bluuebunny/crossref_metadata_2025 huggingface dataset:
Comprehensiveness of Distributed Medical Education Systems: A Regional Population-Based Perspective
Authors: Burrows Andrea , Laupland Kevin
Published: July 2020

Background: The core business of medical schools includes clinical (education and service) and academic (research) activities. Our objective was to assess the degree to which these activities exist in a distributed medical education system in Canada. Methods: A population-based design was utilized. Programs were contacted and public records were searched for medical trainees and faculty positions within a province in Canada during the 2017/2018 academic year. Data were expressed as positions per 100,000 residents within the Lower Mainland, Island, and Northern and Southern interior regions. Results: Substantial differences in the distribution of medical students by region was observed with the highest observed in the Northern region at 45.5 per 100,000 as compared to Lower Mainland, Island, and Southern regions of 25.4, 16.8, 16.0 per 100,000, respectively. The distribution of family medicine residents was less variable with 14.9, 10.7, 8.9, and 5.8 per 100,000 in the Northern, Island, Southern, and Lower Mainland regions, respectively. In contrast, there was a marked disparity in distribution of specialty residents with 40.8 per 100,000 in the Lower Mainland as compared to 7.5, 3.2, and 1.3 per 100,000 in the Island, Northern, and Southern regions, respectively. Clinical faculty were distributed with the highest observed in the Northern region at 180.4 per 100,000 as compared to Southern, Island, and Lower Mainland regions of 166.9, 138.5, and 128.4, respectively. In contrast, academic faculty were disproportionately represented in the Lower Mainland and Island regions (92.8 and 50.7 per 100,000) as compared to the Northern and Southern (1.4 and 1.2 per 100,000) regions, respectively. Conclusion: While there has been successful redistribution of medical students, family medicine residents, and clinical faculty, this has not been the case for specialty residents and academic faculty.
Monitoring priority substances in biota under the Water Framework Directive: How effective is a tiered approach based on caged invertebrates? A proof of concept study targeting PFOS in French rivers.
Authors: Babut Marc , Fe Benoit J.D. , Jame Patrick , Assoumani Azziz , Lestremau François , Hette-Tronquart Nicolas , Miege Cécile , Perceval Olivier
Published: July 2020

Background: This study aims to describe and test a tiered approach for assessing compliance to Environmental Quality standards (EQSs) for priority substances in biota in line with the European Water Framework Directive. This approach is based on caged gammarids and trophic magnification factors (TMFs) at the first tier, with fish analysed at the second tier at sites exceeding the EQS. A dataset was implemented by monitoring perfluorooctane (PFOS) in caged gammarids exposed at 15 sites in French rivers, and in fish muscle and rest-of- body from the same sites. Isotopic ratios (δ13C and δ15N) were also measured in gammarids and fish. Two scenarios were developed to compare measured PFOS concentrations in fish against predicted concentrations based on measures in caged gammarids and TMFs. Scenario (1) compared measured PFOS concentrations in fish fillets with predicted PFOS concentrations based on measured concentrations in caged gammarids and δ15N. Scenario (2) tested whether or not EQS exceedance was correctly predicted based on measured concentrations in caged gammarids and trophic levels (TLs) from wild fish and gammarid populations.Results: δ13C and δ15N variations showed that caged gammarids used local food resources during exposure in the field. PFOS concentrations in gammarids were fairly variable through time at each site. In fish, concentrations ranged from non-quantifiable to 250 ng g− 1 (wet weight). After adjustment to the TL at which the EQS is set, 12 sites were above the EQS for PFOS. In scenario (1), predicted concentrations were almost correct at 7 sites out of 15. Most incorrect predictions were overestimations that were slightly improved by applying a lower TMF. In scenario (2) we tested several variants for parameters involved in the predictions. The most efficient combination yielded two wrong predictions out of 15. This result was obtained with a higher TMF value, mean concentrations in gammarids from several field exposures, and a TL for gammarids at the median of the distribution in French rivers.Conclusion: The proposed tiered approach was thus efficient. However, the number of sites was relatively limited, and the dataset was biased towards EQS exceedance. The tiered approach warrants further validation.
Clinical Characteristics of 2019 Novel Coronavirus Pneumonia in China: A Systematic Review and Meta-analysis
Authors: Qian Kai , Wang Guo-Ping , Peng Hao , Peng Jun , Cheng Hong-Zhong , Deng Yi , Liu Jun
Published: July 2020

Background

Although novel pneumonia associated with the Corona Virus Disease 2019 (COVID-19) suddenly broke out in China, China has controlled this epidemic effectively. Therefore, evidence-based descriptions of medical and clinical characteristics in China are necessary.
Methods

Literatures have been systematically performed a search on PubMed, Embase, Web of Science, GreyNet International, and The Cochrane Library from inception up to March 15, 2020. Quality of evidence was evaluated according to the STROBE checklist, and publication bias was analyzed by Egger’s test. In the single-arm meta-analysis, A random-effects model was used to obtain a pooled incidence rate. We conducted subgroup analysis according to geographic region and research scale.
Results

