bluuebunny/crossref_metadata_2025 huggingface dataset:
Increased Neutrophil-To-Lymphocyte Ratio After Thrombolysis Improves Prediction of 3-Month Stroke Outcome
Authors: Hou Duanlu , Wang Chunjie , Ye Xiaofei , Zhong Ping , Wu Danhong
Published: February 2021

Objectives-Thrombolysis is the effective therapy for acute ischemic stroke (AIS) within 4.5 hours of onset. It improves prognosis by increasing blood perfusion to the lesion. Though inflammation is a predictor of 3-month outcomes after thrombolysis, the temporal effect of thrombolysis on inflammation and the correlation between inflammation after thrombolysis and patients’ prognosis remain to be elucidated. Materials and Methods-Demographic, clinical, laboratory data before and after thrombolysis, and 3-month mRS scores were collected and compared. The neutrophil-to-lymphocyte ratio (NLR) was divided into low and high NLR subgroups and functional outcomes at 3 months were compared. Multivariate regression analysis was used to test independent predictors of 3-month prognosis. Results- 493 patients with AIS were prospectively enrolled between 1st August, 2017 and 1st September, 2019. 170 received thrombolysis and 323 patients did not. The NLR after thrombolysis was higher than that before thrombolysis among patients who received thrombolysis (p<0.001) and higher than that of patients who did not receive thrombolysis (p<0.001). The NLR after thrombolysis was an independent predictor of 3-month functional outcomes (OR =1.20, 95% CI: 1.01-1.42, p=0.03). The best discriminating value for the NLR is 4.51 (sensitivity 65.7%, specificity 73.1%, AUC: 0.85; 95% CI: 0.77-0.92). Significant difference (62% vs 88%, p<0.001) was observed in the patients with good 3-month outcome between patient groups with the NLR>4.51 and <4.51, respectively. Conclusions-NLR increase after thrombolysis was a predictor of poor 3-month functional outcome in AIS patients.
Ultrasound Study of Layer-specific Strain and Perfusion of Left Ventricular Myocardium in Patients With Dilated Cardiomyopathy
Authors: Tang Sha , Guan Lina , Mu Yuming
Published: February 2021

BackgroundTo investigate the changes in deformation and myocardial microcirculation perfusion of left ventricular three-layer myocardium in patients with dilated cardiomyopathy (DCM) by using speckle tracking imaging (STI) and myocardial contrast echocardiography (MCE).MethodsTwenty-four patients with DCM and 19 healthy controls were selected. Two-dimensional and MCE dynamic images of apical four-chamber, two-chamber, and three-chamber sections and left ventricular mitral valve, papillary muscle and apex sections were collected. The peak values of longitudinal strain (LS), circumferential strain (CS), cross-sectional area of a microvessel (A) and average myocardial microvascular lesion (β) were obtained by Qlab 10.8 workstation values, and myocardial blood flow (MBF) was calculated with A×β to evaluate the deformation and coronary microvascular perfusion of left ventricular three-layer myocardium.ResultsThe brain natriuretic peptide (BNP), left ventricular mass index (LVMI), left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVEDS), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left atrial volume index (LAVI), E peak in early diastolic period/A peak velocity in late diastolic period (E/A) and average E/e' in the DCM group were higher than those in the control group (P < 0.05); left ventricular ejection fraction (LVEF), left ventricular fractional shortening (FS) rate, stroke volume (SV), cardiac output (CO), cardiac index (CI), A peak, and the e' and a' velocities of both the lateral wall and interventricular septum were smaller than those in the control group (P<0.05). The LS, CS, A, β, and A×β of the DCM group were all lower than those of the control group (P < 0.05). The pattern of myocardial strain and perfusion among myocardial layers was subendocardial>middle>subepicardial. The correlation coefficients of LS with A, β, and A×β were -0.500, -0.279 and -0.190, respectively, and the correlation coefficients of CS with A, β, and A×β were -0.383, -0.255 and -0.208, respectively.ConclusionsThe deformation of the three-layer myocardium and coronary microcirculation perfusion in DCM patients were diffusely damaged from the endocardium to the epicardium, layer by layer. The longitudinal function of the left ventricular myocardium was closely related to changes in myocardial microcirculation perfusion.
Systematics and Phylogeography of The Non-Ethiopian Speckled-Pelage Brush-Furred Rats (Lophuromys Flavopunctatus Group) Inferred From Integrative Genetics and Morphometry
Authors: Onditi Kenneth , Peterhans Julian Kerbis , Zhongzheng Chen , Demos Terrence , Bryja Josef , Lavrenchenko Leonid , Musila Simon , Verheyen Erik , Xuelong Jiang
Published: February 2021

