bluuebunny/crossref_metadata_2025 huggingface dataset:
Expand the effective carriers in solid polymer electrolytes via anion-hosting cathode
Authors: Sun Zongjie , Xi Kai , Chen Jing , Abdelkader Amor , Li Mengyang , Lin Yue , Jiang Qiu , Su Yaqiong , Kumar Ramachandran , Ding Shujiang
Published: June 2021

The non-reactive anion migration deteriorates the limited ionic conductivity of the solid polymer electrolytes (SPEs) and accelerates solid-state batteries failure. Here, we introduce an integrated approach in which polyvinyl ferrocene (PVF) cathode encourage anions and Li+ to act as effective carriers simultaneously. The concentration polarization and poor rate performance, caused by insufficient effective carriers, were addressed by the participation of anions in electrode reaction. Specifically, the PVF|Li battery matched with unmodified SPE (PEO-LiTFSI) showed 107 mAh g− 1 initial capacity at 100 µA cm− 2 and maintained 70% retention for more than 2800 cycles at 300 µA cm− 2 and 60°C. Moreover, the slight capacity decrease at 1000 µA cm− 2 and the successful batteries operation at minimal ionic conductivity (8.13×10− 6 S cm− 1) show that the current carrying capacity of SPEs was greatly improved without complex design. This strategy weakens the strict requirements for ion conductance and interface engineering of SPEs, and provides an efficient scenario for constructing advanced polymer-based all-solid-state batteries.
Genome-Wide Association Mapping and Genomic Prediction for Adult Stage Sclerotinia Stem Rot Resistance in Brassica Napus (L) Under Field Environments
Authors: Roy Jayanta , Shaikh T M , Mendoza Luis E. del Río , Hosain Shakil , Chapara Venkat , Rahman Mukhlesur
Published: June 2021

Sclerotinia stem rot (SSR) is a fungal disease of rapeseed/canola that causes significant seed yield losses and reduces its oil content and quality. In the present study, the reaction of 187 diverse canola genotypes to SSR was characterized at full flowering stage using the agar plug to stem inoculation method in four environments. Genome-wide association study (GWAS) using three different algorithms identified 133 significant SNPs corresponding with 123 loci for disease traits like stem lesion length (LL), lesion width (LW), and plant mortality at 14 (PM_14D) and 21 (PM_21D) days. The explained phenotypic variation of these SNPs ranged from 3.6–12.1%. Nineteen significant SNPs were detected in two or more environments, disease traits with at least two GWAS algorithms. The strong correlations observed between LL and other three disease traits evaluated, suggest they could be used as proxies for SSR resistance phenotyping. Sixty-nine candidate genes associated with disease resistance mechanisms were identified. Genomic prediction (GP) analysis with all the four traits employing genome-wide markers resulted in 0.43–0.63 prediction accuracy. However, the prediction efficiency was further improved 0.55–0.88 when we integrated the GWAS information in the GP model. From our study, the identified resistant genotypes and stable significant SNP markers will serve as a valuable resource for future SSR resistance breeding. Our study also suggests that genomic selection holds promise for accelerating canola breeding progress by enabling breeders to select SSR resistance genotypes at the early stage by reducing the need to phenotype large numbers of genotypes.
Multiple Mechanisms Synergistically Induce Pseudomonas Aeruginosa Multiple Drug Resistance
Authors: Yang Lulu , Jiao Fangyan , Bajinka Ousman , Abdelhalim Khalid A , Wu Guojun , Tan Yurong
Published: June 2021

Background: This study was designed to detect the molecular epidemiological characteristics and resistant mechanism of carbapenem resistant Pseudomonas aeruginosa (CRPA) which provide reference for the prevention and treatment of hospital CRPA infection. Methods: 34 strains of CRPA from 2018 to 2019 were isolated and their resistance to 13 commonly used antibiotics was detected using TDR-300B Plus VitEK-2 compact automatic bacterial identification instrument. Then carbapenemase production was detected using Carbe NP test. The efflux pumps MexA and outer membrane protein OprD proteins were detected using RT-PCR and class Ⅰ integron carried with drug-resistant genes were detected using PCR and sequences analysis. Results: Among 34 strains of CRPA, 22 strains were multiple drug resistance (MDR) and 5 strains were extensively drug-resistant (XDR). The results of class Ⅰ integron carried drug-resistant gene sequencing analysis showed the class Ⅰ integron mainly carried aminoglycoside or quinolone antibacterial drug resistant genes. Conclusion: Multiple mechanisms play an important role in the formation and development of MDR or XDR resistance.
Peripheral Perfusion Index as a Marker of Sepsis in Preterm Neonates
Authors: Singh Jasmine , Jain Suksham , Chawla Deepak , Randev Shivani , Khurana Supreet
Published: June 2021