A total of 30 Chinese studies and 1969 patients were included in this meta-analysis. The valid pooled incidence rates of symptoms were as follows: rhinorrhea 5.1% (95% CI: 3.7–6.8, I2 = 31.90), diarrhea 11.0% (95% CI: 9.3–12.9, I2 = 16.58), pharyngalgia 9.4% (95% CI: 7.5–11.7, I2 = 36.40), headache 9.5% (95% CI: 8.5–11.1, I2 = 5.7), and lymphocytopenia 36.7% (95% CI: 33.8–39.8 I2 = 28.73). Meanwhile, 4.3% (95% CI: 3.5–5.4, I2 = 0.00) of patients were found without any symptoms, although they were diagnosed by RT-PCR. In terms of lung CT imaging, most of the patients showed bilateral mottling or ground-glass opacity, and 7.7% (95% CI: 4.4–12.9, I2 = 35.64) of patients had a crazy-paving pattern. In subgroup analysis, the pooled incidence rate of normal CT presentations in the Wuhan area and outside Wuhan area was 2.3% (95% CI: 1.4–3.6, I2 = 24.78) and 5.8% (95% CI: 4.4–7.7, I2 = 32.76) respectively (P = 0.001).
Conclusions

The findings suggest that although most of the COVID-19 patients have symptoms or abnormal CT imaging presentations, a few of them accompany with no symptoms or abnormal CT imaging results should also be noticed. The digestive symptoms and lymphocytopenia may be the potential clinical characteristics, especially for patients with a history of contact with COVID-19. Additionally, the incidence rate of ARDS in the Wuhan area and outside Wuhan area was different; however, the reasons for this phenomenon are unclear.
Cord blood soluble Fas ligand linked to allergic rhinitis and lung function in seven-year-old children
Authors: Su Kuan-Wen , Chiu Chih-Yung , Tsai Ming-Han , Liao Sui-Lin , Chen Li-Chen , Hua Man-Chin , Yao Tsung-Chieh , Huang Jing-Long , Yeh Kuo-Wei
Published: July 2020

Background
Serum or cord blood soluble Fas ligand (FasL) has been related to asthma, allergic rhinitis, and atopic dermatitis in cross-sectional and short-term follow-up studies. However, the association of cord blood soluble FasL with long-term allergic outcomes has seldom been investigated. Thus, this study investigated the relationship between cord blood soluble FasL and long-term allergic outcomes in a follow-up birth cohort.
Methods
The Prediction of Allergies in Taiwanese Children birth cohort study recruited healthy newborns upon delivery. At birth, blood was collected from the umbilical cords of these children, and the cord blood soluble Fas ligand levels were measured. At the age of seven years, the allergic outcome of each child was diagnosed by pediatric allergists and pulmonologists. Tests were conducted to measure the specific immunoglobulin E, fractional exhaled nitric oxide (FeNO), and pulmonary function levels of each child.
Results
Cord blood soluble FasL levels were higher in 7-year-old children with allergic rhinitis (Odds ratio [OR] = 2.41, p = .012) and expiratory airway obstruction (the highest forced expiratory volume in 1 second/ forced vital capacity < 90%, OR = 2.11, p = .022). The FeNO and Dermatophagoides pteronyssinus-specific immunoglobulin E levels of 7-year-old children were positively correlated with cord blood soluble FasL levels (p = .006 and .02, respectively).
Conclusions
In this birth cohort, the cord blood soluble FasL levels were associated with allergic rhinitis, obstructive-type lung function, FeNO, and house dust mite sensitization in 7-year-old children. The cord blood soluble FasL level might be used as a predictor for allergic diseases in children who are 7 years old.
Exposure to ZnO/TiO2 Nanoparticles Affects Health Outcomes in Cosmetics Salesclerks
Authors: Lee Ching-Chang , Lin Yi-Hsin , Hou Wen-Che , Li Meng-Han , Chang Jung-Wei
Published: July 2020

Background: Concerns about the effects of nanoparticles (NPs) on human health are being raised by researchers because the risks of nanocosmetics like sunscreen are unknown. Methods: We explored the association between urinary oxidative stress markers and exposure of cosmetics salesclerks to 20 cosmetics which might contain titanium dioxide (TiO2)/zinc oxide (ZnO) NPs. We then recruited 40 cosmetics salesclerks and 24 clothing salesclerks and categorized them based on their exposure to ZnO and TiO2 NPs. Results: Nineteen and fifteen samples met the EU definition for TiO2 and ZnO nanomaterials, respectively. Participants with a higher co-exposure index of ZnO and TiO2 NPs had a significantly higher base level of urinary 8-hydroxy-2'-deoxyguanosin (8-OHdG) concentrations than the lower co-exposure group (5.82 vs. 2.85 ng/mL, p < 0.001). After potential confounding factors had been adjusted for, the TiO2 and ZnO NP co-exposure index was significantly positively associated with the urinary 8-OHdG base concentration (β = 0.308, 95% CI = 0.106 to 0.510) and the creatinine-adjusted concentration (β = 0.486, 95% CI = 0.017 to 0.954). Conclusion: Current evidence suggests that the likelihood of harm from using sunscreens containing nanoparticles might result in higher urinary 8-OHdG. However, our limited number and types of sample cosmetics might underestimate the risk.
Exposure to Traffic-Related Air Pollution and Changes in Exhaled Nitric Oxide and DNA Methylation in Arginase and Nitric Oxide Synthase in Children with Asthma
Authors: Ji Nan , Fang Mingzhu , Baptista Ana , Cepeda Clarimel , Greenberg Molly , Mincey Ivelisse Colon , Strickland Pamela Ohman , Fiedler Nancy , Kipen Howard M. , Laumbach Robert J.
Published: July 2020

