bluuebunny/crossref_metadata_2025 huggingface dataset:
The Role of Novel Coronavirus Pneumonia Outbreak Maps on the Internet in the Prediction and Early Warning of Infectious Diseases
Authors: Cao yufang , Qiu Rui , Ji Chao , Wu Zhidian , Yang Yijun , Zhang Yingai
Published: November 2020

BackgroundA novel coronavirus (2019-nCOV) has attracted worldwide attention since December 2019 when it appeared in Wuhan, China. The coronavirus disease (COVID-19) can cause respiratory distress syndrome or multiple organ dysfunction syndrome and be life-threatening. Covid-19 incidence can be reduced by using an outbreak map based on Geoinformatics. MethodsThis article introduces geographic mapping on the Internet and uses epidemic maps such as rank circles, choropleth rendering, overlay analysis and animation and other technologies to guide people’s behavior, reduce entry into areas with severe epidemics, and prevent new crowd infections. ResultsBy using various epidemic maps, households can reduce the access of people to the epidemic area (especially travellers to potentially at-risk areas), reduce the possibility of COVID-19 infection, and facilitate the timely diagnosis and treatment of fevered patients or suspected COVID-19. In addition, public health managers can intuitively understand the dynamics of the epidemic and spatial analysis of trends in outbreak dynamics and COVID-19 patterns helped to assist the public health sector and to evaluate/revise current control measures. Conclusion﻿The purpose of these online epidemic data collect and visualize is to notify travellers and assist the public or to analyzing the spatial and current trends and patterns of COVID-19 for public health authorities in assessing/revising current control measures.
Effectiveness of Fiscal Federalism for Poverty Reduction in Nigeria: An Analysis of Federal and State Governments’ Expenditures
Authors: Megbowon Ebenezer Toyin , Aderoju Samuel , Sanusi Gbenga
Published: November 2020

One of the sustained political and economic strategies that have been adopted by various countries over three decades to achieve the desired level of development is fiscal federalism. Through this economic development strategy, various levels of government within an economy have been involved in the pursuit of reducing poverty over the decades. The purpose of this study is to examine the relationship between government expenditure on poverty reduction with respect to federal and state government expenditures respectively. The study employed the auto-regressive distributed lag (ARDL) estimation technique to establish long-run relationship, and to examine the magnitude of the effect of federal and state government expenditures in both the short-run and long-run periods using time-series data for the period 1981 to 2018. Results obtained indicate that only state government expenditure has positive effect on poverty reduction in Nigeria. The findings of this study therefore support the need for greater decentralization and increase in fiscal expenditure responsibilities and strengthening revenue capability in favor of state governments, giving that achieving desired poverty reduction could be achieved through increased state government spending.JEL Classification: E62, H50, I30
Effect of metal decoration on sulfur-based gas molecules adsorption on phosphorene
Authors: Lei Shuangying , Gao Ran , Sun Xiaolong , Chen Jie
Published: November 2020

Using the first-principles calculation based on density functional theory (DFT), we systematically studied the adsorption of sulfur-based gas molecules (H2S, SO2, SO3) on various metal-decorated phosphorenes. To avoid the formation of metal clusters on the surface of phosphorene, eleven metals (Li, Na, K, Rb, Cs, Ca, Sr, Ba, Ni, La, Tl) with bulk cohesive energy less than the binding energy on the phosphorene are considered. Except for H2S on Tl-decorated phosphorene, all metal decorations can improve the adsorption strength of phosphorene to sulfur-based gas molecules, and Eads(H2S) < Eads(SO2) < Eads(SO3) for the same metal decoration case. In addition, some metal-decorated phosphorene systems exhibit interesting magnetic and electrical changes after sulfur-based gas molecule adsorptions, indicating that these metal-decorated phosphorene systems are promising to be used for the detection and removal of sulfur-based gas molecules.
Diarrhoeal diseases in Soweto, South Africa, 2020: a community survey
Authors: Johnstone Siobhan , Page Nicola , Madhi Shabir , Mutevedzi Portia , Myburgh Nellie , Herrera Carlos , Groome Michelle
Published: November 2020

Background In South Africa, there are limited data on the burden of diarrhoea at a community level, specifically in older children and adults. This community survey estimated rates of and risk factors for diarrhoea across all ages and determined the proportion of cases presenting to healthcare facilities. Methods Randomly sampled households were enrolled from an existing urban health and demographic surveillance site. A household representative was interviewed to determine risk factors and occurrence of diarrhoea in the household, for all household members, in the past two weeks (including symptoms and health seeking behaviour). Diarrhoeal rate of any severity was calculated for <5 years, 5-15 years and >15 years age groups. Risk factors for diarrhoea and factors associated with health seeking behaviour were investigated using binomial logistic regression. Results Diarrhoeal rate among respondents (2.5 episodes/person-year (95%CI, 1.8-3.5)) was significantly higher than for other household members (1.0 episodes/person-year (95%CI, 0.8-1.4); IRR=2.4 (95%CI, 1.5-3.7) p<0.001). Diarrhoeal rate was not significantly different between age groups, however younger children (<5 years) were more likely to present to healthcare facilities (OR=5.86 (95%CI, 1.09-31.37), p=0.039). Having a child between 5-15 years in the household was associated with diarrhoea (OR=2.26 (95% CI, 1.32-3.86), p=0.003). While 26.4% of cases sought healthcare, only 4.6% of cases were hospitalised and only 3.4% of cases had a stool specimen collected. Conclusion Diarrhoeal rate was high across all age groups in this community; however, older children and adults were less likely to present to healthcare, and are therefore underrepresented through facility-based clinical surveillance.
Telemedicine Use by Pediatric Rheumatologists during the COVID-19 Pandemic
Authors: Pooni Rajdeep , Ronis Tova , Lee Tzielan
Published: November 2020

