bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors influencing early initiation of breastfeeding among mothers in Rajshahi district, Bangladesh
Authors: Ayesha Ummay , M Abu Sayed Md. Al , Islam Md. Nurul , Hossain Md. Ripter , Tasmia Samme Amena , Hossain Md. Golam
Published: September 2020

Background: Early initiation of breastfeeding (EIBF) is referred to as providing breast milk to the newborn within one hour of birth. EIBF ensures that the infant receives the colostrum containing highly protective antibodies. This study aimed to identify the influential factors of EIBF among mothers in Rajshahi district, Bangladesh. Methods: The data was collected from mothers living in Rajshahi district who had at least one child aged 6-24 months. This study was conducted from January to March, 2019. The EIBF was measured by a principal question, “Did you provide your breast milk to your infant within one hour after delivery?” Frequency distribution and Chi-square test and multivariable binary logistic regression model were utilized in this study for getting prevalence and influential factors of EIBF respectively. Results: This study revealed that the prevalence of EIBF among mothers in Rajshahi district was 88.4%. Multivariable logistic model provided eight influential factors of EIBF: (i) place of delivery, (ii) family monthly income, (iii) husbands’ education level, (iv) mothers’ nutritional status, (v) mothers’ age, (vi) husbands’ occupation, (vii) getting pregnancy with planning, and (viii) mothers taking advice regarding the benefit of breastfeeding during their pregnancy. Conclusions: This study identified several modifiable influential factors of EIBF. The customs, culture and other characteristics are almost the same across the country. These factors could be considered to increase the rate of EIBF among mothers in Bangladesh.
Effect of activity level after a posterior-stabilized TKA on the relative bone mineral density measured on standard radiographs in periprosthetic tibial bone: a five-year follow-up study
Authors: Liu Yong , He Peiheng , Li Xing , Ye Yongheng , Liu Minghao , Chen Weizhi , XU Dongliang
Published: September 2020

Background: The aim of this study was to evaluate the effect of activity level after a posterior-stabilized TKA on the relative bone mineral density measured on standard radiographs in periprosthetic tibial bone. Methods: A retrospective review identified 121 patients (121 knees，19 men/102 women) that underwent PS TKA with 5-year follow-up. Patients activity level was evaluated by University of California Los Angeles (UCLA) activity score, and the relative BMD in periprosthetic tibial bone was measured by ImageJ software on anteroposterior X-ray images. Clinical assessments included Western Ontario and McMaster Universities (WOMAC), Knee Society, VAS score and UCLA activity score. Nonlinear regression analysis was used to assess the impact of activity levels on periprosthesis bone density.Results: Activity level significantly affected rBMD in the proximal tibia, with the smallest reduction in rBMD observed with moderate activity. The difference in rBMD% between the lateral and medial metaphysis was significant. The regions with a significant difference in rBMD% between the lateral and medial metaphysis were closest to the base plate of the prosthesis. The lateral and medial regions closest to the stem of the prosthesis showed no significant difference in rBMD%.Conclusions: We found that activity level had a significant effect on radiographic measurements of BMD at 1 and 3 years but not at 5 years and moderate activity was associated with a minimal reduction in proximal tibial BMD.
Diverting colostomy is an effective procedure for ulcerative chronic radiation proctitis patients after pelvic malignancy radiation
Authors: Huang Xiaoyan , Zhong Qinghua , Wang Huaiming , Zhao Jie , Kuang Yingyi , Guan Qi , He Yanjiong , Qin Qiyuan , Wang Hui , Ma Tenghui
Published: September 2020

Background: Chronic radiation proctitis (CRP) with rectal ulcer is a common complication after pelvic malignancy radiation, and gradually deteriorating ulcers will result in severe complications such as fistula. The aim of this study was to evaluate effect of colostomy on ulcerative CRP and to identify associated influence factors with effectiveness of colostomy.Methods: Between November 2011 to February 2019, 811 hospitalized patients were diagnosed with radiation-induced enteritis (RE) in Sun Yat-sen University Sixth Affiliated Hospital, among which 284 patients presented with rectal ulcer, and 61 ulcerative CRP patients were retrospectively collected and analyzed. Results: The overall effective rate of colostomy on ulcerative CRP was 49.2%, with a highest effective rate of 88.2% within 12 to 24 months after colostomy. 9 (31.1%) CRP patients with ulcers were cured after colostomy and 12 (19.67%) patients restored intestinal continuity, among which including 2 (3.3%) patients ever with rectovaginal fistula. 100% (55/55) patients with rectal bleeding and 91.4% (32/35) patients with anal pain were remarkably alleviated. Additionally, multivariable analysis showed the duration of stoma [OR=1.211, 95% CI (1.060~1.382), P =0.005] and albumin (ALB) level post-colostomy [OR=1.437, 95% CI (1.102~1.875), P =0.007] were two independent influence factors for the effectiveness of colostomy on the rectal ulcer of CRP patients. Conclusions: Colostomy was an effective and safe procedure for treating rectal ulcer of CRP patients, and also a potential strategy for preventing and treating fistula. Duration of stoma for 12~24 months and higher ALB level could significantly improve the effectiveness of colostomy on ulcerative CRP patients.
Developments in asthma incidence and prevalence in Alberta between 1995 and 2015
Authors: Bosonea Ana-Maria , Sharpe Heather , Wang Ting , Bakal Jeffrey A , Befus Dean , Svenson Lawrence W , Vliagoftis Harissios
Published: September 2020

