bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical Predictors of Definitive Treatment Interruptions of Long-course Neoadjuvant Chemoradiotherapy in Locally Advanced Rectal Cancer
Authors: Sapienza Lucas Gomes , Raychaudhuri Sreejata , Nahlawi Suraya Khaled , Ozeir Serene , Abu-Isa Eyad
Published: May 2021

Background: This study aims to identify predictors of definitive treatment interruptions (DTI) of the neoadjuvant long-course radiotherapy (LCRT) in locally advanced rectal cancer (LARC), as well as determine their impact on clinical outcomes.Methods: Patients with stage II-III LARC treated between 2009-2018 were retrospectively analyzed (n=101). Logistic regression models were performed to evaluate the impact of relevant clinical variables on grade 3 or greater (G3+) acute toxicity, definitive treatment interruption (DTI), pathological complete response (pCR), and definitive ostomy (dOST) rates. The secondary outcomes were loco-regional control (LRC), metastasis-free survival (MFS), progression-free survival (PFS), cancer-specific survival (CSS) and overall survival (OS).Results: The incidences of grade 3 and 4 toxicities were 25.3%, and 1.1%, respectively. Most common G3+ toxicity were peri-anal dermatitis (14.7%) and diarrhea (7.4%), which were more frequent in females (p=0.040) and patients with tumor closer to the anal verge (p=0.019). Eleven cases (10.9%) developed DTI, which were associated with these G3+ events (p<0.001). Resection occurred after a median 7.1 weeks (IQR: 6.1-8.9). Downstaging occurred in 57.4% (including 17.8% pCR), 88% achieved negative margins and the dOST rate was 56.4%. After 49.5 months median follow-up, the 5-year LRC, MFS, PFS, CSS and OS were: 94.4%, 78.9%, 74.7%, 85.2% and 81.6%, respectively. DTI events did not impact pCR (p=0.435), dOST (p=0.611) or any survival outcomes. The only factors associated with loco-regional failure were close/positive margins (p<0.001) and pathologic stage ypIII (p=0.002).Conclusions: Tumors close to the anal verge and female sex were associated with increased G3+ toxicity, which was predictive of DTI. The resultant partial or complete omission of the planned boost, however, dose did not increase the chance of local recurrence. Further studies to clarify the benefit and the best timing to deliver the boost are warranted, especially for the patients with positive margins.
Predicting Patient Participation to an ICU Follow-Up Program
Authors: Prevedello Danielle , Steckelmacher Claire , Devroey Marianne , Creteur Jacques , Preiser Jean-Charles
Published: May 2021

Objective: Survivors of intensive care often present long-term sequelae, including cognitive impairment and psychological discomfort. Follow-up programs have therefore been developed to assess and manage these long-term complications. Studying the effectiveness of such programs can be limited by the number of patients lost during follow-up. The aim of this study was therefore to evaluate patient characteristics predictive of participation to an intensive care unit (ICU) follow-up program. Design: In this prospective, nested, case-control study, all patients with an ICU stay of at least five days were invited to participate in an ICU follow-up program. Having attended 2 follow-up sessions at ICU and hospital discharge, they were given an appointment for their 3-month follow up. Patients were divided into two groups (“participants and “non-participants”) according to whether or not they attended this appointment. Multivariable logistic regression analysis was used to identify independent predictors of participation.Settings: An ICU follow-up program from a mixed ICU at a university hospital.Participants: All patients selected to participate to the ICU follow-up program were included in this study. They were allocated into two groups depending on their attendance in the follow-up program. Intervention: NoneMain results: Of the 199 patients included during the study period, 80 (40.2%) were classified as “participants”. These patients had a lower Charlson Comorbidity Index, a longer ICU length of stay (LOS), more frequently received ventilatory support for at least 24 hours and more frequently received extracorporeal membrane oxygenation (ECMO) than non-participant patients. In the multivariable analysis, ICU LOS longer than 10 days was associated with a 3.3 times increased likelihood of participating in the follow-up; a lower Charlson Comorbidity Index also predicted an increased likelihood of participating to the ICU follow-up clinic.Conclusions: Fewer comorbidities and longer intensive care LOS were independent predictors of participation in ICU follow-up.
A Novel Protein AoHPS1 Is Involved In Oxidative Stress and Kojic Acid Synthesis in Aspergillus Oryzae
Authors: Li Yuzhen , Zhang Huanxin , Chen Ziming , Fan Junxia , Chen Tianming , Zeng Bin , Zhang Zhe
Published: May 2021

Aspergillus oryzae usually suffers from oxidative stress during the process of aerobic fermentation. However, there is little information on what genes involve in oxidative stress of A. oryzae. Here, we found that the expression of a novel gene Aohps1 was induced during the growth and development of A. oryzae with and without oxidative stress. Sequence analysis revealed that Aohps1 has four transmembrane regions and is conserved in Aspergillus species. Overexpression and deletion of Aohpi1 caused the growth defects with and without oxidative stress, including mycelium growth, conidia formation and biomass. Meanwhile, the Aohpi1 overexpression strain exhibited more sensitivity to oxidative stress than the Aohpi1 disrupted mutant. Furthermore, overexpression and disruption of Aohps1 resulted in the inhibition of kojic acid production with and without oxidative stress, consistent with the reduced expression of kojA that directly contributed to the synthesis of kojic acid. Additionally, the yield of kojic acid is less in the Aohps1 overexpression strain than in the Aohps1 deletion mutant under oxidative stress. Collectively, the discovery of Aohps1 provides new insights into oxidative stress and kojic acid synthesis in A. oryzae.
Quantum Optic Entanglement Using Graphene Clad Surface Plasmonic Polariton Device
Authors: Sahu Partha Pratim
Published: May 2021