Background: The speckled-pelage brush-furred rats (Lophuromys flavopunctatus group) has been difficult to define given conflicting genetic, morphological, and distributional records that combine to obscure meaningful accounts of its taxonomic diversity. In this study, we inferred the systematics, phylogeography, and evolutionary history of the L. flavopunctatus group using maximum likelihood and Bayesian phylogenetic inference, divergence times, historical biogeographic reconstruction, and morphometric discriminant tests. We compiled comprehensive datasets of three loci (two mitochondrial [mtDNA] and one nuclear) and two morphometric datasets (linear and geometric) from across the known range of the genus Lophuromys.Results: The mtDNA phylogeny supported the division of the genus Lophuromys into three primary groups with nearly equidistant pairwise differentiation: one group corresponding to the subgenus Kivumys (Kivumys group) and two groups corresponding to the subgenus Lophuromys (L. sikapusi group and L. flavopunctatus group). The L. flavopunctatus group comprised the speckled-pelage brush-furred Lophuromys endemic to Ethiopia (Ethiopian L. flavopunctatus members [ETHFLAVO]) and the non-Ethiopian ones (non-Ethiopian L. flavopunctatus members [NONETHFLAVO]) in deeply nested relationships. There were distinctly geographically structured mtDNA clades among the NONETHFLAVO, which were incongruous with the nuclear tree where several clades were unresolved. The morphometric datasets did not systematically assign samples to meaningful taxonomic units or agreed with the mtDNA clades. The divergence dating and ancestral range reconstructions showed the NONETHFLAVO colonized the current ranges over two independent dispersal events out of Ethiopia in the early Pleistocene.Conclusion: The phylogenetic associations and divergence times of the L. flavopunctatus group conform to demonstrated hypotheses surrounding the paleoclimatic and ecosystem refugium impacts on the evolutionary radiation of rodents dependent on stably humid conditions in the East Africa region. The overlap in craniodental variation between distinct mtDNA clades among the NONETHFLAVO suggests unraveling underlying ecomorphological drivers is key to reconciling taxonomically informative morphological characters. The genus Lophuromys requires a taxonomic reassessment based on extensive genomic evidence to elucidate the patterns and impacts of genetic isolation at clade contact zones.
Evolution of Mendelian Dominance in Gene Regulatory Networks Associated With Phenotypic Robustness
Authors: Okubo Kenji , Kaneko Kunihiko
Published: February 2021

Background: Mendelian inheritance is a fundamental law of genetics. Considering two alleles in a diploid, a phenotype of a heterotype is dominated by a particular homotype according to the law of dominance. This picture is usually based on simple genotype-phenotype mapping in which one gene regulates one phenotype. However, in reality, some interactions between genes can result in deviation from Mendelian dominance. Result: Here, by using the numerical evolution of diploid gene regulatory networks (GRNs), we discuss whether Mendelian dominance evolves beyond the classical case of one-to-one genotype-phenotype mapping. We examine whether complex genotype-phenotype mapping can achieve Mendelian dominance through the evolution of the GRN with interacting genes. Specifically, we extend the GRN model to a diploid case, in which two GRN matrices are added to give gene expression dynamics, and simulate evolution with meiosis and recombination. Our results reveal that Mendelian dominance evolves even under complex genotype-phenotype mapping. This dominance is achieved via a group of genotypes that differ from each other but have a common phenotype given by the expression of target genes. Calculating the degree of dominance shows that it increases through the evolution, correlating closely with the decrease in phenotypic fluctuations and the increase in robustness to initial noise. This evolution of Mendelian dominance is associated with phenotypic robustness against meiosis-induced genome mixing, whereas sexual recombination arising from the mixing of chromosomes from the parents further enhances dominance and robustness. Owing to this dominance, the robustness to genetic differences increases, while the optimal fitness is sustained up to a large difference between the two genomes. Conclusion: Mendelian dominance is achieved by groups of genotypes that are associated with the increase in phenotypic robustness to noise.
COVID-19 anosmia and gustatory symptoms as a prognosis factor: a subanalysis of the HOPE COVID-19 (Health Outcome Predictive Evaluation for COVID-19) Registry
Authors: Porta-Etessam Jesús , Núñez-Gil Iván , García Nuria González , Fernández Cristina , Viana-LLamas María , Eid Charbel Maroun , Romero Rodolfo , Molina Marta , Uribarri Aitor , Becerra Victor , Aguado Marcos García , Huang Jia , Rondano Elisa , Cerrato Enrico , Alfonso Emilio , Castro Alex , Marín francisco , Raposeiras Sergio , Pepe Martino , Feites Gisela , Mate Paloma , Cortese Bernardo , Buzón Luís , Javita Jorge , Estrada Vicente
Published: February 2021

