bluuebunny/crossref_metadata_2025 huggingface dataset:
HLA-DPA1 gene is a potential predictor with prognostic values in multiple myeloma
Authors: Yang Jie , Wang Fei , Chen Baoan
Published: September 2020

Background: Multiple myeloma (MM) is an incurable hematological tumor, which is closely related to hypoxic bone marrow microenvironment. However, the underlying mechanisms are still far from fully understood. We took integrated bioinformatics analysis with expression profile GSE110113 downloaded from National Center for Biotechnology Information-Gene Expression Omnibus (NCBI-GEO) database, and screened out major histocompatibility complex, class II, DP alpha 1 (HLA-DPA1) as a hub gene related to hypoxia in MM.Methods: Differentially expressed genes (DEGs) were filtrated with R package “limma”. Gene Ontology (GO) enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway were performed using “clusterProfiler” package in R. Then, protein-protein interaction (PPI) network was established. Hub genes were screened out according to Maximal Clique Centrality (MCC). PrognoScan evaluated all the significant hub genes for survival analysis. ScanGEO was used for visualization of gene expression in different clinical studies. P and Cox p value < 0.05 was considered to be statistical significance.Results: HLA-DPA1 was finally picked out as a hub gene in MM related to hypoxia. MM patients with down-regulated expression of HLA-DPA1 has statistically significantly shorter disease specific survival (DSS) (COX p = 0.005411). Based on the clinical data of GSE47552 dataset, HLA-DPA1 expression showed significantly lower in MM patients than that in healthy donors (HDs) (p = 0.017).Conclusion: We identified HLA-DPA1 as a hub gene in MM related to hypoxia. HLA-DPA1 down-regulated expression was associated with MM patients’ poor outcome. Further functional and mechanistic studies are need to investigate HLA-DPA1 as potential therapeutic target.
Limited effect of rehabilitation for preventing a decrease in functional status after community-acquired pneumonia in elderly patients 
Authors: Chen Hao , Hara Yu , Horita Nobuyuki , Saigusa Yusuke , Hirai Yoshihiro , Kaneko Takeshi
Published: September 2020

Background: Functional status (FS) is often decreased after hospitalization in elderly community-acquired pneumonia (CAP) survivors. Rehabilitation has frequently been used to prevent decreased FS. This study was designed to evaluate the effect of rehabilitation for preventing decreased FS.Methods: This retrospective, observational study was conducted in two medical facilities from January 2016 to December 2018, and hospitalized CAP patients >64 years of age were enrolled. FS was assessed by the Barthel Index (BI) (range, 0–100, in 5-point increments) at admission and before discharge and graded into three categories: independent, BI 80–100; semi-dependent, BI 30–75; and dependent, BI 0–25. Multivariable analysis of factors contributing to decreased FS was conducted with two groups: with a decrease of at least one category (decreased group), or without a decrease of a category (maintained group). Then, the effect of rehabilitation was examined by propensity score analysis by adjusting factors contributing to decreased FS determined in the previous multivariable analysis. Results: The maintained group included 400 patients, and the decreased group included 138 patients. The decreased group had a high frequency of rehabilitation therapy (189 (47.3%) vs 104 (75.4%); p<0.001). Multivariable analysis showed that factors affecting FS were length of stay, aspiration pneumonia, age, and Pneumonia Severity Index (PSI) of category V (odds ratio 1.05, 95%CI 1.04–1.07; 2.66, 95%CI 1.58–4.49; 1.05, 95%CI 1.02–1.09; and 1.92, 95%CI 1.29-3.44; respectively). After adjusting for factors contributing to decreased FS, rehabilitation showed a limited effect in preventing a decreased FS in 166 matched pairs (p=0.327).Conclusions: The effect of rehabilitation was still unclear in CAP, and further research is warranted to find an effective way to conduct rehabilitation.
Association between circulating microRNAs 486, 146b and 15b and serum betatrophin levels in obese; type 2 diabetic and non-diabetic children
Authors: Mohany khalid Mohammad , Alrugaie Osamah , Alwutayd Osama , Al-Nafeesah Abdullah , Saleem Tahia H.
Published: September 2020

Background: This study tested the association between serum levels of microRNA-486, -146b and -15b and betatrophin in normal and obese children with/without type 2 diabetes mellitus (T2DM). Methods: the study included 120 children; divided into three groups: G1 (50 healthy), G2 (35 obese) and G3 (35 obese with T2DM). The levels of microRNA-486, 146b and 15b and serum betatrophin were measured by their corresponding methods. Results: serum microRNA-486, -146b, -15b and betatrophin levels were significantly high in G3 followed by G2 then G1 (p=0.002, >0.001, >0.001, and >0.001, respectively). Especially in G3, these levels correlated positively with the BMI percentile (r=0.44, 0.58, 0.38, and 0.46, p=0.007, >0.001, 0.021, and 0.005, respectively), serum glucose (r=0.56, 0.49, 0.82, 0.60, and 0.42, p>0.001, 0.003, >0.001, and >0.001, respectively) and HbA1c% (r=0.56, 0.39, 0.66, and 0.42, p>0.001, 0.019, >0.001, and 0.032, respectively) while, showed negative correlations with correlated with serum insulin levels (r=-0.37, -0.42, -0.58, and -0.41, p=0.021, 0.012, >0.001 and 0.013, respectively) and with serum C-peptide levels (r=-0.76, -0.50, -0.35 and -0.42, p>0.001, 0.002, 0.036 and 0.011, respectively). Serum betatrophin levels correlated positively with microRNA-486, -146b and -15b levels in G2 (r=0.35, 0.80, and 0.67, p= 0.036, >0.001, and,>0.001, respectively), and in G3 (r=0.57, 0.36, and 0.38, p >0.001, 0.029 and, 0.023, respectively). Conclusions: Circulating microRNA-486, 146b and 15b increase significantly in obese children with T2DM and these levels correlate positively with serum betatrophin levels. Further studies are required to test the role of targeting of these microRNAs and betatrophin in the timely management of obesity and/or T2DM in children.
Measuring the contribution of mobility to malaria persistence
Authors: Gomes Marcelo Ferreira da Costa , Codeço Cláudia Torres , Bastos Leonardo Soares , Lana Raquel Martins
Published: September 2020