Background

To characterize various aspects of telemedicine use by pediatric rheumatology providers during the recent pandemic including provider acceptability of telehealth practices, clinical reliability, and clinical appropriateness.
Methods

An electronic survey was generated and disseminated amongst the Childhood Arthritis and Rheumatology Research Alliance (CARRA) listserv (n = 547). Survey items were analyzed via descriptive statistics by question and correlates amongst burnout and satisfaction with telemedicine were examined via ANOVA with appropriate statistical software.
Results

The survey response rate was 40.8% (n = 223) with the majority of respondents in an attending-level role. We observed that musculoskeletal components of the exam were rated as the most reliable components of a telemedicine exam and 85.6% of survey respondents reported engaging the patient or patient caregiver to help conduct the virtual exam. However, 63.5% of providers reported not being able to elicit the information needed from a telemedicine visit to make a complete clinical assessment. We also noted areas of disagreement regarding areas of patient engagement and confidentiality. We found that approximately one-third (33.5%) of those surveyed felt that their level of burnout was increased due to telemedicine.
Conclusion

In general, providers found exam reliability (specifically around focused musculoskeletal elements) in telemedicine visits but overall felt that they were unable to generate the information needed to generate a complete clinical assessment. Additionally, there were suggestions that patient engagement and confidentiality varied during telemedicine visits when compared to in-person clinical visits. Further qualitative work is needed to fully explore telemedicine use in pediatric rheumatology.
In Vitro Evaluation of Cerebrospinal Fluid Velocity Measurement Agreement, Reliability, and Reproducibility in Type I Chiari Malformation Using 2D Phase Contrast Magnetic Resonance Imaging and 4D Flow Imaging
Authors: Williams Gwendolyn , Thyagaraj Suraj , Fu Audrey , Oshinski John , Giese Daniel , Bunck Alexander C. , Fornari Eleonora , Santini Francesco , Luciano Mark , Loth Francis , Martin Bryn A.
Published: November 2020

Background
Phase contrast magnetic resonance imaging, PC MRI, is a valuable tool allowing for non-invasive quantification of CSF dynamics, but has lacked adoption in clinical practice for Chiari malformation diagnostics. To improve these diagnostic practices, a better understanding of PC MRI based measurement agreement, repeatability, and reproducibility of CSF dynamics is needed.
Methods
An anatomically realistic in vitro subject specific model of a Chiari malformation patient was scanned three times at five different scanning centers using 2D PC MRI and 4D Flow techniques to quantify intra-scanner repeatability, inter-scanner reproducibility, and agreement between imaging modalities. Peak systolic CSF velocities were measured at nine axial planes using 2D PC MRI, which were then compared to 4D Flow peak systolic velocity measurements extracted at those exact axial positions along the model.
Results
Comparison of measurement results showed good overall agreement of CSF velocity detection between 2D PC MRI and 4D Flow (p = 0.86), fair intra-scanner repeatability (confidence intervals ± 2 cm/s), and poor inter-scanner reproducibility. On average, 4D Flow measurements had a larger variability than 2D PC MRI measurements (standard deviations 1.83 and 1.04 cm/s, respectively).
Conclusion
Agreement, repeatability, and reproducibility of 2D PC MRI and 4D Flow detection of peak CSF velocities was quantified using a patient-specific in vitro model of Chiari malformation. In combination, the greatest factor leading to measurement inconsistency was determined to be a lack of reproducibility between different MRI centers. Overall, these findings may help lead to better understanding for application of 2D PC MRI and 4D Flow techniques as diagnostic tools for CSF dynamics quantification in Chiari malformation and related diseases.
A Protocol for a Systematic Literature Review of Economic Evaluation Studies of Interventions to Address Antimicrobial Resistance
Authors: Ananthakrishnan Aparna , Painter Chris , Teerawattananon Yot
Published: November 2020

Background: Antimicrobial resistance (AMR) is accelerated by the widespread and often indiscriminate use of antimicrobials in humans, animals, and the environment. In 2015, the World Health Organization recognised AMR as one of the top ten global health threats, due to its potential to neutralise humanity’s advancements in western medicine by enabling the emergence of new strains of existing pathogens, many of which have no available treatments. Over the past decade, several countries, including those in low- and middle- income contexts, have started implementing interventions to tackle AMR. However, economic evidence regarding the cost-effectiveness of these interventions remain weak. To address this evidence gap, we will conduct a systematic literature review to provide a comprehensive summary on the value for money of different AMR interventions.Methods: We aim to conduct a systematic literature review of all available economic evaluations on interventions addressing AMR and will provide a narrative synthesis of our findings. Systematic searches for relevant studies will be performed across all suitable databases as well as in grey literature sources such as unpublished studies, reports, and other relevant documents. All economic evaluation studies will be included as long as they report an economic outcome. Those studies reporting clinical endpoints alone will be excluded. Selection for final inclusion and data extraction will be performed by two independent reviewers. Discussion: The review will be one of the first of its kind, and the most recent, to systematically review literature on the cost-effectiveness of AMR interventions, an important evidence gap in the economics of AMR. The findings will enable policy and decision-makers, particularly in resource-constrained settings, to better use available resources when selecting interventions to address AMR burdens, Systematic review registration: PROSPERO (Awaiting registration number)
How We Teach Children with Asthma to Use Their Inhaler: A Scoping Review
Authors: McCrossan Patrick , Mallon Orla , Shields Michael , Russell Catherine , Kennedy Lesley , O’Donoghue Dara
Published: November 2020

