bluuebunny/crossref_metadata_2025 huggingface dataset:
Combined effects of serum IgA/C3 ratio and glomerular C3 staining on the renal outcome in adult IgA nephropathy
Authors: Pei Gaiqin , Dong Lingqiu , Wang Siqing , Qin Aiya , Tan Jiaxing , Wei Quan , Tang Yi , Qin Wei
Published: May 2022

Background: The aim of the study was to evaluate the predictive value of serum IgA/C3 ratio and glomerular C3 deposits in kidney biopsy in adult IgA nephropathy.Methods: The study included 722 adult IgAN patients diagnosed based on kidney biopsy. Patients without corticosteroids or immunosuppressive drugs >1 month, were regularly followed up for at least 1 year or until the study end point. The optimum serum IgA/C3 ratio was calculated by AUROC-based cutoff ratio. Proteinuria, creatinine, eGFR, serum IgA, serum C3 were evaluated at baseline. Kidney biopsy was categorized using the Oxford classification, with a calculation of the MEST-C score. The intensity of C3 deposits were rated from 0 (-) to 3 (+++) in immunofluorescence microscopy. The patients were divided into four groups by the serum IgA/C3 ratio and glomerular C3 staining. Results: The baseline data suggested that when serum IgA/C3 ratio was at the same level, patients with a high glomerular C3 staining score (≥2) always had mesangial proliferation, segmental glomerulosclerosis and tubular atrophy/interstitial fibrosis (Group 1 vs Group 2; Group 3 vs Group 4). When glomerular C3 staining was at the same level, proteinuria was significantly higher in patients with serum IgA/C3<2.806 (Group 1 vs Group 3; Group 2 vs Group 4). Renal survival analysis indicated that serum IgA/C3 ≥2.806 and glomerular C3 staining ≥2 (Group 1) were significantly correlated with a poorer prognosis. Multivariate Cox analysis demonstrated that the hypertension, proteinuria, serum creatinine, CKD stage, T1/2 and C3 staining as independent predictive factors of renal survival were independent protective factors for renal survival. Conclusions: Elevated serum IgA/C3 and glomerular C3 staining might be related to the detrimental renal survival in adult IgAN.
Effects of shot peening velocity and coverage on peen forming
Authors: Chen Kewen , Wu Jizhan , Lin Qinjie , Zhu Jiazan , Wei Peitang , Liu Huaiju
Published: May 2022

As an effective forming technique, peen forming is widely used in sheet metal components with large dimensions. However, the production efficiency is seriously limited as several peening tests are required before actual production. To address this issue, a numerical simulation method of peen forming was proposed. In this work, an elastoplastic peening finite element model was developed to study the relations between process parameters and forming effects. A set of peen forming tests with different coverages and velocities were conducted to validate the model. Results indicate that the maximum errors of converted arc height and forming curvature are less than 5% and 14%, respectively. Additionally, the saturation phenomenon can be observed as the peening coverage reaches 60%. The corresponding depth of the maximum compressive residual stress varies almost linearly with shot velocity.
γ Radiation Image Denoising Based on Speckle Splitting
Authors: Deng Hao , Zhang Hua , Zhao Hao , Wang Hai
Published: May 2022

The images captured with CMOS sensor in γ radiation scene mainly affected by single-shot noise, induced noise and ionized air glow noise. In this paper, we propose a two-stage image denoising method based on speckle splitting to improve the clarity of the image originated from the γ radiation scene. Concretely, we first losslessly split the noisy image into multiple sub-images by dilated down-sampling, making the speckle noise in the original image decomposed into isolated point noise in the sub-images. Secondly, the median filtering is utilized to remove salient noise in sub-images. Lastly, aiming at the problem of incomplete denoising due to subtle differences between non-salient noises and background pixels. The gradient-guided NLM filtering in YUV color space is presented for second-stage denois-ing. Extensive experiments are carried out on the images captured from Co60 γ radiation scene. Compared with the original image, our method improves the PSNR by 8.17dB and SSIM by 0.32. Experimental 1 Springer Nature 2021 L A T E X template 2 γ Radiation Image Denoising Based on Speckle Splitting results demonstrate that the proposed method enjoys the state-of-the-art performance in improving the clarity of γ radiation image.
Knowledge, attitude and practice of evidence-based medicine among resident physicians in hospitals of Syria: a cross-sectional study.
Authors: Alabdullah Muhammad Nour , Alabdullah Hadi , Kamel Sondos
Published: May 2022

Background
Evidence-based medicine (EBM) is to integrate the best research evidence with our clinical expertise and circumstances and unique values of our patient. However, there are no studies about using EBM in clinical practice among resident doctors in Syria. In this study, we aimed to evaluate the self-reported knowledge, attitude and practice of EBM by resident doctors throughout different teaching hospitals in Syria.
Methods
The study is a cross-sectional. A self-reported online questionnaire was used to collect data about knowledge, attitude and practice of EBM from 214 resident physicians working in secondary and tertiary teaching hospitals. The study was conducted between September 2021 and February 2022.
Results
Two hundred and fourteen physicians responded to the questionnaire with a response rate of 85.6%. The overall mean scores of knowledge, attitude and practice of EBM were 59.17%, 74.29% and 53.91%, respectively. The participants displayed Low level of awareness of resources and statistical terms used in EBM. The most well-known resources for residents were Up To Date and PubMed. Among the participants, pediatric residents achieved the highest score in practicing EBM, while family medicine residents were the worst.
Conclusion
The general impression about the EBM among Syrian residents was as following: low knowledge, neutral attitude and poor practice. Training workshops should be set up to teach residents the skills needed to move from opinion-based practice to evidence-based practice.
Influence of Electronic Medical Record Management Systems on the Disease Activity and Frequency of Outpatient Visits of Patients with Ankylosing Spondylitis: A Cross-Sectional Study
Authors: Huang Pei-Ju , Liu Yen-Tze , Chen Yi-Hsing , Chen Yi-Ming , Lai Kuo-Lung , Hsieh Tsu-Yi , Hung Wei-Ting , Lin Ching-Tsai , Tseng Chih-Wei , Tang Kuo-Tung , Chou Yin-Yi , Wu Yi-Da , Hsieh Chia-Wei , Chen Yen-Ju , Liao Yu-Wan , Chen Hsin-Hua , Huang Wen-Nan , Huang Chin-Yin
Published: May 2022