Background
Traffic-related air pollution (TRAP) has been associated with increased risk of airway inflammation in children with asthma. While epigenetic changes could potentially modulate TRAP-induced inflammatory responses, few studies have assessed the temporal pattern of exposure to TRAP, epigenetic changes and inflammation in children with asthma. Our goal was to test the time-lag patterns of personal exposure to TRAP, airway inflammation (measured as fractional exhaled nitric oxide, FeNO), and DNA methylation in the promoter regions of genes involved in nitric oxide synthesis among children with asthma.
Methods
We measured personal exposure to black carbon (BC) and FeNO for up to 30 days in a panel of children with asthma. We collected 90 buccal cell samples for DNA methylation analysis from 18 children (5 per child). Methylation in promoter regions of nitric oxide synthase (NOS1, NOS2A, NOS3) and arginase (ARG1, ARG2) was assessed by bisulfite pyrosequencing. Linear-mixed effect models were used to test the associations of BC at different lag periods, percent DNA methylation at each site and FeNO level.
Results
Exposure to BC was positively associated with FeNO, and negatively associated with DNA methylation in NOS3. We found strongest association between FeNO and BC at lag 0–6 hours while strongest associations between methylation at positions 1 and 2 in NOS3 and BC were at lag 13–24 hours and lag 0–24 hours, respectively. The strengths of associations were attenuated at longer lag periods. No significant associations between exposure to TRAP and methylation levels in other NOS and ARG isoforms were observed.
Conclusions
Exposure to TRAP was associated with higher levels of FeNO and lower levels of DNA methylation in the promoter regions of the NOS3 gene, indicating that DNA methylation of the NOS3 gene could be an important epigenetic mechanism in physiological responses to TRAP in children with asthma.
Elevated Serum Triglyceride Predicates Recurrence of Colorectal Polyps in Patients with Advanced Adenomas
Authors: Liu Sudong , Liu Boying , Wen Pingwu , Gu Xiaodong , Weng Ruiqiang
Published: July 2020

Background
The recurrence of colorectal polyps is common and impacted by various factors. The aim of this study is to explore the association between lipid profiles and recurrence of colorectal polyps.
Methods
We retrospectively analyzed lipid profiles of 435 patients underwent colonoscopy with removal of colorectal polyps, and observed the recurrence of polyps by follow-up endoscopy within the following 1.5 years. Regression logistic was used to evaluate the association between lipid profiles and polyp recurrence.
Results
During the 1.5-year follow-up, recurrences of colorectal polyps were observed in 135 out of 435 patients (30.34%). Patients with recurrent polyps showed higher levels of total cholesterol (TG) (P = 0.006), lower levels of high-density lipoprotein cholesterol (HDL-C) (P = 0.008) and apoliprotein A1 (ApoA1) (P = 0.033). Regression logistic model suggested that TG was an independent risk factor of polyp recurrence (OR: 1.81; CI: 1.29–2.55; P = 0.039) in patients with advanced adenomas.
Conclusions
The lipid profiles are associated with the recurrence of colorectal polyps. Elevated TG would serve as an independent risk predictor of polyp recurrence in patients with advanced adenomas.
Tribological behavior of Ti(C, N)-TiB2 composite cermets using FeCoCrNiAl high entropy alloys as binder over a wide range of temperatures
Authors: Li Zhanjiang , Fu Peixin , Zhu Chenglong , Hong Chunfu , Dai Pinqiang
Published: July 2020

The Ti(C, N)-TiB2 composite cermets with different binders (HEAs or Ni-Co) were fabricated by mechanical alloying and vacuum hot-pressing sintering. Wear resistance of two composite cermets at elevated temperatures was studied. Wear mechanism was characterized by a combination of scanning electron microscopy and energy dispersive spectroscopy. Experimental results indicated that HEAs binder composite cermets possessed excellent wear resistance comparing with Ni-Co binder composite cermets. At lower temperatures, no obvious difference was observed in worn surfaces of two cermets. Abrasive wear mechanism was dominant wear mechanism. At greater than 600 °C, oxidative wear and adhesive wear were found to be dominant wear mechanism. The wear rate of HEAs binder composite cermets was 11.8%, 17%, 39.25%, and 46.7% lower than that of Ni-Co binder composite cermets at 200℃, 400℃, 600℃, and 800℃, respectively. Enhanced wear performance of Ti(C, N)-TiB2-HEAs composite cermets is attributed to relatively high hardness and toughness, as well as excellent high-temperature softening resistance and oxidation resistance of HEAs.
The Relevance of Using Games for Teaching Noun Phrases in English Language Teaching Class
Authors: Roy Abhipriya
Published: July 2020

Game-based learning makes learners collaborative, communicative and interactive. Strategic games improve the functioning of the brain. Gaming creates a dynamic atmosphere and develop skills while emotionally connecting the learners to the subject matter. The research paper focuses on the use of games inside the classroom and favours games to be a good teaching method for teaching noun phrases. It suggests the use of experimental method where a pre-test and a post-test will be used for data collection. It has suggested five language games for teaching noun phrases for analysing the impact of games for teaching noun phrases and their impact on language comprehension and language production. It also highlights the further scope of research.
Anti-oxidative effects of nicotinamide mononucleotide, a regulator of aging, on rat high glucose-induced tenocytes in vitro
Authors: Yamaura Kohei , Mifune Yutaka , Inui Atsuyuki , Nishimoto Hanako , Kataoka Takeshi , Kurosawa Takashi , Mukohara Shintaro , Niikura Takahiro , Kuroda Ryosuke
Published: July 2020

