bluuebunny/crossref_metadata_2025 huggingface dataset:
A comparative study of patients’ satisfaction in different levels of hospitals in Beijing: Why do patients prefer high-level hospitals?
Authors: Cui Chengsen , Zuo Xu , Wang Yujia , Song Haiyan , Shi Jingyu , Meng Kai
Published: February 2020

Background: In order to promote integration of medical resources, Beijing built medical alliances since 2012, but this reform did not change the state of disordered medical treatment. Patients are still willing to go to high-level hospitals for medical treatment. What causes patients to prefer high-level hospitals? In order to explore the reasons for the high-level medical treatment behavior of patients and guide patients to visits orderly, we conducted the study and compared the patients' satisfaction in different level hospitals under the background of the medical resource integration.
Methods: This study conducted a questionnaire survey among 1,250 patients who were selected in 18 medical alliances in Beijing from October to December 2016. The study type is a comparative study based on cross-sectional data. The patients’ satisfaction was the main outcome, descriptive analysis, a chi-square test, a nonparametric test and binary logistic regression analysis were used. The level of statistical significance was set at p<0.05.
Results: The overall satisfaction score of the medical alliances is 3.375, and the satisfaction score of core hospitals and cooperative hospitals is 2.77 and 3.07. The overall patient satisfaction rate is 44.62%, and the satisfaction rate of core hospitals and cooperative hospitals is 34.34% and 50.43%. The type of hospital and understanding of medical alliance policy are the associated factors of the patients’ satisfaction with the medical alliance.
Conclusions: The patients’ satisfaction of cooperative hospitals was higher than that of core hospitals. Although the patients are more satisfied with the service attitude of the cooperative hospitals, they still prefer core hospitals due to their higher expectation for medical treatment and greater trust in the medical technology of the core hospitals. It is necessary to explore the establishment of the closed medical alliances under the unified management of human and financial resources, to promote medical alliances to become a community of common interests and provide integrated medical services for patients.
The mutational spectrum of Hunter syndrome reveals correlation between biochemical and clinical profiles in Tunisian patients
Authors: chkioua latifa , Grissa Oussama , Leban Nadia , Gribaa Moez , Boudabous Hela , Turkia Hadhami Ben , Ferchichi Salima , Tebib Neji , Laradi Sandrine
Published: February 2020

Background: Mucopolysaccharidosis type II (MPS II) or Hunter syndrome is an X-linked recessive lysosomal storage disorder resulting from deficient activity of iduronate 2-sulfatase (IDS) and the progressive lysosomal accumulation of sulfated glycosaminoglycans (GAGs). Methods: A diagnosis of MPS II or Hunter syndrome was performed based on the following approach after a clinical and paraclinical suspicion. Two biochemical and molecular tests were carried out separately and according to the availability of the biological material. Results: All patients in this cohort presented the most common MPS II clinical features. Electrophoresis of GAGs on a cellulose acetate plate in the presence of a high concentration of heparane sulfate showed an abnormal dermatan sulfate band in the patients compared with that in a control case. Furthermore, leukocyte IDS activity ranged from 0.00 to 0.75 nmol/h/mg of leukocyte protein in patients. Five previously reported mutations were identified in this study patients: one splice site mutation, c.240+1G>A; two missense mutations, p.R88P and p.G94D; a large deletion of exon 1 to exon 7; and one nonsense mutation, p.Q396*. In addition, two novel alterations were identified in the MPS II patients: one frame shift mutation, p.D450Nfs*95 and one nonsense mutation, p.Q204*. Additionally, five known IDS polymorphisms were identified in the patients: IVS3-16 (c.419-16 delT), p.T214M (c.641C>T), p.T146T (c.438 C>T), IVS5-87 (c.709-87G>A), and IVS7+38 (c.1006+38T>C). Conclusions: The high level of urine GAGs and the deficiency of iduronate 2-sulfatase activity was associated with the phenotype expression of Hunter syndrome. Molecular testing was useful for the patients’ phenotypic classification and the detection of carriers.
Dilation of the Cystic Duct Confluence in Laparoscopic Common Bile Duct Exploration and Stone Extraction in Patients with Secondary Choledocholithiasis
Authors: Yang Xiao-Bin , Xu An-Shu , Li Jian-Gang , Xu Yong-Ping , Xu De-Song , Fu Chao-Chun , Deng Da-Bo , Li Jie , Zhang Ma-Zhong
Published: February 2020