Background
To investigate the impact of an electronic medical record management system (EMRMS) on disease activity and the frequency of outpatient visits among patients with ankylosing spondylitis (AS).
Methods
We identified 652 patients with AS who were followed up for at least 1 year before and after the first Ankylosing Spondylitis Disease Activity Score (ASDAS) assessment and compared the number of outpatient visits and average visit time within 1 year before and after the initial ASDAS assessment. Finally, we analyzed 201 patients with AS who had complete data and received ≥ 3 continuous ASDAS assessments at an interval of 3 months, and we compared the results of the second and third ASDAS assessments with those of the first.
Results
The number of annual outpatient visits increased after ASDAS assessment (5.8 ± 3.4 vs. 5.4 ± 3.4, p < 0.001), particularly among those with a high initial disease activity. The average visit time was reduced within 1 year after ASDAS assessment (8.7 ± 3.8 vs. 9.2 ± 4.4 min, p = 0.030), especially among patients whose ASDAS-C-reactive protein (CRP) was < 1.3 (8.5 ± 3.3 vs. 9.2 ± 4.2 min, p = 0.022). Among patients who received at least three ASDAS assessments, the third ASDAS-CRP was significantly lower than the first (1.5 ± 0.8 vs. 1.6 ± 0.8, p = 0.049).
Conclusion
The use of an EMRMS increased the frequency of ambulatory visits among AS patients with high disease activity and reduced the visit time among those with an inactive disease. Continual ASDAS assessments may help control the disease activity of patients with AS.
Trial registration
Institutional Review Board (IRB) of Taichung Veterans General Hospital (TCVGH-IRB No.: CE20145B)
Is the Economic Benefit of Mixed Forest Better than Pure Forest Considering Harvesting Intensity and Carbon Payment?
Authors: Lin Yow-Ru , Liu Wan-Yu
Published: May 2022

Applying clear-cutting to an even-aged pure forest is a conventional forest operation for wood production. However, this kind of operation is not suitable for sustainable management with multiple objectives. In contrast, mixed-forest is a forestation strategy that accommodates diversity. The goal of this study was to assess an operation model that transforms from an even-aged pure forest into a mixed forest. Analysis in which an even-aged pure forest of Cryptomeria japonica was cut under a fixed harvesting intensity and replanted with the native broad-leaved tree species Cinnamomum camphora were conducted. In this study, the primary income for the forest owner was derived from wood sales and carbon payments. After deducting the costs of afforestation, management, and cutting, the land expectation value was estimated. The effects of critical variables, such as cutting time, harvesting intensity, and carbon price, were analyzed. This study explored strategies by which value could be increased in the transition from an even-aged pure forest to a mixed forest. Feasible methods included reducing the costs of afforestation, management, and cutting while increasing carbon prices to increase profits from wood and carbon income. Higher harvesting intensity could contribute to greater production of Cryptomeria japonica and increase the area available for ​​planting Cinnamomum camphora, resulting in greater profits from wood and carbon income. The net present value from market value would be from − 8,428 USD/ha to − 2,446 USD/ha and that from carbon value will be from 5,151 USD/ha to 6,895 USD/ha. However, this measure would also substantially affect forest ecology. A sole focus on increasing the production value of forestland will neglect the original goal of transforming from an even-aged pure forest into a mixed forest.
WOACCPP: Wisdom Of Artificial Crowds for Controller Placement Problem with Latency and Reliability in SDN-WAN
Authors: Thalapala Vidya Sagar , Mohan Anandhu , Guravaiah Koppala
Published: May 2022

The highly motivated Software-Defined Networking (SDN), the network programmability architecture made network maintenance easy. Multiple controllers are used to provide better scalability and reliability to the network in SDN. However, to enhance the network’s performance in networks at a large scale, the placement of controllers needs to be optimized. The Wisdom of Artificial Crowds (WOAC) genetic algorithm is used to minimize propagation latency by using the fewest possible controllers. To evaluate the performance of proposed technique the Internet2 OS3E topology is considered. The proposed controller placement technique reduces latency and improves reliability by comparing the existing solutions namely Modified Density Peak Clustering (MDPC) and optimized K-means approaches. The proposed method out performs existing techniques by 10% improves in latency and maximizes the reliability.
Genome-wide Identification of R2R3-MYB Gene Family and Response to Stress in Zingiber officinale Roscoe
Authors: Yao Xiaoyan , Meng Fei , Wu Liping , Guo Xiaohu , Sun Zongping , Jiang Weimin , Zhang Jing , Wu Jing , Wang Shuting , Wang Zhaojian , Su Xinglong , Dai Xiuru , Qu Changqing , Xing Shihai
Published: May 2022