Olfactory and gustatory dysfunctions (OGD) are a frequent symptom of Coronavirus disease 2019 (COVID-19). It has been proposed that the neuroinvasive potential of the novel SARS-CoV-2 could be due to olfactory bulb invasion, conversely studies suggest it could be a good prognostic factor. The aim of the current study was to investigate the prognosis value of OGD in COVID-19.These symptoms were recorded on admission from a cohort study of 5868 patients with confirmed or highly suspected COVID-19 infection included in the multicenter international HOPE Registry (NCT04334291).There was statistical relation in multivariate analysis for OGD in gender, more frequent in female 12.41% vs 8.67% in male, related to age, more frequent under 65 years, presence of hypertension, dyslipidemia, diabetes, smoke, renal insufficiency, lung, heart, cancer and neurological disease. We did not find statistical differences in pregnant (p=0.505), patient suffering cognitive (p=0.484), liver (p=0.1) or immune disease (p=0.32). There was inverse relation (protective) between OGD and prone positioning (0.005) and death (<0.0001), but no with ICU (0.165) or mechanical ventilation (0.292). On univariable logistic regression OGD was found to be inversely related to death in COVID-19 patients. The Odds Ratio was 0.26 (0.15-0.44) (p<0.001) and Z was -5.05.The presence of anosmia is fundamental in the diagnosis of SARS.CoV-2 infection, but also could be important when classifying patients and in therapeutic decisions. Even more knowing that it is an early symptom of the disease. Knowing that other situations as being Afro-American or Latino-American, Hypertension, renal insufficiency, or increase of C-reactive protein (CRP) imply a worse prognosis we can make a clinical score to estimate the vital prognosis of the patient.The exact pathogenesis of SARS-CoV-2 that causes olfactory and gustative disorders remains unknown but seems related to the prognosis. This point is fundamental, insomuch as could be a plausible way to find a treatment.
In Vitro Efficacy Comparison of Linezolid, Tedizolid, Sutezolid and Delpazolid Against Rapid Growing Mycobacteria Isolated in Beijing, China
Authors: Wen Shuan , Gao Xiaopan , Zhao Weijie , Huo Fengmin , Jiang Guanglu , Dong Lingling , Zhao Liping , Wang Fen , Yu Xia , Huang Hairong
Published: February 2021

The natural resistance of rapid growth Mycobacterium (RGM) against multiple antibiotics renders the treatment of caused infections less successful and time consuming. Therefore, new effective agents are urgently needed. The aim of this study was to evaluate the in vitro susceptibility of 115 isolates, constituting different RGM species, to four oxazolidinones i.e. delpazolid, sutezolid, tedizolid and linezolid. Additionally, 32 reference strains of different RGM species were also tested. The four oxazolidinones exhibited potent in vitro activity against the recruited RGM reference strains, 24 out of 32 RGM species had MICs ≤ 8 µg/mL against all four oxazolidinones whereas tedizolid and delpazolid generally presented lower MICs than linezolid or sutezolid. Tedizolid showed the strongest activity against clinical isolates of M. abscessus with MIC50 = 1 µg/mL and MIC90 = 2 µg/mL. MIC values for tedizolid were usually 4- to 8-fold less than the MICs of linezolid for M. abscessus subsp. abscessus. The MIC distributions of sutezolid and linezolid were similar, while delpazolid showed 2-fold lower MIC as compared with linezolid. Linezolid was not active against most of the tested M. fortuitum isolates, since 22 out of the 25 M. fortuitum were resistant against linezolid. However, delpazolid exhibited better antimicrobial activity against these isolates with 4-fold lower MIC values, in contrast with linezolid. In addition, the protein alignment of RplC and RplD and structure based analysis showed that there may be no correlation between oxazolidinones resistance and mutations in rplC ,rplD and 23srRNA genes in tested RGM. This study showed tedizolid harbors the strongest inhibitory activity against M. abscessus in vitro, while delpazolid presented the best activity against M. fortuitum, which provided important insights on the potential clinical application of oxazolidinones to treat RGM infections.
Malicious Traffic classification using Long Short-Term Memory (LSTM) model
Authors: K Naresh Kumar Thapa , Duraipandian N.
Published: February 2021

Malicious traffic classification is the initial and primary step for any network-based security systems. This traffic classification systems include behavior-based anomaly detection system and Intrusion Detection System. Existing methods always relies on the conventional techniques and process the data in the fixed sequence, which may leads to performance issues. Furthermore, conventional techniques require proper annotation to process the volumetric data. Relying on the data annotation for efficient traffic classification may leads to network loops and bandwidth issues within the network. To address the above-mentioned issues, this paper presents a novel solution based on artificial intelligence perspective. The key idea of this paper is to propose a novel malicious classification system using Long Short-Term Memory (LSTM) model. To validate the efficiency of the proposed model, an experimental setup along with experimental validation is carried out. From the experimental results, it is proven that the proposed model is better in terms of accuracy, throughput when compared to the state-of-the-art models. Further, the accuracy of the proposed model outperforms the existing state of the art models with increase in 5% and overall 99.5% in accuracy.
Research on the Spatial Pattern and Spatial Heterogeneity of Chinese Elite Hospitals
Authors: Shi Baoguo , Wang Yuping , Zheng Ji , Zhang Xiyu , Li Ye
Published: February 2021