Background: Many options exist for the management of cholelithiasis and secondary choledocholithiasis. Among them, laparoscopic common bile duct exploration (LCBDE) with choledocotomy followed by laparoscopic cholecystectomy has gained popularity. However, efforts should be made to ensure minimally invasive or noninvasive management of the common bile duct (CBD). For this purpose, we modified the surgical modality, exploring the use of laparoscopic transcystic dilation of the cystic duct confluence in CBD exploration (LTD-CBDE). Based on our preliminary experience, we can use this technique to resolve patients with secondary common bile duct stones, and the effect is better than placing T tubes.Methods: Sixty-eight patients were randomly offered the new LTD-CBDE technique from December 2015 to April 2018. During the surgery, we dilated the cystic duct confluence with separation forceps and/or a columnar dilation balloon. Subsequently, CBD exploration and stone extraction were performed with a choledochoscope. The entrance of the CBD was covered with a cystic duct stump wall and was subjected to primary closure at the end of surgery.Results: Forty-nine females and 19 males with cholelithiasis and secondary choledocholithiasis were included. The mean age was 53 years old (18 to 72 year). Of these patients, 62 (91.2%) were successfully treated with the LTD-CBDE technique, and bile leakage was observed in 3 patients (4.4%). The mean operation time was 106 minutes, and the mean hospital stay was 5.9 days. Among the other 6 patients, 3 were converted to open cholecystectomy due to severe fibrosis, unclear anatomical structure at Calot’s triangle (n=2) or Mirizze syndrome (n=1); LCBDE was performed in 3 patients due to cystic duct atresia (n=2) and low level of flow from the gallbladder duct into the CBD (n=1). These patients had a smooth postoperative course. In total, 43/68 of the patients presented no radiological evidence of retained CBD stones at the postoperative follow-up (40 patients treated with LTD-CBDE) one year later.Conclusions: The current work suggests that LTD-CBDE for the management of cholelithiasis and secondary choledocholithiasis is a feasible, safe and effective technique with a low complication rate. LTD-CBDE offers another alternative for surgeons to treat patients in similar scenarios. However, additional randomized, controlled studies are needed to demonstrate its efficacy, safety, and impact on CBD stenosis.
Disentangling the mechanisms shaping the surface ocean microbiota
Authors: Logares Ramiro , Deutschmann Ina M. , Junger Pedro C. , Giner Caterina R. , Krabberød Anders K. , Schmidt Thomas S.B. , Rubinat-Ripoll Laura , Mestre Mireia , Salazar Guillem , Ruiz-González Clara , Sebastián Marta , de Vargas Colomban , Acinas Silvia G. , Duarte Carlos M. , Gasol Josep M. , Massana Ramon
Published: February 2020

Background The ocean microbiota modulates global biogeochemical cycles and changes in its configuration may have largescale consequences. Yet, the underlying ecological mechanisms structuring it are unclear. Here we investigate how fundamental ecological mechanisms ( selection , dispersal and ecological drift ) shape the smallest members of the tropical and subtropical surface-ocean microbiota: prokaryotes and minute eukaryotes (picoeukaryotes). Furthermore, we investigate the agents exerting abiotic selection on this assemblage as well as the spatial patterns emerging from the action of ecological mechanisms. To explore the previous, we analysed the composition of surface-ocean prokaryotic and picoeukaryotic communities using DNA-sequence data (16S- and 18S-rRNA genes) collected during the circumglobal expeditions Malaspina-2010 and TARA-Oceans . Results We found that the two main components of the tropical and subtropical surface-ocean microbiota, prokaryotes and picoeukaryotes, appear to be structured by different ecological mechanisms. Picoeukaryotic communities were predominantly structured by dispersal-limitation, while prokaryotic counterparts appeared to be shaped by the combined action of dispersal-limitation, selection and drift. Temperature-driven selection appeared as a major factor, out of a few selected factors, influencing species co-occurrence networks in prokaryotes but not in picoeukaryotes, indicating that association patterns may contribute to understand ocean microbiota structure and response to selection. Other measured abiotic variables seemed to have limited selective effects on community structure in the tropical and subtropical ocean. Picoeukaryotes displayed a higher spatial differentiation between communities and a higher distance decay when compared to prokaryotes, consistent with a scenario of higher dispersal limitation in the former after considering environmental heterogeneity. Lastly, random dynamics or drift seemed to have a more important role in structuring prokaryotic communities than picoeukaryotic counterparts. Conclusions The differential action of ecological mechanisms seems to cause contrasting biogeography, in the tropical and subtropical ocean, among the smallest surface plankton, prokaryotes and picoeukaryotes. This suggests that the idiosyncrasy of the main constituents of the ocean microbiota should be considered in order to understand its current and future configuration, which is especially relevant in a context of global change, where the reaction of surface ocean plankton to temperature increase is still unclear.
The relationship between symptom burden and systemic inflammation differs between male and female athletes following concussion.
Authors: Battista Alex P Di , Churchill Nathan , Rhind Shawn G. , Richards Doug , Hutchison Michael G.
Published: February 2020

Background: Inflammation appears to be an important component of concussion pathophysiology. However, its relationship to symptom burden is unclear. Therefore, the purpose of this study was to evaluate the relationship between symptoms and inflammatory biomarkers measured in the blood of male and female athletes following sport-related concussion (SRC). Results Forty athletes (n = 20 male, n = 20 female) from nine interuniversity sport teams at a single institution provided blood samples within one week of an SRC. Twenty inflammatory biomarkers were quantitated by immunoassay. The Sport Concussion Assessment Tool version 5 (SCAT-5) was used to evaluate symptoms. Partial least squares (PLS) analyses were used to evaluate the relationship(s) between biomarkers and symptoms. In males, a positive correlation between interferon (IFN)- and symptom severity was observed following SRC. The relationship between IFN- and symptoms was significant among all symptom clusters, with cognitive symptoms displaying the largest effect. In females, a significant negative relationship was observed between symptom severity and cytokines IFN-, tumor necrosis factor (TNF)-, and myeloperoxidase (MPO); a positive relationship was observed between symptom severity and MCP-4. Inflammatory mediators were significantly associated with all symptom clusters in females; the somatic symptom cluster displayed the largest effect. Conclusion: These results provide supportive evidence for a divergent relationship between inflammation and symptom burden in male and female athletes following SRC. Future investigations in SRC should be cognizant of the potentially sex-specific pathophysiology underlying symptom presentation.
Factors associated with risk of developmental delay in preschool children in a setting with high rates of malnutrition: a cross-sectional analysis of data from the IHOPE study, Madagascar
Authors: Miller Ann , Garchitorena Andres , Rabemananjara Faramalala , Cordier Laura , Randriamanambintsoa Marius , Rabeza Victor , Razanadrakoto Hery-Tiana Rahaniraka , Ramakasoa Ranaivozafindary Rakoto , Ratsimbazafy Baolova Nathaline , Ouenzar Mohammed Ali , Bonds Matthew H. , Ratsifandrihamanana Lisy
Published: February 2020