Background: Zingiber officinale Roscoe (ginger), as a plant used for medicine and food, has a pivotal position all over the world. The R2R3-MYB transcription factor family is one of the largest, and it plays a significant role in plant growth, development, and stresses resistance. According to existing reports, the amounts of R2R3-MYB genes varies greatly among all kinds of plants. However, genome-wide discovery of ZoMYBs family and its corresponding stresses have not been reported in Z. officinale.Results: The genome-wide analysis of R2R3-MYB genes in Z. officinale was carried out in this study. Protein analysis included phylogenetic analysis and conserved motifs analysis, while gene analysis included chromosome localization and gene replication analysis, gene structure analysis, cis-regulatory element analysis and gene expression pattern analysis under two different stresses. A total of 299 candidate ZoMYB genes were discovered in Z. officinale. Based on the grouping of R2R3-MYB genes in a model plant Arabidopsis thaliana, ZoMYBs was divided into 8 groups and distributed across 22 chromosomes at uneven densities. Through gene duplication analysis, a total of 28 segmental duplication were identified in ginger genome. In addition, the expression pattern of 10 chosen ZoMYBs in leaves of Z. officinale were detected under ABA and low temperature stress treatments. The result revealed that there were differences in gene expression of these ten MYB genes in ginger under ABA treatment and low temperature treatment.Conclusions: Our results revealed the characteristics of ZoMYB genes family and provided valuable information for improving the ability of Z. officinale to cope with environmental changes during growth and development.
Investigating The Role of Households’ Health Care Expenditures on The Iranian Households’ Welfare Using DSGE Framework
Authors: Izadi Hamid Reza
Published: May 2022

Nowadays, the study of the share of households' health expenditures in their total consumption expenditures and its impact on the well-being of households and society has become an important issue as it is applied in policy and planning by government officials. The objective of this paper is to examine the impact of changes in the share of health expenditures in the basket of total household consumption expenditures and to show that small changes in the variable have significant effects on consumption, desirability, and consequently the well-being of society. This paper examines the role of households’ health care expenditures on the Iranian households’ welfare Using dynamic stochastic general equilibrium framework. The results of this modeling suggest that a decrease in the share of household health expenditures leads to an increase in other household expenditures and, consequently, increases household welfare by increasing utility. The reason for this is that by increasing its health and medical expenditures, the household must reduce its consumption of other goods, which decreases its total utility. It should be noted that this decrease is due to the fact that households are less inclined to spend a larger share of their total consumption expenditure on health services. In general, then, it can be said that an increase in the share of households' health expenditures in their total expenditures leads to a decrease in welfare, and a decrease in this share increases household welfare. However, factors such as the inefficiency of the insurance system, poor monitoring of the health system, and problems in accessing and using health services can have a major impact on households' acceptance, desire, and use of health services and should be considered a serious problem. JEL classification: E63, F42, H51, N3, p36
Early-life stress and dietary fatty acids impact the brain lipid/oxylipin profile into adulthood, basally and in response to LPS
Authors: Reemst Kitty , Broos Jelle Y. , Abbink Maralinde R. , Cimetti Chiara , Giera Martin , Kooij Gijs , Korosi Aniko
Published: May 2022

Brain lipid dysregulation is a hallmark of depression and Alzheimer’s disease, also marked by chronic inflammation. Early-life stress (ELS) and dietary intake of polyunsaturated fatty acids (PUFAs) are risk factors for these pathologies and are known to impact inflammatory processes. However, if these early-life factors alter brain lipid homeostasis on the long-term and thereby contribute to this risk remains to be elucidated. We have recently shown that an early diet enriched in omega(ω)-3 PUFAs protected against the long-term negative effects of ELS on cognition and neuroinflammation. Here, we aim to understand if modulation of brain lipid and oxylipin profiles contributes to the detrimental effects of ELS and the protective ones of the diet. We therefore studied if and how ELS and early dietary PUFAs modulate the brain lipid and oxylipin profile, basally as well as in response to an inflammatory challenge, to unmask possible latent effects. Male mice were exposed to ELS via the limited bedding and nesting paradigm, received an early diet with high or low ω6/ω3 ratio (HRD and LRD) and were injected with saline or lipopolysaccharide (LPS) in adulthood. Twenty-four hours later plasma cytokines (Multiplex) and hypothalamic lipids and oxylipins (liquid chromatography tandem mass spectrometry) were measured. ELS exacerbated the LPS-induced increase in IL-6, CXCL1 and CCL2. Both ELS and diet affected the lipid/oxylipin profile long-term. For example, ELS increased diacylglycerol and LRD reduced triacylglycerol, free fatty acids and ceramides. Importantly, the ELS-induced alterations were strongly influenced by the early diet. For example, the ELS-induced decrease in eicosapentaenoic acid was reversed when fed LRD. Similarly, the majority of the LPS-induced alterations were distinct for control and ELS exposed mice and unique for mice fed with LRD or HRD. LPS decreased ceramides and lysophosphotidylcholine, increased hexosylceramides and prostaglandin E2, reduced triacylglycerol species and ω6-derived oxylipins only in mice fed LRD and ELS reduced the LPS-induced increase in phosphatidylcholine. These data give further insights into the alterations in brain lipids and oxylipins that might contribute to the detrimental effects of ELS, to the protective ones of LRD and the possible early-origin of brain lipid dyshomeostasis characterizing ELS-related psychopathologies.
Characterization of an endoplasmic reticulum stress-related signature to predict prognosis in Colorectal Adenocarcinoma
Authors: Xu Yu , Xie Yang-Mei , Sun Wen-Sha , Zi Rong , Lu Hong-Qiao , Xiao Le , Guo Shi-Kui , Gong Kun-Mei
Published: May 2022