BackgroundOne reason that asthma remains poorly controlled in children is poor inhaler technique. Guidelines recommend checking inhaler technique at each clinical visit. However, they do not specify how best to train children to mastery of correct inhaler technique. Many children are simply shown how to use inhalers which results in less than 50% with correct inhaler technique. The aim of this scoping review is to explore published literature on teaching methods used to train children to master correct inhaler technique.MethodsWe searched (from inception onwards): Medline, Embase, Scopus, Web of Science, CINAHL and the Cochrane library. We included quantitative studies, (e.g. randomised controlled trials, cohort studies and case-control studies), published from 1956 to present, on teaching inhaler technique to children with asthma. Data was extracted onto a data charting table to create a descriptive summary of the results. Data was then synthesised with descriptive statistics and visual mapping.ResultsTwenty-eight papers were identified for full text analysis. Educational interventions were found to be taking place in a variety of clinical areas and by a range of healthcare professional disciplines. ‘Brief-Instruction’ and ‘Teach-Back’ were identified as two primary methods of providing inhaler technique training in the majority of papers. Secondary themes identified were; use of written instruction, physical demonstration, video demonstrations and/or use of inhaler devices to augment inhaler technique training.ConclusionThere are a variety of means by which inhaler technique has been taught to children. We have not analysed the effectiveness of these different interventions, but have described what has been trialled before in an attempt to focus our attentions on what may potentially work best. The majority of these methods can be dichotomised to either ‘Brief-Intervention’ or ‘Teach-Back’. Based on our analysis of this scoping review, we consider the following as areas for future research; how many times does a given intervention have to be done in order to have the desired effect? For what duration does the intervention need to continue to have a long-lasting effect? And, what is the best outcome measure for inhaler technique? Systematic review registrationOpen Science Framework (osf.io/n7kcw).
Endogenous PCSK9 may influence circulating CD45neg/CD34bright and CD45neg/CD34bright/CD146neg cells in patients with type 2 diabetes mellitus
Authors: Tripaldi Romina , Lanuti Paola , Simeone Paola , Liani Rossella , Bologna Giuseppina , Ciotti Sonia , Simeone Pasquale , Castelnuovo Augusto Di , Marchisio Marco , Cipollone Francesco , Santilli Francesca
Published: November 2020

Protease proprotein convertase subtilisin/kexin type 9 (PCSK9) is a regulator of LDL cholesterol clearance and has been associated with cardiovascular risk. PCSK9 inhibitors increase in vivo circulating endothelial progenitor cells (EPCs), a subtype of immature cells involved in ongoing endothelial repair. We hypothesized that the effect of PCSK9 on vascular homeostasis may be mediated by EPCs in patients with or without type 2 diabetes mellitus (T2DM). Eighty-two patients (45 with, 37 without T2DM) at high cardiovascular risk were enrolled in this observational study. Statin treatment was associated with higher circulating levels of PCSK9 in patients with and without T2DM (p<0.001 and p=0.036) and with reduced CD45neg/CD34bright (p=0.016) and CD45neg/CD34bright/CD146neg (p=0.040) only among patients with T2DM.
In the whole group of patients, statin treatment was the only independent predictor of low number of CD45neg/CD34bright (β=-0.230; p=0.038, adjusted R2=0.041). Among T2DM patients, PCSK9 circulating levels were inversely related and predicted both the number of CD45neg/CD34bright (β=–0.438; p=0.003, adjusted R2=0.173), and CD45neg/CD34bright/CD146neg (β=–0.458; p=0.002, adjusted R2=0.191) independently of age, gender, BMI and statin treatment.
In high-risk T2DM patients, high endogenous levels of PCSK9 may have a detrimental effect on EPCs by reducing the endothelial repair and worsening the progression of atherothrombosis.
Driving Health Technologies Towards Performance: A Contextualization Within the Hospital Sector
Authors: Gabutti Irene
Published: November 2020

The authors have requested that this preprint be removed from Research Square.
Vascular endothelial growth factor-A (VEGFA) gene polymorphisms may serve as genetic marker for Coronary Heart Disease (CHD)
Authors: Huang Kang , Lu Shijuan , Zhou Yilei , Lin Dehong , Chen Zibin , Zhong Zanrui , Zhong Jianghua
Published: November 2020