Background: 50% of Malagasy children have moderate to severe stunting. In 2016, a new 10-year National Nutrition Action Plan (PNAN III) was initiated to help address stunting and developmental delay. We report factors associated with risk of developmental delay in 3 and 4 year olds in the rural district of Ifanadiana in southeastern Madagascar in 2016.
Methods: The data are from a cross-sectional analysis of the 2016 wave of IHOPE panel data (a population-representative cohort study begun in 2014). We interviewed women ages 15-49 using the MICS Early Child Development Indicator (ECDI) module, which includes questions for physical, socio-emotional, learning and literacy/numeracy domains. We analyzed ECDI data using standardized z scores for relative relationships for 2 outcomes: at-risk-for-delay vs. an international standard, and lower-development-than-peers if ECDI z scores were >1 standard deviation below study mean. Covariates included demographics, adult involvement, household environment, and selected child health factors. Variables significant at alpha of 0.1 were included a multivariable model; final models used backward stepwise regression, clustered at the sampling level.
Results: Of 432 children ages 3 and 4 years, 173 (40%) were at risk for delay compared to international norms and 68 children (16.0%) had lower-development than peers. This was driven mostly by the literacy/numeracy domain, with only 7% of children considered developmentally on track in that domain. 50.5% of children had moderate to severe stunting. 76 (17.6%) had >=4 stimulation activities in past 3 days.

Greater paternal engagement (OR 1.59(1.13, 2.21)) was associated with increased delay vs. international norms. Adolescent motherhood (OR3.89 (1.32, 11.48)) decreased children’s development vs. peers. Engagement from a non-parental adult reduced odds of delay for both outcomes (OR(95%CI =0.76 (0.61, 0.93) & 0.28(0.16, 0.50) respectively). Stunting was not associated with delay risk (1.33 (0.83, 2.14) or low development (0.91(0.47, 1.74)) when controlling for other factors.
Conclusions: In this setting of high child malnutrition, stunting is not independently associated with developmental risk. A low proportion of children receive developmentally supportive stimulation from adults, but non-parent adults provide more stimulation in general than either mother or father. Stimulation from non-parent adults is associated with lower odds of delay
Health care use and treatment-seeking for depression symptoms in rural India: An exploratory cross-sectional analysis
Authors: Roberts Tessa Naomi , Shidhaye Rahul , Patel Vikram , Rathod Sujit D
Published: February 2020

Background There is a large “treatment gap” for depression worldwide. This study aimed to better understand the treatment gap in rural India by describing health care use and treatment-seeking for depression. Methods Data were analysed from a two round cross-sectional community survey carried out in rural Madhya Pradesh between May 2013 and December 2016. We examined the proportion of individuals who screened positive for depression (≥10) on the Patient Health Questionnaire (PHQ-9) who sought treatment in different sectors, for depression symptoms and for any reason, and compared the latter with health service use by screen-negative individuals. We analysed the frequency with which barriers to healthcare utilisation were reported by screen-positive adults. We also analysed the association between seeking treatment for depression and various predisposing, enabling and need factors. Results 86% of screen-positive adults reported seeking no depression treatment. However, 66% had used health services for any reason in the past 3 months, compared to 46% of screen-negative individuals (p<0.0001). Private providers were most frequently consulted by screen-positive adults (32%), while only 19% consulted traditional providers. Structural barriers to healthcare use such as cost and distance to services were frequently reported (54% and 52%, respectively) but were not associated with treatment-seeking for depression. The following factors were found to be positively associated with treatment-seeking for depression: higher symptom severity; reporting lack of energy, lack of interest/pleasure, low self-esteem, or slow movements/restlessness on more than 7 days in the past 2 weeks; being married; having discussed depression symptoms; and reporting problems with medication availability and supply as a barrier to healthcare. No evidence was found for an association between treatment-seeking for depression and most socio-economic, demographic or attitudinal factors. Conclusions These findings suggest that the majority of adults who screen positive for depression seek healthcare, although not primarily for depression symptoms, indicating the need to improve detection of depression during consultations about other complaints. Private providers may need to be considered in programmes to improve depression treatment in this setting. Further research should test the hypotheses generated in this descriptive study, such as the potential protective role of marriage in facilitating treatment-seeking.
Risk Factors of Malnutrition in Chinese Children with Congenital Heart Defect
Authors: Zhang Mingjie , Wang Liping , Huang Rui , Sun Chongrui , Xu Zhuoming
Published: February 2020