Background
Colorectal cancer (CRC) is a malignant tumor of the digestive tract with high incidence and mortality rates. Colorectal adenocarcinoma (COAD) is accounting for the majority of CRC. Endoplasmic reticulum stress-related genes play a role in cancer. This study aimed to develop a novel prognostic risk model for COAD based on endoplasmic reticulum stress-related genes, providing theoretical support for prognosis and clinical treatment ofCOAD.
Methods
Two cohorts, The cancer genome atlas (TCGA)- COAD cohort and GSE39582 dataset were enrolled in the study. The differentially expressed genes (DEGs) were determined using the ‘limma’ R package. The ‘clusterProfiler’ R package was utilized to conduct Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis. Univariate and multivariate Cox analyses were performed to identify the prognostic genes. The risk score model was constructed and verified by internal and external cohorts. We analyzed the changes of enriched pathways in the high- and low-risk groups by gene set variation analysis(GSVA). The immune infiltration landscape was calculated by single sample gene set enrichment analysis (ssGSEA) and the immunotherapy response was assessed by the Tumour Immune Dysfunction and Exclusion (TIDE) algorithm. The expression of prognostic genes in clinically normal and COAD samples was verified by Real Time Quantitative polymerase chain reaction (RT-qPCR).
Results
A total of 147 differentially expressed endoplasmic reticulum stress-related genes (DE-ERSGs) in COAD were identified. We screened eight prognostic genes to construct endoplasmic reticulum stress-related gene signature through Cox regression analysis in the training set of TCGA-COAD cohort. Then we validated the risk score model by a testing set of TCGA-COAD cohort and GSE39582 cohort. The univariate and multivariate Cox regression analysis demonstrated the risk score was a robust independent prognostic factor in overall survival prediction. The GSVA also suggested that the gene signature was related to the immune-related pathways. The result of ssGSEA implied that there were significant differences in the immune microenvironment between the high- and low-risk groups. The TIDE analysis revealed that the risk score could predict the clinical response of immunotherapy. The result of RT-qPCR demonstrated that the expression trends of prognostic genes in clinical samples were consistent with the result from public database.
Conclusion
Our study identified prognostic endoplasmic reticulum stress-related genes and established a novel risk signature, which could predict prognosis in COAD patients and provide theoretical support for clinical treatment of COAD.
Waste haven effect: unpacking the impact of environmental regulation
Authors: Rocha Thais Nunez
Published: May 2022

Developing countries can become waste havens due to environmental regulation differences with their trade partners. This paper analyses the effectiveness of the implementation of the Basel Convention in the European Union (EU-WSR), by studying the impact of the EU-WSR on hazardous waste trade. The analysis focuses first on the less developed EU countries, and then on developing countries. To that end, a gravity model is applied to a panel dataset. Results show that there is not enough evidence to identify a waste haven effect in the less developed EU countries, using both aggregated and disaggregated measures of environmental regulations. Increasing differences in the ratification of environmental treaties could lead to growing imports of waste though. In the analysis for developing countries, there is no evidence of the efficacy of the EU-WSR. Moreover, it is found that increasing differences in environmental regulation can lead to a Waste Haven Effect. These findings provide insights into the efficacy of International Environmental Agreements.JEL codes: F13, F18, Q53, Q56, Q58
Towards the Ionizing Radiation Induced Bond Dissociation Mechanism in Oxygen, Water, Guanine and DNA Fragmentation: A Density Functional Theory Simulation
Authors: KC Santosh , Abolfath Ramin
Published: May 2022

The radiation-induced damages in bio-molecules are ubiquitous processes in radiotherapy and radio-biology, and critical to space projects. In this study, we present a precise quantification of the fragmentation mechanisms of deoxyribonucleic acid (DNA) and the molecules surrounding DNA such as oxygen and water under non-equilibrium conditions using the first-principle calculations based on density functional theory (DFT). Our results reveal the structural stability of DNA bases and backbone that withstand up to a combined threshold of charge and hydrogen abstraction owing to simultaneously direct and indirect ionization processes. We show the hydrogen contents of the molecules significantly control the stability in the presence of radiation. This study provides comprehensive information on the impact of the direct and indirect induced bond dissociations and DNA damage and introduces a systematic methodology for fine-tuning the input parameters necessary for the large-scale Monte Carlo simulations of radio-biological responses and mitigation of detrimental effects of ionizing radiation.
Microalgal potential for sustainable biodiesel production and other bioactives compounds
Authors: Bajwa Kulvinder , Bishnoi Narsi R. , Baloch Muhammad Yousuf Jat , Kumar S. P. Jeevan , Selven Silambrasan Tamil
Published: May 2022

