bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk and prognostic factors of breast cancer with liver metastases
Authors: ji Lei , Cheng Lei , Zhu Xiuzhi , Gao Yu , Fan Lei , wang zhonghua
Published: August 2020

Background: Liver metastasis is a significant adverse predictor of overall survival (OS) among breast cancer patients. The purpose of this study was to determine the risk and prognostic factors of breast cancer with liver metastases (BCLM). Methods: Data on 311,573 breast cancer patients from the Surveillance, Epidemiology, and End Results (SEER) database and 1728 BCLM patients from Fudan University Shanghai Cancer Center (FUSCC) were included. Logistic regression was used to identify risk factors for liver metastasis. Cox proportional hazards regression model was adopted to determine independent prognostic factors in BCLM patients.Results: Young age, invasive ductal carcinoma, higher pathological grade, and subtype of triple-negative and human epidermal growth factor receptor 2 positive (HER2+) were risk factors for developing liver metastasis. The median OS after liver metastasis was 20.0 months in the SEER database and 27.3 months in the FUSCC dataset. Molecular subtypes also played a critical role in the survival of BCLM patients. We observed that hormone receptor-positive (HR+)/HER2+ patients had the longest median OS (38.0 for SEER vs. 34.0months for FUSCC), whereas triple-negative breast cancer had the shortest OS (9.0 vs. 15.6 months) in both SEER and FUSCC. According to the results from the FUSCC, the subtype of HR+/HER2+ (hazard ratio (HR)=2.62; 95% confidence interval (CI)= 1.88-3.66; P<0.001) and HR-/HER2+ (HR=3.43; 95% CI=2.28-5.15; P<0.001) were associated with a significantly increased death risk in comparison with HR+/HER2- patients if these patients did not receive HER2-targeted therapy. For those who underwent HER2-targeted therapy, however, HR+/HER2+ subtype reduced death risk compared with HR+/HER2- subtype (HR=0.74; 95% CI=0.58-0.95; P<0.001).Conclusions: Breast cancer patients at a high risk for developing liver metastasis deserve more attention during the follow-up. BCLM patients with HR+/HER2+ subtype displayed the longest median survival than HR+/HER2- and triple-negative patients due to the introduction of HER2-targeted therapy and therefore it should be recommended for HER2+ BCLM patients.
Clinical study on primary screening of oral cancer and precancerous lesions by oral cytology
Authors: Sukegawa Shintaro , Ono Sawako , Nakano Keisuke , Takabatake Kiyofumi , Kawai Hotaka , Nagatsuka Hitoshi , Furuki Yoshihiko
Published: August 2020

BackgroundThis study was conducted to compare the histological diagnostic accuracy of conventional oral-based cytology and liquid-based cytology (LBC) methods.MethodsHistological diagnoses of 251 cases were classified as negative (no malignancy lesion, inflammation, or mild/moderate dysplasia) and positive [severe dysplasia/carcinoma in situ (CIS) and squamous cell carcinoma (SCC)]. Cytological diagnoses were classified as negative for intraepithelial lesion or malignancy (NILM), oral low-grade squamous intraepithelial lesion (OLSIL), oral high-grade squamous intraepithelial lesion (OHSIL), or SCC. Cytological diagnostic results were compared with histology results.ResultsOf NILM cytology cases, the most frequent case was negative [LBC n = 50 (90.9%), conventional n = 22 (95.7%)]. Among OLSIL cytodiagnoses, the most common was negative (LBC n = 34; 75.6%, conventional n = 14; 70.0%). Among OHSIL cytodiagnoses (LBC n = 51, conventional n = 23), SCC was the most frequent (LBC n = 31; 60.8%, conventional n = 7; 30.4%). Negative cases were common (LBC n = 13; 25.5%, conventional n = 14; 60.9%). Among SCC cytodiagnoses SCC was the most common (LBC n = 16; 88.9%, conventional n = 14; 87.5%). Regarding the diagnostic results of cytology, assuming OHSIL and SCC as cytologically positive, the LBC method/conventional method showed a sensitivity of 79.4%/76.7%, specificity of 85.1%/69.2%, false-positive rate of 14.9%/30.7%, and false-negative rate of 20.6%/23.3%.ConclusionsLBC method was superior to conventional cytodiagnosis methods. It was especially superior for OLSIL and OHSIL. Because of the false-positive and false-negative cytodiagnoses, it is necessary to make a comprehensive diagnosis considering the clinical findings.
Stagewise resolution of temperature-dependent embryonic and postembryonic development in the cowpea seed beetle Callosobruchus maculatus (F.)
Authors: Kutcherov Dmitry
Published: August 2020

Background

The thermal plasticity of life-history traits receives wide attention in the recent biological literature. Of all the temperature-dependent traits studied, developmental rates of ectotherms are especially often addressed, and yet surprisingly little is known about embryonic responses to temperature, including changes in the thermal thresholds and thermal sensitivity during early development. Even postembryonic development of many cryptically living species is understood superficially at best.

Results

This study is the first to estimate the exact durations of developmental stages in the cowpea seed beetle C. maculatus from oviposition to adult emergence at five permissive constant temperatures from 20 to 32°C. Early embryonic development was tracked and documented by means of destructive sampling and subsequent confocal imaging of fluorescently stained specimens. Late embryonic and early larval development was studied with the use of destructive sampling and light microscopy. Well-resolved temporal series based on thousands of embryos allowed precise timing of the following developmental events: formation of the blastoderm; formation, elongation, and retraction of the germ band; dorsal closure; the onset and completion of sclerotization of the cuticle; hatching, and penetration of the first-instar larva into the cowpea seed. Pupation and adult eclosion were observed directly through an incision in the seed coat. The thermal phenotype of C. maculatus was found to vary in the course of ontogeny and different stages scaled disproportionately with temperature, but pitfalls and caveats associated with analyses of relative durations of individual stages are also briefly discussed.

