bluuebunny/crossref_metadata_2025 huggingface dataset:
Eosinophilic Gastroenteritis as a Cause of Non-Helicobacter pylori, Non-gastrotoxic Drug Ulcers in Children
Authors: Joo Jung Yeon , Cho Jin Min , Yoo In Hyuk , Yang Hye Ran
Published: July 2020

Background: While Helicobacter pylori (H. pylori) ulcers has declined recently, H. pylori-negative and/or gastrotoxic drug-negative peptic ulcers (HNGN-PU) has increased. This study aimed to analyze the etiology of peptic ulcers in children and the differences in clinical, laboratory, endoscopic, and histopathologic findings of peptic ulcers according to etiology, including eosinophilic gastroenteritis (EoGE).Methods: In total, 255 children (157 boys and 98 girls) with peptic ulcers were recruited. The subjects were categorized into 5 groups according to the etiology of the ulcer: 1) H. pylori infection (n = 51); 2) gastrotoxic drugs (n = 18); 3) idiopathic (n = 144); 4) systemic disease (n = 23); 5) EoGE (n = 19). Clinical data were reviewed and analyzed retrospectively.Results: Age at diagnosis, ulcer recurrence, atopic dermatitis history, white blood cell count, blood eosinophil count, platelet count, serum albumin level, iron level, erythrocyte sedimentation rate, and C-reactive protein level differed significantly among the 5 groups (all p < 0.05). Regarding endoscopic findings, multiple ulcers and gastric mucosal nodularity differed among the 5 groups (all p < 0.05). When comparing the EoGE ulcer group with the others, EoGE group revealed older ages (p = 0.022), higher rates of ulcer recurrence (p = 0.018), atopic dermatitis history (p = 0.001), and both blood and tissue eosinophilia (both p = 0.001).Conclusions: EoGE ulcers constituted 10.2% of HNGN-PU in pediatric patients. In children with HNGN-PU, peripheral eosinophilia, ulcer recurrence, and atopic dermatitis history might imply EoGE, necessitating thorough investigation of tissue eosinophils during endoscopic biopsy.Trial registration: A total of 255 children was retrospectively registered between between July 2003 and April 2017.
Effect of Hookah (water pipe) smoking on Anti-Mullerian Hormone levels
Authors: Albeitawi Soha , Almehaisen Lama , Obeidat Rawan , Shehab Qasem , Elisabetta Garavaglia
Published: July 2020

The authors have withdrawn this preprint due to author disagreement.
Assessing the impacts of the Agenda Gap intervention for youth mental health promotion through policy engagement: A study protocol
Authors: Jenkins Emily , Haines-Saah Rebecca , McGuinness Liza , Hirani Saima , Boakye-Yiadom Noah , Halsall Tanya , Rivers Robert , Morris Jonathan
Published: July 2020

Background: Mental health challenges are a leading health concern for youth globally, requiring a comprehensive approach incorporating promotion, prevention and treatment within a healthy public policy framework. However, the broad enactment of this vision has yet to be realized. Further, mental health promotion evidence specific to youth is still emerging and has not yet focused at a policy level. This is a critical gap, as policy is a key mental health promotion lever that can alter the social and structural conditions that contribute to shaping youth mental health outcomes for all youth, across the full spectrum of need. Responsive to this research and intervention priority, our prototype study intervention – the Agenda Gap – is comprised of an innovative, multi-media engagement intervention, developed in collaboration with youth. This intervention aims to equip youth and build capacity for them to lead meaningful policy change reflective of the mental health needs of diverse communities of youth, including those who experience structural vulnerability and who would not typically have had their voice represented in policymaking processes. Methods: This study will use a multiple case study design and mixed methods grounded in a realist approach and will be conducted in three sites across two Canadian provinces (British Columbia and Alberta). In an earlier phase of this research, we collaboratively designed the prototype intervention with youth, community and policy partners. In this phase of the study, the intervention will be implemented and further tested with new groups of youth collaborators (n=10-15/site). Outcome data will be collected through realist qualitative interviews, validated questionnaires (i.e., Child and Youth Resilience Measure (CYRM-12), General Self-Efficacy (GSE) Scale, and the Critical Consiousness Scale (CCS)) and additional survey items developed by our study team. Analysis will focus on identification of key context-mechanism-outcome configurations to provide comprehensive insights into how this intervention works, for whom, and in what context. Discussion: This study is unique in its “upstream” focus on youth-engaged policymaking as a tool for improving the social and structural conditions that influence youth mental health across socioecological levels. Through the implementation and testing of the Agenda Gap intervention with diverse youth, this study will contribute to the evidence base on youth-engaged policymaking as a novel and innovative, mental health promotion strategy.
The aceE involves in mycolic acid synthesis and biofilm formation in Mycobacterium smegmatis
Authors: Chen Suting , Teng Tianlu , Wen Shuan , Zhang Tingting , Huang Hairong
Published: July 2020

