bluuebunny/crossref_metadata_2025 huggingface dataset:
Distinct sequence features underlie microdeletions and gross deletions in the human genome
Authors: Qi Mengling , Stentson Peter , Ball Edward , Tainer John , Albino Bacolla , Kehrer-Sawatzki Hildegard , Cooper David , zhao huiying
Published: September 2021

Microdeletions and gross deletions are important causes
(~20%) of human inherited disease. Their genomic
locations are strongly influenced by the local DNA sequence environment.
Yet no systematic study has examined the generative mechanisms. Here, we
obtained 42,098 pathogenic microdeletions and gross deletions from the
Human Gene Mutation Database (HGMD) that together form a continuum of
germline deletions ranging in size from 1 bp to 28,394,429 bp. We
analyzed the sequence within 1-kb of the breakpoint junctions and found
the frequencies of non-B DNA-forming repeats, GC content, and the
presence of seven of 78 specific sequence motifs in the vicinity of
pathogenic deletions correlated with deletion length for deletions of
length ≤30 bp. Furthermore, we found the repeats of DR, GQ, and STR
appear to be important for the formation of longer deletions
(>30 bp) but not for the formation of shorter deletions
(≤30 bp) and significantly (Chi-square test P-value < 2E-16)
more microhomologies were identified in flanking short deletions than
long deletions (length >30 bp). We provide evidence to
support a functional distinction between microdeletions and gross
deletions. A deletion length cut-off of 25-30 bp may serve as an
objective means to functionally distinguish microdeletions from gross
deletions.
CF GLOBAL CARE: Collaboration Between Two CF Centers; University of Michigan, USA and Marmara University, Istanbul, Turkey before and during the COVID-19 Pandemic
Authors: Nasr Samya , Gokdemir Yasemin , Eralp Ela Erdem , Karakoc Fazilet , Ergenekon Almala , Tapley Christopher , Dagher Sharyn , Bouma Sandra , Kenis-Coskun Ozge , Kocamaz Damla , Karadag Bulent
Published: September 2021

Solving the world’s health challenges requires multidisciplinary
collaborations that bring together the talents, experiences, resources,
and ideas from multiple sectors in low and middle-income countries
(LMIC) and high -income countries (HIC). Cystic Fibrosis (CF) was
thought to be a disease of Caucasian populations from European decent.
However, it has been shown to affect people from all ethnic backgrounds.
CF care varies significantly for people with CF (pw CF) from HIC with
median survival approaching 50 years of age, to LMIC with pw CF dying in
infancy or early childhood. To address the discrepancy in quality of
care and outcomes, we report on a collaboration between our team at the
University of Michigan cystic fibrosis center (UoM CFC), through support
from the Middle East CF Association (MECFA) and the CF Foundation (CFF),
and a CF center in Turkey (Marmara University CF Center, Istanbul) to
address deficiencies and improve quality of care in that center. The
collaboration has been successful in improving Ma CFC data and patient
care. This partnership can be viewed as a model of collaboration to be
duplicated in other Middle East Countries and LMIC to deliver optimal CF
care.
Zanamivir aqueous solution in severe influenza: A global Compassionate Use Program, 2009–2019
Authors: Wang-Jairaj Jie , Jayabalan Tharaka , Joshi Aditya , Miller Irene , Zammit-Tabona Peter , Peppercorn Amanda , Oliver Amanda
Published: September 2021