Conclusion

Disproportionate changes in developmental durations with temperature may have important implications when study design requires a high degree of synchronization among experimental embryos or when the occurrence of particular stages in the field is of interest, as well as in any other cases when development times need to be estimated with precision. This work provides one of the first examples of integration of embryological techniques with ecophysiological concepts and will hopefully motivate similar projects in the future. While experiments with Drosophila remain to be the main source of information on animal development, knowledge on other model species is instrumental to building a broader picture of developmental phenomena.
Dynamic Changes in the Immune Response Correlate with Disease Severity and Outcomes During Infection with SARS-CoV-2
Authors: Zheng Fang , Chen Ruochan , Yao Run , Huang Yaxiong , Li Ning , Liu Jiyang , xie Yuanlin
Published: August 2020

Background:Little is known about the dynamic changes in the patient immune responses to SARS-CoV-2, and how different responses are correlated with disease severity and outcomes.Method:A total of 74 patients with confirmed COVID-19 were included from January 29th to February 15th 2020. Clinical characteristics and dynamic changes in immune response were analyzed and compared between severe and non-severe patients. ResultsOf the 74 patients, 17 suffered from severe disease and 57 from non-severe disease. Patients with severe disease tended be older (65.29 ± 12.33 years vs. 45.37 ± 18.66 years), and had a greater degree of underlying disease (41.18% vs. 24.56%) , lower lymphocytes counts (0.69 ± 0.36 × 10⁹ vs. 1.46 ± 0.75 × 10⁹) , higher neutrophil-lymphocyte-ratios (NLRs; 3.76 (3.15–5.51) vs. 2.07 (1.48–2.93)) and lower eosinophil counts (0.01 ± 0.01 × 10⁹ vs. 0.05 ± 0.07 × 10⁹), than that in non-severe patients. The number of immune cell subtypes, including helper T cells, suppressor T cells, B cells, and natural killer cells was significantly decreased in severe cases compared to that in non-severe cases (335.47 vs. 666.46/mL; 158 vs. 334/mL; 95 vs. 210/mL; 52 vs. 122/mL, respectively). As the condition of the patients improved, the number of neutrophils decreased significantly in the severe patients. All patients who recovered exhibited a gradual and persistent increase in eosinophil counts and lymphocyte counts, including helper T cells, suppressor T cells, and natural killer cells. In addition, the levels of most of inflammatory cytokines, including IFN-γ, IL-2, IL-4, IL-6, IL-10, IL-17A, and TNF–α generally decreased as the patients gradually recovered.ConclusionsCollectively, our study provides novel information on the kinetics of the immune responses to COVID-19. Furthermore, our study indicates that both innate and adaptive immune responses correlate with better clinical outcomes.
Development and Validation of a Prognostic Implications of Chromosome Abnormalities Algorithm for Newly Diagnosed Multiple Myeloma
Authors: Luo Tiancheng , Qiang Wanting , Lu Jing , He Haiyan , Liu Jin , Li Lu , Jiang Hua , Fu Weijun , Du Juan
Published: August 2020

BACKGROUND: Fluorescence in situ hybridization (FISH) evaluation is essential for initial risk stratification in multiple myeloma (MM). While the presence of specific cytogenetic abnormalities confers a heterogeneity impact on prognosis, the cutoff values are not exactly comparable among different centers, we performed K-Adaptive Partitioning (Kaps), a novel statistical method, to development and validation of a prognostic implications of chromosome abnormalities algorithm for newly diagnosed multiple myelomaMETHODS: A total of 533 patients with newly diagnosed MM admitted to Shanghai Changzheng Hospital were enrolled. All patients underwent FISH detect cytogenetic abnormalities. The prognostic impact of cytogenetic abnormalities (CA) detected by FISH were analyzed. RESULTS: The K-Adaptive Partitioning method was used to calculate the chromosomal abnormal cut-off values as follows: 17p - 20.1%, 13q - 85%, 1q21 + 39%, t (11, 14) 55.5%, t (14,16) 87%, t (4,14) 53.5%. According to EMN criteria for CA, 17p- and 1q21 + are the independent factors affecting both OS and PFS among CA. The analysis based on the cutoff value obtained by Kaps suggests that 13q-, t(14,16) , 17p- and 1q21 + are independent factors affecting OS among CA; t(14,16) , 17p- and 1q21 + are independent factors affecting PFS among CA. Based on the survival analysis results, the prognostic model was constructed. The c-index of the prognostic model calculated by the Kaps method was 0.719 (95% CI, 0.683 to 0.756; corrected 0.707), while the c-index of the prognostic model according to the EMN criteria was 0.714 (95% CI, 0.678 to 0.751; corrected 0.696). To analyze the influence of the number of adverse CA on the prognosis, both the EMN criteria and the criteria analysis by the Kaps suggest that the more adverse CA, the OS and PFS became shorter.CONCLUSION: This study shows that chromosomal abnormalities in different proportions and combinations can affect the prognosis of multiple myeloma patients. Effective criteria should be formulated to evaluate the prognosis of MM patients better.
Clinical analysis of tracheobronchial foreign body aspiration in children: A focus on external and intrinsic factors
Authors: gan weigang , Xiao Ning , Feng Yiyuan , zhou danmei , hu juanjuan , Liu Shixi , zou Jian
Published: August 2020