Background: Facing the problems of unreasonable allocation of medical resources and health inequity, the layout of elite hospitals in China deserves further attention. This paper explores the unbalanced allocation of high-quality resources and its influencing factors in the development of China's health system , so as to provide reference for the rational distribution of high-quality medical resources in China and other countries, from the perspective of space.Methods: This study investigated 706 elite hospitals in 31 provinces, cities and autonomous regions in 2017. In this paper, geographic weighted regression (GWR), spatial lag model and spatial error model are used to study the influencing factors and spatial heterogeneity of spatial pattern.Results: Spatial auto-correlation of elite hospitals in China is of great significance and the results of OLS regression showed that city level, number of medical schools, urban population and resident population were its significant variables. Further, its spatial agglomeration phenomenon were confirmed through SEM and SLM model. Among them, the city level is the most important factor affecting the spatial distribution of elite hospitals in China. The influence intensity of urban level gradually weakened from northeast to southwest. And medical colleges, whose degree of influence is gradually increasing from northeast to southwest, is the second influence factor. There is a weak relationship between the distribution of elite hospitals and population size,which indicates other factors' important impact.Conclusion: China's elite hospitals are unevenly distributed and have obvious spatial heterogeneity. Therefore, we suggest that we should pay attention to the spatial governance of high-quality medical resources, attract medical elites in the region, increase investment in medical education in the scarce areas of elite hospitals and develop tele-medicine service. Through these means, we can solve the problem of unbalanced spatial distribution of medical resources and the demand of areas lacking high-quality medical resources.
Whole-Genome Resequencing Reveals Genetic Structure and Introgression in Chinese Pudong White Pigs
Authors: Huang Min , Wu Zhongping , Wang Xiaopeng , Li Desen , Liu Shaojuan , Zheng Sumei , Yang Lijuan , Liu Bingbing , Li Guixin , Jiang Yongchuang , Zhang Hui , Chen Hao , Ren Jun
Published: February 2021

Background: Pudong white (PDW) pigs originating from Shanghai, are the only Chinese indigenous pigs with white coat color except Rongchang (RC) pigs. However, there is limited information about its overall genetic structure, relationship with other breeds especially the East Chinese (ECN) and European pig due to the white coat of PDW. Whole-genome sequencing provides the effective approach to get the unique information of genome. The high-depth whole-genome sequencing data of 26 global pig breeds, European Wild boars (EWB), Chinese Wild boars (CWB) and out group (OUT) were implemented to detect the genetic structure, signature of selection and potential exotic introgression in PDW pigs.Results: The PDW pigs belonging to ECN pigs based on genetic relationship, and harbor lower genetic diversity and higher inbreeding coefficient compared to other Chinese indigenous pigs. Both the f3 and D-statistics analysis demonstrated that PDW pigs shared apparent alleles with Large White (LW) pigs. Then, two statistics, haplotype heat-map, copy number variation (CNV) and rIBD analysis further revealed that PDW pigs carry the same KIT genotype and share haplotypes at PARG-MARCHF8 locus with LW pigs, suggesting that the lineage of European (EUR) pigs in PDW originated from LW pigs. After detecting the KIT mutations in different pig breeds, PDW was confirmed to be same with LW at DUP1, DUP2 and the splicing mutation on intron 17 of KIT which determine the white coat color phenotype in European white pigs.Conclusions: This study shows that ECN pigs crossed with LW pigs after introduced to China about 110-164 years ago, where the offspring carrying KIT genotype that caused white coat color phenotype, and then were selected due to the rare white coat color in Chinese indigenous pigs, gradually forming PDW pig breed. To our knowledge, this study gives the first thorough description of the genetic structure of PDW pig via whole-genome resequencing data. This study not only advances our understanding of genetic structure, molecular phylogeny, and molecular origin of PDW pigs, but also provides a basis for facilitating the development of a national project for the conservation and utilization of this unique Chinese local population.
The Role of Computed Tomography in the Diagnosis of Rare Congenital Heart Disease: Interrupted Aortic Arch
Authors: Feng Yusen , Wang Lijuan , Liu Hui , Sun Guifang , Liu Bin , Ma Pengcheng , Wang Liqiong , Zhang Xuguang
Published: February 2021

Background: Interrupted aortic arch (IAA) is a rare congenital anomaly of the aortic arch and an anatomical interruption of the lumen between the ascending and descending aorta. Computed tomography (CT) has become a reliable noninvasive diagnostic method for congenital IAA .The purpose of this study was to To investigate the imaging features of IAA and improve the understanding and diagnosis of the disease. Methods: The imaging features and postoperative pathological data of 25 patients with IAA confirmed by dual-source computed tomography (DSCT) angiography were analyzed in this retrospective study. Results: Among the 25 patients with IAA, 15 were type A, 7 were type B, 0 were type C and D, and 2 were type E. The diameter of the pulmonary artery trunk in type A was larger than that in type B (P < 0.05). However, there were no significantly different between type A and type B abomg the ascending aorta diameter; descending aorta; ascending aorta/ descending aorta ratio; left pulmonary artery main trunk diameter; right pulmonary artery main trunk diameter; left pulmonary artery trunk/ pulmonary artery trunk ratio; right pulmonary artery trunk/pulmonary artery trunk ratio; left pulmonary artery trunk/right pulmonary artery trunk ratio.Conclusion: The imaging findings of IAA have typical and specific signs, and the types of IAA are not comprehensive. One type of patient identification can be added: patients who are dissected between the left common carotid artery and left subclavian artery opening, and the descending aorta is circulated by the chest collaterals. Patients with wide pulmonary artery in the IAA are usually type A patients. Patients with IAA after surgical repair require lifetime follow-up, mainly to monitor left ventricular outflow tract obstruction and recurrent aortic coarctation.
Availability and Service Provision of Multidisciplinary Diabetes Foot Units in Australia: A Cross-Sectional Survey.
Authors: Vo Uyen Giao , Gilfillan Molly , Hamilton Emma Jane , Manning Laurens , Munshi Bijit , Hiew Jonathan , Norman Paul Edward , Ritter Jens Carsten
Published: February 2021