Purpose: Coronary heart disease (CHD) is a common cardiovascular disease resulting from interaction of multiple environmental and genetic factors. This study aimed to confirm whether single nucleotide polymorphisms (SNPs) in VEGFA gene were associated with CHD in the Han Chinese population. Materials and Methods: Blood samples were collected from 501 CHD patients and 496 healthy individuals. Genotyping of five SNPs within VEGFA was performed using Agena MassARRAY platform. Odd ratios (ORs) and 95% confidence intervals (95%CIs) were calculated to evaluate the association between SNPs and CHD risk.Results: The genotype “C/T” of rs3025021 in VEGFA was found to be associated with CHD susceptibility (OR = 1.35, 95% CI = 1.02- 1.80, p = 0.038) in the overall. Rs833068 was observed to be associated with the reduced risk of CHD at age > 61 years and ≤ 61 years, respectively. And three loci (rs833068, rs3025021 and rs6905288) were related to the CHD risk in males. In addition, rs3025021 was associated with increased risk of CHD in patients with hypertension or diabetes. Conversely, three loci (rs833068, rs3025030 and rs6905288) were related to the CHD risk in patients without hypertension. The rs833068 was associated with reduced risk of CHD in patients without diabetes. Finally, we found a strong LD between rs833068 and rs833070. Conclusion: Gene polymorphisms in VEGFA were notably correlated with altered CHD risk in the Han Chinese population. Large sample size and well - designed studies are needed to further clarify the potential mechanisms underlying the CHD.
Magnetic COFs as satisfied support for lipase immobilization and recovery to effectively achieve the production of biodiesel by great maintenance of enzyme activity.
Authors: Zhou Zi-Wen , Xing Xiu , Li Jun , Hu Zu-E , Xie Zong-Bo , Wang Na , Yu Xiao-Qi
Published: November 2020

Background: Production of biodiesel from renewable sources such as non-edible vegetable oils by enzymatic catalysis has been a hotspot but remains a challenge on the efficient use of an enzyme. COFs featuring large surface area and porosity should be applied as an ideal support to impede aggregation of lipase and methanol. However, the naturally low density limits its application. In this work, we reported a facile synthesis of core-shell magnetic COF composite (Fe3O4@COF-OMe) to immobilize RML (Rhizomucor miehei lipase), in order to achieve its utilization in biodiesel production.Result: This strategy gives extrinsic magnetic property, and the magnetic COFs is much heavier and could disperse in water medium well, facilitating the attachment with enzyme. The resultant biocomposite exhibited an excellent capacity of RML due to its high surface area and fast response to the external magnetic field, as well as good chemical stability. The core-shell magnetic COF-OMe structure not only achieved highly efficient immobilization and recovery processes, but also maintained the activity of lipase to a great extent. RML@Fe3O4@COF-OMe performed well in practical applications, while free lipase did not. The biocomposite successfully achieved the production of biodiesel from Jatropha curcas Oil with a yield of about 70% in the optimized conditions. Conclusion: Magnetic COFs (Fe3O4@COF-OMe) for RML immobilization greatly improved catalytic performance in template reaction and biodiesel preparation. The magneticity makes it easily recovered and separated from system. This first successful attempt of COFs-based immobilized enzyme broadened the prospect of biodiesel production by COFs with some inspiration.
Do Contributing Factors for Health Inequality Really Indicate Worse Conditions Among Upper Non-manual Workers Than Among Lower Non-manual and Manual Workers in Korea?: A Cross-sectional Study Using a Nationally Representative Survey Data of Korea
Authors: Noh Eunjeong , Khang Young-Ho
Published: November 2020

Background: Despite the consensus that higher occupational classes tend to have better health and lower mortality rates, a previous study reported reversed occupational gradients in mortality rates among Korean men after the economic crisis in the late 2000s. This study investigated occupational gradients in socioeconomic position and multiple pathway indicators known to affect mortality.Methods: We used data from 4,176 men aged 35–64 in Korea, derived from the 2007-2009 and 2013-2015 Korean National Health and Nutrition Examination Surveys, to compare the age-standardized prevalence and age-adjusted mean value of each contributing factor to health inequality among occupational groups, which were divided into upper non-manual workers, lower non-manual workers, manual workers, and others. Contributing factors included childhood and adulthood socioeconomic position indicators, biological risk factors, health behaviors, psychosocial factors, and work environment.Results: Upper non-manual workers had prominently higher levels of education, income, parental education, and economic activity than lower non-manual and manual workers. The rates of smoking and high-risk alcohol consumption were lower in the non-manual classes, and the rate of weight control activities was higher. Depression and suicidal ideation levels were lower and perceptions of the work environment were better among non-manual workers than among their manual counterparts.Conclusions: This study confirmed occupational inequality in a wide range of socioeconomic positions and pathway indicators in Korea, with consistently favorable patterns for upper non-manual workers. These occupational gradients do not support the previously reported reversed pattern of higher mortality in non-manual groups than in the manual job class in Korea.
Gametocyte Carriage After Seasonal Malaria Chemoprevention in Plasmodium Falciparum Infected Asymptomatic Children 
Authors: Ahmad Abdullahi , Prom Aurelia , Bradley John , Ndiath Mamadou , Etoketim Blessed , Bah Mamadou , Vangeetruyden Jean-Pierre , Drakeley Chris , Bousema Teun , Achan Jane , D'Alessandro Umberto
Published: November 2020