Background: Asthma is a chronic respiratory disease characterized by reversible bronchoconstriction and airway inflammation. According to Statistics Canada in 2014, 8.1% of Canadians aged 12 and older reported having asthma diagnosed by a health care professional. Therefore, in 2014 there were an estimated 274,661 persons with asthma in Alberta. Most epidemiological studies estimate prevalence and incidence using survey-based data, which has limitations. The Ontario Asthma Surveillance Information System (OASIS) group has developed and validated an algorithm for epidemiologic asthma studies using provincial health databases. In Alberta, there are some studies using provincial databases, but most are restricted to Emergency Department visits and do not represent the entire asthma population. Using the validated asthma definition for epidemiologic studies, we performed an analysis of the Alberta Health administrative databases to investigate and report province-wide asthma prevalence, incidence and mortality in Alberta from 1995 to 2015.Methods: Data from administrative databases, provided by Alberta Health, was analyzed to determine age and sex specific prevalence, incidence and mortality of the asthma population. The population cohort was all individuals residing in the province of Alberta, ages 0 to 99 from 1995-2015. Kendall’s Tau coefficient test was used to ascertain whether the observed trends were statistically significant. Results: Between 1995 and 2015, the age-standardized incidence of asthma decreased by more than 50% in both males and females. Prevalence; however, increased 3-fold over the 20 years for both genders from 3.9% to 12.3% (Tau=1.00, p<0.0001) in females and from 3.5% to 11.6% (Tau=1.00, p<0.0001) in males. Thus, in 2015 there were 496,927 people with asthma in Alberta. All-cause mortality in the asthma population decreased over time, in both females (Tau=-0.71, p<0.0001) and males (Tau=-0.69, p=0.0001). For the last several years, all-cause mortality was higher in those with asthma. There were ~7 deaths/1000 in the population with asthma versus ~5 deaths/1000 in those without asthma. Conclusions: The incidence of asthma decreased in both females and males while prevalence continued to increase, but at a slower rate than previously. All-cause mortality in asthma patients was higher than in those without asthma, but both decreased over time.
The effect of the difference in the C2-7 angle on the occurrence of dysphagia after anterior cervical discectomy and fusion with the Zero-P Implant System
Authors: Huang Chengyi , Meng Yang , Wang Beiyu , Yu Jie , Ding Chen , Yang Yi , Wu Tingkui , Liu Hao
Published: September 2020

Objectives: To investigate the effect of the difference in C2-7 angle on dysphagia after anterior cervical discectomy and fusion (ACDF) with the Zero-P Implant System.Methods: A retrospective analysis of 181 patients who underwent ACDF with the Zero-P Implant System and had at least one year of follow-up from January 2011 to November 2018 was performed. All patients were divided into a non-dysphagia group and a dysphagia group to explore the effect of the difference between postoperative and preoperative C2-7 angle (dC2-7A) on postoperative dysphagia. At the same time, other possible related factors including the difference between postoperative and preoperative O-C2 angle (dO-C2A), sex, age, body mass index (BMI), intraoperative time, estimated blood loss, diabetes mellitus, hypertension, smoking, alcohol consumption, prevertebral soft-tissue swelling (PSTS), the highest segment involved in the surgery and the levels of surgery segments were analyzed.Results: In total, the non-dysphagia group comprised 139 patients and the dysphagia group comprised 42 patients. The single-factor analysis showed that smoking, PSTS and dC2-7A were significantly different between the two groups (P<0.05). Spearman’s correlation coefficient showed no significant correlation between the degree of dysphagia and dC2-7A (P>0.05). The results of the multiple-factor analysis with an ordinal logistic regression model showed that smoking, PSTS and dC2-7A were significantly associated with the incidence of dysphagia (P<0.05).Conclusions: The postoperative C2-7 angle has an important effect on the occurrence of dysphagia in patients undergoing Zero-P implant system interbody fusion surgery.
Trilobatin ameliorates insulin resistance through IRS-AKT-GLUT4 signaling pathway in C2C12 myotubes and ob/ob mice
Authors: Liu Min , Wang Lujing , Li Xigan , Wu Yucui , Yin Fei , Liu Jianhui
Published: September 2020

Background: Trilobatin, a natural compound, has been found to exhibit anti-diabetic properties in high-fat diet (HFD) and streptozotocin (STZ) induced type 2 diabetic mice. But up to now no research has been reported on the effect of trilobatin on insulin resistance in peripheral tissues. Herein, we determined the effects of trilobatin on insulin resistance in palmitate-treated C2C12 myotubes and ob/ob mice.Methods: 8-10 weeks of male ob/ob mice and same background C57BL/6 mice were used to evaluate the role of trilobatin on insulin resistance; Protein expression and phosphorylation were measured by western blot; Glucose uptake was determined a fluorescent test.Results: treatment with trilobatin prevented palmitate-induced insulin resistance by enhancing glucose uptake and the phosphorylation of insulin resistance substrate 1 (IRS1) and protein Kinase B, (PKB/AKT), recovered the translocation of GLUT4 from cytoplasm to membrane, but preincubation with LY294002, an inhibitor of PI3K, blocked the effects of trilobatin on glucose uptake and the distribution of GLUT4 in C2C12 myotubes. Furthermore, administration with trilobatin for 4 weeks significantly improved insulin resistance by decreasing fasting blood glucose and insulin in serum, enhancing the phosphorylation of IRS1 and AKT, and recovering the expression and translocation of GLUT4 in ob/ob mice.Conclusions: IRS-AKT-GLUT4 signaling pathway might be involved in trilobatin ameliorating insulin resistance in skeletal muscle of obese animal models.
Economy-wide effects of reducing the time spent for water fetching and firewood collection in Ethiopia
Authors: Mosa Abdulaziz , Grethe Harald , Siddig Khalid
Published: September 2020

