (IVB) is an effective intervention for deliveries complicated by prolonged labour or fetal distress, but its use is declining in many low-resource settings. In this paper, we examined intra-hospital rates of IVB, factors associated, and neonatal outcomes after IVB in Nepal. Methods This is a prospective cohort study of all deliveries conducted in 12 public hospitals (4 high volume, 4 medium volume and 4 low volume) across Nepal for 18 months . We calculated the rate of IVB and used logistic regression to assess the association between IVB and neonatal morbidity (Apgar score < 7 at 5 minutes, shoulder dystocia) and mortality. Results A total of 81,581 deliveries were included in the study, of which 3001 (3.4%) were IVBs., while rates in high volume, medium volume, and small volume hospitals were 3.6%, 3.7% and 1.2% respectively. The odds of Apgar score < 7 at 5 minutes was almost three-fold (aOR 2.92, 95% CI, 2.49-3.42) with IVB compared to spontaneous vaginal birth (SVB). The odds of shoulder dystocia was three-fold (aOR 3.04, 95% CI, 2.19-4.22) with IVB compared to SVB. The odds of first day mortality was lower in medium volume (aOR-0.57, 95% CI, 0.42-0.78) hospitals compared to high volume hospitals. Conclusions The rate of IVB varied by volume of hospital. The neonatal outcome were poor among the babies born to IVB, and neonatal outcomes were worse after IVB at high-volume hospitals. Further studies to explore factors determining the rate of IVB and better neonatal outcomes.
Impact of health literacy and self-care behaviors on health-related quality of life in Iranians with type 2 diabetes: a cross-sectional study
Authors: Gaffari-fam Saber , Lotfi Yosef , Daemi Amin , Babazadeh Towhid , Sarbazi Ehsan , Abbasabad Ghader Darghahi , Abri Hamed
Published: April 2020

Background
Regarding the importance of health literacy as a key factor in self-care, appropriate understanding of health information by patients with type 2 diabetes mellitus (T2DM) is fundamental for better management of risk factors, which can also benefit their quality of life. This study aimed to describe the relationship between health literacy (HL), and self-care behaviors with health-related quality of life (HRQL) in patients with T2DM.
Methods
A cross-sectional survey was done in Iran in 2019. Patients were recruited randomly from health centers by medical records (n = 192, 55.2% male, mean age 58.12 years). The data collection included demographic form, health literacy questionnaire, diabetes self-care behavior questionnaire, and world health organization’s Quality of Life-BREF (WHOQOL-BREF). Analyses were adjusted for confounders using hierarchical regression analysis.
Results
HL as predictor variables explained 47.5% of variance in overall HRQL (p-value < 0.001), reading health information was the strongest HL dimension (β = 0.478). Self-care behaviors explained an additional 13.6% of the HRQL variance. In total, 65.5% of the variation in the HRQL is explained by the HL, self-care behavior, and the demographic variables.
Conclusions
We found that more almost two-third of the HRQL explained by the HL and self-care behaviors. Given the importance of health literacy and self-care behaviors in the quality of life in patients with T2DM, adoption of health-promoting behaviors and increasing health literacy can be beneficial for promoting quality of life among these patients.
Stigmasterol Sensitizes Endometrial Cancer Cells to Chemotherapy By repressing Nrf2 Signal Pathway
Authors: Liao Hong , Bai Mingzhu , Zhu Dan , Chen Huifen , Yan Shihuan , Yu Jing , Zhu Huiting , Zheng Wenxin , Fan Guorong
Published: April 2020