Background : The study aimed to investigate the risk factors of malnutrition in children with congenital heart defect (CHD) in China. Methods: This cohort study was performed at the biggest pediatric heart center in China; 3252 patients with CHD who underwent cardiac surgeries in 2013 were included. Anthropometric measurements included weight for age Z score (WAZ), weight for height Z score (WHZ), and height for age Z score (HAZ). The patients were classified as normal nutritional status and malnutrition, based on a cut-off Z score of <-2. Factors associated with malnutrition were determined using logistic regression analysis. Results: The prevalence of preoperative WAZ <-2 (underweight), HAZ <-2 (stunting), and WHZ<-2 (wasting) was 23.3%, 23.3%, and 14.3%, respectively. The multivariable analysis of preoperative malnutrition showed that hospitalization, age at surgery, risk adjustment for congenital heart surgery-1 >3, mechanical ventilation, pulmonary hypertension, and acyanotic heart disease were associated with underweight. Parents’ height, single ventricle, and cyanotic heart disease were associated with stunting. Hospitalization and pulmonary hypertension were associated with wasting. After surgery, the patients presented a significant improvement in growth within the first year in all three parameters and grew to the normal range of WAZ (-0.3±0.9, P<0.001), HAZ (0.2±0.8, P=0.001), and WHZ (0.03±0.6, P<0.001) at two years after surgery. The prevalence of underweight, stunted, and wasting declined to 3.2%, 2.7%, and 1.9% three years after surgery. Malnutrition after surgery was associated with cardiac residual cardiac abnormalities (OR=35.3, p<0.0001), high Ross classiﬁcation of heart function (OR=27.1, p<0.0001), and long-term taking oral diuretics (OR=20.5, P=0.001). Conclusions: Malnutrition is still a problem in children with CHD in China, especially before the surgery. There is need to strengthen the nutrition support for children with CHD before surgery. Hemodynamic factors were found to be the risk factors associated with malnutrition after operation.
Occurrence and removal of illicit drugs in different wastewater treatment plants with different treatment techniques
Authors: Deng Yanghui , Guo Changsheng , Zhang Heng , Yin Xingxing , Chen Like , Wu Daishe , Xu Jian
Published: February 2020

Background: As a class of contaminants of emerging concern (CECs), illicit drugs should be taken into account in the water management because of their social and public health risks. Wastewater treatment plants (WWTPs) are usually considered as the source and sink of contaminants, and drug residues are observed in their effluents due to the inefficient removal of CECs. In this study, wastewater samples were collected from eight WWTPs in Changzhou City for assessment of the abuse of 12 illicit drugs in the city by wastewater-based epidemiology (WBE) method.
Results: Drug concentrations ranged from
Association between gene polymorphisms of voltage-dependent Ca2+ channels andhypertension in the Dai people of China: a case-control study
Authors: Huang LiFan , Chu Yan , Huang Xiaoqin , Ma Shaohui , Lin Keqin , Huang Kai , Sun Hao , Yang Zhaoqing
Published: February 2020

Background: Abnormal calcium homeostasis related to the development of hypertension. As the key regulator of intracellular calcium concentration, voltage-gated calcium channels (VDCCs), the variations in these genes may have important effects on the development of hypertension. Here we evaluate VDCCs variability with respect to hypertension in the Dai ethnic group of China.Methods: A total of 1034 samples from Dai individuals were collected, of which 495 were used as cases, and 539 were used as controls. Blood pressure was measured using a standard mercury measurement method, three times with a rest for 5 min, and the average was used for analyses. Seventeen single nucleotide polymorphisms (SNPs) in the four protein-coding genes (CACNA1A, CACNA1C, CACNA1S, CACNB2) of VDCCs were identified by multiplex PCR-SNP typing technique. Chi-square tests and regression models were used to analyse the associations of SNPs with hypertension. Results: The results of chi-square tests showed that the allele frequencies of 5 SNPs were significantly different between the case and the control groups (P<0.05), but the statistical significance was lost after Bonferroni’s correction. However, after adjusting for BMI, age, sex and other factors by logistic regression analyses, the results showed that 5 SNPs consistent with chi-square tests (rs2365293, rs17539088, rs16917217, rs61839222 and rs10425859) were still statistically positive. Conclusions: This finding suggested that the significant association of these SNPs with hypertension may be noteworthy in future studies.
Novel role of hesperidin improve obesity in HFD mice by modulating the composition of the gut microbiota
Authors: Liu Zhihua , Liu Ting , Lei Chao , Song Weiqi , Fang Rong , Chen Hui , Li Chen , Li Xiaomei , Liang Xue , Huang Qinghong , Ti Huihui , Sun Ning , Ma Yanlei
Published: February 2020

Background: Hesperidin is a plant-derived dihydroflavone derivative with multiple pharmacological functions. Obesity is associated with low-grade chronic inflammation and intestinal dysbiosis. We examined the possibility that hesperidin may prevent diet-induced obesity by modulating the composition of the gut microbiota. High-fat diet (HFD)-fed mice were treated with hesperidin. Its effects on the gut microbiota were assessed by horizontal faecal microbiota transplantation (FMT) and 16S rRNA gene amplicon sequencing-based microbiota analysis.
Results: Gut microbiota analysis revealed that hesperidin selectively promoted the growth of beneficial Lactobacillus salivarius and harmful Staphylococcus sciuri and Desulfovibrio C21_c20 and inhibited that of beneficial Bifidobacterium pseudolongum and Mucispirillumschaedleri and harmful Helicobacter ganmani and Helicobacter hepaticus . However, hesperidin reversed obesity and inflammation and improved gut integrity in HFD-fed mice. The anti-obesity effects and hesperidin-modulated Lactobacillus salivarius, Desulfovibrio C21_c20, Mucispirillumschaedleri and Helicobacter hepaticus were transmissible via horizontal faeces transfer from hesperidin-treated mice to HFD-fed mice.
Conclusions: Hesperidin plays a dual role in both beneficial and harmful microbes. However, its overall effects reduce body weight and reverse HFD-related disorders in HFD-fed mice.
A pioneer usage of nanogold sandwich ELISA in the detection of hydatid antigen in humans as a tool for improvement of serodiagnostic testing.
Authors: Elawamy Waleed E , Rashed Samia M , Nassr Mona E , Shalash Ibrahim R A , Ali Nagwa S , Elghanam Amera S , Nageeb Marwa M
Published: February 2020