Background: To achieve the goal of malaria elimination, it is important to determine the role of human mobility of maintain parasite transmission. The Alto Jurua basin (Brazil) has one of the largest prevalence of malaria vivax and malaria falciparum in the Amazon. The goal of this work was to estimate the contribution of human commutation on the persistence of malaria in this region using data from a origin-destination survey.Methods: Data from the origin-destination survey was used to describe the intensity and motivation for commutation between rural settlements and urban areas in two municipalities, Mancio Lima and Rodrigues Alves. The relativetime-person spent in each locality per household was estimated. A logistic model was fitted to estimate the effect of commuting on the probability of getting malaria for a householder from a zone of residence commuting to another zone.Results: Our main results suggest that this population is not very mobile. 96% of household reported spending more than 90% of the annual person-hour at localities within the same zone of residence. Study and work are the most prevalent motivations for commuting, 40.5% and 29.5% respectively. Spending person-hours in urban Rodrigues Alves conferred relative protection to the residents of urban Mancio Lima. On the other hand, spending time in urban Rodrigues Alves conferred protection against malaria for those living in urban Mancio Lima. The opposite effect occurs for those spending time in the rural areas of both municipalities.Conclusion: In the alto Jurua region, the place one lives is a stronger determinant of malaria risk than the place ones commute. These municipalities of a hotspot of Plasmodium transmission, thus understanding the main fluxes is essential to planning control strategies because the probability of getting malaria is dependent on the intensity of transmission of both, the area of origin and the area to which the displacement take place. The natural conditions for the circulation of pathogens such as the Plasmodium spp, combined with the pattern of mobility of humans in the Amazon, make clear the need of disease control perspective change. It is essential that intersectoral public policies be the basis for health mitigation actions.
Novel technique of repairing right partial anomalous pulmonary venous connection with intact atrial septum using in situ interatrial septum as a flap in a 68-year-old-woman: a case report
Authors: Morishita Atsushi , Hagino Ikuo , Tomioka Hideyuki , Katahira Seiichiro , Hoshino Takeshi , Hanzawa Kazuhiko
Published: September 2020

Background: Partial anomalous pulmonary venous connection draining into the right atrium with an intact atrial septum is a very rare clinical entity in the adult population. Partial anomalous pulmonary venous connection must be suspected as a differential diagnosis when the cause of right heart enlargement and pulmonary artery hypertension is unknown.Case presentation: This study describes the surgical case of an isolated right partial anomalous pulmonary venous connection to the right atrium in a 68-year-old woman, who underwent tricuspid ring annuloplasty and right-sided maze procedure simultaneously. She had complaints of gradually progressing dyspnea on exertion. However, a diagnosis could not be established despite consultations at multiple hospitals for over a year. Right heart catheterization revealed severe pulmonary artery hypertension with a mean pulmonary artery pressure of 46 mmHg, step-up phenomenon of oxygen saturation at the mid-level of the right atrium with a pulmonary-to-systemic blood flow ratio of 2.4, and a pulmonary vascular resistance of 3.1 Wood Units. As medical treatment with pulmonary artery vasodilator therapy did not improve her symptoms, she underwent surgical repair. An atrial septal defect was created surgically with a curvilinear tongue-shaped cut. The right anomalous pulmonary veins were rerouted through the surgically created atrial septal defect into the left atrium with a baffle comprised of the interatrial septum flap, kept in continuity with the anterior margin and sutured while mobilizing the enlarged right atrium. The patient had an uneventful postoperative course and remains asymptomatic.Conclusions: The described surgical technique could be considered an effective alternative for patients undergoing surgical repair for a partial anomalous pulmonary venous connection isolated to the right atrium. The indication for surgery must be judged on a case-by-case basis in these patients with prevalent systemic-to-pulmonary shunting.
Oral corticosteroids for post-infectious cough in adults: study protocol for a double-blind randomized placebo-controlled trial in Swiss family practices (OSPIC trial)
Authors: Merlo Christoph , Essig Stefan , Brancati-Badarau Domnita Oana , Leuppi Jörg Daniel , Speich Benjamin , Erlanger Tobias E , Hemkens Lars G , Zeller Andreas
Published: September 2020