Here, Graphene clad plasmonics waveguide is introduced as a two surface plasmonic polariton modes interference (GTSPPMI) coupler to obtain optically manipulated quantum interference. The manipulation of Handel Ou Handel (HOM) quantum interference is demonstrated theoretically in nano-scale two modes coupler through refractive index modulation in Graphene clad with incidence of an ultra fast optical pulse energy. The quantum entanglement of fidelity ~ 97.5% is obtained by incidence of optical pulse of energy 5.12 pJ and width 3.8 ps in Graphene cladding. Our results promise to obtain fast and compact optical reconfiguring of quantum plasmonics circuit in comparison to electrooptic and themooptic coupler.
Predictors of the Relationship Between the Duration of Cancer and Care Time With the Supportive Care Needs of Patients and the Quality of Life of Their Caregivers: A Path Analysis
Authors: Attari Seyedeh Maryam , mahmoodi Zohreh , Nimekari Mozhgan Mohammadzadeh , Nasiri Malihe , taziani Yaghoub Ashouri , Ozgoli Giti
Published: May 2021

Background: Breast cancer patients face various material, physical and psychological problems. The growing trend of breast cancer in Iran, the referral of patients in the advanced stages of the disease, and the mutual impact of patients and caregivers on each other show the need for further supportive care from the community and family. This study aimed to identify the predictors of the direct and indirect relationships of the duration of cancer and care time with the supportive needs of the patients and the quality of life of their family caregivers.Methods: This descriptive-analytical study was carried out on 150 patients and their caregivers in Iran. Data were collected using the Supportive Care Needs Survey-short form (SCNS-SF34), the Caregiver Quality of Life Index-Cancer (CQOLC) scale, and a socio-demographic checklist and were then analyzed in SPSS-24 and Lisrel-8.8 software using descriptive-analytical statistics and path analysis.Results: The mean age of the patients and caregivers was 45.76±10.44 and 43.46±9.5, respectively. Based on the test results, the duration of cancer was positively correlated with the total score of supportive needs in both paths (B=0.799). The patients’ sexuality needs had the highest negative correlation with their duration of cancer in the direct path (B=-0.87) and psychological needs the highest negative correlation in the indirect path (B=-0.32). The care time (in hours) had the highest positive correlation with the total score of supportive needs (B=15.6) in both the direct and indirect paths, and the highest positive correlation with physical needs in the direct path (B=10.65). The caregivers’ quality of life had a negative and direct relationship with the duration of cancer (B =-0.27) and there was a positive and direct relationship between care time and the caregivers’ quality of life (B=3.09). Conclusions: Duration of cancer and care time had the highest positive correlation with the patients’ supportive needs, and the caregivers’ quality of life had a negative correlation with the duration of cancer and a positive correlation with care time. It is therefore vital to emphasize the design and implementation of supportive care programs for breast cancer patients and their family caregivers.
Establishment of a Diagnostic Model to Distinguish Coronavirus Disease 2019 From Influenza a Based on Laboratory Findings
Authors: Xing Dongyang , Tian Suyan , Chen Yukun , Wang Jinmei , Sun Xuejuan , Li Shanji , Xu Jiancheng
Published: May 2021

BackgroundCoronavirus disease 2019 (COVID-19) and Influenza A are common disease caused by viral infection. The clinical symptoms and transmission routes of the two diseases are similar. This study established a model of laboratory findings to distinguish COVID-19 from influenza A perfectly. MethodsIn this study, 56 COVID-19 patients and 54 influenza A patients were included. Laboratory findings, epidemiological characteristics and demographic data were obtained from electronic medical record databases. Elastic network models, followed by a stepwise logistic regression model were implemented to identify indicators capable of discriminating COVID-19 and influenza A. ResultsA monogram is diagramed to show the resulting discriminative model. The majority of hematological and biochemical parameters in COVID-19 patients were significantly different from those in influenza A patients. In the final model, albumin/globulin, total bilirubin and erythrocyte specific volume were selected as predictors. This model has been demonstrated to have a satisfactory predictive performance to discriminate between COVID-19 and influenza A (AUC=0.844) using an external validation set. Conclusion﻿The establishment of a diagnostic model on laboratory findings is of great significance for the identification of COVID-19 and influenza A.
Effect of zinc supplementation on renal and sexual function of men with diabetic nephropathy and impotence, a randomized double-blind cross over clinical trial
Authors: Sharifi Faranak , Shajari Zahra , Feizy A.Amir
Published: May 2021