Microalgae have been gaining wide attention from scientific and industrial point of view as a source of high-lipid feedstock to produce biodiesel. Current research work was focused primarily on biodiesel production using algal biomass with the objectives of collection, isolation, screening and characterization of appropriate algal species. In this context, sixty seven microalgal strains were isolated including fresh and marine water sources from five regions of India. Screening of high lipid microalgae strains was carried out using Nile Red method for detection of neutral lipid droplets. Out of sixty seven, four potent biodiesel producing strains namely Chlorococcum aquaticum, Scenedesmus obliquus, Nannochloropsis oculata and Chlorella pyrenoidosa were selected on the basis of high lipid and biomass accumulation and having desirable FAME profile of palmitic (16:0), palmitoleic (C16:1), stearic (C-18:0) and oleic acids (C-18:1), respectively, which implies that these strains can be successfully used for biodiesel production.
Digital Holographic Microscopy of Spiropyran-Based Dynamic Materials
Authors: Jamali Ramin , Rad Vahideh Farzam , Razaghi Masoumeh , Mohamadnia Zahra , Khorasani Mojtaba , Moradi Ali-Reza
Published: May 2022

Spiropyran (SP) based dynamic materials undergo structural changes in response to external stimuli. In this paper, we show that digital holographic microscopy (DHM) is an effective candidate for characterization of SPs (embedded in polymer matrices) and for monitoring of their dynamical changes. The polymer matrices are polylactic acid (PLA) and poly(methyl methacrylate) (PMMA) films, which are decorated with SPs and immobilized on graphene quantum dots (GQDs). GQDs are modified by benzylamines prior to the loading of SP species because of the enhancement of hydrophobic characteristics. UV irradiation is used as the external stimulus and the dynamical changes of the samples before and after UV irradiation are measured. DHM is arranged on a novel self-referencing setup which substantially reduces the sensitivity of DHM to environmental vibrations. Morphometric information for characterization of the samples are obtained by analysis of the recorded digital holograms. The experimental results demonstrate the potential of the presented technique to serve as an alternative technique for surface measurement methodologies such as atomic force microscope and stylus profiler for surface characterization of similar materials.
SGLT2 inhibitor versus carbohydrate-restricted isocaloric diet: Reprogramming oxidation in type 2 diabetes
Authors: Igarashi Hiroyuki , Uchino Hiroshi , Kanaguchi Momoko , Hisanaga Kaori , Sato Genki , Yoshikawa Fukumi , Furuta Masashi , Washizawa Naohiro , Usui Shuki , Miyagi Masahiko , Hirose Takahisa
Published: May 2022

Objective: This study aimed to determine whether the carbohydrate-restricted isocaloric (CRIC) diet and sodium/glucose cotransporter-2 inhibitor (SGLT2i) differed with respect to the fasting and postprandial energy expenditure (EE) and macronutrient oxidation, and insulin dose required to achieve euglycemia. Methods: This randomized 3-arm open-label prospective study enrolled 23 patients with type 2 diabetes (male/female: 14/9, age: 53.6±14.2 years, body mass index: 26.9±4.8 kg/m2, HbA1c: 12.5±1.6%) treated with titrated basal-bolus insulin subsequent to the control diet (CON) alone, administration of canagliflozin 100 mg/day (SGLT2i) to the CON, or CRIC diet for 12 weeks. The main outcome measures included the fasting and postprandial EE, respiratory quotient (RQ), and required dose of insulin. Results: Although the fasting EE was similar in all groups, postprandial EE was significantly elevated in the SGLT2i and CRIC groups compared to the CON group (p=0.03 and 0.04). The fasting RQ was lower in the SGLT2i group (p=0.049) and delta-RQ (postprandial RQ/fasting RQ) was elevated due to increased carbohydrate substrate utilization in the SGLT2i (p=0.04) and CRIC (p=0.03) groups compared to the CON group. The total required daily dose of insulin was significantly higher in the CRIC (p=0.02) group, although the amount of available carbohydrate was similar in the CRIC and SGLT2i groups. Conclusion: The CRIC diet resulted in a similar fasting and postprandial EE and substrate oxidation compared to SGLT2i. The increased insulin requirement in the CRIC diet indicates that a relatively high lipid and protein ratio (compared to the SGLT2i and CON) may influence insulin requirement.
Oral Thc: Cbd Cannabis Extract in Main Symptoms of Alzheimer Disease: Agitation and Weight Loss
Authors: Palmieri Beniamino , MsC Maria Vadalà
Published: May 2022

OBJECTIVES: Ten million new cases of dementia are recorded annually worldwide, with agitation and idiopathic weight loss being the most common symptoms. Several pharmacological therapies have emerged in recent years, but the clinical use of cannabis extracts in older patients with AD is constantly growing. This retrospective, analytical, observational, spontaneous trial aimed to enhance the clinical action of THC: CBD cannabis extract administration in AD patients with severe symptoms such as agitation, weight loss, cognitive impairment, and sleep disturbance.METHODS: Thirty patients (9 men and 21 women) diagnosed with mild, moderate, or severe AD, aged 65-90 years, appealing to our Second Opinion Medical Consultation (Modena, Italy), were enrolled and required to use oil-diluted cannabis extract, Bedrocan® (22% THC, 0.5% CBD, Olive Oil 50 ml), twice a day for 12 weeks. The efficacy of cannabinoid therapy was evaluated at baseline and 12 weeks after therapy, employing three self-administered questionnaires completed by the parents of the enrolled patients: NPI-Q, CMAI, and MMSE.KEY FINDINGS: The NPI-Q demonstrated a reduction (p<0.0001) in agitation, apathy, irritability, sleep disturbances, and eating disturbances, consequently improving caregiver distress. Levels of physically and verbally aggressive behaviours, measured using the CMAI questionnaire, were lower (p<0.0001) in all patients. The MMSSE questionnaire confirmed a significant decrease (p<0.0001) in cognitive impairment in 45% of the patients.CONCLUSION: Our anecdotical, spontaneous, and observational study demonstrated the efficacy and safety of oil-diluted cannabis extract in patients with AD. The limitations of our study are: 1) small patient cohort, 2) absence of control group, 3) self-administered questionnaires that are the most practical but not objective instruments to assess the neurologic functions of AD patients.
The gene expression features reveal the connection between chloride-relevant gene and disease
Authors: Huang Yanruo , Wang Qihang , Peng Yunsong , Du Wenjie , Wang Qi , Qi Jiangtao , Hao Zijian , Wang Yingwei
Published: May 2022