The authors have withdrawn this preprint from Research Square.
Predictors of Poor Postoperative Outcomes in Pediatric Surgery Patients in Rural Sub-Saharan Africa
Authors: Peiffer Sarah , Ssentongo Anna E. , Keeney Laura , Amponsah-Manu Forster , Yeboako Richard , Ofosu-Akromah Richard , Arkorful Temitope Ebenezer , Agyemang Eric , Tsai Anthony , Oh John , Ssentongo Paddy
Published: February 2020

Background/Purpose Perioperative complications cause significant pediatric morbidity and mortality in low- and lower middle -income countries. This study investigates factors associated with prolonged length of stay, 90-day readmission and in-hospital mortality among pediatric patients in eastern Ghana. Methods This is a retrospective review of perioperative morbidity and mortality in children <18 years at Eastern Regional Hospital (ERH) in Koforidua, Ghana. All pediatric surgeries performed between January 2015 and December 2017 were included in this study and secondary analysis was performed. Results We analyzed 468 patients <18 years of age with a median length of stay (LOS) of 3 days. The readmission and in-hospital mortality rates were 138 and 17 per 1000 patients, respectively. The most common procedures were herniorrhaphy (19%) and appendectomy (15%). Major procedures, gastrointestinal surgery, surgical trauma, surgical infection and having insurance were significantly associated with prolonged LOS. Age and male gender were significantly associated with in-hospital mortality. Malaria was significantly associated with 90-day readmission. Conclusions Malaria infection is a significant and actionable risk factor for readmission in the pediatric surgical population in sub-Saharan Africa. Preventing readmission in patients with malaria could reduce readmission rates by 74%, leading to potential cost-savings and reductions in morbidity.
Does the self-employment status affect the rural migrants’ health in China: the transmission channel of social health insurance?
Authors: Wang Zicheng , Wu Qiushi , Ming Juan
Published: February 2020

Background There are growing attentions paid on rural migrants’ health. Previous studies found that rural migrants are more exposed to disease risks. The present study aims to explore the causal effect of self-employment behavior on the rural migrants’ health status, two issues are addressed to discuss: Does self-employment status affect the health of rural migrants? What is the potential mechanism linking the self-employment behavior and health status? Methods The dataset from the 2017 National Migrants Population Dynamic Monitoring Survey (NMPDMS-2017) is applied to explore the causal effect; the Logit regression is performed to make baseline estimation, while the IV-LPM estimation is applied to correct the endogeneity of self-employment. Additionally, the Logit regression is conducted to explore the transmission channel. Results The self-employed are more susceptible to sub-health status (OR= 1.042; 95% CI= 1.001, 1.084) and chronic disease (OR= 1.394; 95% CI= 1.317, 1.476), even when correcting the endogeneity, the causal effect estimation also demonstrates that the self-employed are more vulnerable to suffer sub-health status (Coefficient= 0.067; 95% CI= 0.050, 0.084) and chronic disease (Coefficient= 0.020; 95% CI= 0.008, 0.032). The self-employed are less likely to participate in social health insurance (OR= 0.057; 95% CI= 0.053, 0.061). Conclusion The self-employed are more likely to suffer sub-health status and chronic disease, the self-employment behavior take harmful effect on the rural migrants’ health. Social health insurance may serve as transmission channel linking self-employment and rural migrants’ health, that is, the self-employed are less prone to participate in the urban health insurance program, which induce to an insufficient health service to maintain health.
WITHDRAWN: Correlates of highly caffeinated beverage consumption among Korean adolescents
Authors: Kwak Ho-Kyung , Sa Jaesin , Choe Siyoung , Chaput Jean-Philippe , Chung Joon , Cummings Gayle , Lee Jounghee
Published: February 2020

Background : Adolescents in South Korea may be particularly vulnerable to highly caffeinated beverage consumption, which may lead to psychological and physiological problems. However, correlates of highly caffeinated beverage consumption have not been rigorously examined for Korean adolescents. This study investigated socio-demographic and behavioral factors related to highly caffeinated beverage consumption, using a nationally representative sample of Korean adolescents.

Methods : We used 267,907 middle and high school students from the Korea Youth Risk Behavior Web-based Survey collected from year 2014 to 2017 for the present cross-sectional study. We employed multiple logistic regression to examine the associations between highly caffeinated beverage consumption and socio-demographic and behavioral factors.

Results : Highly caffeinated beverage consumption was higher in 2017 than 2014 (23.9% vs. 12.0%) among Korean adolescents. Drinkers of highly caffeinated beverages were more likely to be boys, to be overweight or obese, to overestimate their body weight, to drink soda > 1 time per week, and to drink sweetened beverages > 1 time per week ( p s < .05). Additionally, drinkers of highly caffeinated beverages were more likely to feel stressed, to feel sadness and depression, to seriously consider suicide, and to attempt suicide during last 12 months ( p s < .05). Among male participants, drinkers of highly caffeinated beverages were less likely to meet the recommended 8 to 10 hours of sleep per night ( p < .05).