Background: Neonatal sepsis is a major contributor to neonatal mortality in India. Blood culture, the gold standard for the diagnosis of sepsis takes 48-72 hours while the serological markers have suboptimal diagnostic test characteristics. Perfusion Index (PI) is a real time, non-invasive marker that can detect microcirculatory changes before other clinical manifestation of sepsis. Objective: To determine the diagnostic accuracy of PI in detecting hospital-acquired sepsis before overt clinical manifestations. Material and Methods: A prospective observational study was conducted in the Neonatal Intensive Care Unit (NICU) of a tertiary care hospital. Participants: Term and preterm neonates admitted to NICU. Methods: PI was continuously monitored in all enrolled neonates. Clinical sepsis was defined using the Neonatal Krankenhaus-Infektions-Surveillance-System (NeoKISS). PI below 1.24 and 0.88 for term and preterm neonates, respectively, was defined as low PI. The time of fall of PI below this value and time of clinical sepsis as per NeoKISS was noted and the difference was calculated. Results: Among 72 neonates (gestational age:32.2±3.2 weeks, birth weight:1420, IQR 1100-1855 g), a total of 93 events of suspected sepsis were noted, of which 70 were sepsis screen positive. 16 events were associated with culture positive sepsis. Using a cut off of 0.88 in preterm neonates, PI yielded a sensitivity of 89.47% (95% CI 78.48% to 96.04%), specificity of 56% (95% CI 34.93% to 75.60%), positive predictive value of 82.26% (95% CI 74.70% to 87.92%), and negative predictive value of 70% (95% CI 50.36% to 84.29%) in detection of hospital acquired sepsis. The positive and negative likelihood ratios came to be 2.03 (95% CI 1.30 to 3.19) and 0.19 (95% CI 0.08 to 0.43), respectively.Conclusion: This study shows that PI might serve as an early, non-invasive marker of hospital acquired sepsis in preterm neonates.
Reduction of Preterm Births in South West England During The COVID-19 Pandemic: Staff Perceptions Versus Evidence
Authors: Maslin Kate , McKeon-Carter Roisin , Hosking Joanne , Stockley Lauren , Southby Clara , Shawe Jill , Latour Jos
Published: June 2021

The COVID-19 lockdown had a series of intended and unintended consequences, including reduced infections, changes in activities and work practices. Some of these changes may have been beneficial to perinatal outcomes, however other factors such as reduced access to face-to-face healthcare and/or reluctance to attend hospital for fear of exposure to infection may have contributed negatively to antenatal care. A systematic review suggests that preterm births have not significantly changed overall, but they have decreased in high-income countries. The aim of this audit was to compare neonatal admissions in the South West of England during 2020 to 2018 and 2019. Anonymised birth and neonatal admission rates from January-December 2020 was obtained and compared to data from 2018–2019. The results demonstrate a decreasing of neonatal unit admissions between 2018–2020 (p = 0.002). However, the reduction in neonatal unit admissions is observed from 2018 and there were no significant differences across gestational groups. It is unclear without nationwide data whether the trends observed in our audit are generalisable and related to the COVID-19 pandemic. However, the data have clinical significance and revisiting clinical practices like organisational and workforce issues is warranted. Future research exploring the impact of lockdowns on behaviour change during pregnancy is required to understand the reality of pregnancy and preterm birth.
Patient Understanding Of Cardiopulmonary Resuscitation Status
Authors: Khadka Sushmita , Suwal Kriti , Adhikari Nirajan , Dadeboyina Chandrakala , Thomas Litty , Senapathi Sri , Walsh James
Published: June 2021

BackgroundCardiopulmonary Resuscitation (CPR) or Code status discussion usually happen late in the hospital admission. Lack of clear communication, various level of training of providers and discrepancy in health literacy among patient act as barrier in proper understanding of code status understanding. In this study we utilized brief video and validated survey to determine if viewing a short, educational video could improve patient understanding of CPR and code status at Robert Packer Hospital.MethodThis study was conducted as single center randomized study at Guthrie Robert Packer Hospital. Total number of participants was 150. Participants were randomly assigned (1:1) to Intervention group where they viewed brief educational video. The primary end point was the composite score ranging from 0 to 15 generated based on correct responses to the questionnaire (supplemental file). ResultThere was statistically significant high understanding of code status among intervention group with mean composite score of 8.6 with a significant difference between the video group (10.3) and control group (6.9) with a p-value < 0.001. The multivariate linear model had a significant F-statistic with a p-value of < 0.001. We found age and randomization group significantly changes the composite scores. On average, the composite score of the intervention group was 3.36 points higher than the control group with 95% confidence interval of 2.36 – 4.35, p<0.001, when adjusted for age and gender of the patient.ConclusionUnderstanding of cardiopulmonary resuscitation status holds important place in guiding management of a patient. Use of short video explaining CPR and code status was found to be effective in improving patient understanding of these issues. It has the potential to save time and improve patient’s understanding if incorporated into code status discussions with hospitalized patients.
Microstructural and Physical Properties of Thermoplastic Corn Starch/Polystyrene Blend Foams Affected by Different Contents and Combinations of Plasticizers
Authors: Zabihi Amirreza , Fasihi Mohammad , Rasouli Sajad
Published: June 2021

A comprehensive study was performed on thermoplastic corn starch (TPS)/polystyrene (PS) blend foam to optimize the formulation from the aspects of plasticizer content and the blend ratio. Plasticization of native starch was implemented with various contents of plasticizer (water + glycerol), 21, 23, 25 and 29%, and water/glycerol ratio of 1/2, 2/3, 3/2 and 2/1 using melt extrusion process. The influence of plasticizer loading content and also its combination on the microstructural and physical properties of the blend foam were investigated. The morphological consideration was also carried out by scanning electron microscopy (SEM) to evaluate the distribution and regularity of the foam cells. In the following, full factorial method in Minitab software was used to optimize the formulation according to the properties. Moreover, the effect of PS content on the moisture absorption and cell structure of TPS/PS blend foam was evaluated. The addition of 20% PS to TPS caused to 6 times higher expansion ration than PS and 60 % higher than TPS, while 50 % lower moisture absorption than TPS. This combination can be a good alternative candidate for warm food packing applications.
Targeted Nanostructured Lipid Carrier Containing Galangin as a Promising Adjuvant for Improving Anticancer Effects of Chemotherapeutic Agents
Authors: Hajipour Hamed , Nouri Mohammad , Ghorbani Marjan , Bahramifar Ali , Emameh Reza Zolfaghari , Taheri Ramezan Ali
Published: June 2021

