bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring contextual factors influencing the implementation of evidence-based care for hypertension in Rwanda: a cross-sectional study using the COACH questionnaire
Authors: Baumann Ana A , Hooley Cole , Goss Charles W , Mutabazi Vincent , Brown Angela L , Schechtman Kenneth B , Twagirumukiza Marc , de las Fuentes Lisa , Reeds Dominic , Williams Makeda , Mutimura Eugene , Bergström Anna , Nishimwe Aurore , Ingabire Cecile , Davila-Roman Victor G
Published: September 2021

Importance

Hypertension is the largest contributor to the Global Burden of Disease. In Rwanda, as in most low-income and middle-income countries, an increasing prevalence of hypertension and its associated morbidity and mortality is causing major healthcare and economic impact. Understanding healthcare systems context in hypertension care is necessary.

Objective

To study the hypertension healthcare context as perceived by healthcare providers using the Context Assessment for Community Health (COACH) tool.

Design

A cross-sectional cohort responded to the COACH questionnaire and a survey about hypertension training.

Setting

Three tertiary care hospitals in Rwanda.

Participants

Healthcare professionals (n=223).

Primary outcome(s) and measure(s)

The COACH tool consists of 49 items with eight subscales: resources, community engagement, commitment to work, informal payment, leadership, work culture, monitoring services for action (5-point Likert Scale) and sources of knowledge (on a 0–1 scale). Four questions surveyed training on hypertension.

Results

Responders (n=223, 75% women; 56% aged 20–35 years) included nurses (n=142, 64%, midwives (n=42, 19%), primary care physicians (n=28, 13%) and physician specialists (n=11, 5%)). The subscales commitment to work, leadership, work culture and informal payment scored between 4.7 and 4.1 and the community engagement, monitoring services for action and organizational resources scored between 3.1 and 3.5. Sources of knowledge had a mean score of 0.6±0.3. While 73% reported having attended a didactic hypertension seminar in the past year, only 28% had received long-term training and 51% had <3-year experience working with hypertension care delivery. The majority (99%) indicated a need for additional training in hypertension care.

Conclusions

There is a need for increased and continuous training in Rwanda. Healthcare responders stated a commitment to work and reported supportive leadership, while acknowledging limited resources and no monitoring systems. The COACH tool provides contextual guidance to develop training strategies prior to the implementation of a sustainable hypertension care programme.
Willingness to seek medical care for tuberculosis and associated factors among the elderly population in Shenzhen: a cross-sectional study
Authors: Wang Yunxia , Feng Jing , Zhang Juanjuan , Shen Xin , Lei Zihui , Zhu Yi , Meng Xin , Di Hongkun , Xia Wenqi , Lu Zuxun , Guo Yanfang , Yuan Qing , Wang Xiaojun , Gan Yong
Published: September 2021

Objectives

This study was aimed to assess the willingness of elderly people to seek medical care for tuberculosis (TB) and the associated influencing factors.

Design

A cross-sectional study.

Setting

A multistage random survey was conducted in Bao’an District of Shenzhen in China.

Participants

A total of 1200 elderly people aged 65 or above were recruited for the study and completed a structured questionnaire between September and October 2019.

Main outcome measures

Descriptive and binary logistic stepwise regression analyses were conducted to analyse the characteristics of elderly individuals, their willingness to seek medical care for TB and associated factors.

Results

Among the final 1123 respondents, 943 (84.0%) were willing to seek medical care if they discovered suspicious TB symptoms. Binary logistic stepwise regression analysis indicated that respondents whose family annual income per capita was 50 000–100 000¥ (OR=2.56, 95% CI: 1.44 to 4.54, p<0.01) and who had positive attitudes (≥3 scores: OR=3.10, 95% CI: 1.90 to 5.05, p<0.01) or practices (≥4 scores: OR=3.13, 95% CI: 1.82 to 5.39, p<0.01) towards TB were more willing to seek medical care for TB.

Conclusions

Willingness to seek medical care for TB in the elderly population can be improved according to the determinants.
Prevalence of midline cervical spine tenderness in the non-trauma population
Authors: Delaney J Scott , Al-Kashmiri Ammar , Alalshaikh Abdulaziz , Al-Ghafri Saif , Saluja Sanjeet Singh , Correa Jose A
Published: September 2021

Objective

The Canadian C-Spine Rule (CCR) and the National Emergency X-Radiography Utilization Study (NEXUS) criteria are two commonly used clinical decision rules which use midline cervical spine (c-spine) tenderness on palpation as an indication for c-spine imaging post-trauma. This study was undertaken to determine the prevalence and location of midline c-spine tenderness in the non-trauma population.

Methods

We prospectively evaluated consenting adult patients presenting to an urban ED or university sport medicine clinic in Montreal, Canada between 2018 and 2020 for atraumatic non-head and neck-related reports over a 20-month period. The presence and location of pain during midline c-spine palpation as assessed by two examiners during separate evaluations was recorded. Patient information such as age, neck length and circumference, gender, body mass index (BMI) and scaphoid tenderness was also collected.

Results

Of 478 patients enrolled, 286 (59.8%) had midline c-spine tenderness on palpation with both examiners. The majority of those with tenderness were female (70.6%). When examining all patients, tenderness was present in the upper third of the c-spine in 128 (26.8%) patients, middle third in 270 (56.5%) patients and lower third in 6 (1.3%) patients. Factors associated with having increased odds of midline c-spine tenderness on palpation included a lower BMI and the presence of scaphoid tenderness on palpation.

