bluuebunny/crossref_metadata_2025 huggingface dataset:
Multiple Transplantation of Mesenchymal Stem Cells in an Active Progressive Multiple Sclerosis Patient: Long Term Therapeutic Outcomes.
Authors: Liu Shijie , Mao Xihong , Hou Zongliu , Wei Huan , Gao Hui , Liu Ying , Xie Yanhua , Tang Weiwei , He Shan , Zhao Yiyi , Wang Wenju , Li Lin , Wang Xiaodan , Meng Mingyao
Published: January 2021

Background: Multiple sclerosis (MS) is one of the most common idiopathic inflammatory demyelinating disease. One of the challenges in the treatment of MS is how to overcome relapses without severe adverse effects. Due to their immunoregulatory properties and safety, mesenchymal stem cells (MSCs), present a potential alternative for treatment for MS. Objectives: The efficacy and safety of a long-term MSCs therapy in MS remain to be established. In this communication, we report the clinical condition and disease progression of an MS patient treated for 11 years, with multiple infusions of MSCs derived from either his bone marrow (BM), pooled human umbilical cords (UC), or from his own child umbilical cord. Methods: A male patient diagnosed as progressive MS (EDSS score 3) was enrolled into our study and received 1×106 cells/kg of MSCs, at least once a year for 9 years. Results: The MSCs treatment was well tolerated with no significant side effects. Following the transplantation of MSCs, the overall EDSS scores of the patient decreased over the 10 years period of observation. MRI investigation did not reveal any new lesions. However, upon the cessation of the MSCs treatment, the EDSS score increased from 1.0 to 3.5, further supporting the notion that in such a patient, the transplantation of MSCs, had a significant beneficial effect. Conclusions: This case study is the first to report on the beneficial effects of multiple infusions of BM- and UC-MSCs in a progressive MS patient, over a period of 11 years, in absence of any other treatments. Hence, multiple infusions of MSCs may provide a novel therapeutic avenue for patients with aggressive MS.
Effects of Exotic Plantation Expansion and Management Intervention on Woody Plant Species Diversity, Regeneration and Soil Seed Bank in Tarmaber District, Ethiopia
Authors: Nigussie Melese Bekele , Assefa Dessie Assefa , Gebremariam Yohannis Gebremariam
Published: January 2021

This study was carried out in Tarmaber district north shewa zone Ethiopia to determine the effect of plantation forest with management intervention on woody plant species diversity, regeneration and soil seed bank species composition in five different forest types, which are adjacent natural forest, managed Cupressus lusitanica, unmanaged C. lusitanica, managed Eucalyptus globules and not managed E. globules plantation forests. A total of 75 circular sample plots of 314 m2 were established along a transect lines. Soil seed bank analysis was done from soil samples collected in each of the plots (225 samples) to examine the similarity between the soil seed bank and aboveground flora. Different diversity index and ANOVA was used in SPSS software for analysis. The result showed that a total of 51 woody plant species was recorded in adjacent natural forest (41), managed C. lusitanica (27), not managed C. lusitanica (9), managed E. globules (22) and not managed E. globules (13) species. Regeneration of seedlings were 3538, 5567, 707, 1462 and 2524 mean stems ha− 1 for natural forest, managed C. lusitanica, not managed C. lusitanica, managed E. globules and not managed E. globules respectively. Unmanaged C. lusitanica plantations had significantly lower densities of mature tree stems ha− 1 as compared to managed C. lusitanica, managed E. globules and adjacent natural forest (F = 14.03, p < 0.05).Similarly in terms of sapling density ha− 1 unmanaged C. lusitanica was significantly lower from other forest types (F = 7.37, p < 0.05). However managed C. lusitanica had significantly higher seedling regeneration (stem density ha− 1) than other plantation and adjacent natural forests (F = 16.11, p < 0.05). Generally mean stem densities including tree, sapling and seedling of woody species among different forest types managed C. lusitanica was significantly higher among different forest types (F = 13.01, p < 0.05). From the soil seed bank a total of 22 plant species (20 native and 2 exotic) species were recovered. In different forest types the number of species recorded was in adjacent natural forest (19), managed C. lusitanica (11), unmanaged C. lusitanica (4), managed E. globules (7) and unmanaged E. globules (5). The similarity of the oil seed bank was more or less similar to the above ground flora with maximum Sorenson’s similarity values of 0.633. Generally with appropriate management intervention undergrowth vegetation and soil seed bank status in plantation forest had good species composition and diversity.
Stresses and consequences among physicians of Bangladesh during COVID-19 pandemic: an assessment of experience and perception.
Authors: Parveen Mosammat Kohinoor , Hannan Md Jafrul , Hasan Md Samiul , Chowdhury Tanvir Kabir , Afroz Rokhsana Dil , Ferdoush Jannatul , Hoque Md Mozammel , Nandy Alak
Published: January 2021