Background: With growing global prevalence of diabetes mellitus, diabetes-related foot disease (DFD) is contributing significantly to disease burden. As more healthcare resources are being dedicated to the management of DFD, service design and delivery is being scrutinised. Through a national survey, this study aims to investigate the current characteristics of services which treat patients with DFD in Australia.Methods: An online survey was distributed to all 195 Australian members of the Australian and New Zealand Society for Vascular Surgery investigating aspects of DFD management in each member’s institution.Results: From the survey, 52 responses were received (26.7%). A multidisciplinary diabetes foot unit (MDFU) was available in more than half of respondent’s institutions, most of which were tertiary hospitals. The common components of MDFU were identified as podiatrists, endocrinologists, vascular surgeons and infectious disease physicians. Majority of respondents (84.3%) identified vascular surgery as being the primary admitting specialty for DFD patients that require hospitalisation. This finding was consistent even in centres with MDFU clinics. Less than 20% of MDFUs had independent admission rights.Conclusions: Most tertiary centres in Australia provide their diabetic foot service in a multidisciplinary environment however their composition and function remain heterogeneous. The findings of this study provide an opportunity to evaluate current practice and, to initiate strategies aimed to improve outcomes of patients with DFD.
Methodology Proposal of ADHD Classification of Children Based on Cross Recurrence Plots
Authors: Aceves-Fernandez Marco
Published: February 2021

Dealing with electroencephalogram signals (EEG) are often not easy. The lack of predicability and complexity of such non-stationary, noisy and high dimensional signals is challenging. Cross Recurrence Plots (CRP) have been used extensively to deal with detecting subtle changes in signals even when the noise is embedded in the signal. In this contribution, a total of 121 children performed visual attention experiments and a proposed methodology using CRP and a Welch Power Spectral Distribution have been used to classify then between those who have ADHD and the control group. Additional tools were presented to determine to which extent the proposed methodology is able to classify accurately and avoid misclassifications, thus demonstrating that this methodology is feasible to classify EEG signals from subjects with ADHD. Lastly, the results were compared with a baseline machine learning method to prove experimentally that this methodology is consistent and the results repeatable.
The Dermal Nipple-Areola-Complex Flap Method in Female-to-Male Gender Affirming Surgery
Authors: Bøkset Mari Irgens , Carstensen Lena Felicia , Jensen Jesper Poul Næsted
Published: February 2021

Background:Subcutaneous mastectomy (SCM) plays a major role in female-to-male (FtM) gender affirming surgery, and obtaining a flattering chest contour remains a challenge to the surgeon. We present an operative method using a dermal nipple-areola-complex (NAC) flap with the aim to create a naturally masculine appearance, while reducing the risk of NAC complications by maintaining sufficient neurovascularization.Methods:Through a horizontal incision, a superior thoracic full skin flap was elevated at the dissection plane for mastectomy. The mastectomy was continued inferiorly, creating an inferior flap including the NAC. The surface of the inferior flap was deepithelialized, secluding the NAC, which allowed the inferior dermal flap to be inserted posterior to the superior flap. A circular defect was created in the superior flap, into which the NAC was sutured.Results:The surgery delivered satisfactory results with an aesthetically pleasing masculine appearance and a high level of patient satisfaction. We were able to place the horizontal scars inferiorly along the pectoral muscles, which enabled some camouflage. Additionally, the inferior flap provided a uniform filling effect to the chest, further contributing to the male aesthetic. There were no NAC complications.Conclusion:The dermal NAC flap method could be applied as an excellent alternative to the traditionally performed free nipple graft technique in FtM gender confirming surgery. The method is simple, provides an aesthetically appealing outcome, and poses a low risk of NAC complications. Intraoperatively, it allows for good exposure and a uniform removal of breast tissue, as well as repositioning and/or reduction of the NAC where required.
ARID1A Upregulation Predicts Poor Survival in Patients with Liver Cancer
Authors: Jiang Feng , Wei Ke , Wang Ming , Wu Chuyan
Published: February 2021

Objective: ARID1A has been identified as a possible biomarker for certain cancers. There is, however, some debate regarding its function in liver cancer. Methods: Associations between clinical variables and ARID1A were evaluated. Cox and Kaplan – Meier analysis were used to examine clinicalopathological factors linked to overall survival of patients with liver cancer. Gene Set Enrichment Analysis (GSEA) was conducted using the dataset of the Cancer Genome Atlas. Results: High expression of ARID1A was correlated with the gender and tumor topography (T) diagnosis of liver cancer. Patients with elevated ARID1A expression had poorer prognosis than those with low ARID1A expression. The study also showed that ARID1A was an independent risk factor for overall survival. GSEA established pathways involved in ERBB signaling, cancer, insulin signaling, mTOR signaling, MAPK signaling, VEGF signaling, Ubiquitin signaling, and Wnt signaling as differentially enriched in ARID1A-high expression liver cancer. Conclusion: ARID1A has been shown to be expressed at high rates of liver cancer and to represent a possible independent molecular marker for diagnosis and prognosis of liver cancer.
Delayed Pancreatic Fistula: An Unaccustomed Complication Following Pancreaticoduodenectomy.
Authors: Jena Suvendu Sekhar , Meher Dibyasingh , Ranjan Rahul
Published: February 2021