BackgroundTreatment of clinical Plasmodium falciparum malaria with sulfadoxine-pyrimethamine (SP) and amodiaquine (AQ) is associated with increased post-treatment gametocyte carriage. The effect of seasonal malaria chemoprevention (SMC) with SP and AQ on gametocyte carriage was assessed in asymptomatic Plasmodium falciparum infected children. MethodsThe study was carried out in eastern Gambia. Asymptomatic malaria infected children aged 24-59 months old eligible for SMC (SMC group) and children 5-8 years that did not receive SMC treatment (comparison group) were recruited. Baseline gametocyte prevalence was determined by molecular methods before SMC administration and 13 days after. Gametocyte carriage between the groups was compared using the Chi-squared test and within person using conditional logistic regression.ResultsDuring the 2017 and 2018 malaria transmission seasons, 65 and 75 children were recruited in the SMC and comparison groups respectively. Before SMC administration, gametocyte prevalence was 10.7% (7/65) in the SMC group and 13.3% (10/75) in the comparison group (p=0.64). At day 13 after SMC administration, this was 9.4%, (5/53) for the SMC group and 12.7%, (9/71) for the comparison group (p=0.57). Within the SMC group, gametocyte carriage before and after SMC administration was similar (OR 0.6, 95% CI 0.14 – 2.51) (p=0.48).ConclusionIn this study with relative low gametocyte prevalence prior to SMC treatment, no evidence was observed that SMC increased gametocyte carriage in asymptomatic malaria infected children.
The Investigational Clinical Center: a clinical-supportive and patient-centered trial unit model. Ten years of experience through normal and pandemic times of a large pediatric Trial Center in Italy.
Authors: Pontrelli Giuseppe , Ciabattini Marco , De Crescenzo Franco , Biondi Isabella , Cocchiola Rossana , Copponi Giorgia , Frillici Claudia , Molinari Francesca , Rocchi Francesca , Simonetti Alessandra , Rossi Paolo , Livadiotti Susanna
Published: November 2020

Evidence-based medicine relies on appropriately designed, conducted and reported clinical trials (CTs) to provide the best proofs of efficacy and safety for pharmacological and non-pharmacological treatments. Modern clinical research features high complexity and requires a high workload for the management of trials-related activities, often hampering physicians’participation to clinical trials. Dealing with children in clinical research adds complexity: rare diseases, parents or legal guardian reluctance to engage and recruitment difficulties are major reasons of pediatric trials failure. However, because in paediatrics many treatments are prescribed off-label or are lacking, well-designed clinical trials are particularly needed. Clinical Trial Units (CTUs) are indeed an important asset in the implementation of clinical trials, but their support to investigators is limited to administrative and non-clinical tasks. In this paper we present the model of the Investigational Clinical Center (ICC) of the Bambino Gesù Children’s Hospital in Rome. The ICC includes clinicians supporting the Principal Investigators (PIs) for clinical management of enrolled patients in compliance of Good Clinical Practice, the legal framework of Clinical Trials. Furthermore, we present ten years’ experience in paediatric clinical trials and how it has been disrupted during the COVID-19 pandemic. The activity of the ICC has been evaluated according to six metrics of performance. The ICC model offers a complete support, helping investigators, patients and their families to overcome majority of barriers linked to clinical research, even in time of pandemic. We propose this organization as an innovative model for total-supportive and patient-centered clinical trial implementation.
Neck circumference as an independent predictor for NAFLD among postmenopausal women with normal body mass index
Authors: Shi Jie , Wang Zixuan , Zhang Weiwei , Niu Yixin , Lin Ning , Li Xiaoyong , Zhang Hongmei , Ning Guang , Fan Jiangao , Qin Li , Su Qing , Yang Zhen
Published: November 2020

Background
Neck circumference, a proxy for upper-body subcutaneous fat, is a unique and pathogenic fat depot that confers additional metabolic risk. The purpose of present study was to determine whether neck circumference associates with nonalcoholic fatty liver disease (NAFLD) in postmenopausal women with normal body mass index.
Methods
A cross-sectional survey (n = 2492) and a 3.1-year follow-up investigation (n = 1354) were conducted among Chinese postmenopausal women with normal BMI (18.5 to < 25 kg/m2). Neck circumference was measured horizontally at the lower margin of the laryngeal prominence.
Results
In the cross-sectional analysis, large neck circumference was associated with the presence of NAFLD (odds ratio 2.28; 95% CI 1.74–2.98; highest tertile versus lowest tertile) after adjustment for confounding factors. Among 1,354 subjects without the NAFLD at baseline, 429 (31.7%) incident NAFLD cases occurred at 3.1 years. Neck circumference was positively associated with triglycerides, homeostasis model assessment of insulin resistance, C-reactive protein, and negatively associated with high-density lipoprotein cholesterol and adiponectin. Individuals with large baseline neck circumference had a significantly higher risk of NAFLD than those with small neck circumference. The multivariable adjusted hazard ratio was 1.42 (95% CI 1.15–1.97; p for trend = 0.004) for the highest versus the lowest tertile of neck circumference, and was 1.22 (95% CI 1.10–1.41; p = 0.006) per 1-standard deviation increment in neck circumference.
Conclusions
Among postmenopausal women with normal BMI, relatively large neck circumference levels are associated with an increased risk of NAFLD.
Comparison of Maternal and Neonatal Outcomes between Acute Fatty Liver of Pregnancy and Hemolysis, Elevated Liver Enzymes and Low Platelets Syndrome: A Retrospective Cohort Study
Authors: Ang Sau Xiong , Chen Chie-Pein , Sun Fang-Ju , Chen Chen-Yu
Published: November 2020