Conclusions : Highly caffeinated beverage consumption is a potential health concern, as drinkers of highly caffeinated beverages were more likely to report health and behavioral problems. New strategies are needed to effectively curb highly caffeinated beverage consumption in Korea.
Buccolingual Inclination of Canine and First and Second Molar Teeth and The Curve of Wilson in Different Sagittal Skeletal Patterns of Adults Using Cone-Beam Computed Tomography
Authors: Golshah Amin , Rezae Navid , Heshmati Sara
Published: February 2020

Background: This study aimed to assess the buccolingual inclination of canine and first and second molar teeth and the curve of Wilson in different sagittal skeletal patterns in untreated adults using cone-beam computed tomography (CBCT). Methods: Sixty-six CBCT scans of adults (mean age: 28.74±5.25 years) were evaluated in this cross-sectional study. The images were standardized using the Frankfurt horizontal plane and the interorbital line. The sagittal skeletal pattern was determined using the ANB angle and Wits appraisal. Inclination angles were measured by NNT Viewer and Mimics software. The curve of Wilson was measured by connecting the tips of mesiobuccal and mesiolingual cusps of maxillary first and second molars along the buccal groove and measuring the formed angle. Data were analyzed using ANOVA. Results: The intraobserver agreement was 0.969. The mean inclination of maxillary first and second molars in class I and III patients was significantly higher than that in class II patients (P<0.05). The mean inclination of mandibular first and second molars in class II patients was significantly higher than that in class I and III patients (P<0.05). The difference in inclination of maxillary and mandibular canine teeth was not significant (P>0.05). The mean curve of Wilson in second molars of class II patients was significantly higher than that in class I patients (P<0.05). Conclusion: In different sagittal skeletal patterns, a compensatory relationship exists between the opposing teeth, which along with the standards of crowns, can be used to determine the appropriate position of teeth in dental arch.
Drug users’ perceptions, demands, and suggestions for non-occupational post-exposure prophylaxis (nPEP) services in China: a qualitative study
Authors: Jiao Kedi , Li Haochu , Zhang Dapeng , Jiang Zhenxia , Lin Yuxi , Liu Xueyuan , Xu Hengmin , Yan Xuemei , Tang Haoqing , Ma Wei
Published: February 2020

Background Drug users are regarded as a high-risk population of HIV infection. Non-occupational post-exposure prophylaxis (nPEP) is internationally regarded as an effective biomedical prevention against HIV but still a small-scale pilot project in China at present. The aim of this study was to understand drug users’ perceptions, demands and suggestions for nPEP service in China. Methods Nineteen eligible drug users were recruited in this qualitative study. Semi-structured in-depth interviews were conducted by trained interviewers. All of the interviews were audio-taped, transcribed verbatim and analyzed using thematic framework analysis. Results Most of participants had not heard of nPEP and none of them had used this service. After being informed basic knowledge of nPEP, about half of the participants reported willingness to use it. The facilitators included scare of HIV infection and regarding nPEP as a remedial measure in emergency. The barriers included low willingness for fatigue and lethargy after taking drugs, high price and side effects of nPEP medication, long course of nPEP treatment, and fear of privacy disclosure. Most of the participants thought the availability of nPEP would not increase the occurrence of unprotected intercourse and supported the routinization of nPEP services. Most participants chose social media for nPEP propaganda and pharmacies for providing nPEP. Conclusions It is imperative to strengthen propaganda and education of nPEP among drug users, and to encourage them to proactively use nPEP after exposure. Price regulation, side effect management and privacy protection need to be managed well when nPEP is routinized.
New heritable ATRX mutation identified by whole exome sequencing and review
Authors: Shahbazi Zahra , Rostami Golale , Hamid Mohammad
Published: February 2020

Background

ATRX gene encodes a member of the SWI2/SNF2 family of proteins that may act as a transcriptional factor and plays a significant role in the epigenetic regulation of gene expression. The mutations in the ATRX gene have been shown to cause two types of disorders: inherited mutations lead to alpha thalassemia X-linked mental retardation (ATR-X) syndrome and acquired somatic mutations cause alpha thalassemia myelodysplastic syndrome (ATMDS). Here we report a case of ATRX gene mutation without completely features of ATR-X or ATMDS syndromes. Moreover we review previous reports of ATRX gene mutations in both ATR-X syndrome and ATMDS.

Methods

Patient was a 29-year-old male of Arab ancestry with normocytic anemia, low mean corpuscular hemoglobin (MCH), haematocrit percent and red blood cell (RBC) count. He had no sign of mental retardation and facial dysmorphism. The whole exome sequencing method was used to find the disease-causing variants. Moreover we searched HGMD, Ensembl, OMIM and COSMIC databanks for all mutation reported in ATRX gene so far, and Pubmed, WOS, Science direct and springer link for articles that reported ATRX gene mutations.

Results

We identified a hemizygous missense ATRX gene mutation ( ATRX, c.2388A>C, p. K796N) as a new disease-causing variant in the patient.