Purpose

Resistance to chemotherapeutic drugs is the main limitation of cancer therapy. The combination use of anticancer agents and Galangin (a naturally active flavonoid) amplifies the effectiveness of cancer treatment. This study aimed to prepare Arginyl-glycyl-aspartic acid (RGD) containing nanostructured lipid carrier (NLC-RGD) to improve the bioavailability of Galangin and explore its ability in improving the anti-cancer effects of doxorubicin (DOX).
Methods

Galangin loaded-NLC-RGD was prepared by hot homogenization method and characterized by diverse techniques. Then, cytotoxicity, uptake, and apoptosis induction potential of prepared nanoparticles beside the DOX were evaluated. Finally, the expression level of some ABC transporter genes was evaluated in Galangin loaded-NLC-RGD treated cells.
Results

Nanoparticles with appropriate characteristics of the delivery system (size: 120 nm, PDI: 0.23, spherical morphology, and loading capacity: 59.3 mg/g) were prepared. Uptake experiments revealed that NLC-RGD promotes the accumulation of Galangin into cancerous cells by integrin-mediated endocytosis. Results also showed higher cytotoxicity and apoptotic effects of DOX + Galangin loaded-NLC-RGD in comparison to DOX + Galangin. Gene expression analysis demonstrated that Galangin loaded-NLC-RGD downregulates ABCB1, ABCC1, and ABCC2 more efficiently than Galangin.
Conclusion

These findings indicated that delivery of Galangin by NLC-RGD makes it an effective adjuvant to increase the efficacy of chemotherapeutic agents in cancer treatment.
The Effect of Laser Remelting on the Microstructure and Mechanical Properties of the Bonding Interface in a Hybrid Metal Additive Manufacturing Process
Authors: Xue Fei , Cui Xin , Zheng Longfei , Li Mian , Fang Xuewei
Published: June 2021

In order to realize both high-efficient forming with the wire arc additive manufacturing (WAAM) and precise forming with the laser metal deposition (LMD) for some complex-structure and high-precision parts, a hybrid metal additive manufacturing method is proposed. The part is decomposed into sub volumes, then the sub volumes with relatively simple-structure features are formed through WAAM as a substrate, and the other sub volumes with more complex-structure or small-sized features are formed through LMD on the former substrate. However, the mechanical properties of the bonding interface would be reduced, if the later sub volumes are directly deposited by LMD on the rough WAAM substrate surface. In order to avoid unnecessary machining process between WAAM and LMD for high efficiency, and ensure the mechanical properties of WAAM-LMD bonding interface the laser remelting method is applied for improving the profile of WAAM substrate surface. The simulation model of heat transfer and fluid flow in the laser remelting process is established, the influence of the laser power and the scanning speed on the surface-profile improvement is researched by simulation and verified by experiments, Based on that the remelting process parameters are optimized. Furthermore, based on the WAAM formed substrate, the LMD formed volumes are deposited directly, after surface milling and after laser remelting, respectively. Then the microstructure and the mechanical properties of the bonding interface are compared among the three process methods, the feasibility of the laser remelting method for improving the bonding interface performance is verified.
Long-term and Combined Effects of N-[2-(Nitrooxy)ethyl]-3-pyridinecarboxamide and Fumaric Acid on Methane Production, Rumen Fermentation, and Lactation Performance in Dairy Goats
Authors: Li Zongjun , Lei Xinjian , Chen Xiaoxu , Zhang Yu , Shen Jing , Yao Junhu
Published: June 2021

BackgroundIn recent years, nitrooxy compounds have been identified as promising inhibitors of methanogenesis in ruminants. However, when animals receive a nitrooxy compound, a high portion of the spared hydrogen is eructated as gas, which partly offsets the energy savings of CH4 mitigation. The objective of the present study was to evaluate the long-term and combined effects of supplementation with N-[2-(nitrooxy)ethyl]-3-pyridinecarboxamide (NPD), a methanogenesis inhibitor, and fumaric acid (FUM), a hydrogen sink, on enteric CH4 production, rumen fermentation, bacterial populations, apparent nutrient digestibility, and lactation performance of dairy goats.ResultsTwenty-four primiparous dairy goats were used in a randomized complete block design with a 2 × 2 factorial arrangement of treatments: supplementation without or with FUM (32 g/d) or NPD (0.5 g/d). All samples were collected every 3 wks during a 12-wk feeding experiment. Both FUM and NPD supplementation persistently inhibited CH4 yield (L/kg DMI, by 18.8% and 18.1%, respectively) without negative influence on DMI or apparent nutrient digestibility. When supplemented in combination, no additive CH4 suppression was observed. FUM showed greater responses in increasing the molar proportion of propionate when supplemented with NPD than supplemented alone (by 10.2% vs. 4.4%). The rumen microbiota structure in the animals receiving FUM was different from that of the other animals, particularly changed the structure of phylum Firmicutes. Daily milk production and serum total antioxidant capacity were improved by NPD, but the contents of milk fat and protein were decreased, probably due to the bioactivity of absorbed NPD on body metabolism.ConclusionsSupplementing NPD and FUM in combination is a promising way to persistently inhibit CH4 emissions with a higher rumen propionate proportion. However, the side effects of this nitrooxy compound on animals and its residues in animal products need further evaluation before it can be used as an animal feed additive.
Effect of Silica and Carbon-reducing Agents on Ni and Ti iImpurities During Silicon Production
Authors: Zhang Hongmei , Chen Zhengjie , Wen Jianhua , Ma Wenhui , Cao Shijie
Published: June 2021