Background: Health providers working in non-COVID hospitals in Bangladesh may be at an increased risk of infection with the new coronavirus, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) compared to health providers working in COVID-dedicated hospitals due to lower health security measures. Consequently, health practitioners working at such hospitals may be the most vulnerable health group to stress-related problems and mental illness. To our knowledge, there is no study assessing stress-related problems in this particular population and how this group compares to those working in COVID-dedicated units in terms of pandemic-related stress.Methods: An online survey was carried out among 247 medical doctors from Bangladesh (101 females and 146 males). We report descriptive statistics and several group comparisons.Results: The overall stress level among participants was moderated. There were no statistically significant differences in pandemic-related stress between those working in COVID units and those working in regular units. Most participants knew both co-workers and people close to them who had tested positive for SARS-CoV-2. Half of the participants knew someone close to them who had died from COVID-19and 24.7% had got infected themselves.Conclusions: Medical doctors working in Bangladesh experience significant pandemic-related stress regardless of whether they work in COVID-dedicated units or regular units. Our data highlights the importance of detecting stress in health professionals and developing strategies that aim at reducing the same.
Effectiveness of message framing to improve oral health behaviors and dental plaque among pregnant women: a randomized field trial
Authors: Divdar Masoumeh , Araban Marzieh , Heydarabadi Akbar Babaei , Cheraghian Bahman
Published: January 2021

Background: Oral health is considered as a prominent factor that contribute to quality of life. Hormonal changes during pregnancy can influence oral health. Message framing can play an important role in motivating oral health behaviors. The aim of the present study was to investigate the effect of message framing on the oral health behaviors and dental plaque among pregnant women.Methods: This randomized field trial was conducted in 2017 on 108 pregnant women in Izeh county, Iran.The participants were randomly divided into three groups; gain-framed, loss-framed, and control group. The research instrument included a two parts questionnaire containing demographic information and oral health knowledge, attitude, behavioral intention, self-efficacy, practice, and dental plaque index. Gain-and loss-framed messages were sent to the intervention groups via cell phones, but the control group did not receive any messages. The participants’ dental plaque were clinically assessed. Data were analyzed using SPSS version, 23.0. P-value less than 0.05 was considered statistically significant.Results: The mean scores of knowledge, attitude, behavioral intention, and self-efficacy were significantly increased in the gain- and loss-framed intervention groups (gain knowledge (6.05±1.90; CI:5.40-6.71); gain attitude(5.00±3.61; CI:3.75-6.24); gain behavioral intention (2.91±1.59; CI:2.36-3.46); gain self-efficacy (4.42±2.69; CI:3.50-5.35); loss knowledge (5.71±1.52; CI:5.19-6.23); loss attitude (4.54±2.67; CI:3.62-5.46); loss behavioral intention (2.25±1.94; CI:1.58-2.92); loss self-efficacy (3.97±2.60; CI:3.07-4.86) (p<0.001). No significant difference was observed in the control group (knowledge (0.38±1.45; CI:0.12-0.89, p=0.135); attitude (0.88±3.63; CI:0.38-2.14, p= 0.166); behavioral intention (-0.38±1.74; CI: -0.98-0.22, p=0.2); self-efficacy (.0.50±3.23; CI: -1.62-0.62, p=0.37). The rising trend in the mean score of the behaviors in the intervention groups was significantly higher than that in the control group (p<0.001). The ratio of dental plaque on teeth surfaces in the gain- and loss-framed intervention groups also showed a significant decrease compared to control group (gain dental plaque (16.46±11.66; CI:12.46-20.47, p<0.001); loss dental plaque (15.06±8.52; CI:12.13-17.99, p<0.001). Conclusion: Text message intervention improved knowledge, attitude, behavioral intention, self-efficacy, and dental plaque among pregnant women. The results show that text messages mattered, but the framing did not"; because there was a difference between intervention and control groups but not that "message framing matters" because the particular framing of the messages had no pronounced effect.
Community-based intervention for cervical cancer screening uptake in a semi-urban area of Pokhara Metropolitan, Nepal (COBIN-C): Study protocol for a cluster-randomized controlled trial
Authors: Shrestha Aamod Dhoj , Neupane Dinesh , Ghimire Sarita , Campbell Christine , Kallestrup Per
Published: January 2021

Background: Previous studies suggest that health intervention designed to increase cervical cancer screening has been effective to reduce cervical cancer incidence and mortality. The aim of this study is to determine the effect of a home-based health education intervention for increasing cervical cancer screening uptake delivered by trained Female Community Health Volunteers (FCHVs), a category of community health worker in Nepal. Methods: A community-based, open-label, two-armed, cluster-randomized trial [seven clusters (geographical wards) randomized for the intervention, and seven for the control arm]. The participants are recruited from a population-based survey with a sample size of 884. Based on population proportion size, 277 women will be recruited for the intervention group and 413 women recruited for the control group. A 12-month community-based health education intervention will be administered mobilizing the FCHVs, based on the Health Belief Model. The primary outcome measure of the study will be the difference in percentage of cervical cancer screening uptake between the two study arms. The primary outcomes will be modelled by using mixed-effect logistic regression analysis.Discussion: COBIN-C is the first study investigating the effect of a community-based health education intervention by FCHVs on increasing cervical cancer screening uptake among women in Nepal. The purpose of this study is to develop and implement a home-based, culturally sensitive program to increase cervical cancer screening coverage at the community level. Trial registration: ClinicalTrials.gov NCT03808064. Registered on January 14, 2019. (https://clinicaltrials.gov/ct2/show/NCT03808064).
Genome-Wide Identification and Analysis of Class III Peroxidases in Betula pendula
Authors: Cai Kewei , Liu Huixin , Chen Song , Liu Yi , Zhao Xiyang , Chen Su
Published: January 2021