Chloride-mediated signals are involved in forming neural function during development and maintaining its stability in adulthood. The chloride homeostasis is synergistically controlled by various chloride-relevant genes, but their intrinsic relationships remain not fully understood. In this study, an expression profiling of the human brain with different developmental periods was used for the gene expression pattern analysis. Functional analysis for the different expression patterns was performed to explain the functional distinctions of chloride-relevant genes. The major distribution of chloride-relevant genes in single-cell and brain region were investigated to present their spatial expression features. Further exploration was conducted for the relationship between the above expression characteristics of those genes and central nervous system disorders. We found that the chloride-relevant genes regular the specific biological function rather than extensive functions. Additionally, the distribution of chloride-relevant genes is correlated with the pathological regions. Finally, we tested that one of the most well-known chloride-relevant gene SLC12A2 may take an even more important effect on glial cells rather than neurons. Our findings provide a more comprehensive view to explain the temporal and spatial expression characteristics of chloride-relevant genes, which can help to understand the complex roles of chloride-relevant genes in both the development of the normal human brain and the etiology of brain disorders.
Performance of Effective Arterial Elastance as Predictor of Mean Arterial Pressure in Patients with Sepsis or Septic Shock Receiving Fluid Expansion: A Validation Study by Regression Analysis
Authors: Sutherasan Yuda , Junhasavasdikul Detajin , Petnak Tanachai , Theerawit Pongdhep
Published: May 2022

Backgroundwe conducted this study to compare four arterial load parameters and determine which arterial load parameters directly impacted arterial pressure regarding pressure, flow, and arterial system relationship.MethodsWe conducted a cross-sectional study in patients with sepsis who underwent volume expansion (VE). Hemodynamic parameters were recorded before and after VE. The relationship between the change of mean arterial pressure (%MAP) and that of the dynamic arterial elastance (EaDyn), effective arterial elastance (Eaeff), net arterial elastance (EaNet), and net arterial resistance (RaNet) was analyzed.ResultsSixty-two patients were included. The DEaDyn(%) was not correlated with DMAP(%) (r=0.048, P=0.826). Meanwhile, DEaeff(%), DEaNet(%), and DRaNet(%) were correlated with DMAP(%) (r=0.495, P<0.001; r=0.453, P<0.001; and r=0.485, P<0.001, respectively). A multiple linear regression model was analyzed for identifying predictors of DMAP(%) by including DCO(%) and each %change of arterial parameters. The best-fit model was found by including DCO(%) and DEaeff(%) in the regression equation (R2=0.823, adjusted R2=0.817). The model was adjusted by age, sex, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, Sequential Organ Failure Assessment (SOFA) score, arterial lactate level, norepinephrine dosage, ventilator setting, method of VE, and fluid responsiveness and found that DCO(%) and DEaeff(%) remained statistically significant predictors of DMAP(%) (P<0.001 and P<0.001, respectively).ConclusionThe Eaeff was the best AL parameter that correlated with the changes in MAP. Furthermore, the model that included the ∆Eaeff(%) provided the best predictive performance for ∆MAP(%) induced by VE, independent of the fluid responsiveness and norepinephrine dosage.
Categorizing animal diel movement patterns with examples from high-resolution barn owl tracking
Authors: Vissat Ludovica Luisa , Cain Shlomo , Nathan Ran , Toledo Sivan , Spiegel Orr , Getz Wayne M.
Published: May 2022

Background. Movement is central to understanding the ecology of animals. The most easily definable segments of an individual’s lifetime track (i.e., movement path defined by a relocation data time series) are its diel activity routines (DARs). This definability is due to fixed start and end points set by a 24-hour clock that depends on the individual’s quotidian schedule. An analysis of day-today variation in the DARs of individuals and the questions that can be asked, particularly in the context of lunar and annual cycles, and in comparison with other individuals, depends the relocation frequency of movement data. Here we present methods for categorizing the spatio-temporal structure of DARs when the data sampling frequency is on the order of minutes or higher. Methods. Our method involves an initial categorization of DARs with regard to the data pooled across all individuals. We approached this categorization using a Ward clustering algorithm that employs four metrics of trajectory shape (though other measures may equally well be used): 1. openness (distance between start and endpoints, aka net displacement), 2. maximum displacement from start point, 3. maximum diameter, and 4. maximum width. We illustrate the general approach using reverse-GPS data obtained from 44 barn owls, Tyto alba, in northeastern Israel. Results. We clustered 6,230 individual DARs into 7 categories. The first component of principle components analysis, which had the interpretation of DAR size, explained 86.5% of variation. The second, which essentially measure DAR openness, explained 8.4% of variation. We also constructed spatio-temporal distributions of DAR types for individuals and groups of individuals aggregated by age, sex, and seasonal trimester, as well as analyzed the idiosyncratic behavior of individuals within family groups in relation to landscape features. Conclusion. Insights into the types and distributions of DARs in populations may well prove to be more invaluable for predicting the space-use response of individuals and populations to climate and land-use changes than other currently used movement track methods of analysis. anisms of organismal movement, analyzed primarily using relocation data, often collected
Use of Electronic Health Record Best Practice Alerts to Improve Adherence to American Urological Association Vesicoureteral Reflux Guidelines
Authors: Wengryn Derek M. , Halstead N. Valeska Valeska , Beebe Sarah C. , Sevick Carter J. , Vemulakonda Vijaya M.
Published: May 2022