Background: Water fetching and firewood collection are among home activities that are part of the daily routine of many households in rural Ethiopia. Households travel long distances and spend large amounts of time every day for collecting water and firewood. Fetching water and firewood reduce labor available for market related activities such as agriculture that affects production and productivity of these sectors negatively. Better access to water facility and energy efficient technology (such as improved stoves) is expected to release labor for market related activities that can have economy-wide impacts. The objective of this study is to investigate the economy-wide effects of access to water facility and improved stoves. Methods: The study uses the updated 2004/05 Social Accounting Matrix (SAM) of Ethiopia. The SAM is modified to account for a detailed representation of water fetching, firewood collection and leisure activities and commodities. This study applies a single country Computable General Equilibrium (CGE) model to the updated SAM of Ethiopia. The simulation scenario is a 50% increase in the Total Factor Productivity (TFP) of both water fetching and firewood collection activities due to better access to water infrastructure and cooking improved stoves. Results: The findings of the study show that better access to drinking water supply and improved stoves reduces labor time spent for water fetching and firewood collection. The released labor from water fetching and firewood collection partly reallocated to leisure consumption and partly to market related activities. Those freed labors that are reallocated to marketed sectors including agricultural and non-agricultural activities leads to increase employment and enhance domestic production. Better access to drinking water and improved stoves also enhances household welfare. Households that allocate a relatively large proportion of labor to water fetching and firewood collection gain relatively more welfare. Macroeconomic indicators such as GDP, total domestic production, absorption, and imports are also positively affected due to improved access to water and energy efficient technology.Conclusions: It is helpful to recognize the economic significance of labor released from water fetching and firewood collection in any developing economy with a limited supply of water facility and access to energy technology.
Exploration of the Pregnant Women's Experiences During COVID-19 Disease Crisis: A Qualitative Study
Authors: Bakouei Fatemeh , Nikpour Maryam , Rad Hajar Adib , marzoni zahra abadi
Published: September 2020

Background: Prevention and control of COVID-19 disease in pregnant women has become a major concern. Healthcare providers should be aware that restriction of the routine prenatal care may have adverse effects. A qualitative approach can be helpful in understanding the pregnant women's experience and perspective in crisis. The study was conducted to explain the pregnant women's experiences during COVID-19 disease crisis.Methods: The qualitative study was conducted with conventional content analysis. Pregnant women selected with purposive sampling from six urban health centers in Babol (North of Iran). The semi structured individual interviews were done by telephone from May 03 to June 10, 2020. The systematic thematic analysis was used to identify and organize themes into clusters and categories across interviews.Result: We recruited twelve pregnant women until data saturation. Three theme categories extracted from data analysis. The first was "unpleasant feelings during pregnancy", the pregnant women stated feelings in this crisis such as worry, fear, obsession, boredom, nervousness, discouragement, and the like, which led them to have no positive pregnancy experience. The second category was "adjusted lifestyle". They experienced changes in lifestyle with the aim of preventing COVID-19 disease. The third category was “safe pregnancy care”. The pregnant women, while paying attention to the importance of pregnancy care, were forced to limit, delay, or modify some cares in order to be safe. Conclusion: The pregnant women experienced unpleasant feelings in this crisis; therefore, they should receive the necessary consulting to maintain mental health. All pregnant women reported some changes in their lifestyle and pregnancy care in order to health considerations to prevent the disease. Regular training for all pregnant women is necessary to manage this important pregnancy period while maintaining the maternal and fetal health in crisis.
Stromal Changes In The Aged Lung Induce An Emergence From Melanoma Dormancy
Authors: Weeraratna Ashani , Fane Mitchell , Douglass Stephen , Alicea Gretchen , Webster Marie , Rebecca Vito , Marino Gloria , Chhabra Yash , Almeida Filipe , Ecker Brett , Beer Thomas , Tang Hsin-Yao , Kossenkov Andrew , Speicher David , Aguirre-Ghiso Julio
Published: September 2020

Dormant tumor cells escape the primary site, do not grow out into macroscopic tumors in the distal site, but maintain enough plasticity to reactivate and form overt metastatic lesions, sometimes taking several decades. Despite its importance in metastasis and residual disease, few studies have been able to successfully model or characterize dormancy within melanoma. Here, we show that age-related changes in the lung microenvironment facilitate a permissive niche for efficient outgrowth of disseminated dormant tumor cells, in contrast to the aged skin, where age-related changes suppress melanoma growth but drive dissemination. A model of melanoma progression that addresses these microenvironmental complexities is the phenotype switching model, which argues that melanoma cells switch between a proliferative cell state and a slower-cycling, invasive state1–3. Dermal fibroblasts are key orchestrators of promoting phenotype switching in melanoma via changes in the secretion of soluble factors during aging4–8. Specifically, we have identified Wnt5A as a master regulator of activating metastatic dormancy, which enables efficient seeding and survival of melanoma cells in metastatic niches. Age-induced reprogramming of lung fibroblasts increases their secretion of the soluble Wnt antagonist sFRP1, which inhibits Wnt5A, enabling efficient metastatic outgrowth. Further, we have identified the tyrosine kinase receptors AXL and MER as promoting a dormancy-to-reactivation axis respectively. Overall, we find that age-induced changes in distal metastatic microenvironments promotes efficient reactivation of dormant melanoma cells in the lung.
Magnetic and Optical Field Multi-Assisted Li-O2 Batteries with Self-Regulated Charge and Discharge
Authors: Wang Xiao-Xue , Guan De-Hui , Li Fei , Li Ma-Lin , Zheng Li-Jun , Xu Ji-Jing
Published: September 2020