Background: The integrity of cell wall structure is highly significant for the in vivo survival of mycobacteria. We hypothesized that changes in morphology may indicate changes in cell wall metabolism and identified an aceE gene mutant (aceE-mut) which presented a deficient colony morphology on 7H10 agar by screening transposon mutagenesis in Mycolicibacterium smegmatis, basonym Mycobacterium smegmatis (M. smegmatis). This study aimed to identify the functional role of aceE gene in cell wall biosynthesis in M. smegmatis.Results: We observed that the colony morphology of aceE-mut was quite different, smaller and smoother on the solid culture medium than the wild-type (WT) strain during the transposon library screening of M. smegmatis. Notably, in contrast with the WT, which aggregates and forms biofilm, the aceE-mut lost its ability of growing aggregately and biofilm formation, which are two very important features of mycobacteria. The morphological changes in the aceE-mut strain were further confirmed by electron microscopy which indicated smoother and thinner cell envelope images in contrast with the rough morphology of WT strains. Additionally, the aceE-mut was more fragile to acidic stress and exhibited a pronounced defects in entering the macrophages as compared to the WT. The analysis of mycolic acid (MA) using LC-MS indicated deficiency of alpha-MA and epoxy-MA in aceE-mut strain whereas complementation of the aceE-mut with a wild-type aceE gene restored the composition of MA. Conclusions: Over all, this study indicates that aceE gene plays a significant role in the mycolic acid synthesis and affects the colony morphology, biofilm formation of M. smegmatis and bacteria invasion of macrophage.
Direct comparison of magnetic resonance imaging and pathological shrinkage patterns of triple-negative breast cancer after neoadjuvant chemotherapy
Authors: Yoshikawa Katsuhiro , Ishida Mitsuaki , Kan Naoki , Yanai Hirotsugu , Tsuta Koji , Sekimoto Mitsugu , Sugie Tomoharu
Published: July 2020

Background: We aimed to investigate the usefulness of magnetic resonance imaging (MRI) and histopathological shrinkage patterns to formulate a predictive equation for estimating residual tumor size after neoadjuvant chemotherapy (NAC) in triple-negative breast cancer (TNBC) patients. Methods: We enrolled 34 TNBC patients who underwent MRI before and after NAC. The MRI and histopathological shrinkage patterns were analyzed and classified into five categories—types I and II (concentric shrinkage without or with surrounding lesions, respectively), type III (shrinkage with residual multinodular lesions), type IV (diffuse contrast enhancement in the entire quadrant), and non-visualization. The residual tumor sizes following MRI and histopathological examination were also compared.Results: The most common MRI and histopathological shrinkage pattern was type I (41.2% and 38.2%, respectively), followed by non-visualization (26.5% and 32.4%, respectively); the concordance rate between MRI and histopathological shrinkage patterns was 41.2%. There was a strong correlation between MRI tumor size and pathological tumor size (r = 0.89). Based on these findings, a predictive equation for pathological tumor size was formulated as follows: BConclusions: Our equation may aid accurate preoperative assessment. Further studies are needed to determine its predictive value and applicability.
Immunohistochemical Basigin Expression Level in Thyroid Cancer Tissues
Authors: Guo Wan-Ping , Tang Deng , Pang Yu-Yan , Li Xiao-Jiao , Chen Gang , Huang Zhi-Guang , Tang Xiao-Zhun , Lai Qin-Qiao , Gan Jin-Yan , Huang Xiao-Li , Liu Xiao-Fan , Wei Zhi-Xiao , Ma Wei
Published: July 2020

Background: Thyroid cancer (TC) is the most common endocrine malignancy, Basigin (also known as BSG) plays a crucial role in tumor cell invasion, metastasis, and angiogenesis. This study was designed to identify the change of BSG expression in TC and its possible potential mechanism. Methods: The BSG expression levels in TC were demonstrated using data collected from in-house immunohistochemical (IHC), RNA-sequencing (RNA-seq), microarrays and literatures. Integrated analysis was performed to determined BSG expression levels in TC comprehensively. The gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed with the integration of BSG co-expressed genes and differentially expressed genes (DEGs) in TC tissues to explore the potential mechanisms of BSG in TC. Results: The protein expression level of BSG was significantly higher in TC cases based on the IHC experiments. In addition, the combined SMD for BSG expression was 0.39 (p<0.0001), the diagnostic odds ratio was 3.69, and the AUC of the sROC curve was 0.6986 using 1182 TC cases and 437 non-cancerous cases from 17 independent datasets. Furthermore, BSG co-expressed genes tended to be enriched in gene terms of the extracellular matrix (ECM), cell adhesion, and cell-cell interactions. The expression levels of nine hub BSG co-expressed genes were markedly up-regulated in TC cases. Conclusion: BSG expression levels were closely correlated with the progression of TC and may affect the signals of the ECM, cell adhesion, and cell-cell interactions.
Evaluation of the Effect of Cooled Haemodialysis on cognitive Function in Patients suffering with End-stage Kidney Disease (E-CHECKED): Feasibility Randomised Control Trial Protocol
Authors: Dasgupta Indranil , Odudu Aghogo , Baharani Jyoti , Fergusson Niall , Griffiths Helen , Harrison John , Maruff Paul , Thomas G Neil , Woodhall Gavin , Youssef Samir , Tadros George
Published: July 2020