Background Zanamivir is a neuraminidase inhibitor effective against
influenza A and B viruses. In 2009, GlaxoSmithKline (GSK) began clinical
development of intravenous (IV) zanamivir, and initiated a global
Compassionate Use Program (CUP) in response to the evolving H1N1 global
pandemic. The goal of the CUP was to provide zanamivir to critically ill
patients with limited treatment options. Methods Zanamivir was
administered to patients with suspected or confirmed influenza
infection, who were not suitable for other approved antiviral
treatments. Reporting of serious adverse events (SAEs) was mandatory and
recorded in the GSK safety database. A master summary tracking sheet
captured requests and patient characteristics. A case report form was
available for detailing medical conditions, dosing, treatment duration,
and clinical outcomes. Results In total, 4033 requests were made for
zanamivir treatment of hospitalized patients from 38 countries between
2009 and 2019. Europe had the highest number of requests (n=3051)
followed by North America (n=713). At least 20 patients were aged ≤6
months, of whom 12 were born prematurely. The GSK safety database
included 466 patients with ≥1 SAE, of whom 374 (80%) had a fatal
outcome. Drug-related SAEs were reported in 41 (11%) patients,
including hepatic failure (n=6 [2%]) and acute kidney injury (n=5
[1%)]. Conclusions The CUP fulfilled the need to provide global
access to zanamivir prior to product approval. No new safety concerns
were identified in the CUP compared with IV zanamivir clinical studies.
Cardiac Arrest due to Tamponade during Endovascular Stent Implantation: a Case Report
Authors: Yu Rou , Zeng Jun
Published: September 2021

Hemorrhagic cardiac tamponade is one of potentially fatal complications
of endovascular intervention. Usually it is because of perforation of
heart or rupture of aorta. Cases of pericardial effusion without any
arterial or heart injury are rare. Case presentation we reported is a
clinical case of cardiac arrest due to tamponade in a patient with
DeBakey type I aortic dissection (AD) undergoing thoracic aortic stent
implantation. In the early phase of the procedure, hemodynamic changes
of increased central venous pressure and decreased blood pressure - by
tamponade were noticed but unrecognized and lead to cardiac arrest
ultimately. During resuscitation, cardiac tamponade was suspected and
confirmed by transesophageal echocardiography (TEE). The patient was
successfully resuscitated after pericardiocentesis. Conclusion This case
of cardiac tamponade emphasizes the importance of vigilant clinical and
echo assessments, efficient multidisciplinary teamwork in deal with the
rare but severe complication.
Phylogenetic dependence of plant-soil feedback promotes rare species in a subtropical forest
Authors: Jiang Yuan , Wang Zihui , Chu Chengjin , Kembel Steve , He Fangliang
Published: September 2021

The widespread observation that rare species have stronger conspecific
plant-soil feedback (PSF) than common species raises more questions than
answers on how rare species can possibly win the dance with abundant
species. Here, we test soil feedback effect of phylogenetically related
species on seedlings of contrasting local abundance in a subtropical
forest. The results showed that although rare species suffered strong
negative PSF in soils of conspecifics or phylogenetically close
relatives, no such feedback was found in the soils of distant relatives.
In contrast, although common species had weak conspecific PSF, they
suffered consistently strong heterospecific soil feedback. These
mechanisms ensure that rare species would fare well in the neighborhood
of phylogenetically distant heterospecifics but do poorly under their
close relatives, while common species perform relatively well in their
own neighborhood but poorly in others’. This phylogenetic conservatism
in PSF facilitates the persistence of rare species in a community.
A generalized analytical solution of groundwater head response to dual tide in a multilayered island leaky aquifer system
Authors: Z'hao Zhi-Xue , Hao Yonghong , Wang Tongke , Yeh T J , Zhang Ming
Published: September 2021

The hydraulic properties of coastal aquifer systems are relevant to
various hydrogeological, hydro-ecological and engineering problems. This
study presents an analytical solution for predicting groundwater head
fluctuations induced by dual-tide in multilayered island aquifer
systems, consisting of an unconfined aquifer on the top and any number
of leaky aquifers below. The solution was derived via the methods of
matrix differential calculus and separation of variables. It is more
general than any existing analytical solutions for the tidal pressure
propagation since the new solution can consider multilayered aquifer
systems along with the effects of leakage and aquifer length. Using this
solution, we illustrated potential errors that may occur due to
neglecting one or more vital factors affecting groundwater fluctuations.
Besides, we articulated the groundwater response to the dual-tide in
complex coastal aquifers. Considering that some thin semipermeable
layers may be ignored in practical field investigation, we also
demonstrated the effects due to simplification of aquifer layers. The
results showed that with the increase in the number of overlapped leaky
layers, the tidal propagation in the bottom part of multilayered aquifer
system approaches that in a single confined aquifer with the same
transmissivity and storage.
Modelling electrical conductivity variation using a travel time distribution approach
Authors: RIAZI ZAHRA , Western Andrew W , Bende-Michl Ulrike
Published: September 2021