The photo-assisted lithium-oxygen (Li-O2) system emerged as an important direction for future development by effectively reducing the large overpotential in Li-O2 batteries. However, the advancement is greatly hindered by the rapidly recombined photoexcited electrons and holes upon the discharging and charging processes. Herein, we make a breakthrough in overcoming these challenges by developing a new magnetic and optical field multi-assisted Li-O2 battery with 3D porous NiO nanosheets on the Ni foam (NiO/FNi) as a photoelectrode. Under illumination, the photogenerated electrons and holes of the NiO/FNi photoelectrode play a key role in reducing the overpotential during discharging and charging, respectively. By introducing the external magnetic field, the Lorentz force acts oppositely on the photogenerated electrons and holes, suppressing the recombination of charge carriers. The magnetic and optical field multi-assisted Li-O2 battery achieves an ultra-low charge potential of 2.73 V, a high energy efficiency of 96.7%, as well as a good cycling stability of 200 h. This external magnetic and optical field multi-assisted technology paves a new way of developing high-performance Li-O2 batteries and other energy storage systems.
A Rapid Blood Test to Monitor the Immune Status Change of Dairy Cows and to Evaluate their Disease Risk during the Periparturient Period
Authors: Tsai Chia-Yu , Hassan Rick , Hung Hao-Che , Weber Tanya , Price W. J. , Rezamand Pedram , HUO QUN
Published: September 2020

BackgroundDairy cows are at the highest risk of developing clinical and subclinical diseases and disorders in the first few weeks following parturition. During the periparturient period, from approximately 30 days before calving to 30 days postpartum, the immune system of the dairy cows undergoes a multitude of changes to prepare for parturition, colostrum production and lactation. One such change is the transfer of a large amount of immunoglobulin G proteins, especially subclass IgG1 to colostrum, leading to a reduction of IgG1 in the blood. As IgG1 and IgG2 need to maintain a balance to protect animals from intracellular and extracellular pathogens, a disruption of this balance compromises the immune protection of the animals. Rapid tests that can detect these immunological changes may be potentially useful for predicting the risk of dairy cows developing infectious diseases and other adverse health conditions following parturition. ResultsWe report here a new rapid test to detect certain immune status changes in the blood serum of dairy cows. This test uses a nanoparticle probe to evaluate the relative quantity of IgG1 and IgG2 in a sample. The nanoparticle probes are aggregated together upon interaction with bovine IgG2, while bovine IgG1 inhibits such interactions. The nanoparticle aggregates are detected by monitoring the color change of the assay solution using a handheld device. We tested the serum samples from 230 dairy cows collected during periparturient period, from 14-7 days before calving to 7-14 days postpartum. Results show that the test clearly detected an immune status change associated with IgG1/IgG2 relative quantity change around the time of parturition. Data analysis using mixed liner model in SAS (Statistical Analysis System) revealed a significant difference (P value = 0.042) in their test responses between healthy cows and cows with mastitis and/or lameness. ConclusionThe new rapid test we report here can be used to detect and monitor certain immune status change in dairy cows during the periparturient period. The test results may be potentially used to evaluate and predict the health risk of the dairy cows following parturition.
Establishment of prediction models for lung cancer NOG/PDX models: A guideline for machine learning in small biomedical datasets
Authors: Guo Haoyue , Diao Li , Qi Hui , Dai Chunlei , Chen Yu , Tang Xuzhen , He Yayi
Published: September 2020

Background: Targeted therapy and immune checkpoint inhibitors are the most promising treatments for lung cancers but still facing multiple challenges, including resistance and individual difference. Therefore, patient-derived tumor xenografts (PDX) models are developed for drug discovery and screening. NOG mice is under the destruction of the interleukin-2 (IL-2) receptor common gamma chain, which is appropriate for building PDX models to test immunotherapies. However, current studies have little understanding of the causes of genotype mismatches in PDX or NOG/PDX models, which leads to a massive economic and time loss.Methods: Lung cancer tissues from 53 patients were obtained and engrafted into NOG mice. All of the patients' tumors and NOG/PDX models were detected for common gene mutations. Seventeen clinicopathological features were organized and input to stepwise logistic regression based on the lowest Akaike information criterion (AIC), least absolute shrinkage and selection operator (LASSO)-logistic regression, support vector machine recursive feature elimination (SVM-RFE), eXtreme Gradient Boosting (XGBoost), Gradient Boosting & Categorical Features (CatBoost), and synthetic minority over-sampling technique (SMOTE). Finally, the performance of all models was evaluated by the accuracy, area under the receiver operating characteristic curve (AUC), and F1 score in 100 testing groups.Results: Fifty-three lung cancer NOG/PDX models were successfully established, with a genotype matching rate of 79.2% (42/53). Two multivariable logistic regressions revealed that age, the number of driver mutations, epidermal growth factor receptor (EGFR) gene mutations, the type of prior chemotherapy, prior tyrosine kinase inhibitors (TKIs) therapy, and the source were potent predictors. Moreover, CatBoost (mean accuracy=0.960; mean AUC=0.939; mean F1 score=0.908) and 8-feature SVM (mean accuracy=0.950; mean AUC=0.934; mean F1 score=0.903) showed the best performance compared with the other algorithms. Moreover, the combination of SMOTE with SVM significantly improved the predictive capability (mean accuracy: 0.961 vs. 0.958, P=0.025; mean AUC: 0.940 vs. 0.935, P=0.045; mean F1 score: 0.909 vs. 0.903, P=0.047).Conclusions: We established an optimal predictive model to screen lung cancer patients for NOG/PDX models, and also offered a general approach for building prediction models in small unbalanced biomedical samples.
Locating hydrothermal fluid injection of the 2018 phreatic eruption at Kusatsu-Shirane volcano with volcanic tremor amplitude
Authors: Yamada Taishi , Kurokawa Aika K , Terada Akihiko , Kanda Wataru , Ueda Hideki , Aoyama Hiroshi , Ohkura Takahiro , Ogawa Yasuo , Tanada Toshikazu
Published: September 2020