Background: Free radical generation and oxidative stress has been hypothesized to be underlying pathogenesis of diabetic complications like nephropathy and erectal dysfunction. Zinc can reduce lipid per-oxidation and improves endothelial functions. The aim of this study was to evaluate the effects of Zinc on renal and sexual function of men with Type 2 diabetes.Methods:This study has been supported financially by Zanjan University of Medical Sciences and registered in Iranian registry of clinical trials (www.irct.ir) with this code: IRCT138806091179N3.Fifty adult type 2 diabetic men with diabetic nephropathy and erectal dysfunction were enrolled in double-blind, randomized trial. Twenty-five patients received 30 mg Zinc-sulfate per day and the remaining subjects received placebo for three months. Baseline and end-study body mass index (BMI), blood pressure (BP), fasting plasma glucose (FPG), HbA1C, lipid profiles, serum creatinine (Cr), testosterone and zinc concentrations were measured. Albumin/creatinin ratio (ACR) and glumerular filtration rate (GFR) were calculated for all the participants. Sexual dysfunction was determined with International Index for Erectile Dysfunction questionnaire (IIEF-5).Results:Slight non-significant reduction versus a minimal non-significant increase in mean of ACR was seen with Zinc supplementation and placebo respectively (-3.7 ± 17.1 µg/mg vs. 2.8 ± 21.4 µg/mg; P= 0.130. Additionally Zinc supplementation had no effect on GFR and also erectile dysfunction of diabetic patients. However, significant improvement in FPG, HbA1c, total cholesterol and HDL-cholesterol concentration were seen with zinc supplementation (p:0.03). Conclusion: The results suggest that albuminuria, GFR and erectile function of men with type 2 DM cannot be affected by Zinc supplementation in dose of 30mg/day. Further studies in a larger population may be warranted.
Structural Changes in Proteins With Post-translational Modifications in Female Oncopathologies
Authors: Tikhonov Dmitry , Kulikova Liudmila , Kopylov Arthur T. , Rudnev Vladimir , Stepanov Alexander , Malsagova Kristina , Izotov Alexander , Kulikov Dmitry , Zulkarnaev Alexey , Enikeev Dmitry , Potoldykova Natalia , Kaysheva Anna L.
Published: May 2021

Post-translational processing leads to conformational changes in protein structure that modulate molecular functions and change the signature of metabolic transformations and immune responses. Some post-translational modifications (PTMs), such as phosphorylation and acetylation, are strongly related to oncogenic processes and malignancy. This study investigated a PTM pattern in patients with gender-specific ovarian or breast cancer. Proteomic profiling and analysis of cancer-specific PTM patterns were performed using high-resolution UPLC-MS/MS. Structural analysis, topology, and stability of PTMs associated with sex-specific cancers were analyzed using molecular dynamics modeling. We identified highly specific PTMs, of which 12 modified peptides from eight distinct proteins derived from patients with ovarian cancer and 6 peptides of three proteins favored patients from the group with breast cancer. We found that all defined PTMs were localized in the compact and stable structural motifs exposed outside the solvent environment. PTMs increase the solvent-accessible surface area of the modified moiety and its active environment. The observed conformational changes are still inadequate to activate the structural degradation and enhance protein elimination/clearance; however, it is sufficient for the significant modulation of protein activity.
The Role of Patient Navigators in Ambulatory Care: Overview of Systematic Reviews
Authors: Budde Hannah , Williams Gemma , Winkelmann Juliane , Pfirter Laura , Maier Claudia Bettina
Published: May 2021

Background: Patient navigators have been introduced across various countries to enable timely access to healthcare services and ensure completion of diagnosis and follow-up of care. There is an increasing amount of evidence on the positive effect of patient navigation for patients. The aim of this study was to analyse the evidence on patient navigation interventions in ambulatory care and to evaluate their effects on individuals and health system outcomes.Methods: An overview of reviews was conducted, based on a prespecified protocol. All patients in ambulatory care or transitional care setting were included in this review as long as it was related to the role of patient navigators. The study analysed all roles of patient navigators covering a wide range of health professionals such as physicians, nurses, pharmacists, social workers as well as lay health workers or community-based workers with no or very limited training. Studies including patient-related measures and health system-related outcomes were eligible for inclusion. A rigorous data collection was performed in multiple data bases. After reaching an inter-rater agreement, title and abstract screening was independently performed. Of an initial 8362 search results a total of 673 articles were eligible for full-text screening. An extraction form was used to analyse the nine included review.Results: Nine systematic reviews were included covering various patient navigation roles in cancer care, disease screening and transitional care. Seven systematic reviews primarily tailored services to ethnic minorities or other disadvantaged groups. Patient navigators performed tasks such as providing education and counselling, translations, home visits, outreach, scheduling of appointments and follow-up. Six reviews identified positive outcomes in expanding access to care, in particular for vulnerable patient groups. Two reviews on patient navigation in transitional care reported improved patient outcomes and hospital readmission rates and mixed evidence on quality of life and emergency department visits.Conclusions: Patient navigators have shown to expand access to screenings and health services for vulnerable patients or population groups who tend to underuse health services.
Effectiveness of a Continuing Education Program of Drugs with Fiscalized Substance to Improve Pharmacy Staff Competencies.
Authors: Ceballos Mauricio , Ospina Andrea Salazar , Hernandez Daniel Sabater , Amariles Pedro
Published: May 2021

Background: The use of drugs with fiscalized substances without a correct prescription and without ambulatory pharmacy services can have negative consequences for public health. Objectives: To evaluate the effectiveness of a continuing education program in drugstores and pharmacies that improves pharmacy staff competencies to provide ambulatory pharmacy services. Setting: Ambulatory retail establishments (drugstores and pharmacies) in Colombia.Method: A multicenter, prospective, parallel-group, cluster-randomized, controlled clinical trial was conducted. The intervention group (IG) received a continuing education program for 12 months, including web-based social networking sites with a virtual classroom, a virtual course composed of 7 modules, access to a drug and dispensing information system, and pharmacy staff training. Control group (CG) received written material on the correct use of complex dosage forms for 12 months.Main outcome measure: Pharmacy staff competencies (knowledge, skills, and attitudes).Results: The sample was 305 drugstores and pharmacies, 153 in the IG and 152 in the CG. Of the 750-pharmacy staff invited, 88% (659) agreed to participate; a total of 379 pharmacy staff were assigned to the IG and 280 to the CG. Of a total, 65.3% (430) were women with a mean age was 35.6 years. At the end of the study, in the IG was statistically significant differences (p<0.05) in the 25 skills and attitudes self-reported, also knowledge improved in six of the seven assessed modules.Conclusion: Providing a continuing education program using various educational and active participation strategies improves assessed knowledge and self-reported for the provision of ambulatory pharmacy services.
Inverse Halftoning Based on Weighted Nuclear Norm Minimization
Authors: Yang Jun , Jia Xiaojun , Liu Zihao , Chen Li , Wu Ying
Published: May 2021