Water quality dynamics depend strongly on hydrologic flow paths and
transit time within catchments. In this paper we use a travel time
tracking method to simulate stream salinity (as measured by electrical
conductivity) in the Duck River catchment, NW Tasmania, Australia. The
approach couples the StorAge transit time modelling approach with two
different approaches to model electrical conductivity. The first assumes
the catchment has a cyclic salt balance (rainfall source, stream flow
sink) that is in dynamic equilibrium and evapoconcentration of salt is
the only process changing concentration. The second assumes that the
salinity of water in catchment storages is a function of water age in
those stores, without explicitly simulating salt mass balance processes.
The paper compares these alternate approaches in terms of salinity
simulation, simulated stream water age distributions, and simulated
storage age distributions. Both salinity simulation approaches reproduce
stream salinity with high fidelity under calibration and perform well
under validation. The simulations using the age-related solute
concentration approach produce less biased results and thus high model
efficiencies for validation periods. This approach also produces more
consistent model parameter estimates between periods. There are
systematic differences in the resultant age distributions between
models, particularly for the solute balance based simulations where
parameters (catchment storage size) changed more between calibration
periods. The effect of time varying versus static storage selection
functions are compared, with clear evidence that time varying storage
selection functions with parameters linked to catchment conditions
(flow) are essential for adequate simulation of event concentration
dynamics.
Environmental degradation in the transnational area of Changbai Mountain based on multiple remote sensing data
Authors: Sun Yaohang , Nan Ying , Zhang Da , Gan Xuegang , Piao Lichen
Published: September 2021

Rapidly and effectively assessing environmental degradation is essential
for promoting regional sustainable development in the transnational area
of Changbai Mountain (TACM). However, comprehensively understanding
environmental degradation in the TACM is still inadequate. In this
study, we developed an environmental degradation index (EDI) by using
multiple remote sensing data, including enhanced vegetation index (EVI),
gross primary productivity (GPP), land surface temperature (LST), and
MODIS surface reflectance products. We then evaluated its performance
comparing with the remote sensing ecological index (RSEI), and assessed
the environmental degradation across the whole TACM, in the subregions
of China, the Democratic People’s Republic of Korea (DPRK), and Russia
during 2000-2019. The results indicated that the EDI had the advantages
of simplicity and rapidity, which can assess the environmental
degradation in the TACM across long-time scales and large spatial
extent. The TACM experienced a downward trend of environmental changes
from 2000 to 2019. Degraded environment areas (49,329.50 km2) accounted
for 30.09% of the entire TACM. The largest area of the degraded
environment was on the DPRK’s side (i.e., 25,395.00 km2), which was 5.6
times larger than that on the Russian side and 1.3 times larger than
that on the Chinese side. Hotspot areas that experienced significant
environmental degradation just covered 17.69% of the land area of the
TACM, the area of environmental degradation in them accounted for
33.89% of the total degraded environment across the whole TACM. We
suggest that international cooperation policies and measures ought to be
enacted to promote regional sustainable development.
Sustainable medicines use in clinical practice - a clinical pharmacological view on ecopharmacostewardship
Authors: Adeyeye Elizabeth , New Benjamin , Chen Fangyue , Kulkarni Spoorthy , Editor) Marie Fisk (Associate Senior , Coleman Jamie
Published: September 2021