BackgroundTo judge the external factors and intrinsic factors affecting clinical feature of TFBA in west China and propose potential effective intervention measures.Methods: We retrospectively analyzed the clinical data of pediatric patients diagnosed with TFBA and removed foreign body(FBs) by rigid bronchoscopy under general anesthesia at otolaryngeal department from December 2017 to November 2018.ResultsThe gender constituent ratio of male(72) to female(53) was 1.4:1. The patients aged from 1 to 3 years accounting for 76% (95/125). Cough, continous fever and dyspnea were premier symptoms. Right primary bronchus was the most common position invovled where FBs were detected by rigid bronchoscopy in 67 cases(53.6%). Organic foreign bodis were commonest in our study. The guardians of patients between rural(parents 16, grandparents 31) and urban(parents 52, grandparents 26) group were significantly different(χ2=12.583, p=0.000). More children were paid attention delayedly over 72 hours in rural group than urban. More children in group of no hsitory of foreign body aspiration(12, 25%) were treated over 72 hours than in the contrary group.ConclusionPediatric tracheobronchial foreign body aspiration is a kind of common emergency in otolaryngology. Age, gender, tracheobronchial anatomy and other physiological elements were defined as intrinsic factors, while guardians, residence, FBs species and prehospital time were defined as external factors of TFBA. External factors would determine the morbidity, and intrinsic factors would determine patient's condition and mortality. It is very important to take effective measures to control external factors, which was expected to decrease morbidity and mortality.
Fecal microbiota profile in patients with inflammatory bowel disease in Taiwan
Authors: Chang Tien-En , Luo Jiing-Chyuan , Yang Ueng-Cheng , Huang Yi-Hsiang , Hou Ming-Chih , Lee Fa-Yauh
Published: August 2020

Background Inflammatory bowel disease (IBD) is a chronic inflammatory disease that associated with complicated interaction between immune, gut microbiota and environmental factors in a genetically vulnerable host. Dysbiosis is often seen in patients with IBD. Our aim is to investigate the fecal microbiota in patients with IBD and compared to healthy controls in Taiwan. Methods In this cross-sectional study, we investigated fecal microbiota in 20 patients with IBD and 48 healthy controls. Fecal samples from both IBD patients and controls were analyzed by next-generation sequencing method and relevant software. Results The IBD group showed lower bacterial richness and diversity compared to the control group. The principal coordinate analysis also revealed significant structural difference between the IBD group and the control group. These findings were consistent whether the analysis was based on operational taxonomic unit or amplicon sequence variant. However, no significant difference was found when comparing the composition of fecal microbiota between ulcerative colitis (UC) and Crohn’s disease (CD). Further analysis showed that Lactobacillus, Enterococcus, Bifidobacterium and Veillonella were dominant in the IBD group, while Faecalibacterium and Subdoligranulum were dominant in the control group at genus level. When comparing UC, CD and control group, Lactobacillus, Bifidobacterium and Enterococcus were identified as dominant genera in the UC group. Fusobacterium and Escherichia_Shigella were dominant in the CD group. Faecalibacterium and Subdoligranulum were dominant in the control group. Conclusions Compared to the healthy control, the IBD group showed dysbiosis with a significant decreased in both richness and diversity of gut microbiota.
Lymphocyte subset alterations with disease severity, imaging manifestation, and delayed hospitalization in COVID-19 patients
Authors: Wu Daxian , Wu Xiaoping , Huang Jiansheng , Rao Qunfang , Zhang Qi , Zhang Wenfeng
Published: August 2020

Background: COVID-19 continuously threated public health heavily. Present study aimed to investigate the lymphocyte subset alterations with disease severity, imaging manifestation, and delayed hospitalization in COVID-19 patients.Methods: Lymphocyte subsets was classified using flow cytometry with peripheral blood collected from 106 patients.Results: Multivariate logistic regression showed that chest tightness, lymphocyte count, and γ-glutamyl transpeptidase were the independent predictors for severe COVID-19. The T cell, CD4+ T cell and B cell counts in severe patients were significantly lower than that in mild patients (p = 0.004, 0.003 and 0.046, respectively). Only the T cell count was gradually decreased with the increase of infiltrated quadrants of lesions in computed tomography (CT) (p = 0.043). The T cell, CD4+ T cell, and CD8+ T cell counts were gradually decreased with the increase of infiltrated area of the maximum lesion in CT (p = 0.002, 0.003, 0.028; respectively). The T cell count, as well as CD4+ T cell, CD8+ T cell, and NK cell counts were gradually decreased with the increased delayed hospitalization (p = 0.003, 0.002, 0.013, and 0.012; respectively). The proportion of T cell was gradually decreased but B cell was gradually increased with the increased delayed hospitalization (p = 0.031 and 0.003, respectively).Conclusion: T cell and CD4+ T cell counts negatively correlated with disease severity, CT manifestation and delayed hospitalization. CD4+ T cell was mainstay of immunity response in COVID-19 patients.
Intrinsic vs. Extrinsic Motivation as Drivers for Early Engagement in Research by Medical Students
Authors: Alamri Yassar , Monasterio Erik , Beckert Lutz , Wilkinson Tim J
Published: August 2020