BackgroundCough is a common reason for patients to visit general practices. So called post-infectious cough is defined as lasting 3 to 8 weeks after an upper respiratory tract infection. It can be disabling in daily activities, with substantial impact on physical and psychosocial health, leading to impaired quality of life and increased health care costs. Recommendations for the management of post-infectious cough in primary care are scarce and incoherent. A systematic review and meta-analysis of randomised clinical trials (RCT) assessing patient-relevant benefits and potential harms of available treatments identified six eligible RCTs assessing different treatment regimens (i.e. inhaled fluticasone propionate, inhaled budesonide, salbutamol plus ipratropium-bromide, montelukast, nociception-opioid-1-receptor agonist, codeine, gelatine). No RCT found clear patient-relevant benefits and most had an unclear or high risk of bias.Post-infectious cough is thought to be mediated by inflammatory processes that are also present in exacerbations of asthma or chronic obstructive pulmonary diseases for which there is strong evidence that oral corticosteroids provide patient-relevant benefit without relevant harm. We therefore plan to conduct the first RCT evaluating the effectiveness of oral corticosteroids for post-infectious cough.MethodsWe are conducting a triple-blinded randomised-controlled and multicentric superiority trial in primary health care practices in Switzerland. We will include 204 adult patients who consult their general practitioner (GP) for a cough lasting 3 to 8 weeks following an upper-respiratory tract infection. Participants will be randomly allocated to either the 5-day treatment with oral corticosteroids or placebo. The primary outcome is cough-related quality of life assessed by the Leicester Cough Questionnaire score 14 days after randomisation. Secondary outcomes include cough-related quality of life at several time points, overall cessation of cough and adverse events.DiscussionThis RCT will provide evidence on whether oral corticosteroids are beneficial and safe in patients with post-infectious cough. Results can have a substantial impact on the well-being and management of these patients in Switzerland and beyond. An evidence-based treatment for this condition may reduce re-consultations with GPs and spending for antitussive drugs, thus possibly having an impact on health care spending.Trial registrationClinicalTrials.gov NCT04232449, prospectively registered on 18 January 2020 (https://clinicaltrials.gov/ct2/show/NCT04232449).
Variation in mitochondrial minichromosome composition among Hoplopleura lice (Phthiraptera: Hoplopleuridae) from rats
Authors: Fu Yi-Tian , Nie Yu , Duan De-Yong , Liu Guo-Hua
Published: September 2020

Background

The family Hoplopleuridae contains at least 183 species of blood-sucking lice, which widely parasitize both mice and rats. Fragmented mitochondrial (mt) genomes have been reported in two rat lice ( Hoplopleura kitti and H. akanezumi ) from this family, but some minichromosomes were unidentified in their mt genomes.

Methods

We sequenced the mt genome of rat louse Hoplopleura sp. with an Illumina Hiseq platform and compared its mt genome organization with H. kitti and H. akanezumi .

Results

Fragmented mt genome of the rat louse Hoplopleura sp. contains 37 genes which are on 12 circular mt minichromosomes. Each mt minichromosome is 1.8-2.7 kb long, which contains 1-5 genes and one large non-coding region. The gene content and arrangement of three mt minichromosomes of Hoplopleura sp. and H. kitti are different from that of the three mt minichromosomes of H. akanezumi . Phylogenetic analyses based on the deduced amino acid sequences of the eight protein-coding genes showed that the Hoplopleura sp. was more closely related to H. akanezumi than to H. kitti , and then they form a monophyletic group.

Conclusions

Comparison among the three rat lice revealed variation in the composition of mt minichromosomes within the genus Hoplopleura . Hoplopleura sp. is the first species from the family Hoplopleuridae for which a complete fragmented mt genome has been sequenced. The new data provides useful genetic markers for studying the population genetics, molecular systematics and phylogenetics of blood-sucking lice.
Efficacy of definite concurrent chemoradiotherapy for patients with limited-disease small-cell lung cancer: a retrospective, nationwide, population-based cohort study
Authors: Kim Seoree , Hong Ji Hyung , Sung Soo-Yoon , Kim Yeo Hyung , Chun Sang Hoon , Lee Hyun Woo , Lee Jung Soo , Ko Yoon Ho
Published: September 2020

Background: Small-cell lung cancer (SCLC) is a highly proliferative, rapidly growing tumor with a poor prognosis, even in cases of limited disease (LD). Timely and accurate high-intensity therapy is necessary. For concurrent chemoradiotherapy (CCRT), etoposide/platinum (EP)-based regimens are recommended, although irinotecan/platinum (IP)-based regimens are also effective with radiotherapy. This large-scale, retrospective, nationwide cohort study aimed to analyze the efficacy of CCRT in patients with LD-SCLC. Methods: Population data registered between January 2008 and December 2018 was extracted from the Health Insurance Review and Assessment Service of Korea database. Survival outcomes of 4,446 LD-SCLC patients who received CCRT were analyzed. Results: Patients who received EP-CCRT (n = 4,187) showed better progression-free survival (PFS: 11.2 months) and overall survival (OS: 22.2 months) than those who received IP-CCRT (n = 259; PFS: 9.6 months, P = 0.0477; OS: 16.4 months, P <0.0001). When CCRT failed, dual-agent chemotherapy (n = 925; OS: 9.1 months) provided a better survival benefit than single-agent chemotherapy (n = 815; OS: 7.5 months). IP-based chemotherapy resulted in better OS (9.6 months) than EP-based chemotherapy (7.1 months, P = 0.017) in platinum-resistant relapsed patients; the opposite was observed for platinum-sensitive relapsed patients (OS: EP, 17.2 months; IP, 6.6 months; P <0.0001). Poisson regression analysis demonstrated that age, EP-CCRT, and hypercholesterolemia retained significant associations with OS after adjustment for all variables. Conclusion: In the Korean population, the effects of EP-CCRT on OS and PFS are significantly more favorable than those of IP-CCRT.
Prognosis and Risk Factors for Malignant Peripheral Nerve Sheath Tumor: A Systematic Review and Meta-analysis
Authors: Cai Zhenyu , Tang Xiaodong , Liang Haijie , Yang Rongli , Yan Taiqiang , Guo Wei
Published: September 2020