Background: Cognitive impairment is common in haemodialysis (HD) patients and is associated independently with depression and mortality. This association is poorly understood, and no intervention is proven to slow cognitive decline. There is evidence that cooler dialysis fluid (dialysate) may slow white matter changes in the brain, but no study has investigated the effect of cooler dialysate on cognition. This study addresses whether cooler dialysate can prevent the decline in cognition and improve quality of life (QOL) in HD patients.Methods: This is a multi-site prospective randomised, double-blinded feasibility trial. Setting: Four HD units in the United Kingdom.: Participants and interventions Ninety HD patients randomised (1:1) to standard care (dialysate temperature 36.5C) or intervention (dialysate temperature 35°C) for 12 months. Primary outcome measure: Change in cognition using the Montreal Cognitive Assessment (MoCA). Secondary outcome measures: Recruitment and attrition rates, reasons for non-recruitment, frequency of intradialytic hypotension, depressive symptom scores, patient and carers burden, a detailed computerised cognitive test and QOL assessments. Analysis: mixed method approach, utilising measurement of cognition, questionnaires, physiological measurements and semi-structured interviews.Discussion: The results of this feasibility trial will inform the design of a future adequately powered substantive trial investigating the effect of dialysate cooling on prevention and/ or slowing in cognitive decline in patients undergoing haemodialysis using a computerised battery of neuro-cognitive tests. The main hypothesis that would be tested in this future trial is that patients treated with regular conventional haemodialysis will have a lesser decline in cognitive function and a better quality of life over one year by using cooler dialysis fluid at 35°C, versus a standard dialysis fluid temperature of 36.5°C. This also should reflect in improvements in their abilities for activities of daily living and therefore, reduce carers' burden. If successful, the treatment could be universally applied at no extra cost.Trial registration: ClinicalTrials.gov Identifier: NCT03645733. Registered retrospectively on August 24, 2018. URL: https://clinicaltrials.gov/ct2/show/NCT03645733
Wogonin inhibits in vitro herpes simplex virus type 1 and 2 infection by modulating cellular NF-κB and MAPK pathways
Authors: Chu Ying , Lv Xiaowen , Zhang Longfeng , Fu Xingli , Song Siwei , Su Airong , Chen Deyan , Xu Lianhong , Wang Yongfang , Wu Zhiwei , Yun Zhihua
Published: July 2020

Background: Wogonin, a natural flavonoid-like chemical compound, exhibits anti-inflammatory, antitumor, antiviral, neuroprotective, and anxiolytic effects by modulating a variety of cellular signaling pathways including PI3K-Akt, p53, nuclear factor κB (NF-κB), mitogen-activated protein kinase (MAPK) pathways. In this study, its antiviral effect against herpes simplex virus (HSV) type 1 and 2 (HSV-1 and HSV-2) replication was investigated.Results: Wogonin suppressed HSV-2-induced cytopathic effect (CPE) and reduced viral mRNA transcription, viral protein synthesis, and infectious virion particle titers in a dose-dependent manner. A time-of-drug-addition assay demonstrated that wogonin acted as a postentry viral inhibitor. Wogonin also significantly reduced HSV-induced NF-κB and MAPK pathway activation, which has previously been demonstrated to be important for viral replication. Conclusions: Our results suggest that the anti-herpes effect of wogonin may be mediated by modulation of cellular NF-κB and JNK/p38 MAPK pathways and imply that wogonin may be useful as an anti-HSV agent.
Teladorsagia circumcincta beta tubulin: the presence of the E198L polymorphism on its own is associated with benzimidazole resistance
Authors: Valladares Maria Martinez , Valderas-García Elora , Gandasegui Javier , Skuce Philip , Morrison Alison , de Agüero Verónica Castilla Gómez , Cambra-Pellejà Maria , Balaña-Fouce Rafael , Vázquez Francisco A. Rojo
Published: July 2020

Background . Benzimidazole resistance is associated with isotype-1 β-tubulin gene F200Y, E198A and F167Y SNPs. In this study, the recently described polymorphism E198L was reported and analysed in Teladorsagia circumcincta . Methods . The benzimidazole phenotypic resistance was measured by the Faecal Egg Count Reduction Test (FECRT) and the Egg Hatch Test (EHT) using a discriminating dose (DD) in 39 sheep flocks. Around 1,000 larvae collected before and after treatment were used for DNA extraction. The resistant species identified in all flocks was T. circumcincta . The resistance alleles frequencies were measured for F200Y and E198A. A 371 bp fragment of the isotype-1 β-tubulin gene was analysed, including the three codons of interest, and a new pyrosequencing assay was designed for testing E198L. Results . The percentage of resistant flocks was 35% by FECRT or 26% by EHT, however F200Y and E198A SNPs were absent in T. circumcincta . The amplification of a 371 bp fragment confirmed the absence of F167Y and F200Y in 6 resistant flocks. Regarding codon 198, all samples after treatment carried a leucine (CTA). A pyrosequencing assay analysed the allele frequencies for the first two bases at codon 198 independently, G/C and A/T. The correlation between C and T frequencies was almost 1 (r = 0.929; p = 0.000) and the mean value of both was calculated to measure the leucine frequency; this value ranged between 10.4 and 80.7% before treatment, and from 82.3 to 92.8% after treatment. High and similar correlations were reported between the genotypic variables (C frequency, T frequency or mean of both frequencies) and phenotypic resistance (r > 0.720; p = 0.000), although negatively associated with the FECRT and positively with the EHT. According to multivariate linear regression analysis, the T frequency was the most significant variable influencing the phenotypic resistance (FECRT or EHT; p = 0.000). In the EHT, 67.1% of the phenotypic variability is associated with the T frequency but in the FECRT only 33.4%; therefore, the EHT using a DD seems to detect the genotypic resistance more accurately than the FECRT. Conclusions . The E198L polymorphism can confer BZ resistance on its own in T. circumcincta .
Heat Dissipation Performance of Loader-Digger Cooling System based on Simulation and Test Data
Authors: Li Lei , Chen Xi , Liu Di , Zhou Hong-gen , Wu Haiyan
Published: July 2020