BackgroundA student’s motivation is a key factor in their success in undertaking an education endeavour. However, how this relates to involvement in research by medical students is unclear.MethodsAn electronic questionnaire was sent to all medical students at our institution. To ascertain students’ motivation to undertake research, they were asked an open-ended question to describe the single major factor that would encourage them to get involved in research as a medical student. A framework of self-determination theory was used to deductively code the responses as intrinsic motivation (‘IM’; e.g., interest/passion) or extrinsic motivation (‘EM’; e.g. improving CV). The two groups were then contrasted in relation to their research engagement.ResultsA total of 348 students were included in the survey, of whom 204 were coded as IM responses, and 144 were coded as EM responses. Students who engaged in extra-curricular research activities were more likely to report an underlying EM (48% vs. 36%, p = 0.03). They were also older (23.7 ± 3.5 vs. 21.9 ± 3.7, p = 0.005), and more likely to have completed a prior research degree (15% vs. 3%, p = 0.01).ConclusionIn this study, EM was a bigger influencer on research involvement by medical students than IM. Future studies should explore promoters of IM, and include longitudinal data in order to assess whether EM students continue to be involved in research long-term.
Splenectomy May Decrease the Risk of Hepatocellular Carcinoma in Patients with Liver Cirrhosis: A Multi-institutional Cohort Study
Authors: Zhang Xu-Feng , Liu Yang , Li Jian-Hui , Lei Peng , Zhang Xing-Yuan , Wan Zhen , Lei Ting , Wu Xiao-Ning , Ding Hong-Fan , Long Zhi-Da , Li Zong-Fang , Wu Rongqian , Chen Xi , Wang Jian-Xiong , Yuan Peng , Li Yong , Zhou Jun , Pawlik Timothy M. , Lyu Yi
Published: August 2020

BackgroundHypersplenism is a common consequence of liver cirrhosis and a risk factor of hepatocellular carcinoma (HCC) development. The objective of the current study was to identify whether splenectomy for treatment of hypersplenism has any impact on risk of HCC. ­­MethodsPatients who underwent splenectomy for hypersplenism secondary to liver cirrhosis and portal hypertension between 2008 and 2012 were included from seven University Hospitals in China, whereas patients receiving medication treatments for liver cirrhosis and portal hypertension (non-splenectomy) at this time period were also included as control. ResultsA total of 871 patients with liver cirrhosis and hypertension were included synchronously from 7 tertiary hospitals. Among them, 407 patients had a history of splenectomy for hypersplenism, whereas 464 patients who received medical treatment but not splenectomy (non-splenectomy group). The cumulative incidence of HCC development at 1, 3, 5 and 7 years were 1%, 6%, 11% and 16% in splenectomy group, and 2%, 10%, 17% and 24% in non-splenectomy group in the unadjusted cohort (Breslow test = 7.7, p=0.005). Consistently, in the matched cohort, the cumulative rates of HCC diagnosis at 1, 3, 5 and 7 years were 1%, 6%, 7% and 15% in splenectomy group, and 1%, 6%, 15% and 23% in non-splenectomy group (Breslow test = 4.9, p=0.028). On multivariable analysis, splenectomy was independently associated with decreased risk of HCC development (HR 0.55, 95% CI, 0.32-0.95, p=0.031). ConclusionSplenectomy for treatment of hypersplenism may decrease the risk of HCC development.
Nasal eosinophils associated with rheumatoid arthritis: description of some clinical cases and review of the literature
Authors: Caruso Arturo Armone , Prete Salvatore Del , Marasco Daniela , Nappi Liliana , Imperatore Clara , Leo Sabato , Viola Veronica , Gallo Monica , Naviglio Daniele
Published: August 2020

In this review we describe the relation between nasal eosinophilia and rheumatoid arthritis (RA). Moreover we was performed a literature revision that valued the relation between eosinophilia in respiratory system with arthritis. We have examined, through nasal cytology, 7 patients (5 men and 2 women) aged between 7 and 60 years old, with a middle age of 38,5 years; this patients are affected by RA, members of UO of Diagnostic ORL and nasal cytology of the AIAS (Italian Association of Disadvantages assistance) of Afragola.Between them we put in evidence only a case of youth RA. All patients was not allergic and affected by recurrent rhinitis in maintenance therapy and not related with pollen calendar. The withdrawal documented the presence of rare eosinophils in nasal mucosa. This evidence could induce us to use this practice not only as follow up of patients but also as means of early diagnosis.
Evaluation of adhesion of epoxy resin sealant to improve the corrosion resistance of thermal sprayed coatings
Authors: Carneiro Mateus R. D. , Freitas Bruno C. , de Barros Iuri B. , de Campos Jose Brant , Bastos Ivan N. , Costa Hector R. M.
Published: August 2020

The adhesion of coatings on a given substrate has fundamental importance on the functionality of a coating/substrate system. The current paper presents the adhesion strength results of FeCr and CoCr-based deposits produced by electric arc thermal spray process on carbon steel, with an intermediate layer of 95Ni5Al. Three chemical compositions were tested for coating deposition and was characterized using plate and tube specimens made of carbon steel UNS G10200 to result in a screening of performance. Microstructural evaluation by optical microscopy (OM), scanning electron microscopy (SEM) and X-ray diffraction (XRD) were performed. Coating strength was measured using standard pull-off test method. The corrosion resistance was analyzed with salt spray exposure, electrochemical polarization and impedance spectroscopy (EIS) tests. The adhesion strength of FeCr and CoCr alloy coatings shows an overall average tensile strength of 27.2 MPa. All sealed conditions presented low corrosion and the samples with epoxy sealant exhibited a high resistance against corrosion. The X-ray diffraction results have revealed the presence of alpha and gamma FeCr alloys and chromite as deposited phases after the coating process.
L1CAM Expression in Recurrent Estrogen Positive/HER2 Negative Breast Cancer
Authors: Moisini Ioana , Zhang Huina , D’Aguiar Marcus , Hicks David G. , Turner Bradley M.
Published: August 2020