Background: No available meta-analysis was printed to systematically introduce the MPNST clinic outcome and risk factors based on largely pooled data. This systematic review and meta-analysis aimed to investigate 5-year OS rate, 5-year EFS rate and LR rate for MPNST, and to assess potential risk factors for prognosis.Methods: Electronic articles published between January 1, 1966 and February 29, 2020, were searched and critically evaluated. The authors independently reviewed the abstracts and extracted data for 5-year OS rate, 5-year EFS rate, LR rate, and potential risk factors for prognosis.Results: Twenty-eight literatures were finally included for meta-analysis. The pooled 5-year OS rate, 5-year EFS rate, and LR rate were 49%, 37%, and 38%, respectively. The significant prognostic factors for survival were NF1 status, tumor size, depth, location, malignant grade, margin status, chemotherapy, and radiotherapy. Age and sex were not associated with survival.Conclusion: Survival and local recurrence of MPNST are poor. Worse prognosis is mainly associated with NF 1, large size, deep to fascia, high grade, metastases and location (trunk and head & neck). Complete resection with adequate surgical margins is the mainstay protective factor of MPNST patients, following necessary adjuvant therapies.
Surveillance on schistosomiasis in five PLADs of the People’s Republic of China in the post-elimination era
Authors: Guo Jing-Yi , Xu Jing , Zhang Li-Juan , Lv Shan , Cao Chun-Li , Li Shi-Zhu , Zhou Xiao-Nong
Published: September 2020

Background: The People’s Republic of China (P. R. China) has made significant progress on schistosomiasis control. Among the 12 provinces (municipality, autonomous region) with schistosomiasis endemic in P. R. China, Guangdong, Shanghai, Fujian, Guangxi and Zhejiang provincial-level administrative divisions (PLADs, following as five PLADs) had successively eliminated schistosomiasis during 1985–1995. However, consolidation of the schistosomiasis elimination in these five PLADs remains challenging. In the current study, we sought to understand the epidemic situation in these post-elimination areas and their surveillance capabilities on schistosomiasis. Methods: Annual data reflecting the interventions and surveillance on human beings, cattle and snails based on county level from 2005 to 2016 were collected through the national schistosomiasis reporting system and the data were analyzed to understand the epidemic status of schistosomiasis in the five PLADs. Ten counties were selected according to the endemic situation before elimination in the five PLADs. A standardized score sheet was designed to assess the surveillance capacity for schistosomiasis of selected disease control agencies in five PLADs and ten counties. Assessment on surveillance capacity including schistosomiasis diagnostic skills, identification of snails’ living and infection status and knowledge about schistosomiasis and its control were made. And the accuracy rate of the assessment was calculated. Results: The comprehensive assessments showed that no local cases in humans and cattle or infected snail were found in these five PLADs since 2005, and the surveillance abilities on schistosomiasis of the prevention and control institutions in five PLADs were appropriate. However, from 2005 to 2016, a total of 221 imported cases were detected in Zhejiang, Shanghai and Fujian PLADs, and 11.98 hm2 of new snail habitats were found in Zhejiang, Shanghai and Guangxi PLADs. In addition, snail infestation reoccurred in 247.55 hm2 of former snail habitats since 2011. For the surveillance capacity assessment on diagnosis skills, the accuracy rate of IHA was 100%, and the accuracy rate of MHT was 89.3%. For snail identification, the accuracy rate of identifying the snails’ living status was 100%, and the average accuracy rate of identifying infection status of snails was 98.1%. The average accuracy rate of the questionnaire survey was 98.0%.﻿Conclusions: Elimination of schistosomiasis was consolidated successfully in five PLADs of P.R. China due to effective and strong post-elimination surveillance. Comprehensive consolidation strategies should be focused on the elimination of residual snails and the prevention of imported infection sources among the five PLADs to consolidate the achievements of schistosomiasis control.
Transcriptome-IPMS analysis reveals a tissue-dependent miR156/SPL13 regulatory mechanism in alfalfa drought tolerance
Authors: Feyissa Biruk A , Renaud Justin , Nasrollahi Vida , Kohalmi Susanne , Hannoufa Abdelali
Published: September 2020