High temperature of the radiator group is harmful to the power system and hydraulic system. In order to improve the heat dissipation performance of the loader, the flow field characteristics of the cooling chamber are analyzed by simulation and heat balance test. Firstly, the mathematical model of heat flow is established. Secondly, the flow field in the cooling chamber under different speeds is simulated based on CFX. And then the influence of fan position and internal flow field distribution on radiator performance is studied. Through the simulation of four different distances, it is concluded that the optimal distance between cooling fan and radiator is 76mm. Finally, a testing system is built for the temperature acquisition of engine water radiator, torque converter oil radiator, hydraulic oil radiator and air-to-air cooler of the hood structure, and then the simulation results are verified. The test results show that the heat dissipation performance of the whole machine meets the requirements after optimization, and the optimized scheme can make the loader-digger in an efficient and energy-saving operation state.
Preliminary evidence of imaging of chemokine receptor-4 targeted PET/CT with [68Ga]pentixafor in non-Hodgkin lymphoma: comparison to [18F]FDG
Authors: Pan Qingqing , Luo Yaping , Zhang Yan , Chang Long , Li Ji , Cao Xinxin , Li Jian , Li Fang
Published: July 2020

Background: In order to study the CXCR4 expression with [68Ga]pentixafor PET in different types of non-Hodgkin lymphoma, we performed a retrospective study to describe the [68Ga]pentixafor PET/CT imaging in a spectrum of lymphomas and to compare it with [18F]FDG PET/CT. Results: Twenty-seven patients with newly diagnosed non-Hodgkin lymphoma were recruited retrospectively. [68Ga]pentixafor PET showed increased radioactivity in lymphoplasmacytic lymphoma (n = 8), marginal zone lymphoma (n = 4), diffuse large B cell lymphoma (n = 3), follicular lymphoma (n = 2), mantle cell lymphoma (n = 1), unclassified indolent B cell lymphoma (n = 3) and enteropathy associated T cell lymphoma (n = 3). However, peripheral T cell lymphoma, not otherwise specified (n = 1), and NK/T cell lymphoma (n = 2) were not avid for [68Ga]pentixafor. In comparison to [18F]FDG PET, [68Ga]pentixafor PET demonstrated more extensive disease and higher radioactivity in lymphoplasmacytic lymphoma and marginal zone lymphoma. Conclusion: CXCR4 expression varies in different types of non-Hodgkin lymphoma. Overexpression of CXCR4 was detected with [68Ga]pentixafor PET/CT in lymphoplasmacytic lymphoma, marginal zone lymphoma, diffuse large B cell lymphoma, follicular lymphoma, mantle cell lymphoma, unclassified indolent B cell lymphoma, and enteropathy associated T cell lymphoma. The uptake of [68Ga]pentixafor was higher than [18F]FDG in lymphoplasmacytic lymphoma and marginal zone lymphoma.
mRNA profile provides novel insights into stress adaptation in mud crab megalopa, Scylla paramamosain after salinity stress
Authors: Zhang Yin , Wu Qingyang , Fang Shaobin , Li Shengkang , Zheng Huaiping , Zhang Yueling , Ikhwanuddin Mhd , Ma Hongyu
Published: July 2020

Background
Mud crab, Scylla paramamosain, a euryhaline crustacean species, mainly inhabits the Indo-Western Pacific region. Wild mud crab spawn in high-salt condition and the salinity reduced with the growth of the hatching larvae. When the larvae grow up to megalopa, they migrate back to estuaries and coasts in virtue of the flood tide, settle and recruit adult habitats and metamorphose into the crablet stage. Adult crab can even survive in a wide salinity of 0–35 ppt. To investigate the mRNA profile after salinity stress, S. paramamosain megalopa were exposed to different salinity seawater (low, 14 ppt; control, 25 ppt; high, 39 ppt).
Results
Firstly, from the expression profiles of Na+/K+/2Cl- cotransporter, chloride channel protein 2 and ABC transporter. It turned out that the 24 h might be the most influenced duration in the short-term stress. We collected megalopa under different salinity for 24 h and then submitted to mRNA profiling. Totally, 57.87 Gb Clean Data were obtained. The comparative genomic analysis detected 342 differentially expressed genes (DEGs). According to the most significantly DEGs such as gamma-butyrobetaine dioxygenase-like, facilitated trehalose transporter Tret1, sodium/potassium-transporting ATPase subunit alpha, rhodanese 1-like protein, etc. and the significantly enriched pathways including lysine degradation, choline metabolism in cancer, phospholipase D signaling pathway, Fc gamma R-mediated phagocytosis, and sphingolipid signaling pathway. it indicated that in the short-term salinity stress, the megalopa might regulate some mechanism such as metabolism, immunity responses, osmoregulation to adapt to the alteration of the environment.
Conclusions
It indicated that the megalopa as a crab larvae has the ability to protect itself from the short-term salinity stress so as to live a migration life. This study mines beneficial genetic resources for research on crustacean and provides novel insight into understanding the molecular mechanism of stress adaptation of crustacean responses to environmental stressors.
Effect of Genetic Polymorphisms of CYP2C19 on the Steady-state Serum Concentrations of Valproic Acid in Chinese Han Patients With Schizophrenia
Authors: WANG Shengdong , Li Jing , Song Mingfen , Yan Pan , Ju Xuan , Liu Jian , Wang Chengpeng , Shi Jianfei
Published: July 2020