Background Nicotinamide adenine dinucleotide (NAD+) plays an important role in energy metabolism, mitochondrial function, aging, and cell death. Nicotinamide mononucleotide (NMN) is one of the key precursors of NAD+. The purpose of this study is to evaluate the oxidative stress effects of NMN on rat tenocytes in-vitro.Methods Tenocytes from normal Sprague–Dawley rats were cultured in regular glucose (RG) and high-glucose (HG) conditions with or without NMN, and were divided into four groups: RG NMN−, RG NMN+, HG NMN−, and HG NMN+. Cell viability, reactive oxygen species (ROS) production, apoptosis, and messenger RNA (mRNA) expressions of NADPH oxidase (NOX) 1, NOX4, interleukin (IL)-6, SIRT1, and SIRT6, were determined in-vitro.Results The NMN groups led to significantly higher cell viabilities compared with the other groups. The mRNA expressions of NOX1, NOX4, and IL6, in the HG NMN+ group were significantly lower compared with those of the HG NMN− group. Conversely, the corresponding expressions of the SIRT1 and SIRT6 levels in the HG NMN+ group were significantly higher compared with those of the HG NMN−group. Both the accumulation of ROS and apoptosis in the HG NMN− group were significantly higher compared with those in the RG NMN− group at 48 h.Conclusion The expression levels of NOX1, NOX4, IL6, and ROS were significantly reduced by NMN. These results suggest that NMN could effectively reduce the oxidative stress by activating SIRT1 and SIRT6, and by inhibiting the activity of NOX and apoptosis in the tenocytes.
A Prospective Study to Assess the Value of Liquid Chromatography-Tandem Mass Spectrometry in the Management of Paediatric Poisoning at Red Cross War Memorial Children’s Hospital, Cape Town, South Africa
Authors: Washaya Norbertta , Evans Alicia , Muloiwa Rudzani , Smith Peter , Buys Heloise
Published: July 2020

Paediatric poisoning is a common presentation to emergency departments worldwide.(1, 2)Though it has a good prognosis, it is an important cause of both morbidity and mortality.(1, 3) In 2016 it was responsible for 6 268 554 disability adjusted life years (DALYs) globally, with children less than 15 years accounting for 45% of these DALYs.(4) In a study done in South Africa, poisoning was responsible for 5.7% of all hospital admissions.(2) While, a retrospective patient folder review carried out at a hospital in Johannesburg, indicated that toxin ingestion was responsible for 17% of the admissions in to the paediatric intensive care unit.(5)
Cutaneous manifestations associated with COVID-19 in children: A Systematic Review
Authors: Shah Seema , Akhade Kiran , Ganguly Satyaki , Nanda Rachita , Mohapatra Eli , Goel Anil Kumar
Published: July 2020

Background: Cutaneous manifestation of COVID 19 in children has not yet been reviewed systematically and hence this review gives a future direction to the clinicians to be vigilant for skin presentations during such pandemic.Methodology: The review was done as per the guidelines of PRISMA and literature search was done on PubMed database using keywords as COVID-19, children and skin in different combinations. Articles published in English with cases of age 1 month to 18 years were eligible. The outcome included varied aspects of cutaneous and COVID-19 infection. The review protocol was not registered.Results: Of 51 publications identified, 13 studies containing 149 children met the eligibility criteria. Acrally located erythematous maculopapular lesion was the most common finding in 138 children. Erythema multiforme, varicella like exanthem and Kawasaki disease like presentations were reported in the rest of the cases. The duration of the skin lesion was 1-2 weeks in 43%. Skin biopsy done in 18 cases revealed superficial & deep perivascular and peri-eccrine lymphocytic infiltrate & lymphocytic vasculitis. RT-PCR was positive in 13.8% cases. Serological markers for HSV, parvovirus B19 analyzed across various studies, were found negative, except for mycoplasma pneumoniae in 2 of 20 cases tested.Discussion: Clinicopathologic analysis established chilblains like lesion in 43% cases with no confirmed etiology like cold exposure, autoimmune dysfunction, drug reaction, or viral infection. The usual cephalo-caudal spread of a viral exanthem was also missing. However, a low number of discussed cases was a limitation of the study.Conclusion: In the absence of any confirmed etiology for such cutaneous manifestations, the possibility of COVID-19 should be explored and evaluated thoroughly during such pandemic.
Increased P450 aromatase levels in post-menopausal women after acute ischemic stroke
Authors: Manwani Bharti , Fall Pamela , Zhu Liang , O’Reilly Meaghan Roy , Conway Sarah , Staff Ilene , McCullough Louise D.
Published: July 2020