Background: We investigate L1CAM expression in ER positive/HER2 negative breast carcinomas. The finding of a potential correlation between high L1CAM expression and recurrent/metastatic disease in luminal A and B breast carcinomas may be helpful for risk stratification and open opportunities for targeted therapies.Methods: 304 cases comprising 152 cases of ER positive, PR positive/negative and HER2 negative recurrent/metastatic breast carcinomas and 152 non-recurrent controls were included. ER, PR, HER-2, Ki-67 status, Nottingham grade, tumor size, tumor stage, number of foci, lymph node status, lymphovascular invasion, phenotype, laterality, age at diagnosis and first distant or local recurrence were recorded. Results: L1CAM positive cases showed increased specificity for recurrence and these patients were significantly younger than L1CAM negative ones. Compared to L1CAM negative recurrent cases, L1CAM positive ones had a noticeably higher Ki-67, tended to be larger and recurred sooner. All L1CAM positive recurrent/metastatic cases were of the luminal B subtype compared to 67.3% of the L1CAM negative cases. Conclusions: L1CAM is highly specific for recurrence in a subset of breast cancer patients and may be associated with more aggressive behavior, particularly in luminal B breast cancers with higher Ki-67 expression. Further investigation about the prognostic value of L1CAM is warranted.
Luks-PV Induce HOXA9 Degradation Through Autophagy in MLL-rearranged Acute Myeloid Leukemia
Authors: Qiang Ping , Fang Chao , Song Kaidi , Shi Lan , Dai Yuanyuan , Chang Wenjiao , Xu Liangfei , Wang Xingbing , Liu Xin , Liu Huilan , Sun Zimin , Ma Xiaoling
Published: August 2020

Background: Our previous studies have demonstrated that Luks-PV have good anti-leukemia ability effects and could possibly be a promising therapy for adult acute myeloid leukemia (AML). Aberrant over-expression of HOXA9 is a prominent feature of AML driven by multiple oncogenes, and therapeutic degrading of HOXA9 may be an effective treatment strategy in AML. This paper focused on the Luks-PV-regulating autophagy pathway, aiming to investigate the role of Luks-PV in mixed-lineage leukemia (MLL)-rearranged AML. Methods: The data of leukemia patients were downloaded from the gene expression profiling of TCGA datasets. Taking primary AML and THP-1 cells as the model system in vitro, Luks-PV-inhibited cell proliferation was determined by CCK‐8 and flow cytometry assays. The role of Luks-PV in autophagy regulation was analyzed using immunoblotting, transfection and immunofluorescence.Results: HOXA9 was over-expressed and associated with a poor prognosis in AML patients bearing MLL rearrangement. After the application of pharmacologic inhibitors of autophagy, Luks-PV induced cytotoxic autophagy in AML cells, as suggested by biochemical and microscopy results. HOXA9 molecules were detectable within autophagosomes after Luks-PV treatment, indicating that autophagy induction accounted for the degradation of HOXA9. Moreover, Luks-PV-induced HOXA9 downregulation inhibited AML cell proliferation, suggesting that HOXA9 could be degraded through Luks-PV-induced autophagy.Conclusion: Luks-PV suppresses AML cell proliferation by inducing HOXA9 degradation.
Knowledge, Attitude, And Perception of Oral and Maxillofacial Surgery Specialty Amongst Healthcare Professionals, and the General Public from a Gulf Cooperation Council (GCC) Country
Authors: Kamal Mohammad , Abdulwahab Mohammad , Al-Zaid Ahmed
Published: August 2020

Background
Oral and maxillofacial surgery specialty has grown rapidly in Kuwait in recent years. However, the general public and healthcare professionals remain unaware of its expanding scope of practice. The aim of the study is to assess public and professional (dental and medical) perception of the oral and maxillofacial surgical specialty in Kuwait.
Methods
This is a cross-sectional study evaluating responses of dental professionals, medical professionals, and general public in Kuwait toward the oral and maxillofacial surgical specialty using a previously validated survey instrument with 100 participants in each group. Participants were asked to choose the most appropriate specialist to treat certain procedures across 4 disciplines: reconstruction, trauma, pathology, and cosmetic. Statistical comparison was conducted between dentists and medical doctors using Fisher’s exact test with a p-value of < 0.05.
Results
Disparities were noted each group’s responses. Oral and maxillofacial surgery was preferred overall for most clinical scenarios in trauma (p < 0.001), pathology (p < 0.001), and reconstructive surgery (p < 0.001). Plastic surgery was preferred for cosmetic surgeries (p < 0.001).
Conclusions
This study indicates the need to increase awareness and conduct health campaigns regarding oral and maxillofacial surgery among healthcare professionals, especially medical doctors, and the general public.
Transcriptome Analysis of lncRNA-mRNA Interactions in the Non-Small Cell Lung Cancer
Authors: Liu Bin , Li Jing , Li JiMan , Liu GuangYuan , Wang YongSheng
Published: August 2020