Background : We previously reported on the interplay between miR156/SPL13 and WD40-1/DFR to improve response to drought stress in alfalfa ( Medicago sativa L.). Here we aimed to investigate whether the role of miR156/SPL13 module in drought response is tissue-specific, and to identify SPL13-interacting proteins. We analyzed the global transcript profiles of leaf, stem, and root tissues of one-month old RNAi-silenced SPL13 ( SPL13 RNAi) alfalfa plants exposed to drought stress and conducted protein-protein interaction analysis to identify SPL13 interacting partners. Result : Transcript analysis combined with weighted gene co-expression network analysis showed tissue and genotype-specific gene expression patterns. Moreover, pathway analysis of stem-derived differentially expressed genes (DEG) revealed upregulation of genes associated with stress mitigating primary and specialized metabolites, whereas genes associated with photosynthesis light reactions were silenced in SPL13 RNAi plants. Leaf-derived DEG were attributed to enhanced light reactions, largely photosystem I, II, and electron transport chains, while roots of SPL13 RNAi plants upregulated transcripts associated with metal ion transport, carbohydrate, and primary metabolism. Using immunoprecipitation combined with mass spectrometry (IPMS) we showed that SPL13 interacts with proteins involved in photosynthesis, specialized metabolite biosynthesis, and stress tolerance. Conclusions : We conclude that the miR156/SPL13 module mitigates drought stress in alfalfa by regulating molecular and physiological processes in a tissue-dependent manner.
A systematic review and meta-analysis protocol examining the clinical characteristics and epidemiological features of olfactory dysfunction (OD) in coronavirus disease 2019 (COVID-19)
Authors: Tan Rosemond Qian-Xiu , Li Wai Tak Victor , Shum Wing-Zi , Chu Sheung Chit , Li Hang-Long , Shea Yat-Fung , Chung Tom Wai-Hin
Published: September 2020

Background The coronavirus disease 2019 (COVID-19) pandemic has caused recurring and major outbreaks in multiple human populations around the world. The plethora of clinical presentations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been described extensively, of which olfactory dysfunction (OD) was established as an important and common extrapulmonary manifestation of COVID-19 infection. The aim of this protocol is to conduct a systematic review and meta-analysis on peer-reviewed articles which described clinical data of OD in COVID-19 patients. Methods This research protocol has been prospectively registered with the Prospective Register of Systematic Reviews (PROSPERO; CRD42020196202). CINAHL, ClinicalTrials.gov, Cochrane Central, EMBASE, MEDLINE and PubMed, as well as Chinese medical databases: China National Knowledge Infrastructure (CNKI), VIP and WANFANG will be searched using keywords including “COVID-19”, “coronavirus disease”, “2019-nCoV”, “SARS-CoV-2”, “novel coronavirus”, “anosmia”, “hyposmia”, “loss of smell”, and “olfactory dysfunction”. Systematic review and meta-analysis will be conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the Meta-analyses Of Observational Studies in Epidemiology (MOOSE) guidelines. Articles will be screened according to pre-specified inclusion and exclusion criteria. Included articles will be reviewed in full; data including patient demographics, clinical characteristics of COVID-19-related OD, methods of olfactory assessment, and relevant clinical outcomes will be extracted. Statistical analyses will be performed using the Comprehensive Meta-Analysis version 3. Discussion This systematic review and meta-analysis protocol will aim to collate and synthesise all available clinical evidence regarding COVID-19-related OD as an important neurosensory dysfunction of COVID-19 infection. A comprehensive search strategy and screening process will be conducted to incorporate comprehensive clinical data for robust statistical analyses and representation. The outcome of this study will aim to improve our understanding of the symptomatology and clinical characteristics of COVID-19-related OD and identify knowledge gaps in its disease process, which will guide future research in this specific neurosensory defect.Systematic Review registration: PROSPERO registration number: CRD42020196202
The Impact of COVID-19 Pandemic on Cardiac Surgery in Israel
Authors: Keizman Eitan , Ram Eilon , Kachel Erez , Sternik Leonid , Raanani Ehud
Published: September 2020

Background: Ever since the coronavirus disease 2019 (COVID-19) has become a pandemic, worldwide efforts are being made to “flatten the curve”. Israel was amongst the first countries to impose significant restrictions. As a result, cardiac surgeons have been required to scale down their routine practice, resulting in a significant reduction in the number of cardiac surgeries. The aim of this study is to characterize the impact of COVID-19 on cardiac surgery in Israel.Methods: This is a retrospective observational study performed in two cardiac surgery departments in Israel and includes all patients who underwent cardiac surgery in March and April during the years 2019 and 2020. The patient cohort was divided into two groups based on the year of operation. Analysis of the patients’ baseline characteristics, operative data, and postoperative outcome, was performed.Results: The 2019 group (n=173), and the 2020 group (n=108) were similar regarding their baseline characteristics, previous medical history, and rates of previous revascularization interventions. However, compared to the 2019 group, patients in the 2020 group were found to be more symptomatic (NYHA class IV; 2.4% vs. 6.2%, p=0.007). While all patients underwent similar procedures, patients in the 2020 group had significantly longer procedural time (p<0.001). In-hospital mortality rate was found to be significantly higher in group 2020 (13% vs. 5.2%, p=0.037).Conclusions: While the number of patients undergoing cardiac surgery declined during the outbreak period, the rate of surgical mortality increased. One explanation for this might be delayed hospital arrival.
The Relationship Between Proxy Agency and the Medical Decisions Concerning Pediatric Patients in Palliative Care: A Qualitative Study.
Authors: Fay Martina , Guadarrama Jessica , Colmenares-Roa Tirsa , Moreno-Licona Yrai , Cruz-Martin Ana Gabriela , Pelaez-Ballestas Ingris
Published: September 2020