The inverse halftoning technology refers to restore a continuous-tone image from a halftone image with only bi-level pixes. However, recovering the continuous images from their halftoned ones is normally ill-posed, which making the inverse halftoning algorithm very challenging. In this paper, we propose an optimization model with two alternate projections (TAP) for image inverse halftoning under the weighted nuclear norm minimization (WNNM) framework. The main contributions are two-folds. First, the WNNM nonlocal regularization term is established, which offers a powerful mechanism of nonlocal self-similarity to ensure a more reliable estimation. Second, the alternate minimization projections are formulated for solving the image inverse halftoning, which reconstructs the continuous-tone image without destroying the image details and structures. The experiment results shown that the proposed method outperformed the state of the arts in terms of both objective measurements and subjective visual performance.
Hybrid promoter engineering strategies in Yarrowia lipolytica: isoamyl alcohol production as a test study
Authors: Zhao Yu , Liu Shiqi , Lu Zhihui , Zhao Baixiang , Wang Shuhui , Zhang Cuiying , Xiao Dongguang , Foo Jee Loon , Yu Aiqun
Published: May 2021

Background: In biological cells, promoters drive gene expression by specific binding of RNA polymerase. They determine the starting position, timing and level of gene expression. Therefore, rational fine-tuning of promoters to regulate the expression levels of target genes for optimizing biosynthetic pathways in metabolic engineering has recently become an active area of research. Results: In this study, we systematically detected and characterized the common promoter elements in the unconventional yeast Yarrowia lipolytica, and constructed an artificial hybrid promoter library that covers a wide range of promoter strength. We also report for the first time that upstream activation sequences (UAS) of Saccharomyces cerevisiae promoters can be functionally transferred to Y. lipolytica. Subsequently, using the production of a versatile platform chemical isoamyl alcohol as a test study, the hybrid promoter library was applied to optimize the biosynthesis pathway expression in Y. lipolytica. By expressing the key pathway gene, ScARO10, with the promoter library, 1.1-30.3 folds increase in the isoamyl alcohol titer over that of the control strain Y. lipolytica Po1g KU70∆ was achieved. Interestingly, the highest titer increase was attained with a weak promoter PUAS1B4-EXPm to express ScARO10. These results suggest that our hybrid promoter library can be a powerful toolkit for identifying optimum promoters for expressing metabolic pathways in Y. lipolytica.Conclusion: We envision that this promoter engineering strategy and the rationally engineered promoters constructed in this study could also be extended to other non-model fungi for strain improvement.
Novel Fabrication of Engineered Nano-Selenium Incorporated Hydrogel for Potential Therapy and Care and of Acute Myocardial Infarction
Authors: Li Jianmei , Wang Pengfei
Published: May 2021

Recent years, the cardiac vascular disease has arisen owing to acute myocardial infarction (MI) and heart failures leads to death worldwide. Various treatments are available for MI in modern medicine such as implantation of devices, pharmaceutical therapy, and transplantation of organs, nonetheless it has many complications to find an organs donor, devices for stenosis, high intrusiveness and long-time hospitalization. To overcome these problems, we have designed and developed a novel hydrogel material with combination of Se NPs loaded poly(ethylene glycol)/tannic acid (PEG/TA) hydrogel for the treatment of acute MI repair. Herein, Se NPs was characterized by the effective analytical and spectroscopic techniques. In vitro cell compatibility and anti-oxidant analyses were examined on human cardiomyocytes in different concentrations of Se NPs and appropriate Se NPs loaded hydrogel samples to demonstrate its greater suitability into in vivo cardiac applications. In vivo investigations of MI mice models injected with Se hydrogels established that LV wall thickness was conserved significantly from the value of 235.6 µm to 390 µm. Addition that, the relative scar thickness (33.6 %) and infarct size (17.1 %) of the MI model was enormously reduced after injection of Se hydrogel when compared to the Se NPs and control (MI) sample, respectively, which confirmed that Se introduced hydrogel have greatly influenced on the restoration of infarcted heart. Based on the investigated results of the nanoformulated samples, it could be a promising material for future generations treatment of acute myocardial infarction and cardiac repair applications.
Risk Assessment of Arsenic Toxicity Through Ground Water-Soil-Rice System in Maldah District, Bengal Delta Basin, India
Authors: Khanam Rubina , Hazra Gora Chand , Bag Animesh Gosh , Chatterjee Nitin , Kulsum Pedda Ghouse Peera Sheikh , Shukla Arvind Kumar
Published: May 2021