As a serious malignancy with high incidence and fatality, non-small cell lung cancer (NSCLC) has affected millions of people each year worldwide. However, the 5-year survival rate of NSCLC is still not satisfactory. Therefore, it is particularly imperative and necessary to explore the underlying molecular mechanisms of NSCLC to contribute to the potential therapeutic targets and strategies. Six clinical samples including three normal tissues and three cancer tissues obtained from patients diagnosed with NSCLC were sequenced through Illumina Hiseq2500 sequencer. Differentially expressed lncRNAs and mRNAs analysis were implemented using the edgeR, and the function of differentially expressed lncRNAs and mRNAs were analyzed with GO and KEGG enrichment analysis. Then, top 10 dysregulated lncRNAs and mRNAs were screened out. Finally, the co-expression, biological function and pathway networks of dysregulated lncRNA with the predicted target genes were constructed. Differentially expressed lncRNAs and mRNAs could distinguish cancerous tissues from normal tissues. The functions and KEGG pathway of differentially expressed lncRNAs and mRNAs mainly were enriched in immune response, metabolism, phagosome, cytokine receptor interaction and IL-17 signaling pathway. The co-expression network revealed that top ten dysregulated lncRNAs were interacted with IGH gene cluster. Furthermore, the biological function and pathway network also indicated that dysregulated lncRNAs were involved in immune process. The results demonstrated that the biologic function of dysregulated lncRNAs that may be involved in immune process. Our data provides a foundation of the biologic significances of lncRNAs to contribute to the therapeutic targets and strategies for NSCLC to promote the survival for patients.
Effects of chronic remote ischemic conditioning on atrial fibrillation burden in patients with permanent pacemakers
Authors: Chen Long , Liu Yaowu , Zhu Didi , Yu Jinbo , Yu Chunlei , Chen Zhongpu , Jin Hong , Ren Liqun , Zhou Qianxing
Published: August 2020

Background: The burden of atrial fibrillation (AF) has been attractive recently and may be associated with stroke risk and mortality. Remote ischemic conditioning could reduce the incidence, inducibility and sustainability of AF. But the effects of chronic remote ischemic conditioning (CRIC) on atrial fibrillation burden in patients with pacemaker implanted are still unknown.Design: This was a single‑center, prospective, randomized, open-labeled clinical study.Methods: Sixty-six patients with permanent pacemakers were randomly divided into CRIC group and control group after 4 weeks screening. CRIC treatment was performed twice a day for 12 weeks. A remote ischemic conditioning protocol consisted of 4 × 5 min inflation/deflation of the blood pressure cuff applied in the upper arm to create intermittent arm ischemia. Pacemaker programming was performed for four times: before screening (-4-week), after screening and before randomization (0-week, baseline), 4-week and 12-week follow-up. Data including AF burden, longest duration of AF and cumulative numbers of atrial high-rate episodes (AHREs) were collected.Results: Sixty-one patients (31 patients in CRIC group and 30 patients in control group) completed the study. CRIC was well-tolerated by patients after 12 weeks treatment. The burden of AF in CRIC group was decreased significantly at 4-week compared with that at 0-week (14.7%±18.5% vs 17.0%±20.7%, p < 0.001), which further decreased at 12-week compared with that at 0-week (8.6%±10.2% vs 17.0%±20.7%, p < 0.001) and that at 4-week (8.6%±10.2% vs 14.7%±18.5%, p < 0.001), which was not observed in the control group. AF burden also reduced significantly after 12-week CRIC compared with that in control group (8.6%±10.2% vs 17.6%±19.5%, p = 0.013). Repeated measurement ANOVA showed that the changes of AF burden was associated with CRIC instead of time (p < 0.01). In addition, there were trends that longest duration of AF and cumulative numbers of AHREs were reduced after 12-week CRIC.Conclusions: This study suggests that a 12-week course of CRIC treatment could reduce AF burden in patients with permanent pacemakers, supporting widespread use of CRIC in the daily lives of these patients, which need to be verified in the future.Clinical Trial RegistrationRegistration name: Effects of remote ischemic conditioning on atrial fibrillation burden in patients with paroxysmal atrial fibrillationRegistration number: ChiCTR-IOR-17012666Registered 14 September 2017; URL: www.chictr.org.cn/showproj.aspx?proj=21591
Turnaround Time of Acute Multi-Modal Stroke Imaging Should Not Be More Than 11 Minutes
Authors: Senanayake Channa , Beharry James , Tsui Stanley , Mouthaan Paul , Wu Teddy Y. , Choi Philip M.C.
Published: August 2020