Background: Sex differences in stroke have been attributed to the neuroprotective effects of estrogen, yet most clinical trials of estrogen supplementation for stroke prevention have failed. The contribution of sex hormones to stroke outcome remains a subject of debate. Aromatization of testosterone to estradiol in neural tissue leads to sexual differentiation. Emerging data suggests aromatase activity increases in response to brain injury, and increased aromatase expression is seen in the ischemic penumbra in animal models. The objective of this study was to examine the levels of endogenous sex steroids after acute ischemic stroke and determine if levels of sex steroids were associated with acute stroke outcomes.Methods: Peripheral blood from ischemic stroke patients was collected under an approved IRB within 24 hours of symptom onset. 17 β estradiol, testosterone and aromatase levels were measured in the serum of both men and women. Hormone levels were compared in men vs. women in stroke and control groups and correlated with outcomes (NIHSS and change in the modified Rankin Scale (mRS), defined as difference of premorbid and discharge mRS) using multivariate regression.Results: We found no significant change in estradiol levels 24 hours after stroke in men (p = 0.86) or women (p = 0.10). In men, testosterone significantly decreased after stroke as compared with controls (1.83 ± 0.12 vs 2.86 ± 0.65, p = 0.01). Aromatase levels were significantly higher in women after stroke as compared with controls (2.27 ± 0.22 vs 0.97 ± 0.22, p = 0.002), but not in men (p = 0.84). Estradiol levels positively correlated with higher NIHSS at the time of admission, (r = 0.62, p = 0.0001) and higher change in mRS, (r = 0.38, p = 0.02) in women. Similar correlations between estradiol levels with NIHSS, (r = 0.34, p = 0.02) and change in mRS, r = 0.3, p = 0.04, was seen in men.Conclusions: Higher estradiol levels correlated with worse acute stroke outcomes, regardless of the sex. Testosterone levels decreased after stroke in men. As seen in animal models, aromatase levels increase after acute ischemic stroke, but this was only true for older women. These indicate an active aromatization process in post-menopausal women after acute ischemic stroke. We speculate that aromatase mediated local production of estradiol may occur in the female brain after acute ischemic stroke.
Comprehensive Transcriptome Analysis of Hypothalamus Reveals Genes Associated With Disorders of Sex Development in Pigs
Authors: Tan Shuwen , Zhou Yi , Zhao Haiquan , Wu Jinhua , Yu Hui , Yang Yin , Yang Yalan , Zhao Huabin , Li Hua
Published: July 2020

Background
Disorders of sex development (DSD) is a chronic autoimmune disease characterized by systemic inflammation, pathological osteogenesis, and endocrine abnormality. However, its genetic etiology remains mostly unknown. In addition, little research focuses on the regulation mechanism from the view of transcriptomics in the hypothalamic-pituitary-gonadal axis (HPGA). The hypothalamus is the integrated center of the HPGA mediating neural, hormonal, and environmental stimulus to sex development.
Methods
Three XX-DSD (SRY-negative) pig (DSD) and three NF pigs (five months old, 40 kg ± 5 kg) were selected by external genitalia observation and sex determining region Y gene (SRY) detection. The hypothalamus were sampled for RNA isolation, and the mRNA, lncRNA and miRNA expression profiles were analyzed by sequencing.
Results
A total of 1,258 lncRNAs, 1,086 mRNAs, and 61 microRNAs were found to differentially express in XX-DSD pigs compared with normal female pigs. Many genes in hormone biosynthesis and secretion pathway are significantly up-regulated, and the up-regulation of GNRH1, KISS1 and AVP may be the candidate genes leading the abnormal secretion of GnRH. Next, we predicted the lncRNA-miRNA-mRNA co-expression triplets and constructed three competing endogenous RNA (ceRNA) potentially associated with DSD. Functional enrichment suggested TCONS_00340886, TCONS_00000204 and miR-181a were related to GnRH secretion.
Conclusions
Our research revealed the first transcriptomic profile in the hypothalamus of XX-DSD pigs and provided new insight in coding and non-coding RNAs that may be associated with DSD in pigs.
Research on the Secure Medical Big Data Ecosystem Based on Hadoop
Authors: Zhang Xiangfeng , Wang Yanmei
Published: July 2020

This paper designs and implements a secure medical big data ecosystem on top of the Hadoop big data platform. It is designed against the background of the increasingly serious trend of the current security medical big data ecosystem. Since traditional healing activities take place in medical institutions, patient users must travel to these institutions to learn about their treatment status. The personalized health information system designed for this purpose enables patient users to understand their treatment and rehabilitation status anytime and anywhere. The above is a consideration from the perspective of the patient user, from the perspective of personal health data. Because traditional medical health data is scattered throughout different independent medical institutions, and these databases are heterogeneous. As a distributed accounting technology for multi-party maintenance and backup information security, blockchain is a good breakthrough point for innovation in medical data sharing. The characteristics of blockchain without a central server make the system without a single point In case of failure, the stability of the system is well maintained. In this paper, the system realizes the personal health data centre on the Hadoop big data platform, and the original distributed data is stored and analysed centrally through the data synchronization module and the independent data acquisition system. Utilizing the advantages of the Hadoop big data platform, the personalized health information system for stroke has designed to provide personalized health management services for patients and facilitate the management of patients by medical staff.
Stereotactic Body Radiotherapy Versus Conventional/Moderate Fractionated Radiation Therapy with Androgen Deprivation Therapy for Unfavorable Risk Prostate Cancer
Authors: Patel Sagar Anil , Switchenko Jeffrey , Fischer-Valuck Ben , Zhang Chao , Rose Brent , Chen Ronald , Jani Ashesh , Royce Trevor J
Published: July 2020