Valproic acid is an anticonvulsant, which is also widely used for treating psychiatric disorders. Some clinical trials have demonstrated benefits of valproic acid augmentation therapy in schizophrenia. Interindividual variability in valproic acid dose and serum concentration may reflect functional consequences of genetic polymorphisms in genes encoding drug-metabolizing enzymes. The aim of this study was to determine the relationship between serum concentrations of valproic acid and single nucleotide polymorphisms of the cytochrome P450 (CYP) 2C19 gene in patients with schizophrenia. All patients had been receiving fixed dose of valproic acid for at least 2 weeks. The daily doses were 0.5–1.5 g. No other drugs except olanzapine were coadministered. Serum concentrations of valproic acid were measured using the ultra-high performance liquid chromatography method with mass-spectrometric detection. The CYP2C19 (CYP2C19*2 G681A and CYP2C19*3 G636A) genotypes were identified by real-time PCR analyses. The mean concentration/dose ratios of valproic acid was significantly higher in patients with 1 (P = 0.029) or 2 (P = 0.007) mutated alleles for CYP2C19 than in those without mutated alleles. The mean concentration/dose ratios of valproic acid was significantly higher in patients with CYP2C19 *1/*2 genotype (P = 0.029) or CYP2C19 *2/*3 genotype (P = 0.014) than in those with CYP2C12 *1/*1 genotype. The findings of this study suggest that CYP2C19 genotypes play an important role in controlling steady-state serum concentrations of valproic acid in Chinese Han population.
Urinary Exosome Based Androgen Receptor Variant 7 Detection in Metastatic Castration Resistant Prostate Cancer Patient
Authors: Wang Chao , Liu Xiang , Li Hongyan , Zhao Libo , Kong Guanyi , Chen Jing , Li Zhi , Qi Jianfei , Tian Ye , Zhang Fengbo
Published: July 2020

BACKGROUND Androgen receptor variant 7 (AR-V7) detection provides important reference to the clinical management of abiraterone in metastatic castration-resistant PCa (mCRPC). We performed a noninvasive urine-derived exosomal AR-V7 analysis in mCRPC patients. METHODS A total of 34 mCRPC patients were categorized into 16 patients responded to abiraterone (ABI-Sta group) and 18 were resistant to abiraterone (ABI-Res group). First morning urine collected from patients as well as healthy control were used for analysis. Exosomal RNA was isolated for AR-V7 detection, and the correlation between AR-V7 expression and the therapeutic effect of abiraterone was analyzed.RESULTS Urine is ideal biological sample for exosome separation and androgen receptor full-length (AR-FL) analysis. Positive urine-derived exosomal AR-V7 were detected in 32.4% (11 of 34) mCRPC urine samples. Positive AR-V7 is more common in ABI-Res patients (50.0% in ABI-Res group vs. 12.5% in ABI-Sta patients respectively, p=0.009) and associate with higher PSA progression rate and poorer overall survival (p=0.0031, 0.0012). CONCLUSIONS Urine-derived exosome is an alternative option for liquid biopsy-based AR-V7 detection in prostate cancer. Urinary exosomal AR-V7 is a dynamic marker that may predict the response to abiraterone in mCRPC patients.
Systematic Review and Bibliometric Analysis of African Anesthesia and Critical Care Medicine Research Part I: Hierarchy of Evidence and Scholarly Productivity
Authors: Kanmounye Ulrick Sidney , Tochie Joel Noutakdie , Mbonda Aimé Noula , Wafo Cynthia Solam , Daya Leonid , Atem Thompson Hope , Nyalundja Arsène Daniel , Eyaman Daniel Cheryl
Published: July 2020

BackgroundResearch is an essential component of Anesthesia, and the contributions of researchers and institutions can be appreciated from the analysis of scholarly outputs. Such analyses help identify major contributors and trends in publication. Little is known about the state of Anesthesia and Critical Care Medicine (ACCM) research in Africa. In this study, the authors analyzed the study designs and contributions to ACCM research in Africa.MethodsThe authors searched PubMed, Embase, Web of Science, and CINAHL from inception to May 4, 2020, for articles on or about ACCM in Africa. The titles and abstracts of the articles were screened first on Rayyan. Then, the full-text of eligible articles were screened. Data were extracted, and the number of articles per physician anesthesia providers and provider density were calculated. Kruskal Wallis test and Spearman's correlation were used, and a P-value <0.05 was considered to be statistically significant.ResultsOf the 4690 articles, only 886 (18.9%) were included in the analysis. The articles were published between 1946 and 2020 in 278 target journals. 55 (6.2%) articles were published in the South African Journal of Surgery, 51 (5.8%) in Anesthesia and Analgesia, and 46 (5.2%) in Anaesthesia. 291 (32.8%) studies were cross-sectional. 195 (22.0%) first authors were from Nigeria, 118 (13.3%) from South Africa, and 88 (9.9%) from the USA. Malawi (1.67), Togo (1.06), and Sierra Leone (1.00) had the highest number of articles per provider. Whereas Ethiopia (580.00), Nigeria (336.21), and Malawi (333.33) had the highest number of articles per provider density. ConclusionThe results reported in this study highlight contributions of Africans and the hierarchy of evidence in African anesthesiology research and critical care medicine. These results may aid in setting the research agenda.
LncRNA HOTAIR regulates the expression of E-cadherin to affect nasopharyngeal carcinoma progression by recruiting histone methylase EZH2 to mediate H3K27 trimethylation
Authors: Yang Feng-lian , Wei Yu-xia , Liao Bi-yun , Wei Gui-jiang , Qin Hai-mei , Pang Xiao-xia , Wang Jun-li
Published: July 2020