Background: Class III peroxidases (POD) proteins are widely present in the plant kingdom that are involved in a broad range of physiological processes including stress responses and lignin polymerization throughout the plant life cycle. However, little is known about the POD genes in Betula pendula, although it has been characterized in Arabidopsis, rice, poplar, maize and Chinese pear. The POD genes remain to be determined in Betula pendula.Results: A total of 90 nonredundant POD genes were identified in Betula pendula. (designated BpPODs). These POD genes were divided into twelve groups based on their phylogenetic relationships. The BpPODs are unevenly distributed on the 14 chromosomes. In addition, some BpPODs were located sequentially in tandem on chromosomes, inferred that tandem duplication contributes to the expansion of the POD gene family in Betula pendula. Analysis of the distribution of conserved domains of BpPOD proteins showed that all these proteins contain highly conserved motifs. We also investigated their expression patterns in different tissues, the results show that some BpPODs might play significant roles in root, xylem, leaf and flower. Furthermore, under low temperature conditions, some BpPODs showed different expression patterns at different times. Conclusions: Comprehensive study of the POD genes suggests that their functional diversity during Betula pendula growth and development. Our findings provide a basis for further functional analysis on POD gene family in Betula pendula.
Age-related Changes of Microbiota in Midlife Associated with Reduced Saccharolytic Potential: An In Vitro Study
Authors: Chen Junkui , Pi Xionge , Liu Wei , Ding Qunfang , Wang Xin , Jia Weiguo , Zhu Liying
Published: January 2021

Background: Gut microbiota is critical in maintaining human health, of which diversity and abundance are subject to significantly reduce in seniors. Gut microbiota is reported to be stable across the long adulthood in general, but lack of careful examination, especially for the midlife people. Results: To characterize the gut microbiota in midlife, we investigated the faecal microbiota between two groups of healthy people, young, 20-39 years old, n=15; and midlife, 40-60 years old, n=15. Metabolic responses of the microbiota were studied through in vitro batch fermentation model. Although no difference was observed in the diversity indices between the two age groups, a wide range taxonomic changes were found in the faecal microbiota. Furthermore, substantial Bifidobacterium reduction was also found in both faecal and fermented samples. The faecal SCFAs are similar in both groups，as well as starch fermentation broth. However, after inulin fermentation, the acetate concentration and inulin degradation rate decreased while the gas production increased in midlife group, suggesting a deficiency of saccharolytic potential in midlife, especially for non-digestible carbohydrate. Conclusions: Our data demonstrate that gut microbiota begin to change as early as in midlife. The reduction in Bifidobacterium dominates the change of the microbiota composition in midlife resulting in attenuated saccharolytic capacity of inulin, leading to insufficient acetate production which might be associated with healthy problems in this transition period from young to elderly.
A comparison of diagnostic algorithms and clinical parameters to diagnose ventilator-associated pneumonia: A prospective observational study
Authors: Rahimibashar Farshid , Miller Andrew Carl , Yaghoobi Mojtaba H. , Vahedian-Azimi Amir
Published: January 2021

BACKGROUND: Suspicion and clinical criteria continue to serve as the foundation for ventilator-associated pneumonia (VAP) diagnosis, however the criteria used to diagnose VAP vary widely. Data from head-to-head comparisons of clinical diagnostic algorithms is lacking, thus a prospective observational study was performed to determine the performance characteristics of the Johanson criteria, Clinical Pulmonary Infection Score (CPIS), and Centers for Disease Control and Prevention’s National Healthcare Safety Network (CDC/NHSN) criteria as compared to Hospital in Europe Link for Infection Control through Surveillance (HELICS) reference standard. METHODS: A prospective observational cohort study was performed in three mixed medical-surgical ICUs from one academic medical center from 1 October 2016 to 30 April 2018. VAP diagnostic criteria were applied to each patient including CDC/NHSN, CPIS, HELICS and Johanson criteria. Tracheal aspirate cultures (TAC) and serum procalcitonin values were obtained for each patient. RESULTS: Eighty-five patients were enrolled (VAP 44, controls 41). Using HELICS as the reference standard, the respective true positive rate (TPR; sensitivity), true negative rate (TNR; specificity), false positive rate (FPR; fall-out) and false negative rate (FNR; miss-rate) for each of the assessed diagnostic algorithms were: CDC/NHSN (Sensitivity 54.2%; Specificity 100%; FPR 95%; FNR 0%), CPIS (Sensitivity 68.75%; Specificity 95.23%; FPR 50%, FNR 2%), Johanson (Sensitivity 67.69%; Specificity 95%; FPR 52.5%, FNR 2%). The positive TAC rate was 81.2%. The sensitivity for positive TAC with the serum procalcitonin level >0.5 ng/ml was 51.8%. CONCLUSION: VAP remains a considerable source of morbidity and mortality in modern ICUs. The optimal diagnostic method remains unclear. Using HELICS criteria as the reference standard, CPIS had the greatest comparative diagnostic accuracy, whereas the sensitivity of the CDC/NHSN was only marginally better than a positive TAC plus serum procalcitonin >0.5 ng/ml. Algorithm accuracy was improved by adding serum procalcitonin >0.5 ng/ml, but not positive quantitative TAC.
Study on pure oxygen exhaust gas combustion: key technology of CO2 capture for high temperature fuel cell with coal syngas
Authors: Wang Hanlin , Lei Qilong , Li Pingping , Liu Changlei , Xue Yunpeng , Zhang Xuewei , Li Chufu , Yang Zhibin
Published: January 2021