Climate change continues to pose a dangerous threat to human health.
However, not only is health impacted by this crisis, healthcare itself
adds to the problem, through significant contributions to green house
gas emissions. In the UK, the National Health Service (NHS) is
responsible for an estimated 4% of the overall national carbon
footprint. Medicines account for a quarter of this and whilst they are
vital in in health now, through sustainable use they can also positively
influence the environmental health of the future. In this review, we
explore how clinical pharmacologists and other health care professionals
can practice sustainable medicines use or eco-pharmaco-stewardship. We
will discuss current and near future environmental practices within the
NHS, which we suspect will resonate with other health systems. We will
suggest approaches for championing eco-pharmaco-stewardship in drug
manufacturing, clinical practices and patient use, to achieve a more a
sustainable healthcare system.
Catheter contact angle influences local impedance drop during radiofrequency catheter ablation: Insight from a porcine experimental study with 2 different LI-sensing catheters
Authors: Matsuura Gen , Fukaya Hidehira , Ogawa Emiyu , Kawakami Sota , Mori Hitoshi , Saito Daiki , Sato Tetsuro , Nakamura Hironori , Ishizue Naruya , Oikawa Jun , Kishihara Jun , Niwano Shinichi , Ako Junya
Published: September 2021

Background: Local impedance (LI) can indirectly measure catheter contact
and tissue temperature during radiofrequency catheter ablation (RFCA).
However, data on the effects of catheter contact angle on LI parameters
are scarce. This study aimed to evaluate the influence of catheter
contact angle on LI changes and lesion size with 2 different LI-sensing
catheters in a porcine experimental study. Methods: Lesions were created
by the INTELLANAV MiFi™ OI (MiFi) and the INTELLANAV STABLEPOINT™
(STABLEPOINT). RFCA was performed with 30 watts and a duration of 30
seconds. The CF (0, 5, 10, 20, and 30 g) and catheter contact angle
(30°, 45°, and 90°) were changed in each set (n=8 each). The LI rise, LI
drop, and lesion size were evaluated. Results: The LI rise increased as
CF increased. There was no angular dependence with the LI rise under all
CFs in the MiFi. On the other hand, the LI rise at 90° was lower than at
30° under 5 and 10 g of CF in STABLEPOINT. The LI drop increased as CF
increased. Regarding the difference in catheter contact angles, the LI
drop at 90° was lower than that at 30° for both catheters. The maximum
lesion widths and surface widths were smaller at 90° than at 30°,
whereas there were no differences in lesion depths. Conclusion: The LI
drop and lesion widths at 90° were significantly smaller than those at
30°, although the lesion depths were not different among the 3 angles
for the MiFi and STABLEPOINT.
A Natural History Study of Nitrous Oxide versus Propofol-Assisted Intrathecal Therapy in the Treatment of Acute Lymphoblastic Leukemia
Authors: Miller Lane , Winter Stuart , Watson David , livingston mylynda , Nemata Resty , Messinger Yoav
Published: September 2021

Background: Childhood acute lymphoblastic leukemia (ALL) treatment
requires numerous lumbar punctures (LPs) with intrathecal (IT)
chemotherapy to prevent and treat central nervous system disease.
Historically, LPs in this setting are performed using propofol sedation.
At our institution, LPs are often alternatively performed under nitrous
oxide (N2O). To date, there have been no large scale assessments
comparing these sedation methods for this purpose. Procedures:
Retrospective cohort study of patients aged 0-31 years with ALL treated
between 1/1/2013-12/31/2018 at the Children’s Minnesota Cancer and Blood
Disorders Center, including all therapeutic LPs performed in the clinic
setting under either propofol or N2O. Results: Among 215 patients and
2677 therapeutic LPs, 56.6% (n = 1515) occurred under N2O with 43.3%
(n = 93) of patients using exclusively N2O with all LPs. The incidence
of traumatic LPs (RBC ≥ 10 cells/µL) were similar between both
treatments (27.3% vs 30.2). Successful IT chemotherapy delivery (99.7%
N2O vs 99.8% propofol) did not differ between sedation types.
Experiencing a traumatic LP under N2O was associated with a sedation
switch for the subsequent LP (aOR 2.40, p=0.002) while older age (aOR
1.08, p<0.0001) and higher BMI percentile (aOR 1.01, p=0.009)
were associated with increased likelihood for undergoing a traumatic LP.
Conclusion: N2O is an effective sedation option for therapeutic LPs in
children with ALL with noninferiority to propofol in terms of IT
chemotherapy administration and traumatic LP incidence. For many
patients, N2O can effectively replace propofol during LP procedures,
which has important safety and quality-of-life implications.
Numerical investigation fluid velocity and heat transfer on the stretching sheet by VIM method and optimization fluid temperature and velocity parameter by Prandtl number and viscoelastic parameter
Authors: Pasha Pooya , Alibak Ali Hosin , Nabi Hossein , Shahdost Farzad tat
Published: September 2021