Arsenic (As), a toxic trace element, is of great environmental concern due to its presence in soil, water, plant, animal and human continuum. Its high toxicity and increased appearance in the biosphere have triggered public concern. The present study measured arsenic (As) concentrations in soil, groundwater and rice plant samples of five selected blocks of Maldah district, West Bengal, India. Soil, irrigation water and rice plant samples were collected from fields from the selected study areas. The results revealed the presence of As in higher concentrations than the maximum permissible limit of As in irrigation water (0.1 mg L− 1by WHO and Indian standard) in groundwater of Manikchak (0.553 ± 0.17 mg L− 1, Kaliachak III (0.528 ± 0.20 mg L− 1), Kaliachak II (0.449 ± 0.15 mg L− 1), Kaliachak I (0.207 ± 0.19 mg L− 1) The level of As in soil was also found to higher in those four blocks. The As content in rice grain and field is positively correlated with As content in irrigation water. The analysis of As of locally grown rice, showed the presence of its concentration higher than recommended safe level of As in rice by FAO/WHO (0.2 mg Kg-1) in some villages. The data of consumption of rice per day in the survey was used for the measurement of average daily dose and hazard quotient. Kaliachak III, Manikchak and Kaliachak II showed HQ greater than 1, indicating the possibility of non-carcinogenic health hazard. The study emphasized the severity of As problem in remote areas of West Bengal, India where people consume As tainted rice due to lack of awareness about the As problem and associated health issues.
Spatial and temporal analysis of Iran precipitation
Authors: Sorkhabi Omid Memarian
Published: May 2021

In this study, spatial and temporal analysis of precipitation in Iran in 2019 and 2020 has been studied. The average annual precipitation in 2019 is about 345 mm and in 2020 285 mm. In 2019, the maximum precipitation was in the western and northwestern regions, and the minimum precipitation was in the central and eastern regions. In 2020, the maximum precipitation was in the northwestern areas and the minimum precipitation was in the central, eastern and southwestern areas. Northwestern regions of Iran have a positive precipitation difference, i.e. in 2020 it had more precipitation. The southern and western regions have a negative difference, i.e. in 2020, there was less rain.
Close Correlations Between The Carotid And Radial Relative Artery Blood Flow Velocity Ratio and BMI and Temperature In Normal Individuals
Authors: Zhu Xiang , Gao Wei , Chi Yong , Wang Zhiyong , Shao Junjie
Published: May 2021

Background: Measuring carotid and radial pulses as a diagnostic method plays a vital role in sphygmology applied via traditional Chinese medicine (TCM). In particular, many TCM theories and doctors have indicated that the pulse force ratio is closely correlated with human physiological conditions, such as weight and body temperature. However, few studies have explored these potential correlations. Thus, the purpose of this study was to investigate the relationships between the pulse strength ratio and human metabolism indicators.Methods: The carotid and radial relative artery blood flow velocity (RABFV) and pulse force from 122 normal adults were examined by ultrasound and manual palpation by a doctor, and the same group was tested via a thermal texture map (TTM).Results: Obvious differences in the body side and sex were not observed in the ratio of carotid and radial RABFV among normal individuals (p>0.05). However, the ratio of young people was greater than that of old people (p<0.001), and strong support was obtained for traditional Chinese medicine (TCM) assumptions of seasonal differences in the ratio (p<0.001). Furthermore, we discovered that the ratio had a negative correlation with BMI and torso temperature but a positive correlation with hand temperature.Conclusion: Our results demonstrated that the ratio of carotid and radial RABFV could serve as an indicator of human physical conditions, such as BMI and human temperature, and represents a valuable tool for evaluating yin-yang properties in TCM clinical practice. The close correlations reported above verified some theories of TCM and provided strong support for sphygmology in TCM.
Novel Polishing Media for Finishing Hip Joint Implants
Authors: Choopani Yahya , Khajehzadeh Mohsen , Razfar Mohammad Reza
Published: May 2021

The authors have requested that this preprint be removed from Research Square.
One Public Health Crisis into Many Others: The impact of COVID-19 on Upstaging of Gastric Cancer
Authors: Jalaeefar Amirmohsen , Shirkhoda Mohammad , Mahmoodzadeh Habibollah , Omranipour Ramesh , Poopak Amirhossein , Sharifi Amirsina
Published: May 2021

Introduction: We aimed to investigate how COVID-19 affects patients with gastric cancer (GC) and what should be expected to happen in post-CVOID-19 era.Methods: A case-control study of GC patients referring to our center in two parallel time periods of February 25th to December 25th of 2020 and 2019 was conducted. Results: Twenty six patients during COVID-19 and 54 patients during pre-COVID-19 time were recruited. Mean age, gender, tumor location and T status distribution were not statistically different between study groups (all p values > 0.05). Regarding N status, distribution of N0, N1, N2 and N3 in pre-COVID group was as follows: 2(3%), 21(39%), 26(48%) and 6 (10%). In COVID-19 group N0 was not reported and N1, N2 and N3 were 7 (27%), 7 (27%) and 13 (46%) (p value < 0.05). Among pre-COVID patients 6 (11%) patients had gross metastasis in staging laparoscopy (SL) and 10 (18.5%) patients had positive malignant cytology. In COVID-19 group positive SL and positive cytology were found in 9(35%) and 11(42%), respectively (all p values < 0.05).Conclusion: Health care systems should adopt reasonable approaches to cancer management, otherwise the upcoming pandemic is locally advanced and metastatic cancers.
Cloudbc-To Ensure Data Integrity in Cloud Computing Environments
Authors: S Amrutha , S MAHESH A
Published: May 2021