Purpose: To evaluate the effect of a guidelines-based best practice alerts (BPA) in the electronic health record (EHR) on adherence to American Urological Association (AUA) vesicoureteral reflux (VUR) guidelines.Methods: Retrospective cohort study of patients aged 0-17 years old with primary VUR with an initial urology clinic visit the year before or year after BPA implementation. Primary outcomes include obtaining vital signs, urinalysis, and ultrasound at initial and one-year follow-up visit. Results: We identified 123 patients with initial visits during the study period, 58 of whom returned for one-year follow-up visits. Patients seen post-BPA were more likely to have height measured at initial visit than those seen pre-BPA (47.3% vs 11.8%, p<0.001). The majority of patients were screened with weight (98.3%) and ultrasound (87.9%) at one-year follow-up both before and after BPA implementation. Neither blood pressure measurements (59.1% vs 55.6%, p>0.5) nor urinalysis orders (23.8% vs 19.4%, p>0.05) significantly increased post-BPA. Conclusion: The use of an EHR-based BPA increased the likelihood of obtaining height measurements by clinic intake staff but did not significantly affect provider adherence to other practice guideline recommendations. Our findings suggest that BPA implementation alone is not sufficient to impact provider uptake of VUR guideline recommendations.
Membraneless Unbuffered Seawater Electrolysis for Pure Hydrogen Production
Authors: Liang Nan-Nan , Park Hyunwoong
Published: May 2022

Seawater electrolysis is promising as an in situ H2 production method, allowing immediate overseas transport of the produced H2. Typically, it proceeds under alkaline conditions to ensure the selectivity of the oxygen evolution reaction (OER) over the chloride oxidation reaction (ClOR). In addition, electrolyzers usually require membranes to inhibit the chlorine reduction reaction (ClRR) and maximize the hydrogen evolution reaction (HER) while separating H2 from O2. In this study, membraneless electrolysis of undisturbed, unbuffered seawater (pH 8.2) is proposed to produce high-purity H2. A ternary component catalyst with Pt, Ru, and Ti (PRT) and a minimized Pt level (Pt0.06Ru0.24Ti0.7Ox) drives ClOR at a Faradaic efficiency (FE) of ~100% in saline water at an industrial level of current density (J = 800 mA cm-2) over 500 h. ClRR is also inhibited on MnOx electrodes, leading to ~100% FE of H2 production even in the presence of chlorines (HClO/ClO-). Finally, the PRT anode/MnOx cathode pair drive ClOR and HER at FEs of ~100% at J = 80 mA cm-2 over 100 h in a single-compartment cell containing seawater. Moreover, the OER and ClRR are completely inhibited during seawater electrolysis.
Usage and Cost-effectiveness of Elective Oocyte Freezing in which In-vitro Fertilization is Exclusively Provided to Married Heterosexual Couples in Asia
Authors: Yang Ih-Jane , Wu Ming-Yih , Chao Kuang-Han , Wei Shin-Yi , Tsai Yi-Yi , Huang Ting-Chi , Chen Mei-Jou , Chen Shee-Uan
Published: May 2022

Background: The previous model-based cost-effectiveness analyses regarding elective oocyte cryopreservation remains debatable, while the usage rate may influence the price per live birth. The aim of this study is to disclose the usage and cost-effectiveness of the planned cryopreserved oocytes after oocyte thawing in real-world situations in which in-vitro fertilization (IVF) is exclusively provided to married heterosexual couples. Methods: This was a retrospective single-center observational study. Women who electively cryopreserved oocytes and presented to thaw the oocytes were categorized as thawed group. The oocytes were fertilized at our center and the sperm samples for each individual was retrieved from their respective husbands. Clinical outcomes were traced and the live birth rate per thawed case was calculated. The costs from oocyte freezing cycles to oocyte thawing, and embryo transfer cycles were accordingly estimated. Cumulative costs per live birth was defined by the cumulative costs divided by the total live births per thawed case.Results: We recruited 645 women with 840 oocyte retrieval cycles for elective oocyte freezing from November 2002 to December 2020. The overall usage rate was 8.4% (54/645). After the storage duration exceeded 10 years, the probabilities of thawing oocytes were 10.6%, 26.6%, and 12.7% from women who cryopreserved their oocytes at the age of ≤35 years, 36–39 years, and ≥40 years, respectively. Among women who thawed their oocytes, 31.5% (17/54) of women achieved live births. For the age groups of ≤35 years, 36–39 years, and ≥40 years, the total live birth rate per thawed case was 63.6%, 42.3%, and 17.6%, respectively, and the cumulative costs for one live birth was $11,704, $17,189, and $35,642, respectively.Conclusions: The overall usage rate was 8.4% in our cohort. The chance of having live births was 31.5% if the individual thawed their oocytes. The findings added to the limited evidence of the usage rate in real-world situations in which IVF is exclusively available to married heterosexual couples, which could aid future analysis and decision-making for women willing to preserve fertility to avoid age-related fertility loss.Trial Registration Number: None.
Provision of labour analgesia and its related barriers among maternal healthcare providers in Kenya: an institutional-based descriptive survey.
Authors: Ouma Gabriel , Orango Omenge , Were Edwin , Omwodo Kimbley
Published: May 2022