Background: Acute fatty liver of pregnancy (AFLP) and hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome are two uncommon disorders that mimic each other clinically, but are distinct pathophysiologically. This study aimed to compare maternal and neonatal outcomes between AFLP and HELLP syndrome.Methods: This retrospective cohort study was performed at a tertiary referral center in Taiwan between June 2004 and April 2020. We used the Swansea Criteria to diagnose AFLP, and the Tennessee Classification System to diagnose HELLP syndrome. Maternal characteristics, laboratory data, complications, and neonatal outcomes were analyzed.Results: During the study period, 21 women had AFLP and 80 women had HELLP syndrome. There was a higher rate of preeclampsia (95.0% versus 23.8%) in the HELLP syndrome group compared to the AFLP group. However, the AFLP group had more other maternal complications including jaundice (85.7% versus 13.8%), acute kidney injury (61.9% versus 15.0%), disseminated intravascular coagulopathy (66.7% versus 8.8%), and sepsis (47.6% versus 10.0%) compared to the HELLP syndrome group. Nevertheless, higher rates of small for gestational age neonates (57.1% versus 33.3%), neonatal respiratory distress syndrome (39.2% versus 8.3%) and neonatal sepsis (34.2% versus 12.5%) were noted in the HELLP syndrome group.Conclusions: AFLP is associated with a higher rate of multiple organ dysfunction in mothers, whereas HELLP syndrome is associated with a higher rate of neonatal morbidity.
Practice of Modern Methods of Family Planning in Two Urban Slums of Karachi and Effect of Counselling
Authors: Akram Dure Samin , Khalid Farah , Hanif Yasmeen , Taj Sobia
Published: November 2020

BACKGROUNDThe means and services used for prevention of pregnancies is referred as Family Planning (FP) (1). The successful implementation of Family Planning has remained a difficult task in Pakistan because of socio-cultural beliefs, lack of information or misinformation and lack of access to contraceptive services. Cultural taboos and social bonds related to women are major factors in the low uptake of FP services (2). METHODOLOGThis study is the analysis of retrospective secondary data from an NGO, HELP’s Family Planning clinics, to determine the trends and patterns of contraceptive methods used in two squatter settlements(Neelam Colony and KKB) in Karachi from 2010-2018. The data originated from Mother and Child centers of HELP. Records of the monthly data collected by CHWs from their catchments areas were obtained and it was cumulated annually. Variables studied included number of women of childbearing age (CBA), number of married women of childbearing age, information about number of family planning users, number of babies born. The data also included different types of FP methods used by married couples. For analysis, the data was entered in Microsoft Excel and then exported to SPSS version 19. Mean and percentages, graphs and other graphics for all the variables were calculated and created through SPSS 19 and Excel.RESULTSThe Mean number of FP users were 43% in Neelum Colony and 48% at KKB. Similar data was reported in PDHS 2017-18 that 34% of married women in Pakistan were opting for methods of family planning (3). Use of Condoms was the most commonly used method of family planning in Neelum Colony and in KKB, recorded as being 36%, and 41% users respectively. The FP2020 reports that there are 34% condom users in Pakistan (4). Our study also found that that that the increase in use of FP was influenced by increased reminders and nudging techniques during counselling by CHWs. CONCLUSIONSTo progressively increase the practice of couples using modern FP methods, it is crucial that repeated messages giving correct scientific information regarding FP methods be given frequently. Acceptance of using FP has to be developed primarily in the male counterpart and therefore, male social mobilisers should form part of a team.
A Study on the Clinical Application of Greater Omental Pedicle Flap Transplantation to Correct Anterior Resection Syndrome in Patients With Low Rectal Cancer
Authors: qin haiquan , Meng Linghou , Huang Zigao , Liao Jiankun , Feng Yan , Luo Shanshan , Lai Hao , Tang Weizhong , Mo Xianwei
Published: November 2020

PurposeLow anterior resection syndrome (LARS) is the most common complication after total mesorectal excision (TME) in patients with low rectal cancer and has been a challenge in colorectal surgery that severely impacts the quality of life of patients. This study aimed to introduce a revised surgical procedure which could effectively maintain rectal compliance and significantly improve LARS after the operation.MethodsWe performed mesorectal reconstruction after routine Dixon-TME using greater omental pedicle flap transplantation in 11 patients with low rectal cancer (5 cases of preoperative neoadjuvant chemoradiotherapy, 5 cases of preoperative neoadjuvant chemotherapy, and 1 case of postoperative adjuvant chemotherapy), thereby simulating the initial anatomical structure of the mesorectum and significantly reducing the postoperative anterior resection syndrome. The lars precision syndrome assessment scale (LARSS) was used to access the LARS.ResultsAt 12 weeks after the 11 patients recovered from the anal defecation function, the average score on the LARS questionnaire was 25.5 ± 0.5 (mild). The average time at which anal function began to recover was 6.2 ± 2.6 weeks after surgery. The recovery was rapid, as the rectal and anal function of all patients generally returned to normal levels within 12 weeks, and the quality of life was close to that before surgery. ConclusionGreater omental flap transplantation can significantly improve LARS after Dixon-TME in patients with low rectal cancer.
The Novel Ferroptosis-related Gene Markers That Can Predict the Survival in Gastric Cancer Patients
Authors: Chen Bang , Xu Xin , Zhu ShaoFu , Yang ShiYi , Yang Kang , Jin MengYao , Wang Tianbin , Men Tao , Cao Guodong , Chen Bo
Published: November 2020