Background The children’s agency and that exercised by parents and health professionals in palliative care, along with structural limitations imposed by the conditions of inequality, will provide a new perspective from medical anthropology and biomedicine to improve pediatric palliative care in complex therapeutic scenarios.The main purpose of the study was to analyze the ways in which children have agency in relation to their parents and palliative care (PC) professionals within the hospital setting, as well as the structural circumstances that constrain said agency.Method A hospital ethnography (by means of non-participant observation and interviews) of the palliative care (PC) unit in a children’s hospital was conducted over the course of six months. A thematic analysis was performed using the ATLAS.ti software .ResultsThirteen cases were reconstructed of underage patients of both sexes boy and girl patients together with their families; five health professionals were interviewed. The analysis identified the following 6 thematic axes, around which this article is organized: 1. The relationship between the exercise of proxy agency and the medical decisions concerning underage patients. 2. Negotiating agency and support in decision-making. 3. Child autonomy. 4. The experiences of health professionals. 5. Limitations of palliative care. 6. Bureaucratization of palliative care.ConclusionsIn pediatric palliative care, agency is a process whereby different agencies intertwine: lack pediatric patients ´agency, the parents’ agency, the parents’ agency as representatives of their children (proxy agency), and the agency of health professionals. The concept of relational agency is proposed, defined as a set of group actions and decision-making centered around the children’s agency and the proxy agency.
Direct and Indirect Therapeutic Effect of Traditional Chinese Medicine as an Add-on for Non-proliferative Diabetic Retinopathy: A Systematic Review and Meta-analysis
Authors: an Xuedong , jin de , duan liyun , zhao shenghui , zhou rongrong , lian fengmei , tong xiaolin
Published: September 2020

Background：Diabetic retinopathy (DR) is the leading cause of blindness in many countries. The current treatment for non-proliferative DR (NPDR) using Western medicine (WM) alone is insufficient. At present, the combination of NPDR treatment with traditional Chinese medicine (TCM) and WM is universally applied. We aimed to evaluate the effectiveness and safety of TCM as an add-on for NPDR using a systematic review and meta-analysis.Method: Data from randomized controlled trials (RCTs) of TCM for NPDR treatment along with WM before July 6, 2019, were collected from the China National Knowledge Infrastructure, Wanfang Database, China Biomedical Database, Pubmed, Embase, and Cochrane Library. Relevant data were extracted by two reviewers. I2 statistics was adopted to appraise heterogeneity. If I2<50% the fixed-effects model was employed, otherwise a random-effect model was employed. (PROSPERO: CRD42019134947)Result: Eighteen RCTs (1522 patients) were included based on the inclusion and exclusion criteria. The results showed that compared with WM alone, TCM (including Compound Xueshuantong Capsule, Qiming Granule, and others) combined with WM for NPDR could improve the overall effiicacy [n=1686，RR1.24(1.18,1.30), P<0.00001, I2=0%], and reduce the influence of risk factors related to NPDR, such as glycated hemoglobin level [n=360, MD -0.85(-1.28, -0.41), P=0.0001, I2=72%], triglyceride (P<0.00001), and total cholesterol (P=0.0008). Moreover, no serious adverse events were reported.Conclusion: Compared with WM alone, TCM+WM could significantly improve NPDR and also reduce the correlation levels of risk factors, such as hyperglycemia, dyslipidemia. However, the small sample included in the study might lead to a publication bias, and therefore, our results should be treated with caution.
Untargeted and Targeted Proteomic Analysis of the Impact of Diabetes Mellitus on Two Adipose Tissue Depots and Blood of Obese Patients
Authors: Arderiu Gemma , Lambert Carmen , Padró Teresa , Vilahur Gemma , Ballesta Carlos , Ybarra Juan , Badimon Lina
Published: September 2020

Background: Obesity has increased over the last years and it is one of the most common cardiovascular risk factors. In addition obesity is associated with the development of other metabolic disorders such as insulin resistance and type-2 diabetes mellitus (T2DM). Here, we have investigated two adipose tissue depots (AT) proteome and secreted serum proteins in obese patients to understand fat tissue characteristics in metabolic syndrome and T2DM.Methods: We used an untargeted proteomic approach to compare white AT of subcutaneous (SAT) and visceral (VAT) depots in type 3 obese patients. In silico analysis and bioinformatics were applied to proteomic data to gain systems biology information. By bead-based targeted multiplex assay system, we simultaneously detected and quantified multiple targets in qualified complex samples and analyzed the changes produced in the adipokine serum composition due to obesity and T2DM.Results: Protein composition in SAT and VAT showed significant differences. There was upregulation of proteins related with the endocrine regulation system in SAT, whereas proteins upregulated in VAT were related to metabolic disorders. VAT protein composition was more sensitive to the presence of diabetes than SAT. A pro-inflammatory state, caused by the secretion of cytokines and related adypokines, was observed in the serum protein composition of both obese and diabetic patients.Conclusions: Our results show a synergic alteration in the metabolic and inflammatory state in both VAT and serum due to the presence of diabetes, whereas changes in SAT were related with endocrine regulation.
Social Listening – Revealing Parkinson’s Disease over Day and Night
Authors: Zhang Hui , Meng Fanwen , Li Xingyu , Ning Yali , Cai Meng
Published: September 2020