The Ni and Ti contents of industrial silicon has a significantly affect the of organic silicon. On the basis of large specific production data, the chemical component of silica and the carbon-reducing agent effect of the Ni and Ti contents of silicon were investigated using statistical techniques. Two furnaces were also studied—an 8.5 MVA furnace and a 12.5 MVA furnace. The effects of TiO2 and NiO impurities on the power consumption of both furnaces were also evaluated using the correlation of the TiO2 and NiO impurities in raw materials with specific power consumption. The consumption of raw materials exhibited a high negative correlation with the TiO2 and NiO impurities in industrial silicon, as determined by linear regression—that is, 82% < |r| < 99%. The influence of Ni on industrial silicon production was also stronger than that of Ti. With an increase in Ni, the power consumption of the 8.5 MWA furnace significantly decreased, whereas that of the 12.5 MWA furnace is increased. Adjusting the content of Ni content can reduce the power consumption of industrial silicon production in the large furnace.
Dental Students’ Preference and Perception on Intraoral Scanning and Impression Making
Authors: Lam Walter , Mak Ken , Maghami Ebrahim , Molinero-Mourelle Pedro
Published: June 2021

Background: To investigate the preference and perception on intraoral scanning and impression making among dental students.Methods: Final-year dental students from the 2019 and 2020 cohorts were invited to complete an online questionnaire via Google-Form. Their preference on the intraoral-scanning/impression making techniques and their perception on these techniques including the ease of defect identification, ease of infection control, need of chairside support, ease to master the technique as a beginner, efficiency in their hands and ease to handle the scanner software (yes/no) were collected. The results were analysed using McNemar tests and binary logistic regression test. All tests were performed at significance level α=0.05.Results: Ninety-seven students participated in this study with a response rate of 96.0%. Eighty-one students (83.5%) have tried intraoral scanning on peers. Fifty-three (54.6%) students preferred intraoral-scanning and were categorized as Pro-scanning group. Forty-four (45.4%) students either preferred impression-making (n=21) or not sure (n=23) were categorized as Others. More than half of students in both groups felt that intraoral-scanning is easier to identify defect, easier in infection control and require less chairside support. Higher proportion of students in the Pro-scanning group felt that intraoral-scanning requires less chairside support, easier to master as a beginner, more efficient in their hands and they can deal well with the scanner software than that in Others (P<0.05). Regression shown that students preferred a technique that they perceived is more efficient (P=0.000).Conclusion: While intraoral scanning has perceived advantages, many students still prefer impression making that works more efficient to them.
Plasticity in visual cortex is disrupted in a mouse model of tauopathy and neurodegeneration
Authors: Papanikolaou Amalia , Rodrigues Fabio , Holeniewska Joanna , Phillips Keith , Saleem Aman , Solomon Samuel
Published: June 2021

Neurodegeneration is a hallmark of many dementias and thought to underlie a progressive impairment of neural plasticity. Previous work in mouse models of neurodegeneration shows pronounced changes in artificially-induced plasticity in hippocampus, perirhinal and prefrontal cortex. However, it is not known how neurodegeneration disrupts intrinsic forms of brain plasticity. Here we characterised the impact of tau-driven neurodegeneration on a simple form of intrinsic plasticity in the visual system, which allowed us to track plasticity at both long (days) and short (minutes) timescales. We studied rTg4510 transgenic mice at early stages of neurodegeneration (5 months) and a more advanced stage (8 months). We recorded local field potentials in the primary visual cortex while animals were repeatedly exposed to a stimulus over 9 days. We found that both short- and long-term visual plasticity were already disrupted at early stages of neurodegeneration, and further reduced in older animals, such that it was abolished in mice expressing mutant tau. Additionally, visually evoked behaviours were disrupted in both younger and older mice expressing mutant tau. Our results show that visual cortical plasticity and visually evoked behaviours are disrupted in the rTg4510 model of tauopathy.
Assessment of the Usefulness of Prognostic Van Nuys Prognostic Index in the Treatment in Ductal Carcinoma in Situ in 15-year Observation
Authors: Kunkiel Michał , Niwińska Anna
Published: June 2021