This study aimed at investigating the variation of heat transfer and
velocity changes of the fluid flow along the vertical line on a surface
drawn from both sides. In the beginning, the several parameters such as
Prandtl number and viscoelastic effect evaluated for heat transfer and
fluid velocity by variation Iteration method. The results were compared
with the numerical method. The second part of the description relates to
the use RSM method in the Design Expert software. In this paper by using
the RSM method, optimized the fluid velocity and heat transfer passing
from the stretching sheet. By increasing the Prandtl number, the
convection heat transfer 43 % increased ratio the minimum Prandtl
number. In accordance with balanced modes for Prandtl number and
viscoelastic parameter and wall temperature, the best optimization
occurred for fluid velocity and fluid temperature with f=0.67 and
θ=0.606. The results of variation iteration method are accurate for the
nonlinear solution. As the value of k increases, the value of fluid
velocity indicates an increase and by increase Prandtl number, the value
of Temperature decreases.
Gene Mutations for Cystic Fibrosis and Predisposition to Chronic Rhinosinusitis in Chinese Children
Authors: Han Yang , Wang Pengpeng , Liu Wenjing , Xiao Xiao , Yang Xiaojian , Tang Lixing , Zhang Wei , ZHANG JIE , Ge Wentong , Ni Xin
Published: September 2021

Background: Chronic Rhinosinusitis (CRS) is a common disease in
children. In recent years, a new airway epithelial ionocyte has been
discovered and is closely related to the expression of cystic fibrosis
transmembrane conductance regulator (CFTR), which provides new ideas for
the study of the mechanism of CRS. However, the carrying status of the
CFTR mutant gene in the Chinese population is not clear. Objective: To
study the frequency and mutations of CFTR and FOXI1 (ForkheadBoxI1) in
Chinese children with CRS, and to analyze whether they are predisposed
to CRS. Methods: A controlled case study was conducted from 2020 to
2021. The CFTR and FOXI1 genomes of 46 children with CRS and 23 children
with no history of CRS from the Chinese mainland area were sequenced,
and the relationship between mutation rate and the disease were
analyzed. Results: 13 CFTR gene mutation sites’ carrying rate in the CRS
group was higher than the control group, and 2 of them was significantly
higher than that in the East Asian population database. The children who
had a history of recurrent upper respiratory tract infection carried
CFTR gene mutations associated with the pathogenesis. There was no
difference in the carrying of FOXI1 mutation between the two groups.
Conclusion: The incidence of CF mutation is higher in Chinese children
with CRS who have no history of Cystic Fibrosis (CF).
c.650A> G (p.E217G) and c.1950C> A (P. F 650
L) and may play a role in the development of CRS conditions in children
in China.
CFD modelling of biomass catalytic fast pyrolysis in bubbling fluidized reactor: effects of catalyst parameters
Authors: Qiu Yajun , Xu Qixiang , Pang Shusheng , Ma Xiaoyuechuan
Published: September 2021