Background: Nocturnal symptoms in Parkinson’s disease are often treated after management of daytime manifestations. In order to better understand the unmet needs of nocturnal symptoms management, we analyzed the characteristics and burden of nocturnal symptoms from patients’ perspectives and explored their changes over time. Overall symptoms (occurring at day or night) were collected to compare whether the unmet needs related to nocturnal symptoms and to overall symptoms are different.Methods: We used a Social Listening big-data technique to analyze large amounts of Parkinson’s disease symptoms in dialogues available from social media platforms in 2016 to 2018. These symptoms were classified as either overall symptoms or nocturnal symptoms. We used share of voice (SOV) of symptoms as a proportion of total dialogues per year to reflect the characteristics of symptoms. Negative sentiment score of symptoms was analyzed to find out their related burden. Results: We found the SOV for overall motor symptoms was 79% and had not increased between 2016 and 2018 (79%, p = 0.5). The SOV for non-motor symptoms was 69% and had grown by 7% in 2018 (p < 0.01). The SOV for motor complications was 9% and had increased by 6% in 2018 (p < 0.01). The SOV of motor symptoms was larger than non-motor symptoms and motor complications (p < 0.01). The SOV of non-motor symptoms was larger than motor complications (p < 0.01). For nocturnal symptoms, 45% of the analyzed PD population reported nocturnal symptoms in 2018, growing by 6% (p < 0.01). The SOV for nocturnal-occurring motor symptoms was higher than most non-motor symptoms. However, non-motor symptoms had the higher increases and evoked higher negative sentiment regardless of whether they occurred during the day or night. For symptoms that can occur at either day or night, each nocturnal symptom was rated with a higher negative sentiment score than the same symptom during the day.Conclusions: The growing SOV and the greater negative sentiment of nocturnal symptoms suggest management of nocturnal symptoms is an unmet need of patients. A greater emphasis on detecting and treating nocturnal symptoms with 24-hour care is encouraged.
Male involvement in birth preparedness and complication readiness in Ethiopia: A Systematic review and Meta-analysis
Authors: Mekonnen Chilot kassa , Abate Hailemichael Kindie , Demessie Negesu Gizaw
Published: September 2020

Background: Male involvement during pregnancy, labor and post-partum care has been shown to improve positive maternal and newborn outcomes. Nevertheless, it continues to be low, especially in low income countries. One of the reasons is the lack of birth preparedness and complication readiness, which is recognized as the most cost-effective and achievable components of safe motherhood programs around the world. Thus, this systematic review and meta-analysis study tried to determine the pooled prevalence of male involvement in birth preparedness and complication readiness (BP/CR) and its associated factors in Ethiopia. Methods: Searching of the primary articles was completed by PubMed/MEDLINE, EMBASE, CINAHAL, and Google Scholar, HINARI portal which includes the SCOPUS, African Index Medicus, and African Journals Online Database. The data was extracted by using a standard data extraction checklist that developed according to Joanna Briggs Institute (JBI).For assessing heterogeneity across the studies I2 statistics was used. The Funnel plot asymmetry and Egger’s tests were used to check the presence of publication bias. A random effect model was used to estimate the pooled proportion of male involvement. Odds Ratio (OR) with the 95% confidence interval was also used to determine the association of identified factors with the outcome variable. Result: From a total of 614, primary studies 8 were eligible for inclusion in the final systematic Review and meta-analysis. The pooled estimate of male involvement in birth preparedness and complication readiness was found to be 40.17% [95%CI (24.01-56.33). Conclusion: The pooled prevalence of male involvement in birth preparedness and complication readiness was relatively low. Thus, Minister of Health with its stake holders better to give emphasis on community awareness programs so as to increase male involvement for birth preparedness and complication readiness.
Feasibility of a Modified SCC Method With and Without Combining the Use of PGA Sheets and Fibrin Glue for Preventing Delayed Bleeding After Gastric ESD
Authors: Abiko Satoshi , Oda Soichiro , Meno Akimitsu , Shido Akane , Yoshida Sonoe , Yoshikawa Ayumu , Harada Kazuaki , Kawagishi Naoki , Sano Itsuki , Oda Hisashi , Miyagishima Takuto
Published: September 2020

Background: Some methods have been developed for preventing delayed bleeding (DB) after gastric endoscopic submucosal dissection (GESD). However, none of the methods can completely prevent DB. We hypothesized that DB can be prevented by a modified the search, coagulation, and clipping (MSCC) method for patients at low risk of DB and by combining the use of PGA sheets and fibrin glue with the MSCC method (PMSCC method) for patients at high risk of DB (anti-bleeding [ABI] strategy). In this study, the technical feasibility of this novel strategy was assessed.Methods: We investigated 123 lesions in 121 consecutive patients who underwent GESD in Kushiro Rosai Hospital between April 2018 and January 2020. The decision for continuation or cessation of antithrombotic agents was based on the Guidelines for Gastroenterological Endoscopy in Patients Undergoing Antithrombotic Treatment.Results: Oral antithrombotic agents were administered to 28 patients (22.8%). En bloc R0 resection rate was 98.4%. The MSCC method and PMSCC method for preventing were performed in 114 and 9 lesions, respectively. The median time of the MSCC method was 16 min and the median speed was 3.6 cm2/10min. The median time of the PMSCC method was 59 min and the median speed was 1.3 cm2/10min. The only delayed procedural adverse event was DB in one (0.8%) of the 123 lesions. Conclusions: The ABI strategy is feasible for preventing DB in patients at low risk and high risk of DB after GESD, whereas the PMSCC method may be necessary for reduction of time.
Fall Risk Prediction via Classification of Lower Extremity Strength in Older Adults with Exergame-Collected Data
Authors: Becker Hagen , Garcia-Agundez Augusto , Müller Philipp Niklas , Tregel Thomas , Miede André , Göbel Stefan
Published: September 2020