Background: Gastric cancer(GC) refers to malignant tumor that derived from gastric epithelial cells. Ferroptosis is another programmed cell demise mode that is Fe-dependent, unique concerning apoptosis, cell necrosis, and autophagy. Current research demonstrates that ferroptosis assumes a basic part of cancer biology. Extracellular matrix(ECM) has been confirmed to play an essential role in the proliferation, apoptosis, metabolism and differentiation of tumor cells. As an important component of the tumor microenvironment, ECM interacts with the immune microenvironment and affects tumor development and progression. Methods: GC data were downloaded from the TCGA database. Furthermore, 259 ferroptosis-related genes were acquired with the FerrDb database. COX regression analysis was used to screen ferroptosis-related genes related to GC's prognosis, and these genes constructed the prediction model. The risk score of the model and clinical data of GC were further analyzed to get the correlation between the model and the overall survival(OS) rate and clinicopathological features. Finally, GO and KEGG enrichment analysis was carried out on the genes of the model. To further analyze the correlation between the genes in the model and tumor immunity, ssGSEA was used to score immune cells and calculate immune-related pathways' activity quantitatively. Results: A prognosis model was constructed according to the 11 ferroptosis-related genes related to prognosis to predict the prognosis of GC patients better. According to univariate and multivariate, risk score can be regarded as an independent predictor.Conclusions: we identified 11 ferroptosis-related genes (NOX4, NOX5, SLC1A5, GLS2, MYB, TGFBR1, NF2, ZFP36, DUSP1, SLC1A4, SP1), which affected the prognosis of GC patients.
Systematic Expression Analysis of Zinc-finger Transcription Factor Family Reveals the Importance of Snai1 in Colorectal Carcinogenesis
Authors: Li Jianxin , Han Ting , Wang Xin , Wang Yinchun , Yang Qingqiang
Published: November 2020

Background: Epithelial-mesenchymal transition (EMT) has long been recognized as one of the most important processes involved in cancer cells metastasis. SNAI1, a member of zinc-finger transcriptional factor family, has been identified as an EMT inducer, but its role in human colorectal cancer (CRC) remains largely unclear.Methods: In the present study, we made a synthesis of the expression of zinc-finger transcription factor family and investigate the prognostic value of SNAI1 in human CRC by using a series of bioinformatic tools.Results: SNAI1 is the only member of zinc-finger transcription factor family that frequently overexpressed in CRC. In addition, overexpression of SNAI1 was remarkably associated with high tumor stage, N classification and M classification in patients with CRC. Patients with high SNAI1 expression had worse prognosis than those with low SNAI1 expression. Moreover, cox regression analysis showed that SNAI1 was an independent risk factor for overall survival in CRC patients. KEGG pathway analysis showed that SNAI1 enriched in pathways of Focal adhesion, PI3K-Akt signaling pathway and ECM-receptor interaction. GO analysis revealed that SNAI1 participated in processes of extracellular matrix organization, cell adhesion and collagen catabolic process. Eventually, co-expression analysis revealed that overexpression of SNAI1 was significantly correlated with Biglycan (BGN), indicating that they may cooperate in regulating the process of EMT, thereby inducing cancer cells metastasis.Conclusions: Our results demonstrated that SNAI1 is overexpressed in CRC and acts as an independent molecular marker for prognosis of CRC patients. SNAI1 is a potential biomarker for diagnosis, targeted therapy and prognostic evaluation of CRC.
Identification of Key Genes and Pathways in Colorectal Cancer by Integrated Bioinformatics Analysis
Authors: Wang Chaochao , Zhang Li , Hu Yingchun
Published: November 2020

PurposeIn order to understand the mechanism of colorectal cancer occurrence and development, we screened related core genes and provided new targets for clinical diagnosis and treatment of colorectal cancer.MethodsWe downloaded CRC-associated gene expression profile of GSE110233 from Gene Expression Omnibus (GEO) dataset. There were 26 samples in this dataset, all the differentially expressed genes (DEGs) with p<0.05 and fold change ≥1 or ≤-1 were identified. Gene ontology (GO) and "Kyoto Encyclopedia of Genes and Genomes" (KEGG) were used to search for these DEG enrichment methods. In addition, the protein-protein interaction (PPI) network was also used to construct visual interactions between proteins. At last, we used GEPIA to conduct the survival analysis 4 down-regulation and 8 up-regulation genes for clarify the potential effects on CRC.ResultsA total of 866 differentially expressed genes were obtained, including 360 up-regulated genes and 506 down-regulated genes. These genes were involve in Cell proliferation; Extracellular exosome; Protein binding; Chemokine activity. Genes were mainly involved in the KEGG pathway termed Cell cycle; PI3K-Akt signaling pathway; Mineral absorption; MicroRNAs in cancer; Cytokine-cytokine receptor interaction. We finally found 12 hubgenes by PPI connective degree whom named PRKACB, FGFR2, FGFR3, CKB, TIMP1, CCNA2, CCNB1, CDC20, CDC6, CCND1, CDK4 and CDK1.ConclusionBioinformatics is helpful for comprehensive and in-depth study of the occurrence and development mechanism of diseases, to screen possible core targets, and to provide a reliable basis for clinical diagnosis and treatment of colorectal cancer.
Real-World Study of Hepatic Hemangioma at a Single Center -- Data From 2008 to 2017
Authors: He Yongfei , Yang Chengkun , Liang Tianyi , Wei Yongguang , Wei Zhongliu , Mo Shutian , Chen Zijun , Liao Xiwen , Su Hao , Zhu Guangzhi , Han Chuangye , Lv Zili , Peng Tao
Published: November 2020