Background/Aim:
In recent years, there has been increasing evidence for the function of long non-coding RNA (lncRNA) in nasopharyngeal carcinoma (NPC).. We aim to delve into the position of lncRNA HOTAIR, together with EZH2, E-cadherin and H3K27me3 in NPC and explore the related mechanisms.
Methods
RT-qPCR and western blot analysis were carried out for detecting lncRNA HOTAIR, EZH2, E-cadherin and H3K27me3 expression in NPC tissues and cells. Moreover, the correlations between lncRNA HOTAIR and EZH2 expression and the clinicopathological characteristics and prognosis of patients with NPC were observed. NPC cell biological functions were examined through gain-of and loss-of function assays. RIP and ChIP assays were applied to detect whether lncRNA HOTAIR in NPC cells could regulate E-cadherin by recruiting EZH2 to mediate trimethylation of H3K27.
Results
LncRNA HOTAIR, EZH2, and H3K27me3 were richly expressed in NPC tissues and cells, and E-cadherin was lowly expressed. The prognosis of patients with overexpression of lncRNA HOTAIR and EZH2 was worse than that of patients with theirs low expression. Down-regulation of either HOTAIR or EZH2 inhibited cell proliferation, promoted apoptosis, suppressed migration and invasion and inhibited tumor growth. HOTAIR recruited histone methylase EZH2 to mediate trimethylation of H3K27 and regulated E-cadherin expression.
Conclusion
Our study suggests that lncRNA HOTAIR inhibits the expression of E-cadherin by stimulating the trimethylation of H3K27 by histone methylase EZH2 to promote cell migration, proliferation, and inhibit apoptosis of NPC cells.
Knowledge, Attitudes, Practices and Risk factors about Malaria in High Endemic Rural Eastern Tanzania
Authors: Mnyone Ladslaus Laurent , Mwamundela Baraka
Published: July 2020

Background: Understanding area-specific knowledge, attitudes, practices and demographic risk factors towards malaria is becoming critical for designing appropriate awareness and control strategies. Methods: A cohort of respondents from 243 randomly selected households across 3 villages in eastern Tanzania was assessed using a standard questionnaire and direct observation.Results: Fifty-three percent of respondents cited Anopheles mosquitoes that were responsible for transmitting malaria, and 85% of those explicitly cited female Anopheles mosquitoes. The rest (47%) knew that malaria is transmitted by a mosquito but could not name it. Commonly cited mosquito breeding sites were water bodies (75%) and rubbish (24%). Majority (61%) knew that the under-fives were most vulnerable to malaria. ITNs were mostly (64%) cited as a means of malaria control. Commonly cited malaria mosquito entry routes were windows (46%), eave opening (10%) and opening on the walls (4%). Majority (70%) confirmed malaria at the health facility. The rest (30%) relied on symptoms. Majority (96%) preferred modern antimalarials. Seventy-nine percent of the respondents owned at least one ITN. Cooking was done predominantly (77%) outdoors, finished cooking and went to bed after 20:00h. Most (58%) respondents still attended night-time outdoor communal gatherings without malaria protection. Conclusions: The current study indicate that majority of participants were aware that Anopheles mosquitoes were responsible for transmitting malaria, they bred in water, under-five children were most vulnerable to malaria, and ITNs constituted the most deployed control measure. Most respondents preferred confirming malaria at the health facility and treatment with modern antimalarials. Yet, the rate of self-diagnosis and self-medication, as well as inappropriate use of bednets requires great improvement. Demographic risk factors for early- and/or outdoor-transmission included night-time outdoor cooking and attending communal gatherings without malaria protection. The findings warrant a subsequent study to show a causal link between night-time outdoor activities, vector biting patterns and malaria prevalence.
An optimized segmentation and quantification approach in microvascular imaging for OCTA-based fibrovascular regression monitoring
Authors: Wu Sheng , Wu Shaowei , Feng Hui , Hu Zizhong , Xie Yejing , Su Yun , Feng Ting , Li Li
Published: July 2020

Background:

Quantification of neovascularization changes in fibrovascular membrane (FVM) acquired from optical coherence tomography angiography (OCTA) imaging is extremely important for diagnosis and treatment monitoring of proliferative diabetic retinopathy (PDR). However, few vessel extraction methods have been reported for quantifying the neovascular changes on fibrovascular membrane (FVM) in proliferative diabetic retinopathy PDR based on OCTA imaging.
Results:

The proposed method has achieved better performance compared with existing algorithms on accuracy and can be used for PRD treatment monitoring. In the study of PDR treatment monitoring, the data show that from the beginning (0 day) to 5th day of treatment, the total length of neovascularization on FVM in this area has been significantly shortened by an 77.8% reduction, indicating significant effects from the treatment applied. Besides, the average width of the neovascularization on FVM at the 7th day after treatment has been increased by 158%, which indicates that most of the narrow neovascularization has been reduced.
Conclusion:

The result and analysis have confirmed that the proposed optimization process with improved VCA method is both effective and feasible to segment and quantify the neovascularization on FVM with less noise and artifacts, thus can be readily applied to monitor the fibrovascular regression within the treatment period.
The presence of aura is not related to changes in the cervical performance and mobility of patients with migraine
Authors: Carvalho Gabriela F , Lodovichi Samuel S , Pinheiro Carina F , Benatto Mariana T , Florencio Lidiane L , Bragatto Marcela M , Dach Fabiola , Bevilaqua-Grossi Debora
Published: July 2020

Background: Migraine is related to musculoskeletal impairment of the neck and the chronicity of migraine is related to greater disability levels. However, it is not known if other forms of migraine, such as migraine with aura, is related to a different pattern of neck impairment.Objective: To assess the musculoskeletal and clinical aspects of the neck in patients with migraine with and without aura.Methods: Up to 125 consecutive patients diagnosed with migraine according to the ICHD-III were recruited from a tertiary headache clinic. Patients were classified by the presence of aura into two groups: migraine with aura (MA, n=37) and migraine without aura (MoA, n=88). The self-report of neck pain was assessed and patients completed the Neck Disability Index (NDI) questionnaire. Furthermore, patients performed the Flexion Rotation Test (FRT) and the Cranio-Cervical Flexion Test (CCFT). Results of all outcomes were contrasted between groups through Mann-Whitney and Qui-square tests.Results: There was no association between the presence of aura and self-report of neck pain (x²: 1.32, p=0.25). No differences were verified between groups regarding presence of neck disability (MA: 10.73, SD: 6.22; MoA: 9.63, SD:8.13, p=0.25) or disability severity (x²=6.17, p=0.10). Groups did not differ regarding the FRT (MA: 35.07°, SD: 7.90 and MoA: 34.60°, SD: 8.70, t=-0.22, p=0.83) and there was no association between positive FRT and presence of aura (x²=3.35, p=0.07). The CCFT did not demonstrate differences among the two groups either (x²=1.65, p=0.80).Conclusion: There is no association between migraine aura and presence or disability of neck pain, reduced superior cervical mobility or reduced neck performance. It is expected to find similar neck profile during the clinical assessment of patients with migraine with and without aura.
Amyl Nitrite Induced Hemolytic Anemia: Acute Therapy and Prevention
Authors: Elshikh Amira , Kango Ghazal , Baalbaki Marwa , Lankowsky Jeffrey , Bawa Amandeep
Published: July 2020