Objective: The goal of this article is to present and evaluate a sensor-based falling risk estimation system. The system consists of an array of Wii Balance Boards (WBB) and an exergame that estimates if the player is at an increased falling risk by predicting the result of the 30 Second Chair-Stand Test (30CST). Methods: 16 participants recruited at a nursing home performed the 30CST and then played the exergame as often as desired during a period of two weeks. For each session, features related to how they walk and stand on the WBBs while playing the exergame were collected. Different classifier algorithms were used to predict the result of the 30CST on a binary basis (able or unable to maintain physical independence). Results: We achieved a maximum accuracy of 91% when attempting to estimate if the player’s 30CST score will be over or under a threshold of 12 points using a Logistic Model Tree. We also believe it is feasible to predict age- and sex-adjusted cutoff scores. Conclusion: An array of WBBs seems to be a viable solution to estimate lower extremity strength and with it the falling risk. In addition, data extracted while playing may form a basis to perform a general screening to identify elderly at an increased falling risk.
Evaluation of Doc’EDS: A French Semantic Search Tool to Query Health Documents from A Clinical Data Warehouse
Authors: Pressat-Laffouilhère Thibaut , Balayé Pierre , Dahamna Badisse , Lelong Romain , Billey Kévin , Darmoni Stéfan Jacques , Grosjean Julien
Published: September 2020

Background: Unstructured data from electronic health record is a gold mine. Doc’EDS is a pre-screening tool based on textual and semantic analysis. The system provides an easy-to-use interface to search documents in French. The aim of this study is to present the tools and to provide a formal evaluation of its semantic features. Material & Methods: Doc’EDS is a search tool built on the top of the clinical data warehouse developed in the Rouen University Hospital. This tool is a multilevel search engine combining structured and unstructured data. It also provides basic analytics features and semantic utilities. A formal evaluation has been conducted to measure the implemented Natural Language Processing algorithms. Results: About 17,3 million of narrative documents are contained in this CDW. The formal evaluation has been conducted over 5,000 clinical concepts that were manually collected. Negation concepts detection F-measure was 0.89, hypothesis concept detection F-measure was 0.57. Conclusion: We hereby present Doc’EDS, a semantic search tool which deals with language subtleties to enhance an advanced full text search engine dedicated to French health documents. This tool is currently used on a daily basis to help researchers identifying patients thanks to unstructured data.
On optical transmittance of ultra diluted gas
Authors: Ratajczak Jakub
Published: September 2020

The paper proposes a model of optical transmittance of ultra diluted gas taking into account gas particles non-locality, the quantum effect of wave function spreading derived from solving the Schr ̈odinger equation for a free particle. A significant increase in the transmittance of such gas is envisaged as compared to the classical predictions. Some quantitative and qualitative consequences of the model are indicated and falsifying experiments are proposed. The classic Beer-Lambert law equation within range of its applicability is derived from the model. Remarks to some astrophysical phenomena and possible interpretations of Quantum Mechanics are made. An experiment consistent with the predictions of this model is referenced.
Effects of Three Anesthesia Drug Combinations in Miniature Pigs.
Authors: Kou Mingqing , Chen Xiaolong , Huang Minggang , Lu Kai
Published: September 2020

Background To compare the effects of three anesthesia drug combinations in miniature pigs. Methods Guizhou miniature pigs （15 male, 15 female, 22-24 months）were randomly divided into three groups (n=10, 5 male, 5 female) and anesthetized intramuscularly (neck) with sumianxin Ⅱ (0.1 ml/kg) and 3% pentobarbital (0.8 ml/kg; Group A); ketamine (10 mg/kg) and 3% pentobarbital (0.8 ml/kg; Group B); or ketamine (10 mg/kg) combined with sumianxin II (0.1 ml/kg; Group C). Induction time, maintenance time, recovery time, and mortality were recorded. Heart rate, respiration, mean arterial pressure, and body temperature were analyzed pre-anesthesia (T0), after induction (T1), 30 min after operation (T2), 60 min after operation (T3), and at the end of anesthesia (resuscitation, T4). Results There were no significant differences in body weight, length, or experimental period between animals in the three treatment groups. The induction times of groups B and C (2-3 min) were significantly shorter than that of group A (7.4±1.1 min). The maintenance time of group B (136±11.4 min) was significantly different from those of groups A and C. The recovery time of group C was 4±1.0 min, compared with 9±0.6 min in group A and 10±1.5 min in group B. In group A, five pigs had adverse reactions (nausea and vomiting), and one pig died. All animals in group B had adverse reactions, and one pig died. The pigs in group C did not experience adverse reactions. The heart rates and respiration of the animals in group C were decreased at T2 and T3 compared with those of group A and B; there were no differences in heart rate and respiration between groups A and B. There were no differences in body temperature or mean arterial pressure of the pigs in the three treatment groups.Conclusions Intramuscular injection of ketamine combined with sumianxin Ⅱ is a suitable anesthesia therapy in miniature pigs because of short induction and recovery times, long maintenance time, and effectiveness.