An outbreak of corona virus caused by a novel virus called SARS-CoV-2 occurred at the end of 2019. The unexpected outbreak and unchecked global spread of COVID19 indicate that the current global healthcare networks have limitations in addressing the crises for public safety. In this paper, we have studied to secure the COVID-19 patients ’ data. Data security and Storage Management becomes the most promising task in it, to manage it we use cloud computing. This leads to the strong evidence of unanswered questions related to the data security over the cloud data centres. The Proposed research work aims to protect the cloud data by implementing the new approach using blockchain technology. a novel secure Online/offline Decentralized Attribute Based Encryption for cloud. The proposed scheme reduces the online computation burden for data owners by completing the preprocessing computation as much as during the offline phase. The proposed scheme eliminates a major of computation overhead on user side by migrating the partial decryption computation to the cloud servers. The secure hash blocks are generated and maintained by the cloud storage devices enhance the data security on the cloud. The block chains allow the user to trace back the malicious data access and modifications.
Multi-Multimodality Integrated Stack-Ensemble Learning for the Prediction of Gleason Grade and Prognostic Outcome in Prostate Cancer: A Proof-of-Concept Study
Authors: Bao Jie , Hou Ying , Zhi Rui , Wang Ximing , Shi Haibin , Hu Chunhong , Zhang Yu-Dong
Published: May 2021

Purpose

To develop a generalizable model, namely PRISK, for the prediction of Gleason grade and prognostic outcome in prostate cancer (PCa) with multiple clinical factors and multiparametric (mp) MRI using stack-ensemble learning.
Methods

PRISK is developed to primarily assess PCa Gleason grade between benign (pG0), 3 + 3 (pG1), 3 + 4 (pG2), 4 + 3 (pG3) and ≥ 4 + 4 (pG4) and secondly predict the biochemical recurrence (BCR) after radical prostatectomy (RP). PRISK was developed with a stacked-ensemble learning of large-scale clinical identifications and mpMRI data in 671 training datasets, and was validated in 232 internal and 539 external datasets.
Results

The stacked-ensemble learning of mpMRI delivered a Radiomics-score and 5 transfer learning signatures from 5 deep transfer learning embedders. The PRISK, build with 10 clinical and imaging embedded predictors, achieved an area under the roc curve of 0.783, 0.798 and 0.762 in training, internal and external validation data for classifying Gleason grade, respectively. Specially, combined use of prostate-specific antigen (PSA), PI-RADS and Radiomics-score had excellent negative predictive value (94.1%) for clinical insignificant disease (pG0-1) and high positive predictive value (79.8%) for high-risk PCa (pG4). PSA ≥ 20 ng/ml (odds ratio [OR], 1.58; 95% confidence intervals [CIs], 1.20–2.08; p = 0.001) and PRISK ≥ G3 (OR, 1.45; 95% CI, 1.12–1.88; p = 0.005) were independent predictors of BCR, with a C-index of 0.76 (95% CI, 0.73–0.79) for predicting BCR by Cox analysis.
Conclusions

We concluded that the PRISK can offer a noninvasive alternative to stratify PCa Gleason grade. This enables a step towards PCa risk stratification.
Internet of Things Energy Efficient Cluster-Based Routing Using Hybrid Particle Swarm Optimization for Wireless Sensor Network
Authors: A Senthil G , Raaza Arun , Kumar N
Published: May 2021

Specialized transducers in Wireless Sensor Networks (WSNs) that offer sensing services to the Internet of Things (IoT) devices have limited storage and energy resources. One of the most vital issues in WSN design is power usage, as it is nearly impossible to recharge or replace sensor nodes’ batteries. A prominent role in conserving power for energy-constrained networks is served by the clustering algorithm. It is possible to reduce network energy usage and network lifespan prolongation by proper balancing of the network load with Cluster Head (CH) election. The single-hop inter-cluster routing technique, in which there is a direct transfer from CHs to the Base Station (BS), is done by the Low Energy Adaptive Clustering Hierarchy (LEACH). However, for networks with large-regions, this technique is not viable. An optimized Orphan-LEACH (O-LEACH) has been proposed in this work to facilitate the formation of a novel process of clustering, which can result in minimized usage of energy as well as enhanced network longevity. Sufficient energy is possessed by the orphan node, which will attempt to be cover the network. The proposed work’s primary novel contribution is the O-LEACH protocol that supplies the entire network’s coverage with the least number of orphaned nodes and has extremely high connectivity rates. A hybrid optimization utilizing Simulated Annealing (SA) with Lightning Search Algorithm (LSA) (SA-LSA), and Particle Swarm Optimization (PSO) with LSA (PSO-LSA) Algorithm is proposed. These proposed techniques effectivelymanage the CH election achieving optimal path routing and minimization in energy usage, resulting in the enhanced lifespan of the WSN. The proposed technique’s superior performance, when compared with other techniques, is confirmed from the outcomes of the experimentations.
Surgical Outcomes of Patients After Treatment of Ruptured Anterior Communicating Artery Aneurysms: “Real-World” Evidence From Southern Thailand
Authors: Sungkaro Kanisorn , Tunthanathip Thara , Taweesomboonyat Chin , Kaewborisutsakul Anukoon
Published: May 2021

Background

Anterior communicating artery (AComA) aneurysm rupture are the most common cause of subarachnoid hemorrhage worldwide. We aim to evaluate the clinical outcomes of patients with ruptured AComA aneurysms who underwent microsurgical clipping and factors related to poor outcomes at our institute.
Methods

We retrospectively review 150 consecutive patients with ruptured AComA aneurysm who underwent surgical clipping in eleven-year period. Their clinical and radiologic features, as well as, clinical outcomes, were reviewed. In addition, logistic regression analysis was performed to identify independent factor for unfavorable clinical outcomes (modified Rankin scale 3–6).
Results