Kusatsu-Shirane volcano has been a particular study field for hydrothermal system and phreatic eruptions with plenty of thermal springs, fumaroles, and a crater lake of Yugama. On 23 January 2018, a phreatic eruption occurred at the Motoshirane cone of Kusatsu-Shirane, where no considerable volcanic activity had been reported in observational and historical records. To understand the eruption process of such a unique event, we examined observed seismic, tilt, and infrasound records. The onset of surface activity accompanied by infrasound signal was preceded by volcanic tremor and inflation of the volcano for 2 minutes. Tremor signals with a frequency of 5–20 Hz remarkably coincide with the rapid inflation. We apply an amplitude source location method to seismic signals in the 5–20 Hz band to estimate tremor source locations. Our analysis locates tremor sources at 1 km north of Motoshirane and at a depth of 0.5–1 km from the surface. Inferred source locations correspond a conductive layer of impermeable cap-rock estimated by magnetotelluric investigations, and an upper portion of the seismogenic region, suggesting hydrothermal activity hosted beneath the cap-rock. Examined seismic signals in the 5–20 Hz band are typically excited by volcano-tectonic events with faulting mechanism. Based on the above characteristics and background, we interpret that excitation of examined volcanic tremor reflects small shear fractures induced by sudden hydrothermal fluid injection to the cap-rock layer. The horizontal distance of 1 km between inferred tremor sources and Motoshirane implies lateral migration of the hydrothermal fluid, although we have not obtained direct evidence. Kusatsu-Shirane has a series of unrest at the Yugama lake since 2014. However, inferred tremor source locations do not overwrap active seismicity beneath Yugama. Therefore, our result suggests that the 2018 eruption was triggered by hydrothermal fluid injection through an independent pathway that has driven unrest activities at Yugama.
An Exploratory, Observational Cohort Study on the Dynamics of Heparin Binding Protein in Cardiothoracic Surgery Using Cardiopulmonary Bypass
Authors: Sterner Niklas , Fisher Jane , Thelaus Louise , Ketteler Carolin , Lemež Špela , Dardashti Alain , Nilsson Johan , Linder Adam , Zindovic Igor
Published: September 2020

BackgroundSurgical trauma and cardiopulmonary bypass (CPB) cause an inflammatory response, difficult to differentiate from postoperative infections. Heparin-binding protein (HBP) is released from neutrophils and has been shown to predict infection-related organ dysfunction and disease progression to severe sepsis. In order to explore the potential of HBP as a biomarker for postoperative infections and asess possible confounding effects of concomitant medications, this study aimed to investigate the pre-, intra- and postoperative dynamics of HBP in cardiac surgery with CPB.Methods Thirty patients undergoing cardiac surgery with CPB were included, of which 15 underwent coronary artery bypass grafting (CABG) surgery and 15 underwent complex procedures with longer CPB duration. Ten patients undergoing lung surgery without CPB were also included as a conventional surgery reference group. HBP was measured at nine different perioperative time points.Results Our results showed that HBP levels were not affected by surgical trauma by itself. An increase in HBP levels was observed immediately following heparin administration and further increased during CPB. Prior to protaminization, we measured higher peak HBP-levels in the complex group (345.7 (287.8-472.6) ng/mL) compared with the CABG group (152.7 (85.3-204.0) ng/mL, p<0.001). HBP decreased rapidly following cessation of CPB and simultaneous protamine administration. Delay of protamine administration revealed that protamine, and not the cessation of CPB is primarily responsible for the rapidly reduced HBP concentration. At the arrival to the ICU, the median HBP levels were 24.8 (15.6-38.1) ng/mL for CABG patients compared with 50.5 (36.5-104.6) ng/mL for complex surgery patients (p=0.004). One day after surgery, HBP levels in all three groups were below the proposed cutoff of 30 ng/mL, previously found to predict development of organ dysfunction during infection, while other biomarkers for infections remained elevated.ConclusionsHBP levels are elevated by administration of heparin and the use of CPB but reduced by protamine administration. At postoperative day one, HBP levels were below the threshold for infection with organ dysfunction, indicating that postoperative HBP measurement may be a better screening tool for postoperative infections than other biomarkers of infections that remain elevated after surgery.
Crizotinib versus alectinib for treatment of ALK-positive non-small cell lung cancer: a pooled analysis of the ALEX, ALESIA and J-ALEX clinical trials
Authors: Zeng Qinghua , Zhang Xiquan , He Shan , Zhou Zhiyong , Xia Luping , Zhang Wenxiong , Zeng Lin
Published: September 2020