Background:Ultrahypofractionation using stereotactic body radiotherapy (SBRT) is an increasingly utilized technique for men with prostate cancer (PC). The comparative efficacy of SBRT plus androgen deprivation therapy (ADT) compared to fractionated radiotherapy (EBRT) plus ADT in higher-risk prostate cancer is unknown. Methods:Men >40 years old with localized PC treated with external beam radiation and concomitant ADT for curative intent between 2004-2016 were analyzed from the National Cancer Database. Patients who lacked ADT or risk stratification data were excluded. 558 men treated with SBRT versus 40,797 men treated with conventional or moderately hypofractionated EBRT were included. Patients were stratified by unfavorable intermediate (UIR) and high (HR) risk using NCCN criteria. Kaplan Meier and Cox proportional hazards were used to compare overall survival (OS) between RT modality, adjusting for age, race, and comorbidity index.Results:With a median follow up of 74 months, there was no difference in estimated 6-year OS between men treated with SBRT versus EBRT regardless of risk group. On multivariable analysis, there was no difference in risk of death for men treated with SBRT compared to EBRT (UIR: adjusted HR 1.09, 95% CI 0.68-1.74, p=.72; HR: adjusted HR 0.93, 95% CI 0.76-1.14, p=.51). On sensitivity analyses, when confining the cohort to men treated with NCCN-preferred dose fractionations, with no comorbidities, or <65 years old, there remained no survival difference between treatment groups for both UIR and HR.Conclusion: Within study limitations, we found no difference in survival between SBRT+ADT and standard of care EBRT+ADT for UIR or HR PC. These results support recent NCCN guideline updates, which include SBRT as a non-preferred option for higher risk men. Prospective validation would further strengthen the evidence basis behind these recommendations.
Practice Patterns for Postoperative Radiation Therapy in Patients with Metastases to the Long Bones: Survey of the Japanese Radiation Oncology Study Group
Authors: Kubota Hikaru , Nakamura Naoki , Shikama Naoto , Tonari Ayako , Wada Hitoshi , Harada Hideyuki , Nagakura Hisayasu , Heianna Joichi , Ito Kei , Nozaki Miwako , Tago Masao , Fushiki Masato , Uchida Nobue , Araki Norio , Sekii Shuhei , Kosugi Takashi , Takahashi Takeo , Kawamoto Terufumi , Saito Tetsuo , Yamada Kazunari
Published: July 2020

BackgroundBecause of the lack of evidence on practice patterns of postoperative radiation therapy (PORT)in patients with metastases to the long bones, it is essential to characterize the current practice patterns and identify factors affecting dose-fractionation to aid future clinical trials. MethodsThe palliative radiation therapy subgroup of the Japanese Radiation Oncology Study Group conducted an internet-based survey to determine the prescription practices and various dose-fractionations used for PORT. Additionally, responders were asked to recommend dose-fractionations in four hypothetical cancer cases, wherein each case represented a patient with impending pathological fractures and one of the four features: limited prognosis, solitary metastasis, radio-resistant primary tumor, or long-term survival. Responders were asked to indicate their preferred irradiation fields and the reasons for choosing long-course radiotherapy over short-course radiotherapy (RT). ResultsEighty-nine radiation oncologists from 67 institutions and 151 RT plans were included. Twenty-two different dose-fractionations were used; the most commonly used and recommended dose-fractionation was 30 Gy in 10 fractions. “Local control” was most the common reason for preferring longer course RT. While fractionated higher-dose regimens were preferred in case of oligometastasis, low dose regimens were preferred in case of limited prognosis; single fraction RT was never preferred. Most respondents recommended involvement of “the entire orthopedic prosthesis.” ConclusionFor PORT of metastases to the long bones, 30 Gy in 10 fractions for the entire orthopedic prosthesis is preferred in current practice. Oligometastasis and a limited prognosis influence the selection of high- and low-dose regimens, respectively. Single fraction RT is never preferred.
Influences of Branch Death on Leaf Nutrient Status and Stoichiometry of Wild Apple Trees (Malus sieversii) During Annual Growth Period in the Western Tianshan Mountains, China
Authors: TAO Ye , NUERHAILATI Maziyirea , ZHANG Jing , YIN Ben-Feng , ZHOU Xiao-Bing , ZHANG Yuan-Ming
Published: July 2020

Background: Malus sieversii (wild apple) is a tertiary relict tree species and a key ancestor of the common cultivated apples today. In recent years, a serious ecological degradation has occurred in the wild apple forests, and many individuals of wild apples have died or have severe dead branches. Whether the death of branches would lead to the change in leaf nutrient stoichiometry of M. sieversii remains unclear. In this study, the N, P, and K contents and the N:P, N:K, and P:K ratios of wild apple trees with three dead branch rates (DBRs; low [LD, < 20%], moderate [MD, 40–60%], and high [HD, > 80%]) during annual growth period, elemental scaling relations, and the possible influencing factors were systematically compared and discussed.Results: Leaf N, P, and K decreased during growth, and N and P did not show significant differences among the different DBRs; however, the HD wild apple trees had the lowest K contents in the photosynthetic and the reproductive organs. Flowers had higher P and K contents than leaves, whereas fruits had low N content. The growth of M. sieversii was always limited by N due to low N:P ratio and N resorption efficiency. The scaling exponents of leaf N–P, N–K, or P–K among the three DBRs did not show any significant difference, and the relationships between stoichiometric ratios and three elements were consistent among three DBRs, revealing an inherent property of M. sieversii. Leaf K content was strongly and negatively influenced by most soil variables. Leaf nutrients were significantly and positively correlated with precipitation and relative humidity, whereas temperature showed the opposite trend.Conclusions: These findings suggest that increasing water input, and improving plant K content and utilization efficiency may be conducive to enhance the resistance and recovery ability of diseased wild apple trees.
Numerical prediction of sporadic E layer occurrence using GAIA
Authors: Shinagawa Hiroyuki , Tao Chihiro , Jin Hidekatsu , Miyoshi Yasunobu , Fujiwara Hitoshi
Published: July 2020