BackgroundPost-operative pancreatic fistula is a morbid complication after pancreaticoduodenectomy. Though most of them present in the immediate post-operative period, few case reports have mentioned it even 7 years after index surgery. Here, we report a delayed presentation of pancreatic fistula 6 months after surgery.Case reportA 57 year old female underwent Whipple’s pancreaticoduodenectomy for pancreatic head adnocarcinoma and was discharged with an uneventful post-operative recovery. She presented after 6 months with complaints of abdominal pain and distension which upon evaluation found to be a pancreatic enzyme rich mutiloculated collection. It was managed with per-cutaneous drain placement.DiscussionPancreatic fistula remained a major cause of morbidity and mortality even after 100 years of its existence. It can be overt fistula which manifest in the immediate post-operative period or occult fistula which manifests long after primary surgery. Various causes of delayed fistula are anastomotic site stricture, previous chemotherapy, infection. The management options available are percutaneous drainage, endoscopic stenting of anastomotic stricture or redoing the anastomosis.ConclusionPancreatic fistula can have a delayed presentation which can be diagnosed and managed with regular follow up.
Predictive Value of Computed Tomography With Coronal Reconstruction in the Right Hemicolectomy With Complete Mesocolic Excision:A Retrospective Study.
Authors: Yu Hui , Zhuang Yong , Jian Jinliang , Yang Chunkang
Published: February 2021

Background:Understanding vascular anatomy is critical for performing central vascular ligation (CVL) in the right hemicolectomy with complete mesocolic excision (CME). This study was aimed to investigate the predictive value of multi-slice spiral computed tomography (MSCT) with coronal reconstruction in the right hemicolectomy. Methods:Eighty patients who underwent right hemicolectomy in our hospital were included. The intraoperative imaging data and the images of MSCT with coronal reconstruction were analyzed retrospectively. The detection rate of the ileocolic vein (ICV) and ileocolic artery (ICA) location and the accuracy of the preoperative prediction of their anatomical relationship were analyzed. The detection rate and preoperative prediction accuracy of the gastrocolic trunk of Henle (GTH), middle colic artery (MCA), and middle colin vein (MCV) were analyzed. The distance from the ICV root to the GTH root (ICV-GTH distance) was measured and analyzed. The maximum distance from the left edge of the superior mesenteric artery (SMA) to the right edge of the superior mesenteric vein (SMV), named “leSMA-reSMV distance,” was measured and analyzed too.Results:74 (92.5%) patients had been located both the ICV and ICA roots and determined the anatomical relationship between them by MSCT, of which 72 were confirmed by intraoperative findings，and the accuracy was 90% (72/80). GTH was located by MSCT in 75 (93.7%) patients, and the accuracy was 91.25% (73/80). MCA was located by MSCT in 47(58.75%) patients, and the accuracy was 46.25% (37/80). MCV was located by MSCT in 51 (63.75%)patients, and the accuracy was 53.75% (43/80). The ICV-GTH distance was measured in 73 (91.2%) patients, and the mean distance was 4.28±2.5cm. The leSMA-reSMV distance was measured in 76 (95%) patients, and the mean distance was 2.21±0.6cm. Conclusions:MSCT with coronary reconstruction can locate the roots of ICV, ICA, and GTH, predict the boundary of SMA and SMV, analyze the anatomical relationship between them, and estimate the location and range of central ligation region, which are of some predictive value in central vascular ligation in the right hemicolectomy with CME.
Finite Element Analysis and in Vitro Biomechanical Experiment on the Effect of Unilateral Partial Facetectomy Performed by Percutaneous Endoscopy on the Stability of Lumbar Spine
Authors: Li Xin-ru , Li Zi-tong , Nong Lu-ming
Published: February 2021

Purpose: To investigate the lumbar biomechanical effects of unilateral partial facetectomy (UPF) of different facet joint (FJ) portions under percutaneous endoscopy. Methods: A 3D finite element (FE) model of the lumbar spine and 40 fresh calf spine models were used to simulate UPF under a physiological load performed through 3 commonly used needle insertion points (IPs) : (1) The apex of the superior FJ (as the first IP), (2) The midpoint of the ventral side of the superior FJ (as the second IP), (3) The lowest point of the ventral side of the superior FJ (as the third IP). The range of motion (ROM) and the L4/5 intradiscal maximum pressure (IMP) were measured and analyzed under a physiological load in all models during flexion, extension, left-right lateral flexion, and left-right axial rotation. Results: When UPF was performed through the first and the third IPs, the ROM of the lumbar spine and the L4/5 IMP in the FE model were significantly increased compared with those in the intact FE model. When UPF was performed through the second IP, the ROM of the lumbar spine and the L4/5 IMP were not significantly different compared with those in the intact FE model. When UPF was performed through the second IP, the ROM of the lumbar spine and the L4/5 IMP in the calf spine models were not statistically different from the intact calf spine model. Conclusion: UPF through the second IP resulted in a minimal impact on the biomechanics of the lumbar spine. Thus, it might be considered as the most appropriate IP for UPF.
Modified Firefly Algorithm for Optimizing Biomedical Breast Cancer Queries
Authors: Ramalingam Gomathi
Published: February 2021