Background: Chemoresistance reduces the 5-year survival rate of endometrial cancer patient, which is the current major obstacle for cancer therapy. Increasing evidence state that Nrf2 contributes to chemoresistance in several kinds of cancer. However, its role in endometrial cancer cells need further study.Methods: Immunohistochemistry was used to detect the expression of Nrf2 in healthy patient and endometrial cancer patient. Nrf2 overexpressed stable transfection cell line was established to evaluated its role in chemoresistance. Dot blot assays were used to assess global hydroxymethylation levels after stigmasterol treatment. Cellular growth activation was detected by CCK8 assay. Western blot was used to evaluate the changes of the target molecules after various treatments.Results: Nrf2 is overexpressed in endometrial cancer tissues compared with the normal endometrium. Overexpression of Nrf2 resulted in decrease sensitivity to cisplatin. In addition, a novel Nrf2 inhibitor, stigmasterol, has been identified, which enhanced the sensitivity to cisplatin, and the mechanism is that stigmasterol declines the Nrf2 protein level.Conclusions: Our data identify stigmasterol as a novel potential inhibitor of Nrf2 and highlight a critical role of stigmasterol in inhibiting chemoresistance in cisplatin combination therapy.
Exploring the Feasibility of using a four-day Training Program to Change the Culture of Disrespect and Abuse in Maternity Care in Ghana
Authors: Dzomeku Millicent Veronica , Mensah Adwoa Bemah Boamah , Nakua Emmanuel Kweku , Lomotey Alberta , Agbadi Pascal , Donkor Peter , Lori Jody R.
Published: April 2020

Objectives To improve childbirth experiences for childbearing women in healthcare facilities in low-and-middle-income countries, it is important to implement a cost-effective intervention to change the culture of disrespect and abuse in maternity care. Thus, we explored the feasibility of using four Respectful Maternity Care Modules in a training program to change the culture of disrespect and abuse in maternity care in a teaching hospital in Kumasi, Ghana.Results Midwives were trained on respect and dignity in childbirth, effective communication, focused antenatal care, and the use of alternative birthing positions for delivery. The statistical test revealed a statistically significant increase in knowledge of RMC following participation in the RMC-M training, z = − 3.43, p = 0.001, with a large effect size (r = 0.63). The median score on the self-developed Respectful Maternity Care Questionnaire increased from pre-program (Md = 10) to post-program (Md = 15). The experts remarked that the content of the training was adequate to enhance midwives’ knowledge, skills, and attitude to provide respectful maternal care. They recommended the inclusion of teaching methods that engages the adult learner in an interactive mode.
Combustion synthesis of NiAl/TiC composite from mechanically activated elemental powders
Authors: Mehrizi Majid Zarezadeh
Published: April 2020

The aim of this study was the synthesis of a homogenous distributed NiAl/TiC composite by combustion synthesis of elemental powders. The effect of the mechanical activation process was evaluated. The phase characterization and evaluation of the microstructure during milling and combustion synthesis were carried on by XRD and SEM-EDS and TEM-EDS, respectively. The XRD result of as-mixed powder compact after combustion synthesis showed that in addition to TiC0.75 and NiAl, some undesired phases like Ni3Al and Ni2Al­3 formed. While after combustion synthesis of 3h mechanically activated powder compact, only AlNi and TiC formed. The microstructural evaluations by SEM-EDS and TEM-EDS analysis confirmed the synthesis of truly homogenized NiAl/TiC composite. The mechanism of NiAl/TiC formation consists of dissolution of nickel, titanium, and graphite in molten aluminum and precipitation of TiC primarily and then the formation of NiAl. The value of microhardness of synthesized NiAl/TiC was 1070±12 HV. The main reason for this result is a uniform distribution of spherical TiC reinforcement in the NiAl matrix. Therefore, the mechanical activation process facilitated the reactions and improved the mechanical properties of the final composite.
Effect of octahedron tilt on structure and magnetic properties of bismuth ferrite
Authors: Hong Yang , Li Jun , Bai Han , Song Zhenjia , Wang Ming , Zhou Zhongxiang
Published: April 2020

Multiferroic trivalent ions doped BiFeO3 ceramics were synthesized using the rapid liquid state method. The trivalent ions (Sm3+, Gd3+, Y3+) doping causes structural distortion without changing the rhombohedral structure. Raman analysis shows that the effect of doping on E modes is greater than A1 modes, and FeO6 octahedron is regulated by ions doping. M-H hysteresis loops show A-site trivalent ions doped samples exhibit improved magnetism compared with pure BiFeO3 since the suppressed spiral spin structure. Doped samples exhibited natural resonance around 16~17 GHz due to the changes in dielectric loss caused by the tilt of the FeO6 octahedron.
Targeting fibroblast activation protein (FAP): Next generation PET radiotracers using squaramide coupled bifunctional DOTA and DATA5m chelators
Authors: Moon Euy Sung , Elvas Filipe , Vliegen Gwendolyn , De Lombaerde Stef , Vangestel Christel , De Bruycker Sven , Bracke An , Eppard Elisabeth , Greifenstein Lukas , Klasen Benedikt , Kramer Vasko , Staelens Steven , De Meester Ingrid , Veken Pieter Van der , Roesch Frank
Published: April 2020