Background: Crizotinib and alectinib were the two most commonly used anaplastic lymphoma kinase (ALK) inhibitors for ALK-positive non-small cell lung cancer (NSCLC). We compared their antitumor efficacies and adverse effects based on a pooled analysis of the ALEX, ALESIA and J-ALEX clinical trials.Methods: Seven databases were searched for eligible articles. The primary endpoints included overall survival (OS), progression-free survival (PFS), central nervous system (CNS)-PFS, drug responses and adverse effects (AEs).Results: Three randomized controlled clinical trials (ALEX, ALESIA and J-ALEX) with a total of 7 articles and 697 patients were included. Compared with crizotinib, alectinib exhibited superior efficacy in PFS (HR [hazard ratio]: 0.35, [0.25-0.49], p < 0.00001), OS (HR: 0.66, [0.47-0.92], p = 0.02), CNS-PFS (HR: 0.17, [0.11-0.24], p < 0.00001), duration of response (HR: 0.31, [0.23-0.42], p < 0.00001), objective response rate (ORR) (Risk ratio [RR]: 0.87, [0.80-0.94], p = 0.0003), partial response (PR) (RR: 0.88, [0.81-0.96], p = 0.004), and grade 3-5 AEs (RR: 1.43, [1.09-1.87], p = 0.009). Additionally, the survival advantages of alectinib compared with crizotinib increased with alectinib’s prolongation of survival time. The disease control rate, complete response and total AEs were comparable between the two groups. A greater increase in constipation, nausea, diarrhea, alanine aminotransferase, vomiting, aspartate aminotransferase, peripheral edema, dysgeusia, and visual impairment as well as a greater decrease in appetite and neutrophil count were associated with the crizotinib groupConclusions: In both antitumor efficacy and safety, alectinib appears to be superior to crizotinib for the treatment of ALK-positive NSCLC.
Identification of a Novel Epithelial-mesenchymal Transition Gene Signature Regulated by KEAP1-NRF2 Pathway in Esophageal Carcinoma
Authors: Elshaer Mohamed , Hammad Ahmed , Wang Xiu Jun , Tang xiuwen
Published: September 2020

BackgroundKEAP1-NRF2 pathway alterations were identified in many cancers including, esophageal cancer (ESCA). Identifying biomarkers that are associated with mutations in this pathway will aid in defining this cancer subset; and hence in supporting precision and personalized medicine. MethodsIn this study, 182 tumor samples from the Cancer Genome Atlas (TCGA)-ESCA RNA-Seq V2 level 3 data were segregated into two groups KEAP1-NRF2-mutated (22) and wild-type (160).The two groups were subjected to differential gene expression analysis and we performed Gene Set Enrichment Analysis (GSEA). Then, the enriched gene set was integrated with the differentially expressed genes (DEGs) to identify a gene signature regulated by the KEAP1-NRF2 pathway in ESCA. Furthermore, we validated the gene signature using mRNA expression data of ESCA cell lines provided by the Cancer Cell Line Encyclopedia (CCLE). The identified signature was tested in 3 independent ESCA datasets to assess its prognostic value.ResultsWe identified 11 epithelial-mesenchymal transition (EMT) genes regulated by the KEAP1-NRF2 pathway in ESCA patients. Five of the 11 genes showed significant over-expression in KEAP1-NRF2-mutated ESCA cell lines. In addition, over-expression of these five genes was significantly associated with poor survival in 3 independent ESCA datasets, including the TCGA-ESCA dataset.ConclusionAltogether, we identified a novel EMT 5-gene signature regulated by the KEAP1-NRF2 axis and this signature is strongly associated with metastasis and drug resistance in ESCA. These 5-genes are potential biomarkers and therapeutic targets for ESCA patients in whom the KEAP1-NRF2 pathway is altered.
Serum MALAT1 Assumes Signifying Capacity in Gastric Cancer Diagnosis.
Authors: Zhang Keqian , Mao Tianqi , He Zhicheng , Wu Xiaojiao , Peng Yu , Chen Yanrong , Dong Yan , Ruan Zhihua , Wang Zhe
Published: September 2020

Background: Gastric cancer (GC) represents one of the most serious cancers worldwide with the increasing mortality. Metastasis associated lung adenocarcinoma transcript 1 (MALAT1), a kind of lncRNAs, has been reported to be involved in the progression of cancers. This study aimed to assess serum expression pattern of MALAT1 and its clinical significance in diagnosis of GC.Methods: Serum specimens were collected from 120 GC patients and 58 healthy individuals. The expression profile of MALAT1 was examined using quantitative real-time polymerase chain reaction (qRT-PCR), and its association with clinical parameters was estimated by chi-square test. The diagnostic value of MALAT1 in GC was evaluated by the receiver operating characteristic (ROC) analysis.Results: Upregulated expression of MALTA1 was found in GC patients compared with the healthy controls (P<0.05). The overexpression of MALAT1 was positively correlated with lymph node metastasis (P=0.041) and TNM stage (P=0.005). An area under the curve (AUC) was 0.897 in ROC analysis, suggesting the high diagnostic value of MALAT1. Conclusion: The expression of MALAT1 was upregulated in GC serum samples, and its expression might serve as a potential diagnostic biomarker in patients with GC.
Associations Between State Intimate Partner Violence-Related Firearm Policies and Injuries Among Women and Men Who Experience Intimate Partner Violence
Authors: Willie Tiara C. , Kershaw Trace , Perler Rachel , Caplon Amy , Katague Marina , Sullivan Tami p.
Published: September 2020