Conclusions

There is a high prevalence of c-spine tenderness on palpation in patients who have not undergone head or neck trauma. This finding may help explain the low specificity in some of the validation studies examining the CCR and the NEXUS criteria.
DESIGN AND PRODUCTION OPTIMIZATION OF PP 20% TALC ADDITIVE FILTER WITH PLASTIC INJECTION MOLDING MACHINE
Authors: OZBAKIS YUSUF , NAS ENGIN
Published: September 2021

In the paper, the design optimization of the food-contact water tank filter used in industrial kitchen products was made and produced in plastic injection molding machine with different parameters. The effects of production parameters on product weight, fabric filter strength (tearing), production time and surface quality (burrs and gas gap) were investigated experimentally and statistically. The design of the experiments was prepared with the Taguchi L[Formula: see text] orthogonal array. Experiment parameters are determined as injection speed (A), holding press (B), holding speed (C), mold temperature (D), melting temperature (E) and compression waiting time (F). As a result, 154% improvement was achieved in the fabric strength as a result of design optimization. As a result of the optimization of the injection parameters of the product, when the response tables were examined, it is determined that the greatest value of filter fabric strength is 298[Formula: see text]N in A2B2C2D1E1F3 parameters. When ANOVA results are analyzed, the most effective parameter for fabric strength and surface quality was determined as mold temperature with 36.38% and compression waiting time with the lowest effective parameter as 0.08%.
Green Algal Models for Multicellularity
Authors: Umen James , Herron Matthew D.
Published: September 2021

The repeated evolution of multicellularity across the tree of life has profoundly affected the ecology and evolution of nearly all life on Earth. Many of these origins were in different groups of photosynthetic eukaryotes, or algae. Here, we review the evolution and genetics of multicellularity in several groups of green algae, which include the closest relatives of land plants. These include millimeter-scale, motile spheroids of up to 50,000 cells in the volvocine algae; decimeter-scale seaweeds in the genus Ulva (sea lettuce); and very plantlike, meter-scale freshwater algae in the genus Chara (stoneworts). We also describe algae in the genus Caulerpa, which are giant, multinucleate, morphologically complex single cells. In each case, we review the life cycle, phylogeny, and genetics of traits relevant to the evolution of multicellularity, and genetic and genomic resources available for the group in question. Finally, we suggest routes toward developing these groups as model organisms for the evolution of multicellularity.
Genetics of Shoot Meristem and Shoot Regeneration
Authors: Eshed Williams Leor
Published: September 2021

Plants exhibit remarkable lineage plasticity, allowing them to regenerate organs that differ from their respective origins. Such developmental plasticity is dependent on the activity of pluripotent founder cells or stem cells residing in meristems. At the shoot apical meristem (SAM), the constant flow of cells requires continuing cell specification governed by a complex genetic network, with the WUSCHEL transcription factor and phytohormone cytokinin at its core. In this review, I discuss some intriguing recent discoveries that expose new principles and mechanisms of patterning and cell specification acting both at the SAM and prior to meristem organogenesis during shoot regeneration. I also highlight unanswered questions and future challenges in the study of SAM and meristem regeneration. Finally, I put forward a model describing stochastic events mediated by epigenetic factors to explain how the gene regulatory network might be initiated at the onset of shoot regeneration.
J. David Jackson (January 19, 1925–May 20, 2016): A Biographical Memoir
Authors: Cahn Robert N.
Published: September 2021

John David (“Dave”) Jackson, a Canadian-born theoretical physicist, contributed significantly to particle, nuclear, and atomic physics. He is best known, however, for his text Classical Electrodynamics, which has been a fixture in physics graduate education around the world for more than 50 years. It is generally referred to simply as “Jackson.” This textbook, which has inspired fear and wonder alike in generations of students, clearly reflects the author's fascination with physical phenomena, his renowned mathematical dexterity, and his appreciation of the elegance of physical laws.

Jackson's major contributions to research included the theory of muon-catalyzed fusion; the analysis, with Kurt Gottfried, of angular distributions in quasi-two-body elementary particle collisions; and the elucidation of charmonium-state decays. Jackson influenced the development of physics research throughout the United States as well as internationally—particularly through his work on the nascent Superconducting Super Collider. An active promoter of civil liberties and human rights, he was one of the leaders of the efforts to free Andrei Sakharov, Yuri Orlov, and Anatoly Shcharansky from Soviet imprisonment.
Adventures with Particles
Authors: Gaillard Mary K.
Published: September 2021

Despite some gender-related bumps in the road, the author had the good fortune that her career spanned the evolution of the Standard Model from its inception in the late 1960s and early 1970s to its final confirmation with the discovery of the Higgs boson in 2012. Her major contributions to these developments and other facets of her career are described.
Review of Single Bubble Motion Characteristics Rising in Viscoelastic Liquids
Authors: Wang Wei
Published: September 2021