IGFC based on high temperature SOFC coupled with CO2 capture process provides a new technology route of high efficiency and nearly zero CO2 emission power system. Flame burning is an ideal method for tail gas treatment. In this paper, an oxy-combustor for a gross 10kW IGFC system anode exhaust gas is experimentally and numerically studied. Simulation method is verified by experiments. Key performances of the combustor are studied under different system process design conditions. 315K might be an ideal condensation temperature before burning for flame stability. CO could be almost fully converted under flame burning condition.CO2 concentration after burning is over 0.958 when excess O2 is less than 5%. Overall, 5% excess O2 could be recommended for CO2 gathering and environmental consideration. An optimal tangential angle exists around 25°for liner temperature controlling. Total fuel utilization percent had better be high enough to make oxygen flame temperature of anode exhaust gas lower than 1800K to make systems environment friendly. The results would be of great value to IGFC and CO2 capture combined system designing.
The clinical efficacy of arthroscopic therapy with knee infrapatellar fat pad cell concentrates in treating knee cartilage lesion: A Prospective, Randomized and Controlled Study
Authors: Zhou Yiqin , Li Haobo , Xiang Dong , Shao Jiahua , Fu Qiwei , Han Yaguang , Zhu Jun , Chen Yi , Qian Qirong
Published: January 2021

Background: To evaluate the clinical efficacy of arthroscopic therapy with infrapatellar fat pad cell concentrates in treating knee cartilage lesions, we conducted a prospective randomized single-blind clinical study of controlled method.Methods: 60 cases from Shanghai Changzheng Hospital during April 2018 to December 2019 were chosen and randomly divided into 2 groups equally. Patients in the experiment group were treated through knee arthroscopy with knee infrapatellar fat pad cell concentrates containing mesenchymal stromal cells, while patients in the control group were treated through regular knee arthroscopic therapy. VAS and WOMAC scores were assessed at pre-operation, and 6-weeks, 12-weeks, 6-months, and 12-months after intervention. MORCART scores were assessed at pre-operation and 12-months after intervention.Results: 29 cases in the experiment group and 28 cases in the control group were followed up. No significant difference in VAS, WOMAC, and MOCART scores were found between the two groups before surgery (P>0.05). The WOMAC-Total and WOMAC-Function scores of experiment group were significantly lower than those of control group 6 months, 12 months after surgery (P<0.05). The VAS-Rest and VAS-Motion scores of experiment group were found significantly lower than those of control group 12 months after surgery (P<0.05). The MOCART scores of experiment group were found significant higher compared with control group 12 months after surgery (P<0.05). No significant difference in WOMAC-Stiffness scores were found between the two groups. Conclusions: The short-term results of our study are encouraging and demonstrate that knee arthroscopy with infrapatellar fat pad cell concentrates containing mesenchymal stromal cells is safe, and provides assistance in reducing pain and improving function in patients with knee cartilage lesions.
Knowledge among the rural parents about the vaccinations and vaccination coverage of children in the first year of life in Papua New Guinea – analysis of data provided by Christian Health Services.
Authors: Gowin Ewelina , Kuzma Jerzy , Januszkiewicz-Lewandowska Danuta
Published: January 2021

BackgroundThis analysis aimed to assess rural parents' knowledge about the diseases prevented by vaccinations and establish vaccination coverage in PNG. MethodsKnowledge of vaccinations was checked through a standard questionnaire (five closed questions). We analyzed data on vaccination coverage from 2016 to 2018 from all Catholic health facilities. Analyzed vaccinations were the pentavalent vaccine (DTaP-HiB-HepB) and measles vaccine given in the first year of life. Coverage was calculated based on the number of vaccines used compared to the number of eligible children.Analyzed vaccinations were the pentavalent vaccine (DTaP-HiB-HepB) and measles vaccine given in the first year of life.ResultsFifty-six parents, including 52 mothers and four fathers, participated in the interview. Many parents (46%) understood that the vaccine prevents diseases. During the analyzed period, a total of 25,502 doses of measles vaccine were given, 31,428 children were vaccinated with the pentavalent vaccine. In 2016, the coverage rate for the measles vaccine was 26.6% and 33.4% for the pentavalent vaccine. In 2017, the coverage rate for measles and pentavalent vaccines was 12.5% and 16.6%, respectively. There were significant differences in immunization coverage between provinces. A decreasing trend in the number of administered vaccinations was observed.ConclusionThe results of this analysis demonstrate that in PNG, the majority of children are not fully immunized. There are significant differences in the vaccination coverage between provinces. As protection from diseases is low, there is a very high risk of an outbreak of vaccine-preventable disease in the community.Delivery of vaccinations in PNG encounters many barriers, from access to healthcare services to natural disasters and inter-tribial conflicts.
Comparison of various aspects of women’s lives between infertile and women with and without tubal ligation: a comparative cross-sectional study
Authors: Ashrafi Mahnaz , Sadatmahalleh Shahideh Jahanian , Mirzaei Negin , Jahangiri  , Youseflu Samaneh , Nasiri Malihe
Published: January 2021