Background: Comprehensive state firearm policies related to intimate partner violence (IPV) may have a significant public health impact on non-lethal IPV-related injuries. Research indicates that more restrictive firearm policies may reduce risk for intimate partner homicide, however it is unclear whether firearm policies prevent or reduce the risk of non-lethal IPV-related injuries. This study sought to examine associations between state-level policies and injuries among U.S. IPV survivors.Methods: Individual-level data were drawn from the National Intimate Partner and Sexual Violence Survey, a nationally-representative study of noninstitutionalized adults. State-level data were drawn from a firearm policy compendium. Multivariable regressions were used to test associations of an IPV firearm policy climate index, as well as individual policies, with non-fatal IPV-related injuries (N=6,565). Results: On average, states had 2 IPV-related firearm policies (range 0 to 6). Overall, IPV-related firearm policy climate was associated with lower odds of experiencing injuries (aOR[95% CI]= .95[.91, .98]). Three specific policies were associated with IPV-related injuries. Individuals who reported IPV and live in states that required firearm surrender of persons convicted of IPV-related misdemeanors (aOR[95% CI]=.78 [.64, .95]), prohibited firearms to persons subject to IPV-related protective orders (aOR[95% CI]=.82[.68, .97]) and convicted of stalking (aOR[95% CI]=.77[.64, .92]) had lower odds of experiencing injuries than individuals living in states without these policies. Conclusions: Restrictive state firearm policies regarding IPV may provide unique opportunities to protect IPV survivors from injuries.
Suan-Zao-Ren Decoction Ameliorate Synaptic Plasticity Through the Inhibition of JAK2/STAT3 Signaling Pathway in APP/PS1 Transgenic Mice
Authors: Long Qing-Hua , Wu Yong-Gui , He Li-Ling , Ding Li , Tan Ai-Hua , Shi He-Yuan , Wang Ping
Published: September 2020

Background: Suan-Zao-Ren Decoction (SZRD) has been widely used to treat neurological illnesses, like dementia, insomnia, and depression. However, mechanisms underlying SZRD’s improvement in cognitive function remains unclear. In this study, we examined SZRD’s effect on APP/PS1 transgenic mice as well as mechanisms associated with SZRD’s action in alleviating neuroinflammation and improving the synaptic plasticity. Methods: The APP/PS1 mice were treated with different dosages of SZRD (12.96 and 25.92 g/kg/d, in L-SZRD and H-SZRD groups, respectively) for four weeks. Morris water maze was conducted to determine changes in behaviors of the mice after the treatment. Meanwhile, in the samples of the hippocampus, Nissl staining and Golgi-Cox staining were used to detect the synaptic plasticity, Western blot (WB) was employed to test expressions of Aβ1-42, APP, ADAM10, BACE1, PS1, IDE, IBA1, GFAP, PSD95 and SYN, as well as the expressions of JAK2, STAT3 and their phosphorylation patterns to detect involvement of JAK2/STAT3 pathway. Besides, we examined the serum contents of IL-1β, IL-6, and TNF-α using ELISA.Results: Compared to the APP/PS1 mice without any treatment, SZRD, especially the L-SZRD, significantly ameliorated cognitive impairment of the APP/PS1 mice with decreases in the loss of neurons and Aβ plaque deposition as well as improvement of synaptic plasticity in the hippocampus (all P<0.05). Also, SZRD, in particular, the L-SZRD markedly inhibited the serum IL-6, IL-1β, and TNF-α, while reducing the expression of p-JAK2-Tyr1007 and p-STAT3-Tyr705 in the hippocampus of the APP/PS1 mice (all P<0.05). Conclusion: The SZRD, especially the L-SZRD, may improve the cognitive impairment and ameliorate the neural degeneration in APP/PS1 transgenic mice through decreasing Aβ accumulation and inhibiting neuroinflammation via JAK2/STAT3 pathway.
Emerging dominance of summer rainfall in driving High Arctic terrestrial-aquatic connectivity
Authors: Beel Casey , Heslop Joanne , Orwin John , Pope Michael , Schevers Amanda , Hung Jacqueline , Lafreniere Melissa , Lamoureux Scott
Published: September 2020

Climate warming-related hydrological transformations are changing material mobilization, composition, and transport pathways along the terrestrial-aquatic continuum. Here, we integrate decade-long hydrometeorological and biogeochemical data from the High Arctic to show that annual fluvial energy is shifting from a skewed (snowmelt-dominated) to a multi-modal (snowmelt- and rainfall-dominated) distribution. This shift enhanced terrestrial-aquatic connectivity for dissolved and particulate material fluxes, but to overcome the watersheds’ buffering capacity for particulate material rainfall events had to increase by an order of magnitude. Permafrost disturbances (< 3 % of the watersheds’ areal extent) reduced watershed-scale DOC export enough to offset concurrent increased DOC export in undisturbed watersheds but play a weaker role in altering C export than the increased magnitude and frequency of late summer rainfall events. However, the disturbances have primed the landscape for accelerated geomorphic change when future rainfall magnitudes and consequent pluvial responses exceed the current buffering capacity of the terrestrial-aquatic continuum.
Immunogenicity and protective efficacy of BBV152: a whole virion inactivated SARS CoV-2 vaccine in the Syrian hamster model
Authors: Mohandas Sreelekshmy , Yadav Pragya D , Shete Anita , Abraham Priya , Mohan Krishna , Sapkal Gajanan , Mote Chandrashekhar , Nyayanit Dimpal , Gupta Nivedita , Srini V K , Kadam Manoj , Kumar Abhimanyu , Jain Rajlaxmi , Majumdar Triparna , Deshpande Gururaj , Patil Savita , Sarkale Prasad , Patil Deepak , Ella Raches , Prasad Sai D , Sharma Sharda , Ella Krishna M , Panda Samiran , Bhargava Balram
Published: September 2020