Ductal carcinoma in situ, a marginal fraction of the mammary gland diseases, is recognized in 25% of breast cancers detected with mammographic screening. The aim of the study was to assess the prognostic value of Van Nuys Prognostic Index, serving to determine the method of treatment according to the recurrence risk From the 737 of cases of DCIS detection patients treated in our department in the years 1996–2011. The remaining 525 patients whose treatment began from excision of local DCIS and whose further course of treatment was determined after histopathological examination, who were left for observation, treated with radiation therapy of breast part left or mastectomy, were qualified for the assessment of mentioned index. The 5-, 10- and 15- year disease recurrence-free survival for the group of 525 patients was 88%, 74% and 62%, respectively. The percentage of 5-, 10- and 15-year disease recurrence-free survival in patients treated in compliance with the VNP Index in individual risk groups did not differ in a statistically significant way. In the low-risk group the percentage of recurrences after local excision, after 5, 10 and 15 years of observation amounted to 8.8%, 22.8% and 28.8%. In patients from this group, the recurrence risk after breast conserving treatment and mastectomy was 2% and 0%, respectively. VNP Index is not an optimal tool for patients with DCIS. It can be helpful only in some clinically difficult cases as one of methods of assessing the risk of recurrence.
Relationships Between Empirical Damage and Direct/Indirect Costs for the Assessment of Seismic Loss Scenarios
Authors: Ludovico Marco Di , De MArtino Giuseppina , Prota Andrea , Manfredi Gaetano , Dolce Mauro
Published: June 2021

The definition of relationships between damage and losses is a crucial aspect for the prediction of seismic effects and the development of reliable models to define risk maps, loss scenarios and mitigation strategies. The paper focuses on the analysis of post-earthquake empirical data to define relationships between buildings’ damage expressed as usability rating or as global damage state and the associated costs for repair (i.e. direct costs) or for population assistance (i.e. a part of total indirect costs). The analysis refers to the data collected on residential buildings damaged by 2009 L'Aquila earthquake. For different usability rating or damage states, the paper presents the costs expressed in terms of percentage with respect to the reference unit cost of a new building (%Cr and %Ca for repair and population assistance costs, respectively). In particular, the costs analysis refers to undamaged, lightly or severely damaged buildings classified according to usability rating (i.e. A, B-C or E according to Italian classification) or to five different global Damage States (DSs). DSs comply with European Macroseismic Scale (EMS-98) and derive from literature available matrices properly defined to convert empirical damage to structural and non-structural components into building global damage. The %Cr probability density functions and relevant statistics derive from the analysis of actual data of post-earthquake reconstruction process, while, to determine those related to %Ca, a deep analysis of population assistance types, person/month assistance cost for each assistance form, and a methodology to associate such costs to each building are herein presented and discussed. Finally the paper presents a relationship calibrated on empirical data to directly correlate repair costs on a building with assistance costs to their occupants.The relationships between empirical damage and direct and indirect costs herein presented are of paramount importance because they allow reliable loss scenarios to be defined by simply using literature fragility curves (defined according to empirical or mechanical approaches) aimed at evaluating the probability of exceeding different usability rating or damage states of existing buildings.
Changes in Body Composition and Cardiometabolic Risk Factors in Relation to the Reduction in Body Mass Index in Adolescents with Obesity
Authors: Durá-Travé Teodoro , Gallinas-Victoriano Fidel , Malumbres-Chacón María , Urretavizcaya-Martinez María , Moreno-González Paula , Ahmed-Mohamed Lotfi
Published: June 2021

Background. There are controversial data in relation to the reduction in BMI-SDS needed to improve adiposity in the pediatric population with obesity. The aim of this work is to determine the minimum variation in body mass index standard deviation score (BMI-SDS) required to improve the values of adiposity markers and cardiometabolic risk factors in growing adolescents with obesity. Methods. A longitudinal study consisting in clinical evaluation (waist circumference, waist-to-height ratio and fat mass index, and blood pressure) and blood testing (insulin resistance and lipid profile) was conducted in 350 adolescents with obesity (152 boys and 198 girls), aged 10.2–14.3 years, that went through a combined intervention (12 months). Results. A decrease in SDS-BMI ≤0.5 was not associated with any significant improvement in the clinical features and blood testing recorded. A decrease in BMI-SDS >0.5, and especially if >1.0, was linked to a significant improvement in adiposity markers. A decrease in BMI-SDS >0.5 was associated with a significant improvement in insulin resistance, and a decrease in BMI-SDS >1.0 was associated with a significant decrease in the percentage of patients who showed high values of systolic blood pressure, HOMA-IR and lipid profile Conclusions. Improvement in body composition, insulin resistance and lipid profile can be observed with reductions in BMI-SDS of ≥0.5 in obese adolescents, while extended benefits are obtained by losing at least 1.0 BMI-SDS.
Paradigm Transition from the “Department Model” to the “Comprehensive Dental Care” Teaching Model
Authors: Khalifa Nadia , Hamseh Amel Ghazi , Michail Abdallah , Awad Manal M.
Published: June 2021

Background
This study aimed to assess students’ perceptions of the gains and challenges of the patient-centered comprehensive care methodology of dental clinical training.
Methods
Self-administered questionnaires were completed by 58 out of 93 students following the end of the academic term 2017–2018.
Results
Most of the students 43 (74%) understood the philosophy behind a holistic approach to patients’ dental care and employing a multidisciplinary style. Students’ self-assessment showed significant preponderance 41 (71%) (P = 0.026) concerning treatment phases and procedural abilities as well as enhancement of their oral rehabilitation case presentations 50 (86%) (P = 0.0001). Half of the students were not able understand what they needed to work on from their daily continuous clinical assessment grades. The comprehensive dental care (CDC) concept helped them gain more confidence 44 (76%) (P = 0.005) and although students benefited from the interaction with specialists and peers the main advantage was having fixed mentors throughout the year (P = 0.000).
Conclusions
The results, besides highlighting the benefits, also address some of the shortcomings of the comprehensive care curriculum especially when it comes to grading. Consequently, there is a need for standardized and regular calibration exercises for clinical tutors (general practitioners) and specialists to enable them to impart consistent information to clinical graduates. It is also necessary for students to receive sufficient feedback on their assessment grades to help them understand and improve upon their deficiencies.
Predicting ketosis during the transition period in Holstein Friesian cows using hematological and serum biochemical parameters on the calving date
Authors: Ha Seungmin , Kang Seogjin , Han Manhye , Lee Jihwan , Chung Hakjae , Oh Sang-Ik , Kim Suhee , Park Jinho
Published: June 2021