Background:
Inhaled nitrites have been a substance of recreational use for centuries, primarily among men who have sex with men (MSM). However, there is a lack of awareness of the use of inhaled nitrites in this population and the possible complications and health disparities it carries. This case report highlights the use of inhaled nitrites in an MSM male with an emphasis on the complications induced by this product, including severe hemolytic anemia and methemoglobinemia. Followed by a review of both acute therapy and preventative therapy by increasing provider awareness.
Case presentation:
A 62-year-old man with a past medical history of glucose-6 phosphate dehydrogenase (G6PD) deficiency presented to the emergency department with atypical chest pain. He was tachypneic and hypotensive with laboratory evidence of end organ damage. He had an acute drop in hemoglobin with elevated bilirubin concerning for acute hemolytic anemia. His arterial blood gas was significant for elevated methemoglobin. The patient reported recent use of “poppers” (inhaled nitrite) which is associated with formation of methemoglobin and hemolytic anemia. Given the severity of his symptoms and elevated methemoglobin, he met criteria for methylene blue administration. However, his G6PD deficiency is a contraindication to methylene blue and the patient was treated conservatively with a positive outcome.
Conclusion:
The following report presents a unique scenario in which a G6PD deficient patient presented with hemolytic anemia and methemoglobinemia after recreational use of inhaled nitrites. The case was complicated with the management challenge of methemoglobinemia in a patient with G6PD deficiency. Prior literature has shown that the use of nitrites is a predictor for high-risk sexual behavior and is associated with positive human immunodeficiency virus (HIV) status. Increasing provider awareness for appropriate counseling is of importance.
Predicting Prostate Cancer Upgrading of Biopsy Gleason Grade Group at Radical Prostatectomy Using Machine Learning-Assisted Decision-support Models
Authors: Liu Hailang , Tang Kun , Peng Ejun , Wang Liang , Xia Ding , Chen Zhiqiang
Published: July 2020

Objective: To develop a machine learning (ML)-assisted model capable of accurately predicting the probability of biopsy Gleason grade group upgrading before making treatment decisions by integrating multiple clinical characteristics.Materials and Methods: We retrospectively collected data from PCa (prostate cancer) patients who underwent systematic biopsy and radical prostatectomy from January 2015 to December 2019 at Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology. The study cohort was divided into training and testing datasets in a 70:30 ratio for further analysis. Four ML-assisted models were developed from 16 clinical features using logistic regression (LR), logistic regression optimized by Lasso regularization (Lasso-LR), random forest (RF) and support vector machine (SVM). The area under the curve (AUC) was applied to determine the model with the highest discrimination. Calibration plots were used to investigate the extent of over- or underestimation of predicted probabilities relative to the observed probabilities in models. Results: In total, 530 PCa patients were included, with 371 patients in the training dataset and 159 patients in the testing dataset. The Lasso-LR model showed good discrimination with an AUC, accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 0.776, 0.712, 0.679, 0.745, 0.730 and 0.695, respectively, followed by SVM (AUC 0.740, 95%CI: 0.690–0.790), LR (AUC 0.725, 95%CI: 0.674–0.776) and RF (AUC 0.666, 95%CI: 0.618–0.714). Validation of the model showed that the Lasso-LR model had the best discriminative power (AUC 0.735, 95%CI: 0.656–0.813), followed by SVM (AUC 0.723, 95%CI: 0.644–0.802), LR (AUC 0.697, 95%CI: 0.615–0.778) and RF (AUC 0.607, 95%CI: 0.531–0.684) in the testing dataset. Both the Lasso-LR and SVM models were well-calibrated. Conclusions: The Lasso-LR model had good discrimination in the prediction of patients at high risk of harboring incorrect Gleason grade group assignment, and the use of this model may be greatly beneficial to urologists in treatment planning, patient selection, and the decision-making process for PCa patients.
Baduanjin Exercise May Improve the Anxiety and Insomnia in COVID-2019 Patients: A Case-Control Study
Authors: Chen Ming-Gui , Qiu Yinlong , Chen Haizhen , Chen Erhui , Zeng Rui-Xiang , Wu Qiaomei , Zhang Xiaoxuan , Zhang Min-Zhou , Lin MeiZhen
Published: July 2020