Enrolled patients included 83 male 67 females with mean age of 51.3 ± 11.5 years. Admission neurological status with a Hunt and Hess grade of 1 or 2 (97 patients; 64.7%) and a WFNS grade of 1 or 2 (109 patients; 72.6%). Unfavorable outcomes at 6 months was observed in 23 (22.0%) patients and mortality rate was 8.0%. The multivariate analysis showed that preoperative intraventricular hemorrhage (IVH) (P < 0.001; OR, 19.66; 95% CI, 5.10–75.80), A1 hypoplasia (P < 0.001; OR, 8.90; 95% CI, 2.82–28.04), and postoperative cerebral infarction (P = 0.025; OR, 3.21; 95% CI, 1.16–8.88) were strongly independent risk factor for unfavorable outcomes in this group.
Conclusions

Among the ruptured AComA aneurysm patients who underwent surgical clipping; proper management of preoperative IVH, A1 hypoplasia and intensive care for postoperative brain infarction are warrant for improved the surgical outcome.
Genome-wide Identification, Expression, Characteristics of the Prolamin Superfamily in Thinopyrum Elongatum and Its Kneading Performance in Common Wheat
Authors: Gao Yu , Xu Shoushen , Ma Xin , Wang Hongwei , Kong Lingrang , Sun Silong
Published: May 2021

Background: Prolamins, unique to Gramineae (grasses), play a key role in the human diet. Thinopyrum elongatum (also known as tall wheatgrass, rush wheatgrass, or Eurasian quackgrass) of Elytrigia is genetically well-characterized, but little is known about its prolamin genes and the relationships with homologous loci in the Triticum genus.Results: In this study, a total of 19 α-gliadin, 9 γ-gliadin, 19 ω-gliadin, 2 high-molecular-weight glutenin subunit (HMW-GS), and 5 low-molecular-weight glutenin subunit (LMW-GS) genes in the Th. elongatum genome were annotated. The transcriptome data of Th. elongatum exhibited differential expression in quantity and pattern in the same subfamily or different subfamilies. In addition, microsynteny and phylogenetic analysis revealed dynamic changes of prolamin gene region and genetic affinities among Th. elongatum, T. aestivum, T. urartu, and Aegilops tauschii. The E genome, like the B genome, only contained DQ8-glia-α1/DQ8.5-glia-α1, which provided a theoretical basis for the study of celiac disease (CD). Dough rheological properties of T. aestivum-Th. elongatum disomic substitution (DS) lines 1E(1A), 1E(1D), and 3E(3A) showed much higher peak height values than that of their parent.Conclusions: Overall, this study provides a comprehensive overview of the prolamin gene superfamily in Th. elongatum, and suggests a promising use of this species in the generation of improved wheat breeds intended for the human diet.
Effect of Platelet-rich Plasma Combined With Core Decompression Bone Grafting for Osteonecrosis of Femoral Head: A Meta-Analysis
Authors: Lai QiZhong , Cai Kaishen , Lin Tianye , Yang Peng , Xiong Binglang , Zou Qizhao , Li Ziqi , He Wei , Chen Zhenqiu , Zhang Qingwen
Published: May 2021

Objective: Core decompression bone grafting usually is used hip-preserving approach for osteonecrosis of femoral head (ONFH). Platelet-rich plasma (PRP) is an adjuvant therapy, combined with core decompression bone grafting for ONFH. However, it remains controversial. Therefore, its efficacy was systematically evaluated and meta-analysis in this study.Methods: Literature on core decompression bone grafting for ONFH was retrieved in CNKI, Wan Fang, PubMed, Embase, Cochrane Library and Web of Science from inception to March 2021. Review Manager 5.3 software and Stata 12.0 software were used for data synthesis.Results: A total of 10 RCTs were included. The results showed at final follow-up that, Harris hip score was significantly difference in the treatment group, adjuvant therapy with PRP (group A) better than the control group (group B), MD=7.53 [95%CI (5.29,9.77)]，P < 0.00001. There was MD=-0.71[95%CI (-0.96, -0.46)], P < 0.00001, of visual analog scale (VAS) of hip pain between the two groups. The excellent and good rate of function of hip was 1.42-fold higher in group A than that in group B, RR=1.42, 95%CI (1.25,1.62), P<0.00001. The progression and total hip arthroplasty were showed improvements, RR=0.37,95%CI (0.21,0.65), P=0.0006 and RR=0.39,95%CI (0.18,0.85), P=0.02, respectively. Begg's and Egger's tests did not indicate publication bias.Conclusion: It was shown that the use of PRP combined with core decompression bone grafting improved the symptoms better than core decompression bone grafting only, and might delay progression and total hip arthroplasty. However, as the study’s limitations, it needed to be fully verified by more large-sample multicenter prospective clinical studies.
Problem-based learning in medical degree teaching: a scoping review
Authors: Trullas Joan Carles , Blay Carles , Sarri Elisabet , Pujol Ramon
Published: May 2021