Ketosis often occurs during the transition period in dairy cows, which leads to economic and welfare problems. Ketosis was reported to be associated with hematological and serum biochemical parameters. However, the association between the parameters on the calving date and ketosis during the postpartum transition period remains unclear. This study aimed to investigate the association. Blood samples were collected from the jugular vein of Holstein cows on calving date and β-hydroxybutyrate was tested once every three days (8 times in 21 days). The cows were divided into three groups: non-ketosis, subclinical ketosis, and clinical ketosis. The clinical ketosis group significantly had the highest values of mean corpuscular volume, mean corpuscular hemoglobin, β-hydroxybutyrate, non-esterified fatty acids, and total bilirubin, but the lowest values of red cell distribution width, the counts of white blood cell, monocyte, and eosinophil, albumin, alanine transaminase, lactate dehydrogenase, and amylase. Non-ketosis group showed the opposite results (p < 0.05). The parameters are associated with the development and severity of ketosis. The findings suggest that these parameters on calving date may be useful indicators to identify dairy Holstein cow susceptible to ketosis during the transition period.
Prevalence and associated risk factors of hypertension and pre-hypertension among the adult population: Findings from the Dubai Household Survey, 2019
Authors: Mamdouh Heba M. , Alnakhi Wafa K. , Hussain Hamid Y. , Ibrahim Gamal M. , Hussein Amal , Mahmoud Ibrahim , Sulaiman Nabil
Published: June 2021

Background
Minimal data is available on the prevalence and correlates of hypertension and prehypertension in Dubai. The study aims to measure the prevalence of hypertension and pre-hypertension and the associated socio-demographic characteristics, behavioral risk factors and comorbidities among the adult population of Dubai.
Methods
This study used data from the Dubai Household Health Survey, 2019. A cross-sectional population survey based on a complex stratified cluster random design. The total eligible sample included 2,530 adults (18+). Sociodemographic and behavioral factors were considered as independent covariates. The main study outcome variables, pre-hypertension and hypertension, were ordinal, with normotension as the reference group.
Results
The overall prevalence of hypertension in adults was 32.5% (38.37% in males and 16.66% in females). Prehypertension was prevalent in 29.8% of adults in Dubai (28.85% in males and 32.31% in females). The multivariate logistic regression analysis revealed that age groups, gender, occupation, and high Body Mass Index were significantly associated with a higher risk of hypertension at the level of p < 0.05. No clear trend toward a higher correlation of hypertension was noted with the increase in age, except after the age of 50 years. Males were five- times more likely to be hypertensive than females. Participants enrolled in skilled and service works had a five times higher risk of hypertension, compared with the reference group (professionals). Obese subjects had a 5.47 times greater correlation of hypertension compared with normal-weight subjects. Physically active individuals were less likely to develop hypertension. For the correlates with prehypertension in the present analysis, skilled and service workers and those working in elementary jobs had a higher risk of prehypertension, compared with the reference group (professionals) Individuals with a status of overweight were associated with a higher prevalence of prehypertension compared with people of normal weight.
Conclusions
This study showed a high prevalence of prehypertension and hypertension among adults in Dubai. Some socio-demographic and behavioral risk factors were correlated with prehypertension and hypertension among the studied population. Interventions aiming at increasing public awareness about such risk factors are essential.
Re-emergence of syphilis in women of reproductive age and its association with the increase in congenital syphilis, the case of Mexico during the years 2010-2019
Authors: García-Cisneros Santa , Herrera-Ortiz Antonia , Olamendi-Portugal Maria , Sanchez-Aleman Miguel A.
Published: June 2021

BackgroundSyphilis is a sexually transmitted infection that is re-emerging in different parts of the world. This infection can be transmitted during pregnancy causing neonatal syphilis. The objective of the study was to determine the trend of syphilis, congenital syphilis, and mortality from congenital syphilis among the Mexican population between the years 2010-2019. MethodsWe formed databases about the incidence of syphilis, the incidence of congenital syphilis, cases of congenital syphilis, and deaths of congenital syphilis using information from the Morbidity and Mortality Yearbooks and the Bulletin of the Mexican Ministry of Health, considering age, sex, the states of Mexico, and year. The trend was analyzed using linear regression, the increase was estimated with 95% confidence intervals, and p<0.05 was considered statistically significant. ResultsThe incidence of syphilis increases on average 0.336 cases/100,000, being higher among women aged 15-19 years (0.693 cases). Congenital syphilis has grown, from 62 cases in the year 2010 to 372 cases in the year 2019; the cases of congenital syphilis have relation to the increase of syphilis among women aged 20-24 years. Fifty percent of the states of Mexico without cases of congenital syphilis in 2010, but only 10% in 2018. Between the years 2010 to 2017, 62 deaths from congenital syphilis were reported. ConclusionCongenital syphilis is increasing in Mexico, as a consequence of the reemergence of syphilis among the population of reproductive age, it is necessary to attend to syphilis in various population groups.
Community-level Educational Attainment and Dementia: A 6-year Longitudinal Multilevel Study in Japan
Authors: Takasugi Tomo , Tsuji Taishi , Hanazato Masamichi , Miyaguni Yasuhiro , Ojima Toshiyuki , Kondo Katsunori
Published: June 2021