Background: Although pain relief is a key component of modern obstetric care, it remains a poorly established service in sub-Saharan countries such as Kenya. Maternal health care providers have an extensive role to play in meeting the analgesic needs of women during childbirth. The study sought to examine the practice of labour pain relief and its deterrents among Kenyan maternal health care providers.Methods: This was an institutional based, cross-sectional descriptive survey. The study population included midwives, obstetricians and anaesthesiologists working at the second largest referral hospital in Kenya. A structured, self-admininisterd questionnaire was used. The pattern of provision of labour analgesics, knowledge, attitude and perceived barriers to labour pain management was described. Results: One hundred and seventeen respondents participated in the study with a response rate of 97.5%. The prevalence of routine labor analgesia provision was 61.5%. The commonest pharmacological method prescribed was nonopioids (13.4 %). Regional analgesia was provided by 4(3.6%) of the respondents. Majority of maternal healthcare providers (53.0%) had poor knowledge of labour pain management. Almost all (93.9%) of the respondents had a positive attitude towards the provision of labour analgesia. Non-availability of drugs and equipment (58.1%), lack of clear protocols and guidelines (56.4%) and absence of adequate skilled personnel (55.6%) were reported as the health system factors that hinder the provision of labour analgesia.Conclusions: More than half of maternal health care providers routinely relieve labour pain; gender, cadre, and years of experience are significantly associated with routine provision of labour analgesia. Epidural analgesia is still quite underutilized. There is a need for development of institutional labour pain management protocols to meet the analgesic needs of women during childbirth.
The River of Life, Death, Livelihood and Pilgrimage: An Assessment of Ganges in Varanasi, Uttar Pradesh
Authors: Jamal Shahid , Sen Prof. Anjan
Published: May 2022

According to Hindu mythology, Ganga is the only river brought from heaven to earth for livelihood security, resettlement and well-being of entire human civilization. Varanasi erstwhile renowned as Banaras and even before famous as Kaashi. It is the land of Lord Shiva, the son of Ganga, land of mystics, guru and mahaguru. The dynamics of change and time rarely shake the rich heritage, resilient capability and capacity of mother river since immemorial times. Life on land and below water in Varanasi is getting under threat because of several anthropogenic activities like sewage discharge, mining and others. These activities are negatively impacting bacteriophage cleaning capacity of mother Ganges. The basic objective of the study is to identify and analyse livelihood security, psychological wellbeing and indigenous knowledge in making ghats resilient from social, political and economic dimensions. A household survey was conducted in Ghats of Varanasi district, Uttar Pradesh in 2021. Both primary and secondary data were used for data collection, while Livelihood Vulnerability Index (LVI) method was used for desired outcome. After the analysis, it was concluded that livelihood security of people is under threat due to several factors like decline in Ganges water level along ghats in Varanasi. Further, it has impacted aquatic habitat and there is need to be more concerned about their habitat than ever before as these hazards will become disasters in time to come. Though, recent coronavirus pandemic has given temporary relief to the river thereby, significant improvement has been observed in her water quality, flow and aquatic flora and fauna.
A retrospective clinical analysis of rescue tracheal intubation
Authors: Chen Hongyang , Deng Qian , Wang Zining , Huang Kun , Zhang Weiyi , Zhu Tao
Published: May 2022

By analyzing the critically ill patients who have undergone emergency tracheal intubation in our hospital inpatients, we can help our medical workers to better treat the critically ill patients. We also analyzed and summarized the best time to intervene in critically ill patients who needed tracheal intubation by understanding the prognosis and regression of patients who had already undergone tracheal intubation, thus improving the survival treatment rate of patients.
A simple system for phenotyping of plant transpiration and stomatal conductance response to drought
Authors: Driever Steven M. , Mossink Leon , Ocaña Diego Nuñez , Kaiser Elias
Published: May 2022

Plant breeding for increased crop water use efficiency or drought stress resistance requires methods to quickly assess the transpiration rate (E) and stomatal conductance (gs) of a large number of individual plants. Several methods to measure E and gs exist, each of which has its own drawbacks and shortcomings. To add to this toolbox, we developed a method that uses whole-plant thermal imaging in a controlled environment, where aerial humidity is changed rapidly to induce changes in E that are reflected in changes in leaf temperature. This approach is based on a simplified energy balance equation, without the need for a reference material or complicated calculations. To test this concept, we built a double-sided, perforated, open-top plexiglass chamber that was supplied with air at a high flow rate (35 L min− 1) and whose relative humidity (RH) could be switched rapidly. Measurements included air and leaf temperature as well as RH. Using several well-watered and drought stressed genotypes of Arabidopsis thaliana that were exposed to multiple cycles in RH (30 to 50% and back), we showed that leaf temperature as measured in our system correlated well with E and gs measured in a commercial gas exchange system. Our results demonstrate that, at least within a given species, the differences in leaf temperature under several RH can be used as a proxy for E and gs. Given that this method is fairly quick, noninvasive and remote, we envision that it could be upscaled for work within rapid plant phenotyping systems.