Background: The aim of this study is to compare anxiety, depression, body image, self-esteem, sexual function (SF), and quality of life (QoL) between infertile women and women with or without tubal ligation (TL).Methods: This cross-sectional study was conducted on 600 women, distributed equally as infertile women, women with or without TL, who met the inclusion criteria. They were selected from the Royan Institute in Tehran (Iran) and a number of health care centers in Tehran (Iran) from May 2017 to February 2019. The subjects were asked to fill out the Short Form Health Survey (SF-12), Female Sexual Function Index (FSFI), Hospital Anxiety and Depression Scale (HADS), Body Image Concern Inventory (BICI), and Rosenberg’ Self-Esteem Scale (RSES). One-way ANOVA was used to find the statistical differences between the three groups.Results: Mean scores of all FSFI domains were found to be lower in the TL women and the differences between the three groups were statistically significant in all domains. Women with TL had more female sexual dysfunction (FSD) (22.43±5.30 vs 24.79±4.74 vs 28.03±3.29, P˂0.001). There was a significant difference between the three groups in SF-12 scores (76.59±13.14 vs 68.49±14.47 vs 78.87±12.62, P˂0.001). Also, there was a significant difference between the three groups in anxiety, depression, and total scores HADS (P˂0.001). Infertile women had lower body image (P˂0.05) and self-esteem was lower in the TL group (P˂0.05).Conclusions: Our findings reveal the adverse effects of TL on the anxiety and depression, sexual life, body image, and QoL of women. It is recommended that the awareness and knowledge of health-care professionals regarding the side-effects of TL in the above-mentioned aspects of women’s lives should be increased and discussed with patients.
Risk factors related to acute respiratory distress syndrome and death in patients with COVID-19: a retrospective cohort study in Wuhan, China
Authors: Wang Jing , Wang Lu , Jin Meng , Lu Zequn , Li Yao , Zhang Xu , Yao Zhi , Dong Tianyi , Wang Yanan , Niu Siyuan , Li Qinglin , Liu Cai , Qi Jirong , Tian Jianbo , Wang Ying , Wang Zhihua
Published: January 2021

Background:The COVID-19 pandemic has been considered a great threat to global public health. We aimed to clarify the risk factors associated with the development of acute respiratory distress syndrome (ARDS) and progression from ARDS to death and construct a risk prediction model.Methods:In this single-centered, retrospective, and observational study, 796 COVID-19 patients developed ARDS and 735 COVID-19 patients without ARDS were matched by propensity score at an approximate ratio of 1:1 based on age, sex and comorbidities. Demographic data, symptoms, radiological findings, laboratory examinations, and clinical outcomes were compared between those with or without ARDS. Univariable and multivariable logistic regression models were applied to explore the risk factors for development of ARDS and progression from ARDS to death and establish a comprehensive risk model. Results:Higher SOFA, qSOFA, APACHE II and SIRS scores, elevated inflammatory cytokines, dysregulated multi-organ damage biomarkers, decreased immune cell subsets were associated with higher proportion of death (34.17% vs 1.22%; P<0.001) and increased risk odds of death (OR=57.216, 95%CI=28.373-115.378; P<0.001) in COVID-19 patients with ARDS. In addition to previous reported risk factors related to ARDS development and death, such as neutrophils, IL-6, D-Dimer, leukocytes and platelet, we identified elevated TNF-α (OR=1.146, 95%CI=1.100-1.194; P<0.001), CK-MB (OR=1.350, 95%CI=1.180-1.545; P<0.001), declined ALB (OR=0.834, 95%CI=0.799-0.872; P<0.001), CD8+ T cells (OR=0.983, 95%CI=0.976-0.990; P<0.001) and CD3-CD19+ B cells (OR=0.992, 95%CI=0.988-0.997; P=0.003) as novel risk factors. Most importantly, the predictive accuracy of the combined model integrating four score systems and these risk factors demonstrated highest among all models for the development of ARDS (AUC= 0.904) and the progression from ARDS to death (AUC= 0.959).Conclusion:COVID-19 patients with ARDS were more likely to develop into death. The potential risk factors and the comprehensive prediction model could be helpful to identify patients that are at risk of developing ARDS with poor prognosis at an early stage, which might help physicians to formulate a timely therapeutic strategy.
Burden and consequence of birth defects in Nepal-evidence from prospective cohort study
Authors: Paudel Prajwal , Sunny Avinash K , Gurung Rejina , Gurung Abhishek , Malla Honey , Rana Netra B , KC Nawaraj , Chaudhary Ram Narayan , KC Ashish
Published: January 2021