Background:Understanding of the association between community-level socioeconomic status and dementia is insufficient. We examined the contextual effect of community-level prevalence of lower educational attainment on the risk of dementia incidence. This work further explored the potential differences in associations for urban and non-urban areas. Methods:We analyzed a six-year prospective cohort data from the Japan Gerontological Evaluation Study, a nationwide survey between 2010 and 2012 of 49,888 (23,339 men and 26,549 women) physically and cognitively independent individuals aged ≥65 years from 346 communities at 16 municipalities in seven prefectures. Dementia incidence was assessed through the public long-term care insurance system by the Ministry of Health, Labor, and Welfare in Japan. Educational years were dichotomized as ≤9 years and ≥10 years. We classified urban and non-urban areas using a Functional Urban Area defined by the European Union (EU) and Organisation for Economic Co-operation and Development (OECD). We performed a two-level (community- and individual-level) multilevel survival analysis to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). Results:The cumulative incidence of dementia during the follow-up period was 10.3%. The mean proportion of educational attainment with ≤9 years was 41.1% (range, 4.7%–88.4%). Higher prevalence of community-level lower educational attainment had a significant association with a higher risk of dementia incidence (HR, 1.03; 95% CI, 1.00–1.06, estimated by 10 percentage points of lower educational attainment) post adjusting for individual-level educational years, age, sex, income, residential years, disease, alcohol, smoking, social isolation, and population density. The association was significant in non-urban areas (HR, 1.05; 95% CI, 1.00–1.10). Conclusions:Older people living in communities with a higher prevalence of less educational attainment among their age demographic tended to develop dementia more often than those living in areas with a lower prevalence of less educational attainment after adjusting for individual-level educational attainment and covariates. In particular, the association was more pronounced in non-urban areas than in urban areas. Securing education for adolescence as a life course and population approach could thus be crucial to prevent dementia later in life among all older people living in non-urban areas.
Investigating the Cutting Force Monitoring System in the Boring Process
Authors: Liu Qiang , Gao Dayong , Jia Ruhong , Zhou Qiang , Bai Zhengyan
Published: June 2021

Due to the closed environment during deep hole boring, it is impossible to observe the working state of the boring bar. Studies show that monitoring the cutting force is the most direct and effective way to reflect the processing status. In this regard, a cutting force monitoring system is designed in the present study for the boring process. The main idea of the designed monitoring system is the piezoelectric effect of the strain gauge. When the tool tip is subjected to the cutting force, the sensor deforms and the strain sensor generates a voltage signal. Accordingly, the cutting force can be obtained by establishing the correlation between the voltage and the applied cutting force. The force of the boring bar and the output of the sensor were analyzed, and an experimental platform for monitoring the boring force was built. This method is applied in a case study and the obtained results demonstrate that the developed cutting force monitoring system has good compatibility, high precision and good dynamic characteristics. It is found that that the measurement error of the designed system in the boring process is less than 9.18%, which meets the accuracy requirements of measurements in the dynamic cutting force under machining conditions.
Identification and Prioritization of Local Indicators of Hospital Bed Allocation in Iran
Authors: Najibi Seyede Maryam , lotfi farhad , Kharazmi Erfan , farhadi payam , Shojaei Payam , Bastani Peivand , Shiraz Zahra Kavosi-
Published: June 2021

Background: The distribution of hospital beds can be used as an indicator for evaluating the distribution of health services. This study aimed to determine and prioritize indicators of bed allocation in Iran.Methods: In the first phase of the study we determined factors affecting bed distribution using a scoping review. In the second and third phases we applied expert panel and Delphi method to localize indicators of bed allocation. Finally, we carried out Analytic Network Process (ANP) approach based on Decision Making Trial and Evaluation Laboratory (DEMATEL) technique (DANP) to determine the weight and importance of indicators and to evaluate the causal relationship between them.Results: We identified 75 criteria affecting the distribution of beds through scoping review. In two rounds of Delphi, 28 criteria were agreed upon and entered into the DANP phase. Population, existence of a reference hospital in the area, the type of hospital (general/specialized), common diseases in the area, existence of home care services have had the most interaction with other variables. The variable of home care services was at the highest level of the causal chain.Conclusions: Bed occupancy rate, the average length of stay, waiting list, as well as type and level of the hospital had the highest priority in the distribution of hospital beds. Moreover, considering the importance of home care, policies should be adopted to expand these services nationwide. The criteria identified in this study will be helpful in developing policies aimed at equitable allocation of hospital beds considering the efficiency criteria.
In vivo Efficacy and Safety of Artemether-Lumefantrine and Amodiaquine-Artesunate for Uncomplicated Plasmodium Falciparum Malaria in Mozambique, 2018
Authors: Nhama Abel , Nhamussua Lidia , Macete Eusébio , Bassat Quique , Salvador Crizolgo , Enosse Sónia , Candrinho Baltazar , Carvalho Eva , Nhacolo Arsenio , Chidimatembue Arlindo , Saifodine Abuchahama , Zulliger Rose , Lucchi Naomi , Svigel Samaly S. , Moriarty Leah F. , Halsey Eric S. , Mayor Alfredo , Aide Pedro
Published: June 2021