The emphasis of this review is to discuss three peculiar phenomena of bubbles rising in viscoelastic fluids, namely, the formation of a cusp, negative wake, and velocity jump discontinuity, and to highlight the possible future directions of the subject. The mechanism and influencing factors of these three peculiar phenomena have been discussed in detail in this review. The evolution of the bubble shape is mainly related to the viscoelasticity of the fluid. However, the mechanisms of the two-dimensional cusp, tip-streaming, “blade-edge” tip, “fish-bone” tip, and the phenomenon of the tail breaking into two different threads, in some special viscoelastic fluids, are not understood clearly. The origin of the negative wake behind the bubbles rising in a viscoelastic fluid can be attributed to the synergistic effect of the liquid-phase viscoelasticity, and the bubbles are large enough; thus, leading to a very long relaxation time taken by the viscoelastic stresses. For the phenomenon of bubble velocity jump discontinuity, viscoelasticity is the most critical factor, and the cusp of the bubbles and the surface modifications play only ancillary roles. It has also been observed that a negative wake does not cause velocity jump discontinuity.
Review of Breast Cancer Pathologigcal Image Processing
Authors: Zhang Ya-nan , XIA Ke-rui , LI Chang-yi , WEI Ben-li , Zhang Bing
Published: September 2021

Breast cancer is one of the most common malignancies. Pathological image processing of breast has become an important means for early diagnosis of breast cancer. Using medical image processing to assist doctors to detect potential breast cancer as early as possible has always been a hot topic in the field of medical image diagnosis. In this paper, a breast cancer recognition method based on image processing is systematically expounded from four aspects: breast cancer detection, image segmentation, image registration, and image fusion. The achievements and application scope of supervised learning, unsupervised learning, deep learning, CNN, and so on in breast cancer examination are expounded. The prospect of unsupervised learning and transfer learning for breast cancer diagnosis is prospected. Finally, the privacy protection of breast cancer patients is put forward.
Methods to Analyse Time‐to‐Event Data: The Kaplan‐Meier Survival Curve
Authors: D’Arrigo Graziella , Leonardis Daniela , Abd ElHafeez Samar , Fusaro Maria , Tripepi Giovanni , Roumeliotis Stefanos
Published: September 2021

Studies performed in the field of oxidative medicine and cellular longevity frequently focus on the association between biomarkers of cellular and molecular mechanisms of oxidative stress as well as of aging, immune function, and vascular biology with specific time to event data, such as mortality and organ failure. Indeed, time‐to‐event analysis is one of the most important methodologies used in clinical and epidemiological research to address etiological and prognostic hypotheses. Survival data require adequate methods of analyses. Among these, the Kaplan‐Meier analysis is the most used one in both observational and interventional studies. In this paper, we describe the mathematical background of this technique and the concept of censoring (right censoring, interval censoring, and left censoring) and report some examples demonstrating how to construct a Kaplan‐Meier survival curve and how to apply this method to provide an answer to specific research questions.
Plesiomonas: A Review on Food Safety, Fish-Borne Diseases, and Tilapia
Authors: Cortés-Sánchez Alejandro De Jesús , Espinosa-Chaurand Luis Daniel , Díaz-Ramirez Mayra , Torres-Ochoa Erika
Published: September 2021

Fish and fish products are considered a fundamental part of the human diet due to their high nutritional value. Food-borne diseases are considered a major public health challenge worldwide due to their incidence, associated mortality, and negative economic repercussions. Food safety is the guarantee that foods will not cause harm to the health of those who consume them, and it is a fundamental property of food quality. Food safety can be at risk of being lost at any stage of the food chain if the food is contaminated by pathogenic microorganisms. Many diverse bacteria are present in the environment and as part of the microbiota of food that can be transmitted to humans during the handling and consumption of food. Plesiomonas shigelloides has been mainly associated with outbreaks of gastrointestinal diseases due to the consumption of fish. This bacterium inhabits the environment and aquatic animals and is associated with the microbiota of fish such as tilapia, a fish of importance in fishing, aquaculture, commercialization, and consumption worldwide. The purpose of this document is to provide, through a bibliographic review of databases (Scopus, Web of Science, and Google Scholar, among others), a general informative perspective on food-borne diseases and, in particular, the consumption of fish and tilapia. Diseases derived from contamination by Plesiomonas shigelloides are included, and control and prevention actions and sanitary regulations for fishery products established in several countries around the world are discussed to promote the safety of foods of aquatic origin intended for human consumption and to protect public health.
A Case of Descending Necrotizing Mediastinitis in a Previously Healthy Child
Authors: Okumura Toshihiko , Tetsuka Nobuyuki , Yamaguchi Makoto , Suzuki Takako , Torii Yuka , Kawada Jun-ichi , Ito Yoshinori
Published: September 2021

Descending necrotizing mediastinitis (DNM) is a rare complication of oropharyngeal and cervical infection, especially in children. We report a case of DNM secondary to a cervical abscess in a previously healthy 1-year-old boy. The patient presented with redness and swelling of the neck and fever. He was treated with an antimicrobial agent for the diagnosis of cervical lymphadenitis. On the sixth day, a huge mediastinal abscess was found, and he was admitted to the intensive care unit. He was successfully treated with surgical drainage and appropriate antimicrobial therapy. The pus culture isolated multiple bacteria, including methicillin-resistant Staphylococcus aureus (MRSA). Although we did not use an antimicrobial agent covering MRSA, the symptoms and test results improved. Washing with drainage was effective. The patient required multidisciplinary treatment, and we collaborated with specialists in other departments. DNM is a severe disease in which team medical care is needed to provide appropriate treatment.
The Technique of English Word Syllable Division in Speech Synthesis Based on Neural Network
Authors: Ma Hongjuan
Published: September 2021