A sporadic E layer has significant influence on radio communications and broadcasting, and predicting the occurrence of sporadic E layers is one of the most important issues in space weather forecast. While sporadic E layer occurrence and the magnitude of the critical sporadic E frequency (foEs) have clear seasonal variations, significant day-to-day variations as well as regional and temporal variations also occur. Because of the highly complex behavior of sporadic E layers, the prediction of sporadic E layer occurrence has been one of the most difficult issues in space weather forecast. To explore the possibility of numerically predicting sporadic E layer occurrence, we have examined various parameters related to sporadic E layer formation using the whole atmosphere–ionosphere coupled model GAIA. By comparing the parameters in GAIA with observed foEs data obtained by ionosonde observations in Japan, we found that variations in the vertical ion convergence at 120 km altitude agree fairly well with variations in foEs. This result suggests that sporadic E layer occurrence can be numerically predicted using the parameters derived from GAIA. We have recently developed a real-time GAIA simulation system that can predict atmosphere–ionosphere conditions for a few days ahead. We present an experimental prediction scheme and a preliminary result for predicting sporadic E layer occurrence.
Artificial Intelligence and Machine Learning in Orthopedic Surgery: A Systematic Review Protocol
Authors: Maffulli Nicola , Rodriguez Hugo C. , Stone Ian W. , Nam Andrew , Song Albert , Gupta Manu , Alvarado Rebecca , Ramon David , Gupta Ashim
Published: July 2020

Background:Artificial Intelligence (AI) and Machine Learning (ML)is interwoven into our everyday lives and has grown enormously in some major fields in medicine including cardiology and radiology. While these specialties have quickly embraced AI and ML, orthopedic surgery has been slower to do so. Fortunately, there has been a recent surge in new research emphasizing the need for a systematic review. The primary objective of this review is to provide an update on the advances of AI and ML in the field of orthopedic surgery. The secondary objectives of this review are to evaluate the applications of AI and ML in providing a clinical diagnosis and predicting post-operative outcomes and complications in orthopedic surgery.Methods:A systematic search will be conducted in PubMed, Science Direct, and Google Scholar databases for articles written in English, Italian, French, Spanish and Portuguese language articles published up to July 2020. References will be screened and assessed for eligibility by at least two independent reviewers as per PRISMA guidelines. Studies must apply to orthopedic interventions, acute and chronic orthopedic musculoskeletal injuries to be considered eligible. Studies will be excluded if they are animal studies, do not relate to orthopedic interventions, or if no clinical data were used. Gold standard processes and practices to obtain a clinical diagnosis and predict post-operative outcomes shall be compared with and without the use of ML algorithms. Any case reports and other primary studies assessing the prediction rate of post-operative outcomes or the ability to identify a diagnosis in orthopedic surgery will be included. Systematic reviews or literature reviews will be examined to identify further studies for inclusion, and results of meta-analyses will not be included in the analysis.Discussion:Our findings will evaluate the advances of AI and ML in the field of orthopedic surgery. We expect to find a large quantity of uncontrolled studies, and a smaller subset of papers describing actual applications and outcomes for clinical care. Cohort studies and large randomized control trial will likely be needed.Trial registration: The Protocol will be registered on PROSPERO international prospective register of systematic reviews prior to commencement.
Total Metals in University of Lagos Wetlands and Sediments and Their Spatial Distribution
Authors: Sowunmi Kehinde , Titilayo Soyebo , Sowunmi Lukman
Published: July 2020

Wetlands are carriers of metals and organic pollutants from natural and anthropogenic sources. Studies have shown that sediments are sinks for these pollutants as they carry more than 99% of the total amount of metals which are released as soluble metals into the Lagoon. The University of Lagos, located at Akoka North eastern part of Yaba in Lagos Mainland runs along a highly industrialized and residential area. This paper reports the total metal concentrations in wetland and sediment and their seasonal variations. Wetland and sediment samples were collected for two seasons in 8 sampling sites. Results showed wetland data having lower concentrations of metals as compared to sediments. Wet season had higher concentrations of metals as compared to other season. Total concentrations in wetlands were Cd (1.0-6.0), Cu (1.0-11.0), Cr (0.3-82.7), Zn (2.7-65.0) and Pb (0.3-16.0) all in μg L-1 respectively. Statistical analysis showed that there was a significant difference between the wet and dry seasons for sediments. Cd was the only metal at acceptable levels while Cr, Cu, Pb and Zn concentrations all exceeded levels deemed acceptable by the SABS and the EPA. Therefore, the wetland is in poor health.
Validation of the French Version of the Fear of COVID-19 Scale and its Associations with Depression, Anxiety and Differential Emotions
Authors: Mailliez Mélody , Griffiths Mark D. , Carre Arnaud
Published: July 2020