Background : Artemisinin-based combination therapy has been the recommended treatment for uncomplicated malaria in Mozambique since 2006, with artemether-lumefantrine (AL) and amodiaquine-artesunate (AS-AQ) as first-line treatments. To assess efficacy of currently used artemisinin-based combination therapy, an in vivo therapeutic efficacy study was conducted. Methods : The study was conducted in four sentinel sites: Montepuez, Moatize, Mopeia and Massinga. Patients between 6 to 59 months old with uncomplicated Plasmodium falciparum malaria (2,000–200,000 parasites/µl) were enrolled between February and September of 2018, assigned to either an AL or AS-AQ treatment arm, and monitored for 28 days. A Bayesian algorithm was applied to differentiate recrudescence from new infection using genotyping data of seven neutral microsatellites. Uncorrected and PCR-corrected efficacy results at day 28 were calculated. Results : Totals of 368 and 273 patients were enrolled in the AL and AS-AQ arms, respectively. Of these, 9.5% (35/368) and 5.1% (14/273) were lost to follow-up in the AL and AS-AQ arms, respectively. There were 48 and 3 recurrent malaria infections (late clinical and late parasitological failures) in the AL and AS-AQ arms, respectively. The day 28 uncorrected efficacy was 85.3% (95% CI: 81.1–88.9%) for AL and 98.8% (95% CI: 96.7–99.8%) for AS-AQ, whereas day 28 PCR-corrected efficacy was 97.9% (95% CI: 95.6–99.2%) for AL and 99.6 % (95% CI: 97.9–100%) for AS-AQ. Molecular testing confirmed that 87.4% (42/48) and 33.3% (1/3) of participants with a recurrent malaria infection in the AL and AS-AQ arms were new infections; an expected finding in a high malaria transmission area. Adverse events were documented in less than 2% of participants for both drugs. Conclusion : Both AL and AS-AQ have therapeutic efficacies well above the 90% WHO recommended threshold and remain well-tolerated in Mozambique. Routine monitoring of therapeutic efficacy should continue to ensure the treatments remain efficacious. Trial registration: Clinicaltrials.gov: NCT04370977
Performance Analysis of Reconfigurable Intelligent Surface in a Dual-Hop DF Relay Empowered Asymmetric RF/FSO Networks
Authors: Odeyemi Kehinde O , Owolawi Pius A. , Olakanmi Oladayo O.
Published: June 2021

In this paper, the performance analysis of a reconfigurable intelligent surface (RIS) in a dual-hop decode-and-forward (DF) relay empowered asymmetric radio frequency (RF)/free space optical (FSO) systems is presented. The RIS-assisted RF network is subjected to Nakagami-m distribution while the RIS-assisted FSO networks experience Gamma-Gamma distribution in which both atmospheric turbulence and pointing errors are considered. Thus, the closed-form expressions for the system outage probability and average bit error rate (ABER) are derived with limited number of reflecting elements at RIS-assisted RF network and multiple number of reflecting elements at RIS-assisted FSO network. Further, to obtain more insight about the system characteristic, the asymptotic closed-form expressions are derived at high signal-to-noise ratio (SNR) for the system performance metrics. The results illustrate the impact of the system and channel parameters on the proposed system in terms of atmospheric turbulence, pointing errors under beam width condition, m-fading parameter, and number of reflecting elements. The correctness of the derived analytical expressions is validated via the Monte-Carlo simulations.
Associations of Body Shapes with Insulin Resistance and Cardiometabolic Risk in Middle-aged and Elderly Chinese
Authors: Zhou Yulin , Hou Yanan , Xiang Jiali , Dai Huajia , Li Mian , Wang Tiange , Wang Shuangyuan , Lin Hong , Lu Jieli , Xu Yu , Chen Yuhong , Wang Weiqing , Bi Yufang , Zhao Zhiyun , Xu Min
Published: June 2021

Background: We aimed to define refined body shapes by using multiple anthropometric traits that represent fat distribution, and evaluate their associations with risk of insulin resistance (IR) and cardiometabolic disorders in a Chinese population. Methods: We performed a cross-sectional analysis in 6570 community-based participants aged ≥ 40 years. Four body circumferences (neck, waist, hip and thigh) and their ratios were put simultaneously into an open-source Waikato Environment for Knowledge Analysis platform to select the worthiest indicators in determining IR. The ratio of the top 3 fat distribution indicators were used to define the refined body shapes. Results: We defined 8 distinct body shapes based on sex-specific combinations of waist-to-hip ratio (WHR), waist-to-thigh ratio (WTR) and waist-to-neck ratio (WNR), which differed in participants’ distribution and risk of IR and related cardiometabolic disorders. In women, as compared to the low WHR-low WTR-low WNR shape, all body shapes were significantly associated with IR and related cardiometabolic disorders; while in men, the low WHR-high WTR-high WNR shape and the higher WHR related shapes were significantly associated with IR and related cardiometabolic disorders. Stratified by WHR, the results were consistent in women; however, no significant associations were detected in men. Conclusions: We defined 8 distinct body shapes by taking WHR, WTR, and WNR, simultaneously into account, which differed in association with risk of IR and related cardioembolic disorders in women. This study suggest that body shapes defined by multiple anthropometrics traits could provide a useful, convenient and easily available method for identification cardiometabolic risk.