Conclusion

According to previous findings, inherited ATRX mutations are associated with a broad spectrum of clinical presentations. Therefore a person with a mild α-thalassemia phenotype may also have mutation in ATRX gene. Accordingly, it is critical for geneticist and physicians to increase awareness in molecular diagnosis of α-thalassemia patients.
A generic emergency protocol for patients with inborn errors of metabolism causing fasting intolerance: a retrospective, single-center chart review of 128 patients
Authors: Hoogeveen Irene J. , Amerongen Tessa van , Weynschenk Frouke J. , Lubout Charlotte M. A. , Boer Foekje de , Fokkert-Wilts Marieke J. , Rodenburg Iris L. , Dam Esther van , Grünert Sarah C. , Martinelli Diego , Spronsen Francjan J. van , Derks Terry
Published: February 2020

Background - Patients with inborn errors of metabolism causing fasting intolerance are at risk of acute metabolic decompensations. Disease specific emergency protocols are widely available, but long-term data on safety and efficacy outcomes are lacking. We hypothesized that a generic emergency protocol can be safe and effective in patients with inborn errors of metabolism causing fasting intolerance. Results - We retrospectively evaluated our generic emergency protocol in 128 patients with a hepatic glycogen storage disease or fatty acid oxidation defect between February 1, 2014 and April 24, 2019. In total, 127 hospital admissions were documented in 54 out of 128 patients (42%). Hypoglycemia (glucose concentration <3.9 mmol/l) was reported in 15% of admissions. Hypoglycemia at admission was uncommon in patients with ketotic glycogen storage disease and verbal patients with a fatty acid oxidation defect. Convulsions, coma or death were not reported. Conclusions - Generic emergency protocols can be safe and effective for home management by the caregivers and the first hour in-hospital management of metabolic emergencies in patients with hepatic glycogen storage disease and medium-chain Acyl CoA dehydrogenase deficiency.
Bone collagen particles combined with hUC-MSCs to repair alveolar cleft in rabbits
Authors: Sun Xue-Cheng , Wang Hu , Li Jian-Hui , Zhang Dan , Ma Xu , Xia Hong-Fei
Published: February 2020

Background: Alveolar cleft is a kind of cleft lip and palate, which seriously affects the physical and mental health of patients. In this study, a similar model of human alveolar cleft phenotype was established in rabbits to evaluate the effect of bone collagen particles combined with human umbilical cord mesenchymal stem cells (hUC-MSCs) on the repair of alveolar cleft. Materials &Methods : In this study, 24 adult Japanese white rabbits (JWRs) were selected and randomly divided into 4 groups. Including normal group, control group, materials group and MSCs group. The model of alveolar cleft was established by removing the incisors on the left side of the upper jaw. The normal group did not receive any treatment. In the control group, the incisors were removed and sutured directly. In the material group, the incisor were removed, then filled with bone collagen particles, and finally sutured. In the MSCs group, the incisors were first removed, then filled with bone collagen granules incubated by hUC-MSCs, and then stitched. Blood biochemical analysis was performed 3 months after the operation. Skull tissues were collected for gross observation, and micro-focus computerized tomography (micro-CT) analysis. Paraffin sections were prepared for histological and immunohistochemical staining. Results: The bone collagen particles and hUC-MSCs are not biotoxic and can promote alvenlus regeneration. Bone collagen particles combined with hUC-MSCs were much better than those used alone in inducing bone repair and regeneration. Conclusions: HUC-MSCs can be used as a bone generation inducer combined with bone materials for bone regeneration and repair. Keywords: alveolar cleft，Bone collagen particle, hUC-MSCs (human umbilical cord mesenchymal stem cells),micro-focus computerized tomography (micro-CT)
Prediction and analysis of human-herpes simplex virus type 1 protein-protein interactions by integrating multiple methods
Authors: Lian Xianyi , Yang Xiaodi , Shao Jiqi , Hou Fujun , Yang Shiping , Pan Dongli , Zhang Ziding
Published: February 2020

Background: Herpes simplex virus type 1 (HSV-1) is a ubiquitous infectious pathogen that widely affects human health. To decipher the complicated human-HSV-1 interactions, a comprehensive protein-protein interaction (PPI) network between human and HSV-1 is highly demanded. Results: To complement experimental identification of human-HSV-1 PPIs, we developed an integrative strategy to predict proteome-wide PPIs between human and HSV-1. For each human-HSV-1 protein pair, four popular PPI inference methods, including interolog mapping, the domain-domain interaction-based method, domain-motif interaction-based method and machine learning-based method, were optimally implemented and employed to generate four interaction probability scores, and then these four scores were further integrated into a final probability score. As a result, a comprehensive high-confidence PPI interaction network between human and HSV-1 was established, which covers 10,432 interactions between 4,546 human proteins and 72 HSV-1 proteins. Functional and network analyses of the HSV-1 targeting proteins in the context of human interactome can recapitulate the known knowledge regarding the HSV-1 replication cycle, supporting the overall reliability of the predicted PPI network. Considering that HSV-1 infections are implicated in encephalitis and neurodegenerative diseases, we focused on exploring the biological significance of brain-specific human-HSV-1 PPIs. In particular, the predicted interactions between HSV-1 proteins and Alzheimer's-disease-related proteins were intensively investigated. Conclusions: The current work can provide testable hypotheses to assist mechanistic understanding of the human-HSV-1 relationship as well as the discovery of anti-HSV-1 pharmaceutical targets. To make the predicted PPI network and the datasets freely accessible to the scientific community, a user-friendly database browser has been released at http://www.zzdlab.com/HintHSV/index.php. Keywords: Human-virus interaction, Protein-protein interaction, Prediction, Herpes simplex virus type 1, Alzheimer's disease
Late complications of radiosurgery for cerebral arteriovenous malformations: report of 5 cases of chronic encapsulated intracerebral hematomas and review of the literature
Authors: Finitsis Stephanos , Anxionnat René , Bernier Valerie , Buccheit Isabelle , Klein Olivier , Bracard Serge
Published: February 2020