The availability of a safe and effective vaccine would be the eventual measure to deal with SARS-CoV-2 threat. Here, we have developed and assessed the immunogenicity and protective efficacy of an inactivated SARS-CoV-2 vaccine (BBV152) in hamsters. Three dose vaccination regime with three formulations of BBV152 induced significant titres of SARS-CoV-2 specific IgG and neutralizing antibodies. The formulation with imidazoquinoline adsorbed on alum adjuvant remarkably generated a quick and robust immune response. Th1 biased immune response was demonstrated by the detection of IgG2 antibodies. Post-SARS-CoV-2 infection, vaccinated hamsters did not show any histopathological changes in the lungs. The protection of the hamsters was evident by the rapid clearance of the virus from lower respiratory tract, reduced virus load in upper respiratory tract, absence of lung pathology and robust humoral immune response. These findings confirm the immunogenic potential of BBV152 and further protection of hamsters challenged with SARS-CoV-2.
Molecular variance analysis (AMOVA) and levels of genetic diversity of complete genome of SARS-CoV-2 virus from of six South American Countries
Authors: Felix Pierre Teodosio , Ramos Robson da Silva , Nascimento Sara da Silva , Silva Willams Felipe Ferreira , Silva Maria Dara Pereira da , Santos Bianca Sarah Ferreira dos , Filho Cícero Batista do Nascimento , Paulino Antônio João , Venâncio Dallynne Bárbara Ramos
Published: September 2020

Although some Countries in South America have implemented laboratory and patient management protocols for the new coronavirus, the lack of access to basic sanitation and hygiene measures, as well as the lack of drugs and vaccines, has significantly interfered with the epidemiological mechanics of the virus, emphasizing its implications. Therefore, trying to understand the evolutionary aspects of the virus, emerges as another strategy that can help in the most varied measures of prophylaxis. In this work, we evaluated the levels of genetic diversity in 38 complete Genomes of SARS-CoV-2 from six countries in South America, using specific methodologies for paired FST, AMOVA, mismatch, demographic and spatial expansions, molecular diversity and for the time of evolutionary divergence. The analyses showed non-significant evolutionary divergences within and between the six countries, as well as a significant similarity to the time of genetic evolutionary divergence between all populations. Thus, it seems safe to affirm that we will find similar results for the other Countries of South America, reducing speculation about the existence of rapid and silent mutations that, although there are as we have shown in this work, do not increase, until this moment, the genetic variability of the Virus, a fact that would hinder the work with molecular targets for vaccines and drugs in general.
Open Penetrating External Laryngotracheal Injury and Abdominal Trauma by Suicide Attempt Successfully Treated With Immediate Intervention: A Case Report
Authors: Kamidani Ryo , Okada Hideshi , Yoshimura Genki , Kato Rina , Kusuzawa Keigo , Ichihashi Masahiro , Kakino Yoshinori , Oiwa Hideaki , Yasuda Ryu , Kitagawa Yuichiro , Fukuta Tetsuya , Okamoto Haruka , Miyake Takahito , Tachi Masahito , Shiba Masato , Nishihori Takesumi , Kuze Bunya , Yoshida Takahiro , Yoshida Shozo , Ogura Shinji
Published: September 2020

Background: An open penetrating external laryngotracheal injury (LTI) is a rare life-threatening injury requiring immediate intervention. Penetrating injuries may cause tissue loss, which makes wound closure difficult sometimes. Here, we report the case of a patient who developed an open penetrating external LTI and abdominal trauma by suicide attempt, which required surgical intervention.Case presentation: A 38-year-old Asian man with depression was found lying on the floor after cutting his neck and abdomen by himself. The emergency services found multiple deep lacerations on his anterior neck and abdomen. He was brought by a helicopter with a physician onboard to a regional trauma center and immediately intubated at the emergency department to secure his airway and prevent airway obstruction. On arrival, his blood pressure was 120/90 mmHg, and his heart rate was 120 beats/min. A pre-shock status was presumed, but other vital signs were normal. Physical examination revealed cut wounds (three lines on the neck and two lines on the abdomen) and no dysphonia. The patient was diagnosed with an open penetrating external LTI, classified as group 5 on the Schaefer classification system and zone Ⅱ on Roon and Christensen’s modification. He was also suspected with a mesenteric injury. We performed an emergency primary laryngotracheal repair and exploratory laparotomy. There was no obvious blood vessel injury, but soft and cartilage tissues were crushed and disconnected completely. On day 8, he underwent wound closure and tracheostomy on the caudal side of the wound. He was successfully weaned from mechanical ventilation on day 9, transferred to the general ward on day 13, decannulated on day 63, and discharged from the hospital thereafter for subacute care.Conclusions: This case was a severe neck injury with complete laryngotracheal separation, but tissue losses due to knife-stabbing were relatively minimal. Wound closure was presumed to occur early during primary repair, even though the purpose of primary repair was originally to secure the airway or manage blood vessel injury. Thus, in the absence of blood vessel injury, wound closure may occur early in patients who developed an open penetrating external LTI by suicide attempt.
Adaptive Neuro-Fuzzy Inference System and a Multilayer Perceptron Model Trained with Grey Wolf Optimizer for Predicting Solar Diffuse Fraction
Authors: Claywell Randall , Nadai Laszlo , Felde Imre , Mosavi Amir
Published: September 2020

The accurate prediction of the solar Diffuse Fraction (DF), sometimes called the Diffuse Ratio, is an important topic for solar energy research. In the present study, the current state of Diffuse Irradiance research is discussed and then three robust, Machine Learning (ML) models, are examined using a large dataset (almost 8 years) of hourly readings from Almeria, Spain. The ML models used herein, are a hybrid Adaptive Network-based Fuzzy Inference System (ANFIS), a single Multi-Layer Perceptron (MLP) and a hybrid Multi-Layer Perceptron-Grey Wolf Optimizer (MLP-GWO). These models were evaluated for their predictive precision, using various Solar and Diffuse Fraction (DF) irradiance data, from Spain. The results were then evaluated using two frequently used evaluation criteria, the Mean Absolute Error (MAE) and the Root Mean Square Error (RMSE). The results showed that the MLP-GWO model, followed by the ANFIS model, provided a higher performance, in both the training and the testing procedures.