Problem-based learning (PBL) is a pedagogical approach that shifts the role of the teacher to the student (student-centred) and is based on self-directed learning. Although PBL has been adopted in undergraduate and postgraduate medical education, the effectiveness of the method is still under discussion. We employed a scoping review to appraise available international evidence concerning to the effectiveness and usefulness of PBL methodology in undergraduate medical teaching programs. We applied the Arksey and O’Malley framework to undertake a scoping review. A search of literature published in English and Spanish identified one hundred and twenty four publications eligible for this review. Despite the fact that this review includes many studies, their design is heterogeneous and only a few provide a high scientific evidence methodology (randomized design and/or systematic review with meta-analysis). Furthermore, most are single-center experiences with small sample size and there are no large multi-center studies. PBL methodology obtains a high level of satisfaction, especially among students. It is more effective than other more traditional (or lecture-based methods) at improving social and communication skills, problem-solving and self-learning skills. Knowledge retention and academic performance are no worse (and in many studies are better) than with traditional methods. PBL is not universally widespread, probably because it requires greater human resources and continuous training for its implementation. More comparative and randomized studies and/or other systematic reviews and meta-analysis are required to determine which educational strategies are the most suitable for training the doctors of the future.
Pre-lacteal Feeding Among Infants Within the First Week of Birth in Eastern Uganda: Evidence From a Health Facility-based Cross-sectional Study
Authors: Akello Rachael , Kimuli Derrick , Okoboi Stephen , Komuhangi Alimah , Izudi Jonathon
Published: May 2021

Background: Pre-lacteal feeding hinders early initiation of breastfeeding and exclusive breastfeeding but is understudied in Uganda. We examined the prevalence and factors associated with pre-lacteal feeding among postpartum mothers in Kamuli district in rural eastern Uganda.Methods: We conducted a cross-sectional study at four large healthcare facilities and randomly sampled mother-baby pairs attending postnatal care clinics. Pre-lacteal feeding was defined as giving anything to eat or drink to a newborn other than breast milk within the first 0-3 days of life. Data were collected using a researcher-administered questionnaire and summarized using frequencies and percentages. The Chi-squared, Fisher’s exact, and Student’s t-tests were used for comparison while the factors independently associated with pre-lacteal feeding were determined using modified Poisson regression analysis, reported as adjusted prevalence risk ratio (aPRR) with corresponding 95% confidence intervals (CI). Results: Of 875 participants enrolled, 319 (36.5%) practiced pre-lacteal feeding. Pre-lacteal feeding was associated with being unemployed (aPRR, 0.70; 95% CI, 0.50-0.91), married (aPRR, 0.71; 95% CI, 0.58-0.87), receiving health education on infant feeding practices (aPRR, 0.72; 95% CI, 0.60-0.86), spontaneous vaginal delivery (aPRR, 0.76; 95% CI, 0.61-0.95), health facility delivery (aPRR, 0.73; 95% CI, 0.60-0.89), knowing that pre-lacteal feeding could lead to difficulties in breathing (aPRR, 0.70; 95% CI0.57-0.86), attendance of antenatal care at public health facility (aPRR, 2.41; 95% CI, 1.71-3.39), and a travel distance of 5 km or beyond from home to health facility (aPRR, 1.46; 95% CI, 1.23-1.72).Conclusion: We observed a high prevalence of pre-lacteal feeding among postpartum mothers in rural eastern Uganda. Pre-lacteal feeding is less likely among the unemployed and married mothers, those who received health education on infant feeding practices, had a spontaneous vaginal delivery, had delivered in a health facility, and knew that pre-lacteal feeding could lead to breathing difficulties in the newborn. Conversely, pre-lacteal feeding is more likely among mothers who attend antenatal care visits at public health facilities and those who travel 5 km or beyond to access health facilities.
Cathelicidin Protects the Brain from Mitochondrial DNA Damage in Health, but not Following Septic Shock
Authors: barbeiro Denise Frediani , Ariga Suely Kubo , Barbeiro Hermes Vieira , Souza-Pinto Nadja C , Silva Fabiano Pinheiro da
Published: May 2021

Recent discoveries have demonstrated that mitochondria play a critical role in innate immune signaling. By the other hand, immune responses may lead to mitochondrial deregulation. Cathelicidins play a critical role in innate immunity, promoting poorly understood cellular responses that may enhance or inhibit several signaling pathways, depending on the health conditions and subjacent microenvironment.Here, we investigated the role of CRAMP, the murine cathelicidin, in healthy mice and following experimental sepsis. We found that sepsis induces significant mitochondrial DNA damage in the prefrontal cortex and that cathelicidin protects the brain from this kind of damage in healthy animals, but not following septic shock.
Ursolic acid reverses liver fibrosis by inhibiting NOX4/NLRP3 inflammasome pathways and bacterial dysbiosis
Authors: Liu Qi , Nie Yuan , Zhang Wang , Wan Yipeng , Huang Chenkai , Zhu Xuan
Published: May 2021

IntroductionActivation of the NOX4/NLRP3 inflammasome pathway has been associated with fibrosis in other organs. An imbalance in intestinal bacteria is an important driving factor of liver fibrosis through the liver-gut axis. This study aimed to explore whether the effect of ursolic acid (UA) on liver fibrosis was associated with the NOX4/NLRP3 inflammasome pathways and intestinal bacteriaMethodsWild-type (WT), NLRP3−/−, and NOX4−/− mice and AP-treated mice were injected with CCL4 and treated with or without UA.ResultUA alleviated liver fibrosis and the expression of NOX4 and NLRP3 was significantly inhibited by UA treatment. Even after CCL4 injection, liver damage and fibrosis-related factors were significantly decreased in NLRP3−/−, NOX4−/−, and AP-treated mice. Importantly, the expression of NLRP3 was obviously inhibited in NOX4−/− and AP-treated mice. In addition, the diversity of intestinal bacteria and the abundance of probiotics in NLRP3−/− and NOX4−/− mice was significantly higher than those in WT mice.ConclusionThe NOX4/NLRP3 inflammasome pathway plays a crucial role in liver fibrosis and is closely associated with the beneficial effect of UA. The mechanism by which the NOX4/NLRP3 pathway is involved in liver fibrosis may be associated with disordered intestinal bacteria.