With the increasing maturity of speech synthesis technology, on the one hand, it has been more and more widely used in people’s lives; on the other hand, it also brings more and more convenience to people. The requirements for speech synthesis systems are getting higher and higher. Therefore, advanced technology is used to improve and update the accent recognition system. This paper mainly introduces the word stress annotation technology combined with neural network speech synthesis technology. In Chinese speech synthesis, prosodic structure prediction has a great influence on naturalness. The purpose of this paper is to accurately predict the prosodic structure, which has become an important problem to be solved in speech synthesis. Experimental data show that the average error of samples in the network training process is lel/85, and the minimum value of the training error after 500 steps is 0.00013127, so the final sample average error is lel = 85 

∗

 0.0013127 = 0.112 < 0.5, and use the deep neural network (DNN) to train different parameters to obtain the conversion model, and then synthesize these conversion models, and finally achieve the effect of improving the synthesized sound quality.
The Stability of the Model and Simulation, Control Issues for Ship System, Education, and Research
Authors: Danh Nguyen Cong
Published: September 2021

This article deals with the study of mathematical models and the assessment of the stability of the motion of ships, investigating properties of the system such as kinetics and stability. This is essential for the selection of suitable control methods according to the requirements set out for the problem. Some control methods require the author to specify control parameters before the operation of the system can be started. Therefore, the survey of the article is useful for the above problem. Control methods through simulation results (PID controller, lag compensator, and lead compensator) give me results that reflect properties of the system (the stability of the operation cycle of the ship model). In addition, control methods for this model, which serve for research and education, are also presented below. Simulation is done by Matlab.
Deep Learning-Based Three-Dimensional Oral Conical Beam Computed Tomography for Diagnosis
Authors: Lin Yangdong , He Miao
Published: September 2021

In order to deeply study oral three-dimensional cone beam computed tomography (CBCT), the diagnosis of oral and facial surgical diseases based on deep learning was studied. The utility model related to a deep learning-based classification algorithm for oral neck and facial surgery diseases (deep diagnosis of oral and maxillofacial diseases, referred to as DDOM) is brought out; in this method, the DDOM algorithm proposed for patient classification, lesion segmentation, and tooth segmentation, respectively, can effectively process the three-dimensional oral CBCT data of patients and carry out patient-level classification. The segmentation results show that the proposed segmentation method can effectively segment the independent teeth in CBCT images, and the vertical magnification error of tooth CBCT images is clear. The average magnification rate was 7.4%. By correcting the equation of R value and CBCT image vertical magnification rate, the magnification error of tooth image length could be reduced from 7.4. According to the CBCT image length of teeth, the distance R from tooth center to FOV center, and the vertical magnification of CBCT image, the data closer to the real tooth size can be obtained, in which the magnification error is reduced to 1.0%. Therefore, it is proved that the 3D oral cone beam electronic computer based on deep learning can effectively assist doctors in three aspects: patient diagnosis, lesion localization, and surgical planning.
Impact of Big Data Analysis on Nanosensors for Applied Sciences Using Neural Networks
Authors: Shitharth S. , Meshram Pratiksha , Kshirsagar Pravin R. , Manoharan Hariprasath , Tirth Vineet , Sundramurthy Venkatesa Prabhu
Published: September 2021

In the current-generation wireless systems, there is a huge requirement on integrating big data which can able to predict the market trends of all application systems. Therefore, the proposed method emphasizes on the integration of nanosensors with big data analysis which will be used in healthcare applications. Also, safety precautions are considered when this nanosensor is integrated where depth and reflection of signals are also observed using different time samples. In addition, to analyze the effect of nanosensors, six fundamental scenarios that provide good impact on real-time applications are also deliberated. Moreover, for proving the adeptness of the proposed method, the results are equipped in both online and offline analyses for investigating error measurement, sensitivity, and permeability parameters. Since nanosensors are introduced, the efficiency of the projected technique is increased by implementing media access control (MAC) protocol with recurrent neural network (RNN). Further, after observing the simulation results, it is proved that the proposed method is more effective for an average percentile of 67% when compared to the existing methods.
A Case of Endometrial Carcinosarcoma Containing Sertoliform Endometrioid Carcinoma Component
Authors: Munakata Satoru , Kushibiki Hanae , Akimoto Taishi , Yamashita Tsuyoshi , Shimoyama Norihiko
Published: September 2021

Carcinosarcomas (CSs) of the endometrium have admixture of malignant epithelial and mesenchymal components. The carcinomatous component exhibit endometrioid, serous, or clear cell differentiation, or are undifferentiated. CSs are considered homologous or heterologous according to the type of sarcomatous component. Sertoliform endometrioid carcinomas (SECs) of the endometrium which comprise a rare subtype of endometrial cancer, typically occur in the ovary. SECs as a carcinomatous component of CS of the endometrium have not been reported. Here, we report an endometrial carcinosarcoma that contains an SEC component. An 88-year-old female presented to a clinic with atypical genital bleeding. She was referred to our hospital and underwent total hysterectomy, bilateral adnexectomy and partial omentectomy due to endometrial carcinoma. Gross examination revealed a polypoid mass in the uterine cavity with massive myometrial invasion. Histologically, the tumor was a high-grade endometrioid carcinoma. In addition to an ordinary conventional endometrioid carcinoma, approximately 30% of the area exhibited sex cord-like pattern and contained small hollow tubules, anastomosing cords and trabeculae, and tightly packed nests. Immunohistochemically, the SEC component showed diffuse p53 staining. Sex cord-like area, especially the solid area, showed positive staining for EMA, vimentin, α-inhibin, CD99, calretinin, p53, CD56, synaptophysin, and chromogranin A, which is a staining pattern similar to that previously reported SEC of the endometrium. Diminished membranous and positive cytoplasmic staining for β-catenin was observed. This is the first case report of an endometrial carcinosarcoma containing an SEC component. SECs of the endometrium might exhibit sex cord-like differentiation in contrast to SECs of the ovary, which do not exhibit sex cord differentiation.
Thermal and Mechanical Properties of Vinyl Ester Hybrid Composites with Carbon Black and Glass Reinforcement
Authors: Guggari Geetanjali S. , Shivakumar S. , Manjunath G. A. , Nikhil R. , Karthick Alagar , Edacherian Abhilash , Ahamed Saleel C. , Afzal Asif , Prasath S. , Saleh B.
Published: September 2021