Querying and retrieving Semantic Web data is a challenging task due to the increment in its volume. Many query languages were designed to retrieve Semantic Web data. A popular querying method of communication in Semantic Web is SPARQL. The query languages were designed with some optimization strategies, and it was found in literature that these query languages were not able to handle large volume of data efficiently. In this research, a Modified Firefly Algorithm (MFA) is applied to optimize the SPARQL queries so that it can retrieve data from a large Semantic Web repository efficiently by reducing query execution time. Every query will have multiple query plans generated with different cost values. The challenge is to choose the best query plan which reduces the query cost and query execution time. The proposed algorithm uses the best query plan in the previous iteration to calculate the distance between two query plans using the radius parameter. The proposed algorithm generates a query plan which is a global optimal solution. MFA is evaluated using the BioPortal dataset with triples containing breast cancer. Experimental analysis is conducted to identify the significant improvement in performance of the proposed work with the existing nature inspired query optimization algorithms. The efficiency of MFA is compared with other algorithms in terms of query execution time and the performance is evaluated.
Diagnostic Mystery — a Rare Right Ventricular Cardiac Hemangioma: a Case Report
Authors: Fan Jingya , Guo Lei , Teng Peng , Dai Xiaoyi , Zheng Qi , Wu Shengjun , Ni Yiming
Published: February 2021

Background: Cardiac hemangiomas are rare in all kinds of benign cardiac tumors. Although cardiac hemangiomas affect all ages and may occur anywhere within the heart, right ventricular hemangiomas are extremely uncommon.Case presentation: We report a 56-year-old woman presented with chest tightness and breath shortness for 3 months. Transthoracic echocardiography and coronary computed tomography angiography showed a mass located adjacent to the apex of the right ventricle but both failed to figure out where the mass originated from, remaining a diagnostic mystery preoperatively. The mass was removed successfully and the histopathological examination confirmed it was hemangioma.Conclusions: Cardiac magnetic resonance should be the ultimate diagnostic tool of cardiac tumors. Surgical removal, associated with a low recurrence rate and long-term survival benefits, should be the first choice of therapy for cardiac hemangiomas.
PROLIFERATE: An adaptable framework to evaluate participatory research products
Authors: Plaza Maria Alejandra Pinero de , Archibald Mandy , Lawless Michael , Ambagtsheer Rachel , Mudd Alexandra , McMillan Penelope , Kitson Alison
Published: February 2021

Background: Participatory research (PR) – the practice of involving stakeholders in research processes – is growing in prominence in health research because it can enhance the impact of research and the translation of research-based knowledge. Yet, the literature indicates that the products of PR studies are rarely evaluated empirically to track, demonstrate, and expand their claimed effectiveness and impact. This lack of measurement tools and frameworks can limit the effectiveness of knowledge translation (KT). Methods: We introduce a framework for evaluating the products of PR called PROLIFERATE. We use an inductive combination of formative and summative evaluation methods to pilot test the framework on a Frailty PR communication product (a video) to determine the methods’ functionality.Results: PROLIFERATE demonstrates adeptness for evaluating barriers and enablers of PR product uptake, effectiveness, and impact. It can identify ways to address barriers by assessing knowledge user perspectives on the comprehensibility of the product, emotional resonance, motivation to change, and future accessibility. Conclusions: PROLIFERATE can enable longitudinal and cross-sectional measurement of PR products in implementation and integrated KT efforts. It can evaluate and track the effectiveness and impact of different types of PR products in a situational responsive manner which compares users, platforms, and other factors in a replicable way.
Identification of novel drug candidates for treating tongue squamous cell carcinoma using computational approaches
Authors: Li Yinghua , Chen Zihao , Chen Lu , Li Weizhong
Published: February 2021

BackgroundTongue squamous cell carcinoma (TSCC) is one of the most common oral squamous cell carcinoma (OSCC) with a high occurrence and a poor prognosis, yet its molecular mechanisms are largely unknown and novel drug candidates are needed. The purpose of this study was to construct gene co-expression networks to identify hub proteins significantly associated with tumor grades and the overall survival (OS) of TSCC patients and provide potential drug candidates. MethodsThe mRNA-sequencing and clinical data were obtained from The Cancer Genome Atlas (TCGA) dataset. Weighted gene co-expression network analysis (WGCNA) was used for identifying the co-expression module related to the tumor grade of TSCC. The hub proteins were selected by the interaction number with other proteins, and their correlations with prognosis and tumor grades were calculated. Virtual screening of compounds by the hub protein structures was used to identify the drug candidates. ResultsWGCNA identified ten co-expression modules, in which the brown module consisted of 163 genes was most significantly correlated with the tumor grade. Six hub genes/proteins (BUB1, CCNB2, CDC6, CDC20, CDK1, and MCM2) tended to be in the central hub of the network. And higher expression levels of these hub genes were associated with tumor grades and worse overall survival. Three compounds, targeting hub proteins, demonstrated high binding affinities, favorable pharmacologic properties, and low toxicity. Conclusion The gene co-expression network-based study could provide additional insight into tumorigenesis and progression of TSCC, and our study might provide novel drug candidates.
Triple-wavelength filter based on the nanoplasmonic metal-insulator-metal waveguides
Authors: Truong Cao Dung , Van Tai Nguyen , Trinh Minh Tuan , Manh Hoang Chu , Tan Hung Nguyen , Hoai Bac Dang
Published: February 2021