The COVID-19 crisis represents a global health concern, including mental health. Regarding the necessity to assess anxiety related to COVID-19, a scale was developed (Ahorsu et al., 2020). The goal of the present study was to validate of the Fear of COVID-19 Scale (FCV-19S) in French (official language in 29 countries), and investigate its relationship with indicators of affective disturbances. The study was performed on 316 participants. The FCV-19S underwent a double back translation procedure. Its psychometric properties were evaluated.The French FCV-19S demonstrated a stable unidimensional structure with robust psychometric properties (strong internal consistency, good convergent and divergent validity, and good test-retest validity). With its robust psychometric properties in assessing the unidimensional construct of the fear of COVID-19, this scale will help to provide a better understanding of the relationship between emotions and psychological or psychiatric disorders during the pandemics in French-speaking countries.
Machine learning based prognostic model for predicting infection susceptibility of COVID-19 using health care data
Authors: Srivat R , Indi Prithviraj N , Agrahari Swapnil , Menon Siddharth , Ashok S. Denis
Published: July 2020

From public health perspectives of COVID-19 pandemic, accurate estimates of infection severity of individuals are extremely valuable for the informed decision making and targeted response to an emerging pandemic. This paper presents machine learning based prognostic model for providing early warning to the individuals for COVID-19 infection using the health care data set. In the present work, a prognostic model using Random Forest classifier and support vector regression is developed for predicting the susceptibility of COVID-19 infection and it is applied on an open health care data set containing 27 field values. The typical fields of the health care data set include basic personal details such as age, gender, number of children in the household, marital status along with medical data like Coma score, Pulmonary score, Blood Glucose level, HDL cholesterol etc. An effective preprocessing method is carried out for handling the numerical, categorical values (non-numerical), missing data in the health care data set. Principal component analysis is applied for dimensionality reduction of the health care data set. From the classification results, it is noted that the random forest classifier provides a higher accuracy as compared to Support vector regression for the given health data set. Proposed machine learning approach can help the individuals to take additional precautions for protecting against COVID-19 infection. Based on the results of the proposed method, clinicians and government officials can focus on the highly susceptible people for limiting the pandemic spread. Methods In the present work, Random Forest classifier and support vector regression techniques are applied to a medical health care dataset containing 27 variables for predicting the susceptibility score of an individual towards COVID-19 infection and the accuracy of prediction is compared. An effective preprocessing is carried for handling the missing data in the health care data set. Principal Component Analysis is carried out on the data set for dimensionality reduction of the feature vectors. Results From the classification results, it is noted that the Random Forest classifier provides an accuracy of 90%, sensitivity of 94% and specificity of 81% for the given medical data set.Conclusion Proposed machine learning approach can help the individuals to take additional precautions for protecting people from the COVID-19 infection, clinicians and government officials can focus on the highly susceptible people for limiting the pandemic spread.
A Comprehensive Investigation of Metagenome Assembly by Linked-Read Sequencing
Authors: Zhang Lu , Fang Xiaodong , Liao Herui , Zhang Zhenmiao , Zhou Xin , Han Lijuan , Chen Yang , Qiu Qinwei , Li ShuaiCheng
Published: July 2020

Background: The human microbiota are complex systems with important roles in our physiological activities and diseases. Sequencing the microbial genomes in the microbiota can help in our interpretation of their activities. The vast majority of the microbes in the microbiota cannot be isolated for individual sequencing. Current metagenomics practices use short-read sequencing to simultaneously sequence a mixture of microbial genomes. However, these results are in ambiguity during genome assembly, leading to unsatisfactory microbial genome completeness and contig continuity. Linked-Read sequencing is able to remove some of these ambiguities by attaching the same barcode to the reads from a long DNA fragment (10kb-100kb), thus improving metagenome assembly. However, it is not clear how the choices for several parameters in the use of Linked-Read sequencing affect the assembly quality.Results: We first examined the effects of read depth (C) on metagenome assembly from linked-reads in simulated data and a mock community. The results showed that C positively correlated with the length of assembled sequences but had little effect on their qualities. The latter observation was corroborated by tests using real data from the human gut microbiome, where C demonstrated minor impact on the sequence quality as well as on the proportion of bins annotated as draft genomes. On the other hand, metagenome assembly quality was susceptible to read depth per fragment (CR), and DNA fragment physical depth (CF). For the same C, deeper CR resulted in more draft genomes while deeper CF improved the quality of the draft genomes. We also found that average fragment length (μFL), had marginal effect on assemblies, while fragments per partition (NF/P) impacted the off-target reads involved in local assembly, namely, lower NF/P values would lead to better assemblies by reducing the ambiguities of the off-target reads. In general, the use of linked-reads improved the assembly for contig N50 when compared to Illumina short-reads, but not when compared to PacBio CCS (circular consensus sequencing) long-reads.Conclusions: We investigated the influence of Linked-Read sequencing parameters on metagenome assembly comprehensively. While the quality of genome assembly from linked-reads cannot rival that from PacBio CCS long-reads, the case for using Linked-Read sequencing remains persuasive due to its low cost and high base-quality. Our study revealed that the probable best practice in using linked-reads for metagenome assembly was to merge the linked-reads from multiple libraries, where each had sufficient CR but a smaller amount of input DNA.