The objective of the work is to investigate both thermal and mechanical properties of vinyl ester/glass composites incorporated with different percentages of carbon black reinforcements through experimental approaches. Analysis of glass transition temperature, thermogravimetric analysis (TGA), degradation temperature, hardness, flexural strength, etc. is performed using differential scanning calorimeter, X‐ray diffraction, tensile machine, and flexural machine, respectively. The scanning electron microscope was used for surface fracture studies. The degradation temperature reduces initially with the percentage of carbon black and then increases. Glass transition temperature increases with the percentage of carbon black while above 500°C temperature, the weight percentage of composite drops. The results also reveal that 4% of carbon with vinyl ester improved the tensile strength by 30%, hardness by 35%, flexural strength by 45%, flexural modulus by 66%, and interlaminate shear strength by 44% when compared with the other percentage of carbon black.
Gamma Precorrection and Phase Error Compensation Methods Based on Three-Frequency with Three-Phase Shift
Authors: Feng Wei , Tang Shaojing , Xu Shinan , Qu Tong , Zhao Daxing
Published: September 2021

Digital fringe projection measurement technology has been widely used in computer vision and optical three-dimensional (3D) measurement. Considering the phase error caused by the gamma distortion and nonlinear error, the active gamma precorrection and phase error compensation methods based on the three-frequency with three-phase shifts are designed to reversely solve the initial phase and accurately compensate phase error. On the one hand, the gamma coefficient of the measurement system depends on precoding two groups of fringe sequences with different gamma coefficients to calculate the corresponded proportional coefficient of harmonic component. On the other hand, the phase error compensation method is designed to compensate the phase error and improve the accuracy and speed of phase calculation after gamma correction. Experiments show that the proposed precalibration gamma coefficient method can effectively reduce the sinusoidal error in nearly 80 percent which only needs fewer fringe patterns. Compared with the traditional three-frequency with four-phase shift method, the proposed method not only has higher phase accuracy and better noise resistance but also has good robustness and flexibility, which is not limited to the gamma distortion model.
Proximate Analysis of Poultry-Mix Formed Feed Using Maize Bran as a Base
Authors: Afolabi Solagbade Saheed , Oyeyode John Oluwafemi , Shafik Wasswa , Sunusi Zubair. A. , Adeyemi Adegoke Abdullahi
Published: September 2021

The purpose of this research was to demonstrate the proximate analysis of poultry-mix made using maize bran as a basis. Red beans, soya beans, and benny beans were the three samples utilised in this study. This work investigates the appropriate poultry mix for birds breed for meat and egg. Thirty grammes of proteinous feedstock were weighed and homogeneously combined with 70 grammes of maize bran. The following was revealed in a proximate analysis of the feeds: moisture ranged from 1.18% to 1.54%, unrefined lipids 0.99–3.08%, total carbohydrate 57% to 72%, ash content 38.48% to 38.92%, unrefined protein 18.38% to 22.53% and unrefined fiber 2.0% to 4.65% respectively for broilers and layers. In terms of nutritional concentrations, all feed samples showed a substantial variation. Based on the findings of the study, it can be stated that Soya bean-maize bran is an excellent poultry-mix formulation that has deep well-disposed benefits and meets nearly all nutritional needs for meat and egg-producing birds.
Species Composition, Diversity, and Habitat Association of Medium- and Large-Sized Mammals in Chimit-Kolla, Abay Gorge, Ethiopia
Authors: Wale Mengistu , Yihune Mesele
Published: September 2021

Identifying the species distribution, diversity, and habitat association provides input to launch proper conservation interventions. A survey of medium- and large-sized mammal species was conducted in Chimit-Kolla area to assess their distribution, diversity, and relative abundance in November 2019 to September 2020. Line transect sampling and focus group discussions were used for data collection. Shannon diversity index and Sorenson’s coefficient were used to compute the diversity and habitat utilization of species. The association of species among habitats was tested using the chi-squared test. In the survey, 18 species of medium- and large-sized mammals belonging to the order Artiodactyla (7 species), Carnivora (6 species), Rodentia (1 species), Primates (3 species) and Tubulidentata (1 species) were recorded. The association of mammalian species among the three habitats was not significant (

p
>
0.05

). However, the abundance of mammal species was significantly associated with forest habitats (

p
<
0.05

). There was a significant variation in abundance of medium- and large-sized mammal species observed in the dry season (157, 57.5%) as compared to the wet season (116, 42.5%) (χ2 = 6.17, df = 1, and

p
=
0.013

). The most abundant species was olive baboon (Papio anubis), followed by grivet monkey (Chlorocebus aethiops) and crested porcupine (Hystrix cristata). While leopard (Panthera pardus), white-tailed mongoose (Ichneumia albicauda), and aardvark (Orycteropus afer) were the rarest mammalian species recorded. Forest habitat has the highest species diversity (H’ = 2.276) than riverine vegetation and wooded grassland. Mammal species showed a considerable similarity among habitats, and the highest similarity was recorded between forest and wooded grassland (S = 0.8). The study area relatively has considerable numbers of medium- and large-sized mammal species, and urgent conservation action is required to reduce the emerging threats (hunting, charcoal production, agriculture, and investment expansion) and ensure survival of mammal species.
A Quantitative Framework to Study Potential Benefits and Harms of Multi-Cancer Early Detection Testing
Authors: Jiao Boshen , Gulati Roman , Katki Hormuzd A. , Castle Philip E. , Etzioni Ruth
Published: September 2021