Background
Fibroblast activation protein (FAP) is a proline selective serine protease that is overexpressed in tumor stroma and in lesions of many other diseases that are characterized by tissue remodeling. In 2014, a most potent FAP-inhibitor (referred to as UAMC1110) with low nanomolar FAP-affinity and high selectivity toward related enzymes such as prolyl oligopeptidase (PREP) and the dipeptidyl-peptidases (DPPs): DPP4, DPP8/9 and DPP2 were developed. This inhibitor has been adopted recently by other groups to create radiopharmaceuticals by coupling bifunctional chelator-linker systems. Here, we report squaric acid containing bifunctional DATA5m and DOTA chelators relied on UAMC1110.
Results
The radiopharmaceuticals DOTA.SA.FAPi and DATA5m.SA.FAPi were synthesized, labeled with gallium-68 and further characterized for in vitro stability, inhibitory efficiency, in vivo targeting properties and ex vivo biodistribution. [68Ga]Ga-DOTA.SA.FAPi and [68Ga]Ga-DATA5m.SA.FAPi showed high complexation after already 10 minutes and high stability over a period of 2 h. Affinity to FAP of DOTA.SA.FAPi and its natGa and natLu-labeled derivatives were in low nanomolar range. Comparable results were obtained for DATA5m.SA.FAPi and its natGa analogue. Additionally, all five compounds showed low affinity for the related protease PREP (high µM range). First proof-of-principle in vivo PET-imaging animal studies of the [68Ga]Ga-DOTA.SA.FAPi precursor in a HT-29 human colorectal cancer xenograft mouse model indicated promising results with high accumulation in tumor and low background signal. Ex vivo biodistribution showed high tumor uptake at 60 min post injection with overall low uptake in healthy tissues.
Conclusion
In this work, novel PET radiotracers targeting fibroblast activation protein (FAP) were synthesized and biochemically investigated. Critical substructures of the novel compounds are a squaramide linker unit derived from the basic motif of squaric acid, DOTA and DATA5m bifunctional chelators and a FAP-targeting moiety. In conclusion, these new FAP-ligands appear promising, both for further research and development as well as for first human application.
miR-20b-5p Functions as Tumor Suppressor microRNA by targeting CyclinD1 in Colon Cancer
Authors: Yang Hui , Lin Jian , Jiang Jinling , Ji Jun , Wang Chao , ZHANG JUN
Published: April 2020

Background
MicroRNA functions as an oncogenic regulator or tumor suppressor in various human tumors. Bioinformatics analysis revealed that miRNA-20b is related to the tumorigenesis, however, the function of miRNA-20b in colon cancer is still not clear.
Methods
Apoptosis, cell cycle, expression of CCND1/CDK/FOXM1 axis in HCT116 cells were examined by flow cytometry, western blot, and Immunohistochemistry. Wound-healing migration assay and transwell assay were performed to test the migration and invasion of tumor cells. Bioinformatics and microarray analysis was performed for further mechanical research. Subcutaneous xenograft mouse models was to verify the function of miR-20b-5p in vivo.
Results
We found that miRNA-20b-5p inhibited the cell cycle, migration and invasion of CC cells, but had no effect on cell apoptosis. CyclinD1(CCND1) was identified as a direct target of miR-20b-5p. Overexpression of miRNA-20b-5p downregulated CCND1 level in HCT-116 cells. Mechanistically, the inhibiton of cell cycle, migration and invasion of CC cells by miRNA-20b-5p is through regulating the CCND1/CDK4/FOXM1 axis. Additionally, we found that miRNA-20b-5p could inhibit the tumorigenesis in murine CC xenograft models in Balb/c nude mice.
Conclusion
Therefore, our findings demonstrated that miR-20b-5p may serve as a tumor suppressor in CC by negatively regulating CCND1 and that miR-20b-5p may be a potential therapeutic target for the management and treatment of colon cancer.