Background-Every year an estimated 7.9 million babies are born with birth defect. Of these babies, more than 3 million die and 3.2 million have disability. Improving nationwide information on prevalence of birth defect, risk factor and consequence is required for better resource allocation for prevention, management and rehabilitation. In this study, we assess the prevalence of birth defect, associated risk factors and consequences in Nepal.Method-This is a prospective cohort study conducted in 12 hospitals of Nepal for 18 months. All the women who delivered in the hospitals during the study period was enrolled. Independent researchers collected data on the social and demographic information using semi-structured questionnaire at the time of discharge and clinical events and birth outcome information from the clinical case note. Data were analyzed on the prevalence and type of birth defect. Logistic regression was done to assess the risk factor and consequences for birth defect. Results-Among the total 87,242 livebirths, the prevalence of birth defects was found to be 5.8 per 1000 live births. The commonly occurring birth defects were anencephaly (3.95%), cleft lip (2.77%), cleft lip and palate (6.13%), clubfeet (3.95%), eye abnormalities (3.95%) and meningomyelocele (3.36%). The odds of birth defect was higher among mothers with age <20 years (adjusted Odds ratio (aOR) 1.64; 95% CI, 1.18-2.28) and disadvantaged ethnicity (aOR 1.78; 95% CI, 1.46-2.18). The odds of birth asphyxia was twice fold higher among babies with birth defect (aOR 1.88; 95% CI, 1.41-2.51) in reference with babies without birth defect. The odds of neonatal infection was twice fold higher among babies with birth defect (aOR 1.82; 95% CI, 1.12-2.96) in reference with babies without birth defect. Babies with birth defect had three-fold risk of pre-discharge mortality (aOR 3.00; 95% CI, 1.93-4.69). Conclusion- Babies with birth defect have high risk for birth asphyxia, neonatal infection and pre-discharge mortality at birth. Further evaluation on the care provided to babies who have birth defect is warranted.
A nomogram based on combining systemic and hepatic inflammation markers for predicting microscopic bile duct tumour thrombus in hepatocellular carcinoma
Authors: Wu Jun-Yi , Sun Ju-Xian , Wu Jia-Yi , Huang Xiao-Xiao , Bai Yan-Nan , Zeng Yong-Yi , Zhang Zhi-bo , Cheng Shu-Qun , Yan Mao-Lin
Published: January 2021

Background: Bile duct invasion is a relatively rare event and is not well characterised in hepatocellular carcinoma (HCC). It remains very difficult to diagnose HCC with bile duct tumour thrombus (BDTT) before surgery. Increasing evidence has revealed that inflammation plays a critical role in tumorigenesis. This study aimed to develop nomograms based on systemic and hepatic inflammation markers to predict microscopic BDTT (micro-BDTT) before surgery in HCC. Methods: A total of 723 HCC patients who underwent hepatectomy as initial therapy between January 2012 and June 2020 were included in the study. Logistic regression analysis was used to identify independent risk factors for micro-BDTT. The nomograms were constructed using significant predictors, including α-fetoprotein (AFP), alkaline phosphatase (ALP), direct bilirubin (DB), prognostic nutritional index (PNI), and γ-glutamyl transferase (γ-GT)/alanine aminotransferase (ALT). The prediction accuracies of the nomograms were evaluated using the area under the receiver operating characteristic (ROC) curve. Results: AFP, ALP, DB, PNI, and γ-GT/ALT were independent risk factors for predicting micro-BDTT (P=0.036, P=0.004, P=0.013, P=0.012, and P=0.006, respectively), which were assembled into the nomograms. The area under the ROC curve of the nomograms combining PNI and γ-GT/ALT for predicting micro-BDTT was 0.804 (95% confidence interval [CI]: 0.730–0.878). The sensitivity and specificity values when used in predicting micro-BDTT before surgery were 0.739 (95% CI: 0.612–0.866) and 0.781 (95% CI: 0.750–0.813), respectively. Conclusions: The nomogram based on combining systemic and hepatic inflammation markers is suitable for predicting micro-BDTT before surgery in HCC patients, leading to a rational therapeutic choice for HCC.
Current status and related factors of turnover intention of primary medical staff in Anhui Province, China: a cross-sectional study
Authors: Chen Guimei , Sang Lingzhi , Rong Jian , Yan Huosheng , Liu Hongzhang , Cheng Jing , Wang Li , Ding Hong , Chen Ren
Published: January 2021

Background The shortage of primary medical staff is an important issue in the management of health human resources, and it is also a problem that all countries in the world need to face together. Since 2009, China has implemented a new series of medical system reforms and the shortage and loss of primary medical staff have been alleviated accordingly. However, China has a large population and it is difficult to distribute health human resources evenly across regions. This study aimed to explore the current status of turnover intention and its relationship with psychological capital, social support, and job burnout, as well as how these factors influence turnover intention of primary medical staff in Anhui province, China.Methods Using structured questionnaires to collect data, including demographic characteristics, turnover intention, psychological capital, social support, and Chinese Maslach Burnout Inventory scale. A total of 1,152 primary medical workers of Anhui were investigated. Data were analyzed by t-test, analysis of variance (ANOVA), Pearson correlation analysis, and multiple linear regression model.Results Total scores of turnover intention, psychological capital, social support, and job burnout of subjects were 14.15 ± 4.35, 100.09 ± 15.98, 64.93 ± 13.23 and 41.07 ± 9.437, respectively. Multiple linear regression showed the related factors of turnover intention were age, job position, work unit, and scores of job burnout. Pearson correlation showed psychological capital and social support were negatively correlated with turnover intention, while the score of job burnout was positively correlated with turnover intention.Conclusion The improvement of psychological capital and social support and the reduction of job burnout may play an important role in reducing turnover intention of primary medical staff. Primary medical managers should strengthen the humanistic care for primary medical staff, optimize the incentive mechanism, and improve internal management of medical institutions for stability.
Automatic Segmentation of Coronary Lumen and External Elastic Membrane in Intravascular Ultrasound Images Using 8-layer U-Net
Authors: Dong Liang , Lu Wei , Jiang Jun , Zhao Ya , Song Xiangfen , Leng Xiaochang , Zhao Hang , Wang Jian’an , Li Changling , Xiang Jianping
Published: January 2021