Background:

Multi-cancer tests offer screening for multiple cancers with one blood draw, but the potential population impact is poorly understood.

Methods:

We formulate mathematical expressions for expected numbers of: (i) individuals exposed to unnecessary confirmation tests ( ${\rm{EUC}}$ ), (ii) cancers detected ( ${\rm{CD}}$ ), and (iii) lives saved ( ${\rm{LS}}$ ) given test performance, disease incidence and mortality, and mortality reduction. We add colorectal, liver, lung, ovary, and pancreatic cancer to a test for breast cancer, approximating prevalence at ages 50, 60, or 70 using incidence over the next 5 years and mortality using corresponding probabilities of cancer death over 15 years in the Surveillance, Epidemiology, and End Results registry.

Results:

${\rm{EUC}}$ is overwhelmingly determined by specificity. For a given specificity, ${\rm{EUC}}/{\rm{CD}}$ is most favorable for higher prevalence cancers. Under 99% specificity and sensitivities as published for a 50-cancer test, ${\rm{EUC}}/{\rm{CD}}$ is 1.1 for breast + lung versus 1.3 for breast + liver at age 50. Under a common mortality reduction associated with screening, ${\rm{EUC}}/{\rm{LS}}$ is most favorable when the test includes higher mortality cancers (e.g., 19.9 for breast + lung vs. 30.4 for breast + liver at age 50 assuming a common 10% mortality reduction).

Conclusions:

Published multi-cancer test performance suggests a favorable tradeoff of ${\rm{EUC}}$ to ${\rm{CD}}$, yet the full burden of unnecessary confirmations will depend on the posttest work-up protocol. Harm–benefit tradeoffs will be improved if tests prioritize more prevalent and/or lethal cancers for which curative treatments exist.

Impact:

The population impact of multi-cancer testing will depend not only on test performance but also on disease characteristics and efficacy of early treatment.

See related commentary by Duffy and Sasieni, p. 3
Integrated Molecular and Immune Phenotype of HER2-Positive Breast Cancer and Response to Neoadjuvant Therapy: A NeoALTTO Exploratory Analysis
Authors: Pizzamiglio Sara , Ciniselli Chiara Maura , Triulzi Tiziana , Gargiuli Chiara , De Cecco Loris , de Azambuja Evandro , Fumagalli Debora , Sotiriou Christos , Harbeck Nadia , Izquierdo Miguel , Nuciforo Paolo , Huober Jens , Cappelletti Vera , Cinieri Saverio , Piccart Martine , Daidone Maria Grazia , Pruneri Giancarlo , Colombo Mario Paolo , Tagliabue Elda , Verderio Paolo , Di Cosimo Serena
Published: September 2021

Purpose:

Little is known about the efficacy of HER2-targeted therapy in patients with breast cancer showing different HER2-pathway dependence and immune phenotypes. Herein, we report a NeoALTTO exploratory analysis evaluating the clinical value of 22 types of tumor-infiltrating immune cells by CIBERSORT and 5 immune-related metagenes in the overall patient population, and in subgroups defined by the TRAR classifier as HER2-addicted (TRAR-low) or not (TRAR-high).

Patients and Methods:

Association of baseline TRAR, immune-related metagenes, and CIBERSORT data with pathologic complete response (pCR) and event-free survival (EFS) were assessed using logistic and Cox regression models. Corrections for multiple testing were performed by the Bonferroni method.

Results:

A total of 226 patients were analyzed: 80 (35%) achieved a pCR, and 64 (28%) experienced a relapse with a median follow-up of 6.7 (interquartile range 6.1–6.8) years; 108 cases were classified as TRAR-low, and 118 TRAR-high. Overall, γδ T-cell fraction [OR = 2.69; 95% confidence interval (CI), 1.40–5.18], and no immune-related metagenes were predictive of pCR. Notably, lymphocyte-specific kinase (LCK) predicted pCR to combination (OR = 2.53; 95% CI, 1.12–5.69), but not to single-agent trastuzumab or lapatinib [OR = 0.74; 95% CI, 0.45–1.22 (Pinteraction = 0.01)]. Integrating LCK with γδ T cells in a multivariate model added to the discriminatory capability of clinical and molecular variables with a shift in AUC from 0.80 (95% CI, 0.74–0.86) to 0.83 (95% CI, 0.78–0.89). In TRAR-low cases, activated mast cells, IFN and MHCII were reduced, and STAT1, HCK1, and γδ T cells were associated with pCR. STAT1 was broadly associated with improved EFS regardless of pCR, and nodal status in overall (HR = 0.68; 95% CI, 0.49–0.94) and in TRAR-low cases (HR = 0.50; 95% CI, 0.30–0.86).