Background: Since December 2019, an epidemic caused by novel coronavirus(2019-nCoV) infection has occurred unexpectedly in China. Because of the sudden nature of the outbreak and the infectious power of the virus, it will inevitably cause people anxiety and other stress reactions. Previous studies showed that Baduanjin exercise was effective for people in anxiety and insomnia. The purpose of this study was to evaluate the potential benefits of Baduanjin exercise on the anxiety and insomnia in COVID-2019 patients.Methods: This is a Case-Control Study. The COVID-2019 patients including 39 Baduanjin exercises or willing to do Baduanjin exercises and 39 age-and gender-matched nonexercising controls. The anxiety and insomnia in COVID-2019 patients were measured by using the GAD-7 and SMH Sleep Questionnaire at baseline and discharge.Results: In the study, the Paired T-test showed that two groups had improved the GAD-7 scores and SMH Sleep Questionnaire compared with baseline at discharge. Baseline results showed there were no significant differences in the GAD-7 scores and SMH Sleep Questionnaire between the two groups. However, the significant differences found in the Baduanjin group included a 43.9% lower (p<0.001) in the GAD-7 score and an approximately 75.9% higher (p=0.003) in SMH Sleep Questionnaire score compare with the control group at discharge.Conclusion: The Baduanjin exercise may improve the anxiety and insomnia in COVID-2019 patients. It can also be used as a form of rehabilitation exercise for discharged patients or patients isolated at home.Trial Registration: ChiCTR2000030528.
Refraining from Seeking Mental Healthcare and Poorer Mental Well-Being: A Longitudinal Population-Based study on Men in Sweden
Authors: Olsson Sara , Burström Bo , Hensing Gunnel , Löve Jesper
Published: July 2020

Background: Depression and anxiety disorder contribute to a significant part of the disease burden among men, yet many men refrain from seeking care or receive insufficient care when they do seek it. This is plausibly detrimental to men’s mental well-being, but there is a lack of population-based research to confirm this. This study investigated 1) if men who had refrained from seeking mental healthcare had poorer mental well-being than those who sought care, 2) if those who sought care but perceived it as insufficient had poorer mental well-being than those who perceived care as sufficient, and 3) if these differences persisted over time. Methods: This longitudinal study used questionnaire data from a population-based sample of 1240 men, aged 19-64 years, in Sweden. Having refrained from seeking mental healthcare, or perceiving the care as insufficient, at any time in life, was assessed in a questionnaire, 2008. Current mental well-being was assessed in both 2008 and 2009 using mean scores on the WHO (Ten) Well-being Index, with a lower score indicating poorer mental well-being. Group differences were calculated using t-tests and multivariable linear regression analysis.Results: Of the men who had perceived a need for mental healthcare, 37% refrained from seeking such care. They had lower mental well-being scores in 2008, compared to those who sought care. Of those seeking care, 29 % perceived it as insufficient. They had lower mental well-being scores in 2008, compared to those who perceived the care as sufficient, but this was not statistically significant when controlling for potential confounders in the regression analysis. There were no differences in mental well-being scores based on care-seeking or perceived care-sufficiency in 2009. Conclusions: This population-based study provides some empirical support for the hypothesis that refraining from seeking mental healthcare, or perceiving the care as insufficient, is detrimental to men’s mental well-being. However, the lack of persistent differences contradicts this hypothesis. The results highlight the need for more research, using larger population-based samples of men, and longer follow-up periods. This should be combined with efforts to increase men’s mental healthcare-seeking and to provide mental healthcare that is perceived as sufficient.
Accuracy and precision of zero-echo-time, single- and multi-atlas attenuation correction for dynamic [11C]PE2I PET-MR brain imaging
Authors: Sousa Joao M. , Appel Lieuwe , Merida Inés , Heckemann Rolf A. , Costes Nicolas , Engström Mathias , Papadimitriou Stergios , Nyholm Dag , Ahlström Håkan , Hammers Alexander , Lubberink Mark
Published: July 2020

Background: A valid photon attenuation correction (AC) method is instrumental for obtaining quantitatively correct PET images. Integrated PET/MR systems provide no direct information on attenuation, and novel methods for MR-based AC (MRAC) are still under investigation. Evaluations of various AC methods have mainly focused on static brain PET acquisitions. In this study we determined the validity of three MRAC methods in a dynamic PET/MR study of the brain.Methods: Nine participants underwent dynamic brain PET/MR scanning using the dopamine transporter radioligand [11C]PE2I. Three MRAC methods were evaluated: single-atlas (Atlas), multi-atlas (MaxProb) and zero-echo-time (ZTE). The 68Ge-transmission data from a previous stand-alone PET scan was used as reference method. Parametric relative delivery (R1) images and binding potential (BPND) maps were generated using cerebellar grey matter as reference region. Evaluation was based on bias in MRAC maps, accuracy and precision of [11C]PE2I BPND and R1 estimates, and [11C]PE2I time-activity curves. BPND was examined for striatal regions and R1 in clusters of regions across the brain.Results: For BPND, ZTE-MRAC showed the highest accuracy (bias < 2%). Atlas-MRAC exhibited a significant bias in caudate nucleus (-12%) while MaxProb-MRAC revealed a substantial, non-significant bias in putamen (9%). R1 estimates had a marginal bias for all MRAC methods (-1.0-3.2%). MaxProb-MRAC showed the largest intersubject variability for both R1 and BPND. Standardized uptake values (SUV) of striatal regions displayed the strongest average bias for ZTE-MRAC (~ 10%), although constant over time and with the smallest inter-subject variability. Atlas-MRAC had highest variation in bias over time (+ 10 to -10%), followed by MaxProb-MRAC (+ 5 to -5%), but MaxProb showed the lowest mean bias. For cerebellum, MaxProb-MRAC showed highest variability while bias was constant over time for Atlas- and ZTE-MRAC.Conclusions: Both Maxprob and ZTE-MRAC performed better than Atlas-MRAC when using a 68Ge transmission scan as reference method. Overall, ZTE-MRAC showed the highest precision and accuracy in outcome parameters of dynamic [11C]PE2I PET analysis with use of kinetic modelling.