Background: Intravascular ultrasound (IVUS) is the golden standard in accessing the coronary lesions, stenosis, and atherosclerosis plaques. In this paper, a fully-automatic approach by an 8-layer U-Net is developed to segment the coronary artery lumen and the area bounded by external elastic membrane (EEM), i.e. cross section area (EEM-CSA). The database comprises of single-vendor and single-frequency IVUS data. Particularly, the proposed data augmentation of MeshGrid combined with flip and rotation operations is implemented, improving the model performance without pre- or post-processing of the raw IVUS images.Results: The mean intersection of union (mIoU) of 0.937 and 0.804 for the lumen and EEM-CSA respectively were achieved, which exceeded the manual labeling accuracy of the clinician. Conclusion: The accuracy shown by the proposed method is sufficient for subsequent reconstruction of 3D IVUS images, which is essential for doctors’ diagnosis in the tissue characterization of coronary artery walls and plaque compositions, qualitatively and quantitatively.
Bilateral Cervical Plexus Block for Anterior Cervical Spine Surgery: Study Protocol for a Randomised Placebo-Controlled Trial
Authors: Mulcahy Michael , Elalingam Thananchayan , Jang Kevin , D'Souza Mario , Tait Matthew
Published: January 2021

Background There has been increasing focus to improve the quality of recovery following anterior cervical spine surgery (ACSS). Postoperative pain and nausea are the most common reasons for prolonged hospital stay and readmission after ACSS. Superficial cervical plexus block (SCPB) provides site-specific analgesia with minimal side-effects, thereby improving quality of recovery. The aim of our study was to investigate the effect bilateral cervical plexus block has on post-operative recovery in patients undergoing ACSS. Methods The study is a pragmatic, multi-centre, blinded, parallel-group, randomised placebo-controlled trial. 136 eligible patients (68 in each group) undergoing ACSS will be included. Patients randomised to the intervention group will have a SCPB administered under ultrasound guidance with a local anaesthetic solution (0.2% ropivacaine, 15mL); patients randomised to the placebo group will be injected in an identical manner with a saline solution. The primary outcome is the 40-item quality of recovery questionnaire score at 24 hours after surgery. In addition, comparisons between groups will be made for 24-hour opioid usage and length of hospital stay. Neck pain intensity will be quantified using the numeric rating scale at 1, 3, 6 and at 24 hours post-operatively. Incidence of nausea, vomiting, dysphagia or hoarseness in the first 24 hours after surgery will also be measured. Discussion By conducting a blinded placebo trial, we aim to control for the bias inherently associated with a tangible medical intervention and show the true treatment effect of SCPB in ACSS. A statistically significant result will indicate an overall improved quality of recovery for patients; alternatively, if no benefit is shown, this trial will provide evidence that this intervention is unnecessary. Trial registration Prospectively registered with the Australia New Zealand Clinical Trials Registry: ACTRN12619000028101. Registration date: 11/01/19.
Patterns of coronal and sagittal deformities in adolescent idiopathic scoliosis
Authors: Mak Trixie , Cheung Prudence Wing Hang , Zhang Teng , Cheung Jason Pui Yin
Published: January 2021

Background: Thoracic scoliosis has been shown to be associated with hypokyphosis in adolescent idiopathic scoliosis (AIS). However, the relationship of sagittal spino-pelvic parameters with different coronal curve patterns and their influence on patient-perceived quality of life is unknown. This study aims to determine the association between coronal and sagittal malalignment in patients with AIS and to determine their effects on SRS-22r scores. Methods: A cross-sectional study was conducted on 1054 consecutive patients with AIS. The coronal Cobb angle, thoracic kyphosis (TK), lumbar lordosis (LL), pelvic incidence (PI), PI-LL mismatch (PI-LL), pelvic tilt (PT), and sacral slope (SS) were measured on standing radiographs. The coronal Cobb angle (mild: 10-20°; moderate: >20-40°; severe: >40°) and PI (low: <35°; average: 35-50°; high: >50°) were divided into 3 sub-groups for comparison. Relationship between coronal curve magnitudes and sagittal parameters was studied as was their association with SRS-22r scores. Results: Low PI had smaller SS (30.1±8.3° vs 44.8±7.7°; p<0.001), PT (-0.3±8.1° vs 14.4±7.5°; p<0.001), and LL (42.0±13.2° vs 55.1±10.6°; p<0.001), negative PI-LL mismatch (-12.1±13.1° vs 4.1±10.5°; p<0.001) as compared to large PI. There were no significant relationships with PI and TK (p=0.905) or curve magnitude (p=0.431). No differences in sagittal parameters were observed for mild, moderate or severe coronal Cobb angles. SRS-22r scores only correlated with coronal Cobb angle and larger Cobb angles were negatively correlated with the function, appearance and pain domains. Conclusions: The sagittal profile for AIS is associated with the pelvic parameters especially PI but not with the coronal curve pattern. All patients have a similar TK regardless of coronal curve type. However, it appears that the coronal deformity is a greater influence on quality of life outcomes especially those >40°.
LncRNA MT1JP plays a protective role in intrahepatic cholangiocarcinoma by regulating miR-18a-5p/FBP1 axis
Authors: Zhao Wei , Zhao Jing , Guo Xiao , Feng Yujie , Zhang Bingyuan , Tian Lantian
Published: January 2021