Background: Chronic encapsulated intracerebral hematomas (CEIHs) are a rare, late complication of radiosurgery for intracranial AVM. We present 5 cases treated mostly by surgical excision and review the literature. Methods: Patients (age 39, 42, 36, 31, 62) presented with headache, paresthesia, hemiparesis or were asymptomatic. CEIHs presented 10 to 13 years (median 12 years) post radiosurgery. Three patients had demonstrated early radiation induced changes post radiosurgery. Angiographic cure, assessed with DSA, was present in all cases except 1 case with a small nidus remnant. MRI demonstrated mixed lesions with a solid enhancing part, organized hematoma and extensive surrounding edema while three cases had also a cystic component. Results: Excision of the CEIHs with complete or partial removal of the capsule was perfomed in 4 patients and resulted in marked clinical improvement. On patient was managed conservatively with administration of steroids as surgery was judged excessively hazardous with eventual stabilization of his symptoms. Conclusions: CEIHs are rare, late complications of radiosurgery for cranial AVM. They may be asymptomatic or provoke symptoms and may be preceded by early radiation induced changes. Complete removal of CEIHS is an effective treatment. Because of the long latency period of CEIHs, patients who had radiosurgery for brain AVMs should be followed by MRI at least 10 years even after complete obliteration. Keywords: Arteriovenous Malformation, Radiosurgery, Complication, Chronic encapsulated intracerebral hematoma
Adiponectin Improves Therapeutic Efficacy of Mesenchymal Stem Cells by Enhancing Their Engraftment and Survival in Peri-infarct Myocardium Through AMPK Pathway
Authors: Tian Xiaqiu , Qian Xiao-Song , Wang Hong , Yang Yue-Jin
Published: February 2020

Background: Poor viability of transplanted mesenchymal stem cells (MSCs)within the ischemic heart has limited their therapeutic potential for cardiac repair. We have recently demonstrated that adiponectin (APN) inhibits the apoptosis of MSCs under hypoxia and serum-deprivation conditionsin vitro. This study investigated whether APN could promote the survival of MSCs in vivoand further contribute to cardiac repair after acute myocardial infarction (AMI), via the adenosine monophosphate-activated protein kinase(AMPK)pathway. Methods: Rats were randomized into six groups: the Sham, AMI control, and 4 other groups that were subjected to AMI followed by treatment with MSCs, APN, APN + MSCs and APN + MSCs + AMPK inhibitor. MSCs labeled with CM-Dil were injected through the jugular vein in 24 hours post AMI. At 4-week after AMI, engraftment of MSCs to the peri-infarct myocardium was evaluated. Cardiac function was assessed using echocardiography and left heart catheterization. Apoptosis and fibrosis were measured with TUNEL and Masson’s trichrome staining. H&E staining and immunohistochemistry against CD 68 and CD 206 were performed to assess the infiltration of inflammatory cells. Expressions of inflammatory cytokines were determined with ELISA. Immunostaining against smooth muscle cell marker α-smooth-muscle actin (α-SMA) and endothelial cell marker CD31 antibodies were performed to assess arteriogenesis and angiogenesis. Results: APN treatment significantly enhanced the engraftment and survival rate of transplanted MSCs accompanied by markedly improved cardiac function and decreased infarct size at 4-week after AMI. Combined administration of APN and MSCs markedly suppressed inflammatory response, specifically promoted shift of infiltrated macrophages to anti-inflammatory phenotype.Combined administration of APN and MSCs also significantly inhibited cardiomyocytes apoptosis, while increased arteriogenesis and angiogenesis in the peri-infarct myocardium when compared with MSCs transplantation alone. These protective effects of APN were associated with AMPK phosphorylation, which were almost completely reversed by AMPK pathway inhibitor. Conclusions: Our results demonstrated that APN could improve the survival and therapeutic efficacy of transplanted MSCs after AMI through AMPK activation.Our study suggests the potential application of APN for improvement of stem cell-based heart repair and regeneration.
Dysfunctional network and mutation genes of hypertrophic cardiomyopathy
Authors: Cui Yunwen , Liu Cheng , Luo Jian , Liang Jie
Published: February 2020

Background Hypertrophic cardiomyopathy (HCM) is a group of heterogeneous diseases that affect the myocardium. It is also a common familial disease. The symptoms are not common and easy to find. Methods In this study, gene expression profiles of 37 samples (GSE130036) were downloaded from GEO database. Differential analysis was used to identify the related dysregulated genes in patients with HCM. Enrichment analysis identified the biological function and signal pathway of these differentially expressed genes. Then, we build PPI network and verify it in GSE36961 dataset. Finally, the gene of single nuclear variants (SNVs) in HCM samples was screened by means of maftools. Results Herein, we obtained 920 differentially expressed genes, and found that these genes are mainly related to metabolic related signaling pathways. 187 interacting genes were identified by PPI network analysis, and the expression trends of C1QB, F13A1, CD163, FCN3, PLA2G2A and CHRDL2 were verified by another dataset. ROC curve analysis showed that they had certain clinical diagnostic ability, and they were the potential key dysfunctional genes of HCM. In addition, we found that PRMT5 mutation was the most frequent in HCM samples, which may affect the pathogenesis of HCM. Conclusions Therefore, the key genes and enrichment results identified by our analysis may provide a reference for the occurrence and development mechanism of HCM. In addition, mutations in PRMT5 may be a useful therapeutic and diagnostic target for HCM.