Background: Multimodal stroke imaging (Non-contrast CT, CT perfusion and CT angiogram) is essential to acute stroke assessment, there is currently no benchmark for this key process from real world data. Methods: Retrospective review of the turnaround time of consecutive multimodal imaging performed for acute stroke assessment at two high volume stroke centers in Australasia from July to September 2019.Results: 252 imaging studies were included from both sites. The overall median time from acquisition to imaging availability was 13 minutes (IQR 11- 16). The median for Christchurch and Box Hill were 11 minutes (IQR 10 – 12) and 15 minutes (IQR 13 – 19) respectively. Conclusions: Multimodal stroke imaging turnaround time of 11 minutes is a reasonable benchmark.
Middle East Respiratory Syndrome in Critically Ill Patients with Diabetes: A Multicenter Observational Study of Clinical Presentation, Management and Outcomes
Authors: Jose Jesna , Al-Dorzi Hasan , Al-Omari Awad , Mandourah Yasser , Al-Hameed Fahad , Sadat Musharaf , Al-Qasim Eman , Alraddadi Basem , Harthy Abdulrahman Al , Mekhlafi Ghaleb A Al , Almotairi Abdullah , Khatib Kasim Al , Abdulmomen Ahmed , Qushmaq Ismael , Sindi Anees , Mady Ahmed , Solaiman Othman , Al-Raddadi Rajaa , Maghrabi Khaled , Rajab Ahmed , Kharaba Ayman , Shalhoub Sara , Al-Aithan Abdulsalam M , Vishwakarma Gajendra K , Bhattacharjee Atanu , Arabi Yaseen
Published: August 2020

Background: Diabetes is a risk factor for infection with coronaviruses. This study describes the demographic, clinical data and outcomes of critically ill patients with diabetes who developed Middle East Respiratory Syndrome (MERS).Methods: This retrospective cohort study was conducted at 14 hospitals in Saudi Arabia (September 2012-January 2018). We compared the demographic characteristics, underlying medical conditions, presenting symptoms and signs, management and clinical course and outcomes between critically ill MERS patients who had diabetes and those with no diabetes. Multivariable logistic regression analysis was performed to determine if diabetes was an independent predictor of 90-day mortality.Results: Of the 350 MERS patients, 171 (48.9%) had diabetes, were more likely to be older and have comorbid conditions. Patients with diabetes were more likely to present with respiratory failure requiring intubation, vasopressors and corticosteroids. The median time to clearance of MERS-CoV RNA was similar (23 days (Q1, Q3: 17, 36) in patients with diabetes and 21.0 days (Q1, Q3: 10, 33) in patients with no diabetes. Mortality at 90 days was higher in patients with diabetes (78.9% versus 54.7%, p<0.0001). Multivariable regression analysis showed that diabetes was an independent risk factor for 90-day mortality (odds ratio, 2.09; 95% confidence interval, 1.18-3.72).Conclusions: Critically ill patients with diabetes constitute half of critically ill patients with MERS, presenting with more severe disease requiring mechanical ventilation compared to those who do not have diabetes. Diabetes is an independent predictor of mortality.
Analysis of clinical characteristics, radiological predictors, pathological features and perioperative outcomes associated with perinephric fat adhesion degree
Authors: Liu Junqiang , Huang Hongwei , Cao Tianyu , Liu Dikuan , Zhu Zheng , Chen Jing , Wang Lina , Zong Huafeng , Song Xishuang , Wang Xuejian , Zhu Xinqing , Chen Qiwei , Nahayo Sony , Wang Jianbo , Yang Deyong
Published: August 2020

Background

To assess the clinical characteristics, radiological predictors and pathological features of perinephric fat adhesion degree (PFAD) graded based on fixed criteria and to determine the impact of adherent perinephric fat (APF) on retroperitoneal laparoscopic partial nephrectomy (RLPN) outcomes.
Methods

84 patients undergoing RLPN were included and graded into 4 groups based on PFAD. Univariate and multivariate analysis were performed for clinical characteristics and radiological predictors of PFAD. Perioperative data was compared between APF groups and non-APF groups. Masson staining determined collagen fibers. Immunohistochemistry detected CD45 immune cells and CD34 vessels.
Results

20, 28, 18 and 18 patients were graded as normal perinephric fat (NPF), mild adherent perinephric fat (MiPF), moderate adherent perinephric fat (MoPF) and severe adherent perinephric fat (SPF), respectively. Multivariate analysis revealed that gender (p < 0.001), age (p = 0.003) and hypertension (p = 0.006) were significant clinical risk factors of PFAD, while radiological predictors included perinephric stranding (p = 0.001), posterior perinephric fat thickness (p = 0.009) and perinephric fat density (p = 0.02). APF was associated with drain output (P = 0.012) and accompanied by immune cells gathering in renal cortex near thickened renal capsule with many vessels.
Conclusions

Clinical characteristics and radiological predictors can evaluate PFAD and may assist guide preoperative surgical option. Pathological features of APF reflect decapsulation and bleeding during kidney mobilization at RLPN.
Institutional outbreak involving multiple clades of IMP-producing Enterobacter cloacae complex sequence type 78 at a cancer center in Tokyo, Japan
Authors: Harada Sohei , Aoki Kotaro , Ohkushi Daisuke , Okamoto Koh , Takehana Kazumi , Akatsuchi Tomomi , Ida Keito , Shoji Daigo , Ishii Yoshikazu , Doi Yohei , Moriya Kyoji , Hayama Brian
Published: August 2020