In this study, a CFD mathematical model has been developed for catalytic
fast pyrolysis (CFP) of biomass. The multi-phase fluid flow, and the
inter-phase momentum and energy transfer processes were modelled with
Eulerian multi-phase formulas. The biomass catalyst fast pyrolysis
reactions were described by using a two-stage, semi-global model.
Specified secondary tar catalytic cracking process, which considers both
intrinsic reaction rates and mass transfer process are embedded to the
developed model by user-defined function (UDF). The developed model has
then been employed to investigate the effects of structural properties
of catalyst, such as specific internal area, average size of active
sites, pore diameter, and tortuosity, on products yields and
composition. The influences of adsorption capability of tar molecule on
catalyst surface and external film mass transfer were also analyzed. The
developed model can be employed for further research and engineering
designs of the catalyst pyrolysis of carbonaceous materials.
An Adaptive Refined Grid Search Strategy for Assessing Operational Flexibility and Application on Refrigerant Selection
Authors: Wang Jiayuan , Smith Robin , Zhu Lingyu
Published: September 2021

A novel adaptive refined grid search strategy is developed for
representative characterization of process feasible region boundaries
and accurate estimation of its hypervolume. In particular, a linked list
data structure adopted from the field of computer science is used to
maintain the grid connectivity information. A uniform perturbation
scheme is used to refine the search only near boundaries. The volumetric
flexibility index FI_V is calculated directly from a summation of
feasible hypercubes in the grid, without the need to apply shape
reconstruction techniques. The proposed adaptive grid search strategy
can capture complex region shapes with reduced sampling costs and
without randomness for better reproducibility. Operational flexibility
is optimized traditionally at a process scale. A case study on
refrigerant selection is presented to demonstrated that the developed
strategy could be combined within a computer-aided molecular design
framework for operational flexibility optimization in molecular scale.
Effects of climate change and pollen supplementation on the reproductive success of two grassland plant species
Authors: Andrzejak Martin , Auge Harald , Korell Lotte , Knight Tiffany
Published: September 2021

Climate change has the potential to alter plant reproductive success
directly and indirectly through disruptions in animal pollination.
Climate models project altered seasonal precipitation patterns and thus
the effects of climate change on available resources and pollination
services will depend on the season. Plants have evolved reproductive
strategies to minimize pollen and resource limitations, and therefore we
expect that the disruption of climate change might cause plants to be
more pollen limited in seasons that become wetter than they were
historically. In this study, we conducted a pollen supplementation
experiment within the Global Change Experiment Facility (GCEF) in
Central Germany. The GCEF experimentally manipulates future climate
based on a realistic scenario of climate change for the region (drier
summers and wetter springs and falls) in a native grassland ecosystem.
We quantified seed production of two perennial species Dianthus
carthusianorum and Scabiosa ochroleuca in response to pollination
treatments (control, supplement), climate treatments (ambient and
future) and season (summer and fall). Dianthus carthusianorum produced
more seeds in future climate conditions independent of the season, but
only when given supplemental pollen. Both species showed an increased
reproduction in summer compared to the fall. We did not find any
evidence for our expectation of higher pollen limitation in the future
climate and fall season (i.e. no three-way interaction pollination x
season x climate), which might be explained by the high drought
tolerance and generalized pollination of our focal plant species. We
conclude that plant reproductive success might be limited by the
services of animal pollinators in future climates, and have many
suggestions for future studies that are necessary to understand the
context-dependence and underlying mechanisms of plant reproductive
responses to climate.
SARS-CoV-2 precipitated Kasabach-Merritt syndrome in a child with Kaposiform Hemangiendothelioma and acute lymphoblastic leukemia
Authors: Zarate Vanessa , Cahuata Alejandra , Diaz Roxana , Chonlon Kenny , Alvarado-Gamarra Giancarlo , Dominguez-Rojas Jesus
Published: September 2021

Kaposiform hemangiendothelioma usually occurs in children under two
years of age and develops thrombocytopenia secondary to sequestration of
platelets within (Kasabach-Merritt phenomenon) and is complicated by
secondary consumption of fibrinogen and clotting factors. SARS-CoV-2
produces cutaneous endothelitis as a direct effect of the presence of
the virus and the host inflammatory response. We describe an 8-month-old
boy with leukemia and SARS-CoV-2 infection who developed
Kasabach-Merritt phenomenon, coagulopathy, and intestinal involvement.
Given the emerging evidence of endothelial and vascular involvement in
COVID-19, the development of tests to detect vascular injury may be
critical to guide the use of new therapeutic strategies.
Recommended Scoring Approach for the Pediatric Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events
Authors: Hinds Pamela , Pinheiro Laura , McFatrich Molly , Waldron Mia , Baker Justin , Mowbray Catriona , Maurer Scott , Cheng Yao , Reeve Bryce , Wang Jichuan
Published: September 2021