Objective: The objective of the present study was to investigate the clinical and epidemiological characteristics of hepatic hemangioma (HH) and the risk factors for complications associated with HH resection in a single center experience.Materials and methods: Clinical data of 5,266,670 outpatients and 246,419 individuals who were physically examined between 2016 and 2017 were used to evaluate epidemiological profiles of HH. A total of 1,981 patients hospitalized with HH between January 1, 2008 and January 1, 2018 were examined to identify relevant features associated with surgery. Results: The study found that HH was similar in male and female incidence, mostly at the age of 40, and the tumor was usually single and mostly located in the right lobe of the liver. No serious postoperative complications occurred, and the method of HH resection was related to the occurrence of postoperative complications.Conclusion: HH is a common benign disease of the liver. There are certain distribution rules in age, tumor size, and location, and laparoscopic HH resection that can reduce postoperative complications.
Statin Use is Associated With a Lower Risk of Recurrence After Curative Resection in BCLC Stage 0-a Hepatocellular Carcinoma
Authors: Yang Shih-Yu , Wang Chih-Chi , Chen Kuang-Den , Liu Yueh-Wei , Lin Chih-Che , Chuang Ching-Hui , Tsai Yu-Chieh , Yao Chih-Chien , Yen Yi-Hao , Hsiao Chang-Chun , Hu Tsung-Hui , Tsai Ming-Chao
Published: November 2020

BackgroundUse of statins is associated with a reduced risk of hepatocellular carcinoma (HCC). However, the effect of statin use on HCC recurrence is unclear. This study aimed to evaluate the effect of statin use on recurrence after curative resection among patients with HCC.MethodsWe retrospectively assessed 820 patients with Barcelona Clinic Liver Cancer (BCLC) stage 0 or A HCC who underwent primary resection between January 2001 and June 2016 at Kaohsiung Chang Gung Memorial Hospital. Exposure to statins was defined as use of a statin for at least 3 months before HCC recurrence. Factors that influenced overall survival (OS) and recurrence-free survival (RFS) were analyzed using Cox proportional hazards models.ResultsOf the 820 patients, 46 (5.6%) used statins (statin group) and 774 (94.4%) did not (non-statin group). During the mean follow-up of 76.5 months, 440 (53.7%) patients experienced recurrence and 146 (17.8%) patients died. The cumulative incidence of HCC recurrence was significantly lower in the statin group than the non-statin group (p = 0.001); OS was not significantly different between groups. In multivariate analysis, age (hazard ratio [HR]: 1.291; p = 0.010), liver cirrhosis (HR: 1.743; p < 0.001), diabetes (HR:1.418; p = 0.001), number of tumors (HR: 1.750; p < 0.001), tumor size (HR: 1.406; p = 0.004) and vascular invasion (HR: 1.659; p < 0.001) were independent risk factors for HCC recurrence, whereas statin use (HR: 0.354; p < 0.001) and antiviral therapy (HR: 0.613; p < 0.001) significantly reduced the risk of HCC recurrence. The statin group still had lower RFS than the non-statin group after one-to-four propensity score matching.Conclusion﻿Statins may exert a chemo-preventive effect on HCC recurrence after curative resection.
A Western Dietary Pattern is Related with Allergic Rhinitis in Young Women
Authors: Rezapour Hadis , Fereidouni Mohammad , Asadi Zahra , Saharkhiz Mansoore , Ayadilord Malaksima , Mahmoudzadeh Sara , Moghadam Mohammad Reza Shadmand Foumani , Ferns Gordon A. , Bahrami Afsane
Published: November 2020

Background: There has been an increasing prevalence of allergic disorders globally, and it may be useful to characterize the predisposing and protective factors for the development of allergy. Diet has been identified as one possible environmental factor implicated in the pathogenesis of allergic diseases. The goal of this study was to evaluate the associations between dietary patterns with the presence of allergies in a group of young women in East of Iran Methods: In total 181 female students enrolled in this study. Presence of allergic diseases including allergic rhinitis (AR), asthma and eczema was confirmed by an expert allergist. Information about dietary intake was collected by using a 65-item validated food frequency questionnaire. Exploratory factor analysis was used to evaluate the relationships among food/nutrition variables. Result: Multivariate odds ratio of having AR was 2.5 (95% CI:1.1-5.1) for the highest compared to lowest tertile of the Western dietary pattern score. But, no significant relationship was found between the traditional dietary pattern and AR, asthma or eczema. Conclusion: Our findings indicate a potential role of Western dietary pattern, characterized by being rich in dairy products, snack, nuts and sugar in the development of AR. Since diet is a modifiable impetus, the relationship between AR and Western dietary pattern may has a clinical application, particularly in those who has risk factors for developing AR.
Fast ISP Coding Mode Optimization Algorithm Based on CU Texture Complexity for VVC
Authors: Liu Zhi , Dong Mengjun , Guan XiaoHan , Zhang Mengmeng , Wang Ruoyu
Published: November 2020

In lately published video coding standard Versatile Video Coding (VVC/ H.266), the intra sub-partitions (ISP) coding mode is proposed. It is efficient for frames with rich texture, but less efficient for frames that are very flat or constant. In this paper, by comparing and analyzing the rate distortion cost (RD-cost) of coding unit (CU) with different texture features for using and not using ISP(No-ISP) coding mode, it is found that CUs with simple texture can get better coding performance in No-ISP coding mode. Based on this observations, a fast ISP coding mode optimization algorithm based on CU texture complexity is proposed, which aims to determine whether CU needs to use ISP coding mode in advance by calculating CU texture complexity, so as to reduce the computation complexity of ISP. The experimental results show that under All Intra (AI) configuration, the coding time can be reduced by 7%, while the BD-rate only increase by 0.09%.