Conclusions:

Immuno-phenotyping holds the promise to complement current predictive models in HER2-positive breast cancer and to assist in new therapeutic development.
Extrachromosomal DNA in HPV-Mediated Oropharyngeal Cancer Drives Diverse Oncogene Transcription
Authors: Pang John , Nguyen Nam , Luebeck Jens , Ball Laurel , Finegersh Andrey , Ren Shuling , Nakagawa Takuya , Flagg Mitchell , Sadat Sayed , Mischel Paul S. , Xu Guorong , Fisch Kathleen , Guo Theresa , Cahill Gabrielle , Panuganti Bharat , Bafna Vineet , Califano Joseph
Published: September 2021

Purpose:

Human papillomavirus (HPV) plays a major role in oncogenesis and circular extrachromosomal DNA (ecDNA) is found in many cancers. However, the relationship between HPV and circular ecDNA in human cancer is not understood.

Experimental Design:

Forty-four primary tumor tissue samples were obtained from a cohort of patients with HPV-positive oropharynx squamous cell carcinoma (OPSCC). Twenty-eight additional HPV oropharyngeal cancer (HPVOPC) tumors from The Cancer Genome Atlas (TCGA) project were analyzed as a separate validation cohort. Genomic, transcriptomic, proteomic, computational, and functional analyses of HPVOPC were applied to these datasets.

Results:

Our analysis revealed circular, oncogenic DNA in nearly all HPVOPC, with circular human and human–viral hybrid ecDNA present in over a third of HPVOPC and viral circular DNA in remaining tumors. Hybrid ecDNA highly express fusion transcripts from HPV promoters and HPV oncogenes linked to downstream human transcripts that drive oncogenic transformation and immune evasion, and splice multiple, diverse human acceptors to a canonical SA880 viral donor site. HPVOPC have high E6*I expression with specific viral oncogene expression pattern related to viral or hybrid ecDNA composition.

Conclusions:

Nonchromosomal circular oncogenic DNA is a dominant feature of HPVOPC, revealing an unanticipated link between HPV and ecDNA that leverages the power of extrachromosomal inheritance to drive HPV and somatic oncogene expression.
A Case of Lung Adenocarcinoma with Pulmonary Hypertrophic Osteoarthropathy Showing Pathological Complete Response to a Pembrolizumab-Containing Chemoimmunotherapy
Authors: Kataoka Naoki , Oura Shoji , Yamaguchi Tomoyuki , Makimoto Shinichiro
Published: September 2021

A 65-year-old woman with prolonged cough and presumed pulmonary hypertrophic osteoarthropathy was referred to our hospital. Computed tomography showed 2 tumors larger than 3 cm in size and massive hilar lymph node enlargement in the right lung. Pathological examination of the transbronchial lung biopsy specimen showed atypical malignant cells, presumed adenocarcinoma, with 1% positivity of programmed cell death 1 ligand (PD-L1). Three courses of chemoimmunotherapy with pembrolizumab (400 mg q3w), carboplatin (AUC 5 mg/mL · min q3w), and pemetrexed (500 mg/m2 q3w) were well tolerated and brought about a quasi-complete response both of the lung tumors and lymph nodes and complete symptom relief of the pulmonary hypertrophic osteoarthropathy, finally leading to the surgical intervention, that is, lobectomy and lymph node dissection. Postoperative pathological examination showed no viable cancer foci both in the lung tumors and lymph nodes. The patient recovered uneventfully. Physicians should note the combination chemoimmunotherapy including pembrolizumab, with curative intent, to optimally treat patients with locally advanced non-small cell lung cancer (NSCLC) even if the NSCLC bears a small amount of PD-L1.
Diagnostic Challenge in a Patient Presenting with Ascites and Hypergammaglobulinemia
Authors: Mustika Syifa , Pratama Mirza Zaka , Lesmana Cosmas Rinaldi Adithya
Published: September 2021

Ascites is defined as the accumulation of intra-peritoneal fluid that can be caused by several diseases. We described a 47-year-old female presenting with low serum-ascites albumin gradient (SAAG) and a markedly high level of serum globulin. Serum protein electrophoresis revealed an M spike in the gamma region. Other laboratory results showed a marked increase in aspartate aminotransferase and alanine aminotransferase and predominantly conjugated hyperbilirubinemia without a sign of dilatation of bile ducts from abdominal ultrasonography examination. Furthermore, the follow-up showed a positive result for the anti-nuclear antibody test. The patient was assessed with autoimmune hepatitis, and the cause of ascites was suggested from portal hypertension although the level of SAAG was low. The ascites condition got improved after salt restriction, diuretics treatment, and abdominal paracentesis. However, the patient passed away because of the intracranial hemorrhage as a result of prolonged INR and APTT due to liver failure.
Vitreous Noise on Optical Coherence Tomography as an Early Finding of Brolucizumab-Related Intraocular Inflammation
Authors: Yoshikawa Yuji , Kumagai Tomoyuki , Shinoda Kei
Published: September 2021