Background Collecting symptom, function and adverse event (AE) data
directly from children and adolescents undergoing cancer care is more
comprehensive and accurate than relying solely on their caregivers or
clinicians for their interpretations. We developed the Pediatric
Patient-Reported Outcomes version of the Common Terminology Criteria for
Adverse Events (Ped-PRO-CTCAE) measurement system with input from
children, parents, and clinicians. Here we report how we determined the
recommended Ped-PRO-CTCAE item scoring approach. Methods Scoring
approaches compared were 1) at the AE attribute (frequency, severity,
interference) using ordinal and dichotomous measures, 2) a weighted
composite AE item score by AE attribute (0.5 - frequency; 1.0 -
severity; 1.5 - interference), and 3) overall number of AEs endorsed.
Associations of each AE attribute, AE item score and overall AE score
with the PROMIS® Pediatric measures of anxiety, depressive symptoms, and
fatigue were examined. The ability of the overall Ped-Pro-CTCAE AE score
to identify patients with PROMIS symptom T-scores worse than reference
population scores was assessed. Clinician preference for score
information display was elicited through interviews. Results The diverse
scoring approaches yielded similar outcomes, including positive
correlations of the Ped-PRO-CTCAE attributes, AE item score, and the
overall AEs score with the PROMIS Pediatric measures. Clinicians
preferred the most granular display of scoring information (actual score
reported by the child and corresponding descriptive term). Conclusions
Although three scoring approaches yielded similar results, we recommend
the AE attribute level of one score per Ped-Pro-CTCAE AE attribute for
its simplicity of use in clinical care and research.
Re-sternotomy for aortic valve replacement with patent coronary artery bypass grafts
Authors: Luthra Suvitesh , Malvindi Pietro , Sarvananthan Sajiram , Okorocha Chiemezie , Ohri Sunil
Published: September 2021

Objective - The aim was to evaluate early and long-term outcomes of
re-sternotomy for aortic valve replacement with previous patent coronary
artery grafts. Methods - Data for re-sternotomy for aortic valve
replacements (group 1 isolated AVR, group 2 AVR with concomitant
procedure) were collected (2000-19). Logistic regression analysis was
performed to identify predictors of in-hospital mortality and
postoperative composite outcome (in-hospital death, TIA/stroke, renal
failure requiring new hemofiltration, deep sternal wound infection,
re-exploration for bleeding/tamponade and length of stay
>30 days). Survival curves were compared using log rank
test. Cox proportion hazards model was used for predictors of long term
survival. Results – Total 178 patients were included (groups 1 - 90
patients, group 2 - 88 patients). Mean age was 75±4 years and mean log
EuroSCORE was 17±12% (15 ± 8% - group 1 vs 19 ± 14% - group 2,
p=0.06). Mean follow up was 6.3±4.4 years. Cardiovascular injury
occurred in 12%. LIMA was most commonly injured. In-hospital mortality
was 7.8% (5% - group 1 versus 10.2% - group 2, p=0.247). NYHA class
III-IV, perioperative IABP and cardiovascular injury were independent
predictors of in-hospital mortality (HR; 13.33, 95% CI; 2.04, 83.33,
p=0.007). Survival was significantly worse with cardio-vascular injury
at re-sternotomy up to 5 years (46% versus 67%, p=0.025) and
postoperative complications (p=0.023). Survival was significantly lower
than age matched first time AVR and UK population. Conclusions – Long
term survival is significantly impaired by cardiovascular injury and
perioperative complications of re-sternotomy.
Maternal lipid profile in pregnancy and embryonic growth: a population-based prospective cohort study.
Authors: Gootjes Dionne , Posthumus Anke , Wols Deveney , Rijke Yolanda de , Lennep Jeanine Roeters van , Steegers Eric
Published: September 2021