Background: Information about the clinical and microbiological characteristics of IMP-producing Enterobacterales has been limited. Here, we describe an institutional outbreak of IMP-producing Enterobacter cloacae complex (ECC) involving multiple clades of ECC sequence type (ST) 78 strains.Methods: Antimicrobial susceptibility testing, whole-genome sequencing, and conjugation experiments of 18 IMP-producing ECC strains isolated during four-year study period were performed. Species and subspecies were determined by average nucleotide identity analysis and clonal relatedness of the isolates was analyzed with multilocus sequence typing and core-genome single nucleotide polymorphism (SNP) analysis. Relevant clinical information was extracted from medical records. Results: Fourteen of 18 IMP-producing ECC isolates were determined as Enterobacter hormaechei ST78. Twelve isolates, including 10 isolates belonging to ST78, carried blaIMP-1 in In316-like class 1 integron located on IncHI2 plasmids. Conjugation experiments were successful for 12 isolates carrying blaIMP-1 on IncHI2 plasmids and for an isolate carrying blaIMP-11 on an IncL/M plasmid. Although isolation of ST78 strains was clustered in a 16-months period suggesting nosocomial transmission, these strains were subdivided into three clades by SNP analysis: clade A (n = 10), clade B (n = 1), clade C (n = 3). A part of clonal relatedness was unexpected by the epidemiological information at the time of isolation of the strains. Most of the IMP-producing ECC strains were susceptible to non-β-lactam antibiotics and had relatively low minimum inhibitory concentrations to carbapenems (≤4 μg/mL). Four of five infections caused by IMP-producing ECC were treated successfully. Conclusions: Whole-genome sequencing analysis revealed the outbreak was caused by three different clades of ST78 strains, where patients had favorable treatment outcome of the infections compared with that caused by Enterobacterales producing other carbapenemases, possibly due to their non-multidrug-resistant phenotype.
The effects of preoperative imaging stability studies on intraoperative correction, postoperative observation, and clinical efficacy of adult lumbar spondylolisthesis treatment
Authors: Jiang Jie , Liu Chong , Zhang Guangping , Xu Guoyong , Liang Tuo , Yu Chaojie , Liao SHian , Zhang Zide , Lu Zhaojun , Wang Zequn , Chen Jiarui , Chen Tianyou , Li Hao , Zhan Xinli
Published: August 2020

Background

The aim of this study is to explore the use of preoperative imaging stability studies of adult lumbar spondylolisthesis and it's effects on intraoperative correction, postoperative observation, and clinical efficacy.
Methods

We retrospectively analyzed a total of 104 patients diagnosed with lumbar spondylolisthesis who underwent Posterior lumbar interbody fusion surgery between 2011 and 2014. The qualified patients were divided into two groups; group A (study/unstable group: 52 cases) and group B (control/stable group: 52 cases). Group A was further divided into group A1 (slip instability: 27 cases) and group A2 (angular instability: 25 cases). The preoperative lumbar sagittal plane translation distances and segmental angle of the preoperative lateral X-rays, hyperflexion X-rays, and hyperextension X-rays were measured and compared with their third-day postoperative lateral X-ray, and slip rate. The occurrences of intraoperative or postoperative complications, one-month postoperative follow-up data, including JOA, and VAS scores were access to evaluate the clinical efficacy of the treatment.
Results

Satisfactory postoperative radiographic correction was recorded in all groups. Better correction and correction was observed in group A1 patients and group B patients who used puller screws compared to those who used normal screws (P < 0.05). However, patients in group A2 who used normal pedicle screws had similar correction as those who used puller screws. The preoperative VAS scores showed that low back and lower extremity pain were higher in A1 and A2 groups compared to group B. However, they were lower one month postoperative. The preoperative JOA scores for the unstable groups (group A1 and A2) were lower than their stable counterpart but higher during the first month postoperative. Our analysis of postoperative complications also revealed no statistically significant difference between groups A1 and B, and groups A2, and B.
Conclusions

Preoperative imaging stability for adult lumbar spondylolisthesis does not affect intraoperative correction. The use of puller pedicle screws in patients with unstable or stable segmental slippage could achieve better correction and correction than with normal pedicle screws. The preoperative symptoms of patients with unstable segments were worse than their stable counterparts; however, their postoperative recovery was quicker in the first month postoperative.
Antioxidant Effect of Elamipretide on Bull’s Sperm Cells During Freezing/Thawing Process
Authors: Kowalczyk Alicja , Ewa Czerniawska Piątkowska
Published: August 2020

Background: Spermatozoa are subjected to drastic changes in temperature, ice crystal formation, and diverse types of stresses (chemical, physical, osmotic, and oxidative) during the cryopreservation process, which severely compromise sperm quality and fertility. In this study, we aimed to investigate the protective role of Elamipretide in the cryopreservation of bull's sperm.Materials and methods: The study included 36 healthy Simmental bulls with an average age of 2 ± 0.5 years housed individually in pens. Two ejaculates were collected from each bull using an artificial vagina at 7 a.m. Subsequently, the semen was extended with animal protein–free commercial BIOXcell® extender (IMV Technologies, L’aigle, France) to a final concentration of 160x106 spermatozoa/mL, and rated in terms of motile sperm percentage, progressive motility, viability and abnormality of spermatozoa. Semen samples that showed more than 60% motility and 60% viability, were selected for the experiment. The fresh semen was then divided into five equal fractions. The first fraction was left for the control group (without Elamipretide), to the next were added in succession 0.1; 1; 5; and 10 μM of Elamipretide TFA (Trifluoroacetic) (MedChemExpress, USA). After that semen was subjected to freezing and thawing. Next semen was assessed for motility, viability, and antioxidant activity (SOD, CAT, MDA).Results: It has been shown that a concentration of 5 and 10 μM proved to be the most effective in terms of tested parameters of the quality of sperm cells subjected to cryopreservation.Conclusion: In conclusion, addition of the Elamipretide to the cryopreservation extender significantly improved frozen-thawed sperm cells quality and their function. The results of this study indicate that Elamipretide can be used as a cryoprotective agent to protect cells against the devastating effects of oxidative stress and increasing sperm survival after cryopreservation.