Background: Cholangiocarcinoma is a common malignant tumor of digestive system. LncRNA metallothionein 1J, pseudogene (MT1JP) has been reported to play tumor-suppressing roles in multiple cancers. However, its effect on cholangiocarcinoma has not been evaluated. Methods: The expression of MT1JP in intrahepatic cholangiocarcinoma specimens and paired para-carcinoma tissues were detected by real-time PCR. The overexpression plasmid and siRNA of MT1JP were transfected into intrahepatic cholangiocarcinoma cells to change the expression levels of MT1JP. CCK-8, flow cytometry and transwell assays were performed to measure proliferation, cell cycle transition, apoptosis, migration and invasion. Dual-luciferase reporter assay, real-time PCR and western blot were carried out to screen the miRNA bound by MT1JP. In addition, xneograft experiment was used to determine the tumorigenesis of cholangiocarcinoma cells in nude mice. Results: MT1JP was downregulated in intrahepatic cholangiocarcinoma specimens, and its expression was related with TNM stage and lymph node metastasis. Overexpression of MT1JP inhibited proliferation, cell cycle transition, migration and invasion, and induced apoptosis in intrahepatic cholangiocarcinoma cells. The knockdown of MT1JP led to opposite results. MT1JP bound to miR-18a-5p to facilitate the expression of fructose-1,6-bisphosphatase 1 (FBP1). MiR-18a-5p was increased in intrahepatic cholangiocarcinoma samples, and its expression was negatively correlated with that of MT1JP. In addition, MT1JP also suppressed tumorigenesis in nude mice. Conclusions: MT1JP alleviated proliferation, migration and invasion, and induced apoptosis in cholangiocarcinoma cells by regulating miR-18a-5p/FBP1 axis. These findings may provide novel insights for clinical diagnosis and treatment of cholangiocarcinoma.
Depressive, anxiety, and burnout symptoms on health care personnel at a month after COVID-19 outbreak in Indonesia: a documentary research using Rasch model analysis
Authors: Sunjaya Deni Kurniadi , Herawati Dewi Marhaeni Diah , Siregar Adiatma YM
Published: January 2021

Background: Health personnel who demonstrated close contact with patients with COVID-19, might experience a higher risk of infection and psychological problems. This study aims to explore depressive, anxiety, and burnout symptoms among health care personnel with a higher risk for psychological trauma.Methods: This study was a cross-sectional study using secondary data from an online assessment, which was conducted one month after the COVID-19 outbreak. A total of 544 respondents from 21 provinces in Indonesia were included. Data on depressive, anxiety, and burnout symptoms were transformed first using the Rasch model and then categorized. Data from health professionals in the higher risk group and the lower risk group were analyzed.Results: A higher percentage of health professionals experiencing depressive symptoms (22.8%), anxiety (28.1%), and burnout (26.8%) are found in the higher risk group. The chance for the higher risk group’s personnel to present with moderate and severe depressive symptoms, anxiety, and burnout are 5.28 (CI: 2.01–13.89; p < 0.05), 1.36 (CI: 0.09–1.96; p > 0.05), and 3.92 (CI: 2.08–7.40; p < 0.05) times higher, respectively. The probability for patient-induced burnout is 2.13 (CI: 1.51–3.007; p < 0.05) times higher and highest among the other burn out dimensions. The depressive symptoms complained were similar between groups: loneliness, sleep disturbances, difficulty concentrating, and inability to initiate activities. Loneliness demonstrates the highest logit value among the symptoms.Conclusions: Health professionals with direct contact and responsibility to treat COVID-19 patients exhibit a higher risk to experience depressive symptoms and burnout. Communication with peers and staying in contact with family needs to be encouraged. Physiological well-being should be considered for high-risk health personnel. Incentive or insurance guaranteed by the government or institution is essential as a reward and compensation during this period.
Two-step Seismic Noise Reduction caused by COVID-19 Induced Reduction in Social Activity in metropolitan Tokyo, Japan
Authors: Yabe Suguru , Imanishi Kazutoshi , Nishida Kiwamu
Published: January 2021

The COVID-19 pandemic that started at the end of 2019 forced populations around the world to reduce social and economic activities; it is believed that this can prevent the spread of the disease. In this paper, we report an analysis of the seismic noise during such an induced social activity reduction in the Tokyo metropolitan area, Japan. Using seismic data obtained from 18 stations in the Metropolitan Seismic Observation Network (MeSO-net), a two-step seismic noise reduction was observed during the timeline of COVID-19 in Tokyo. The first noise reduction occurred at the beginning of March 2020 in the frequency band of 20–40 Hz. This corresponded with the request by the Prime Minister of Japan for a nationwide shutdown of schools. Although social activity was not reduced significantly at this juncture, local reduction of seismic wave excitation in the high frequency band, 20–40 Hz, was recorded at some MeSO-net stations located in school properties. The second reduction of seismic noise occurred at the end of March to the beginning of April 2020 in a wider frequency band including lower frequency bands of 1–20 Hz. This timing corresponds to when the Governors of the Tokyo metropolitan area requested citizens to stay home and when the state of emergency was declared for the Tokyo metropolitan area by the government, respectively. Since then, the estimated population at train stations abruptly dropped, which suggests that social activity was severely reduced. Such large-scale changes in social activity affect the seismic noise level in low frequency bands. The seismic noise level started to increase from the middle of May correlating with increase in population at the train stations. This suggests that social activity restarted even before the state of emergency was lifted at the end of May. The two-step seismic noise reduction observed in this study has not been reported in other cities around the world. Unexpected reduction of social activity due to COVID-19 provided a rare opportunity to investigate the characteristics of seismic noise caused by human activities.