In this paper, we present a proposal for compact photonic wavelength filtering and 3-dB wavelength splitting device based on nanoplasmonic metal-insulator-metal structure. The working performance of the device has been accurately simulated using the temporal coupled-mode theory. We use a numerical simulation method of eigenmode expansion propagation for the overall design process. We show that the transmission efficiency of the drop filter can be significantly enhanced by applying specifically optimization of nanostub waveguide. The proposed structure has potential applications in highly efficient ultra-compact integration circuits as well as in optical communication systems at nanoscale.
Feasibility and Diagnostic Reliability of Quantitative Flow Ratio in the Assessment of Non-Culprit Lesions in Acute Coronary Syndrome
Authors: Erbay Aslihan , Penzel Lisa , Abdelwahed Youssef Salah , Klotsche Jens , Schatz Anne-Sophie , Steiner Julia , Haghikia Arash , Landmesser Ulf , Stähli Barbara Elisabeth , Leistner David Manuel
Published: February 2021

Purpose
Several studies have demonstrated the feasibility and safety of hemodynamic assessment of non-culprit coronary arteries in setting of acute coronary syndromes (ACS) using fractional flow reserve (FFR) measurements. Quantitative flow ratio (QFR), recently introduced as angiography-based fast FFR computation, has been validated with good agreement and diagnostic performance with FFR in chronic coronary syndromes. The aim of this study was to assess the feasibility and diagnostic reliability of QFR assessment during primary PC.
Methods
A total of 321 patients with ACS and multivessel disease, who underwent primary PCI and were planned for staged PCI of at least one non-culprit lesion were enrolled in the analysis. Within this patient cohort, serial post-hoc QFR analyses of 513 non-culprit vessels were performed.
Results
The median time interval between primary and staged PCI was 49 [42–58] days. QFR in non-culprit coronary arteries did not change between acute and staged measurements (0.86 vs 0.87, p = 0.114), with strong correlation (r = 0.94, p≤0.001) and good agreement (mean difference − 0.008, 95%CI -0.013-0.003) between measurements. Importantly, QFR as assessed at index procedure had sensitivity of 95.02%, specificity of 93.59% and diagnostic accuracy of 94.15% in prediction of QFR ≤ 0.80 at the time of staged PCI.
Conclusions
The present study for the first time confirmed the feasibility and diagnostic accuracy of non-culprit coronary artery QFR during primary PCI. These results support QFR as valuable tool in patients with ACS to detect further hemodynamic relevant lesions with excellent diagnostic performance and therefore to guide further revascularisation therapy.
Plasmonic switch Based on asymmetric cavities with embedding square of gold inside the cavities
Authors: Ghadrdan Majid , Shahraki Mojtaba , Mansouri-Birjandi Mohammad Ali
Published: February 2021

In this paper, we proposed an all-optical plasmonic switch based on metal-insulator-metal (MIM) structures. We used the intrinsic nonlinear properties of gold to implement the switch. The proposed switch consists of a bus waveguide side coupled with a pair of asymmetric vertical cavities. We obtained the transmission spectrum of the structure for low input intensities. The results showed that a sharp dip occurs at the wavelength of 860 nm. Due to the nonlinear properties of gold and the nonlinear Kerr effects, the proposed switch has a high transmission ratio of about 0.8 and a low threshold power of 0.07 mW/µm2. The threshold power of the structure with and without using the gold nanostructure shows a reduction of 50%. The result showed that the proposed switch has the potentiality to be applied in the plasmonic integration circuits.
Going Virtual: Youth Attitudes Toward and Experiences of Virtual Mental Health and Substance use Services During the COVID-19 Pandemic
Authors: Hawke Lisa D , Sheikhan Natasha Y , MacCon Karen , Henderson Joanna
Published: February 2021

Background. During the COVID-19 pandemic, youth mental health and substance use services rapidly moved to virtual modalities to meet social distancing requirements. It is important to understand youth attitudes toward and experience of virtual services. Objective. This study examined the attitudes toward and experiences for virtual mental health and substance use services among youth drawn from clinical and non-clinical samples.Method. 409 youth completed a survey including questions about their attitudes toward and experience of virtual services. The survey included quantitative and open-ended questions on virtual care, as well as a mental health and substance use screener. Results. The majority of youth with mental health or substance use challenges would be willing to consider individual virtual services, but fewer would consider group virtual services. However, many have not received virtual services. Youth are interested in accessing a wide variety of virtual services and other supportive wellness services. Advantages and disadvantages of virtual services are discussed, including accessibility benefits and technological barriers. Discussion. As youth mental health and substance use services have rapidly gone virtual during the COVID-19 pandemic, it is essential that we hear the perspectives of youth to promote service utilization among those in need. Diverse, accessible, technologically stable virtual services are required to meet the needs of different youth, possibly with in-person options for some youth. Future research, engaging youth in the research process, is needed to evaluate the efficacy of virtual services to plan for sustainability of some virtual service gains beyond the pandemic period.