We describe a case of brolucizumab-related intraocular inflammation (IOI) detected using vitreous haze on optical coherence tomography (OCT) at an early stage before the patient was aware of any symptom. A 69-year-old female presented with decreased right vision. The patient was diagnosed with pachychoroidal neovasculopathy and started intravitreal aflibercept (IVA) with a 3+ treat-and-extend strategy (TAE). Although the serous retinal detachment (SRD) disappeared after IVA treatment, the patient was managed with treatment every 4 weeks without extending the treatment interval To shorten the treatment interval, intravitreal brolucizumab (IVBr) was started 44 weeks after starting IVA treatment. After initiating IVBr treatment, the SRD completely disappeared. However, 16 weeks after starting IVBr, OCT showed noise in the vitreous cavity, which had not been seen before, and infrared images showed a black smoke-like shadow over the macula. Despite these findings, the patient had no subjective symptoms, and so IVBr was re-administered with an 8-week TAE interval. Five days after IVBr treatment, vitreous inflammatory cells were observed, and the noise in the vitreous cavity and the smoke-like shadow in the infrared image were further enhanced. We diagnosed the patient with brolucizumab-related IOI, and anti-inflammatory treatment was initiated. After extensive treatment, the vitreous opacity gradually disappeared, and the vitreous noise on OCT and the black smoke-like shadow on infrared images disappeared. IOI may have already been present 16 weeks after starting IVBr treatment, when we judged that there was no inflammation and IVBr was re-administered. When following patients receiving IVBr, IOI may be detected by OCT at an earlier stage by evaluating vitreous haze.
Interferon-γ-Induced Myeloid-Derived Suppressor Cells Aggravate Kidney Ischemia-Reperfusion Injury by Regulating Innate Immune Cells
Authors: Ji Jiawei , Zhuang Yuan , Lin Zhemin , Jiang Yihang , Wang Wei , Zhang Xiaodong
Published: September 2021

Objective: Myeloid-derived suppressor cells (MDSCs) are heterogeneous cells which can suppress T-cell functionality. Herein, we evaluated the functional importance of MDSCs in the context of kidney ischemia-reperfusion injury (IRI) and explored their ability to regulate innate and adaptive immune cell function in this context. Methods: The differentiation of MDSCs was induced in vitro by treating cells with GM-CSF and interferon (IFN)-γ. In a murine model of renal IRI, serum creatinine and blood urea nitrogen values were measured to monitor kidney function, while histopathological and immunohistochemical approaches were used to assess kidney injury severity. In addition, flow cytometry was employed to assess the phenotypes and apoptosis of kidney cells in these mice. Results: MDSCs induced by treatment with GM-CSF + IFN-γ could suppress T-cell functionality in vitro. The adoptive transfer of these MDSCs into an IRI mouse model system enhanced kidney damage and impaired renal function following the recruitment of these cells to renal tissues in these mice. Following such adoptive transfer, the relative frequency of MDSCs with a CD11b+Ly6G−Ly6Chigh monocytic-MDSC phenotype decreased, whereas cells with a CD11b+Ly6G+Ly6Clow polymorphonuclear-MDSC phenotype become more prevalent within kidney tissues following IRI. Adoptive transfer also coincided with increased frequencies of macrophages and dendritic cells (DCs) in the kidney tissues. This suggested that M-MDSCs contributed to early-stage renal IRI damage by differentiating into these deleterious cell types. However, MDSC-induced suppression of CD4+ and CD8+ T-cell infiltration was not sufficient to prevent the deterioration of renal function in these mice. Conclusions: Herein, we successfully developed a protocol wherein MDSCs were differentiated in vitro through combination GM-CSF/IFN-γ treatment. When these MDSCs were subsequently adoptively transferred into a murine model of renal IRI, they aggravated kidney damage, likely owing to the differentiation of M-MDSCs into deleterious macrophages and DCs.
Analysis of Cross-Reactivity and Allergic Symptoms of 19 Allergens: Results from NHANES 2005–2006
Authors: Zhu Zhi-Ling , Wu Ying-Xing , Zhang Zhu-Ping , Li Song
Published: September 2021

Introduction: We explored the cross-reactivity among 19 common allergen sources and evaluated the influence of serum IgE concentrations and the number of sensitized allergens on the incidence of allergic symptoms. Methods: We conducted this cross-sectional analysis using data from the National Health and Nutrition Examination Survey (NHANES) 2005–2006 which is a program of studies designed to assess the health and nutritional status of adults and children in the USA. After excluding participants with missing data from the allergen IgE test, allergy questionnaire, and respiratory health questionnaire, a total of 7,224 participants aged 6 years and older were included, as children younger than 6 years old did not complete all 19 allergen-specific IgE tests. Spearman correlation analysis was used to analyze the cross-reactivity between allergen sources. An independent sample Kruskal-Wallis test was performed to investigate the relationship between the serum-specific IgE levels of 19 allergens and the incidence of allergic symptoms. Results: The cross-reactivity between D. farinae and D. pteronyssinus was the strongest (ρ = 0.88), and cross-reactivity of cross-species was universal. With the increase in serum-specific IgE levels of D. farinae, D. pteronyssinus, oak, and birch, the incidence of sneezing increased (p < 0.05). With the increase in serum-specific IgE levels of cats, dogs, peanuts, Aspergillus, and Alternaria, the incidence of wheezing increased (p < 0.05). The incidence of rash was positively correlated with serum-specific IgE levels of D. farinae, D. pteronyssinus, shrimp, and peanut (p < 0.05). The incidence of wheezing continued to increase with an increase in sensitized allergens. When participants were sensitized to <10 allergens, the incidence of sneezing continued to increase as the number of sensitized allergens increased, whereas the incidence of rash did not have a clear association with the number of sensitized allergens. Conclusion: Species that are biologically close are more likely to have antigen cross-reactivity, while cross-reactivity among different species is common. Different allergens tend to cause different allergic symptoms. Different allergic sites in the body have inconsistent responses to the number of sensitized allergens.