Objective To investigate the association between the maternal lipid
profile in early pregnancy and embryonic growth. Design Prospective
population-based cohort study. Setting Rotterdam, the Netherlands.
Population We included 1474 women from the Generation R(otterdam) Study.
Methods The maternal lipid profile was defined as total cholesterol,
triglycerides (TG), high-density lipoprotein cholesterol (HDL-c),
low-density lipoprotein cholesterol (LDL-c), remnant cholesterol,
non-high-density (non-HDL-c) lipoprotein cholesterol concentrations and
the triglycerides/high-density lipoprotein (TG/HDL-c) ratio.
Additionally, maternal glucose concentrations were assessed.
Associations were studied with linear regression models, adjusted for
confounding factors: maternal age, pre-pregnancy BMI, parity,
educational level, ethnicity, smoking and folic acid supplement use Main
Outcome Measures Crown-rump length (CRL). Results Triglycerides and
remnant cholesterol concentrations are positively associated with
embryonic growth (fully adjusted models, 0.17 SDS: 95% CI 0.03 ; 0.30,
and 0.17 SDS: 95% CI 0.04 ; 0.31, respectively). These associations
were not present in women with normal weight (triglycerides and remnant
cholesterol: fully adjusted model, 0.44 SDS: 95% CI 0.15 ; 0.72).
Associations between maternal lipid concentrations and embryonic growth
were not attenuated after adjustment for glucose concentrations. Total
cholesterol, HDL-c, LDL-c, non-HDL-c concentrations and the TG/HDL-c
ratio were not associated with embryonic growth. Conclusions Higher
triglycerides and remnant cholesterol concentrations in early pregnancy
are associated with increased embryonic growth, most notably in
overweight women. Keywords Pregnancy, Cholesterol, Low-density
lipoprotein (LDL-c), High-density lipoprotein (HDL-c), Triglycerides,
Intrauterine development, Fetal growth, Early pregnancy Tweetable
abstract The maternal lipid profile in pregnancy is associated with
embryonic growth.
Post Infarction Ventricular Septal Rupture: Transcatheter intervention or Surgical repair?
Authors: Alfares Fahad , Sandhu Satinder
Published: September 2021

ABSTRACT Post infarction ventricular septal rupture (PIVSR) is an
infrequent but potentially fatal complication of acute myocardial
infarction. • The 30-day mortality rate with the transcatheter approach
when performed in the acute phase (less than two weeks) was 25.3%
compared to 50% when surgery is performed in the acute phase (within
three weeks). • There is no correlation between defect size and
mortality. • NYHA class IV and time to VSD closure are risk predictors
for transcatheter closure for a 30-day mortality rate of 31.5%.
Heart transplantation in the new era of extended donor criteria
Authors: Piperata Antonio , Caraffa Raphael , bifulco olimpia , Avesani Martina , Gerosa Gino , Bottio Tomaso
Published: September 2021

The heart transplantation (HT) is undoubtedly the best treatment for
end-stage heart failure patients (2). However, the organ shortage
remains a major challenge in cardiac surgery. Facing this problem, the
medical community starts to extend the donor criteria to select more
suitable organs for HT. The use of ECDs is still controversial, since it
is associated with a high incidence of primary graft failure (3), and
although it guarantees longer survival than without transplantation,
there is still some hesitation in accepting this practice.
A case of right ventricular infarction due to acute Type A aortic dissection with anomalous aortic origin of the right coronary artery from the left sinus of Valsalva
Authors: Machii Yojiro , Shimada Naohiro , Okamoto Takashi , Tanaka Masashi
Published: September 2021

Anomalous aortic origin of a coronary artery from the opposite sinus is
a rare congenital condition that can cause sudden death in young people.
When it is associated with acute aortic dissection, acute myocardial
infarction can occur due to enlargement of the sinus of Valsalva. We
report the case of a 71-year-old man with anomalous origin of the right
coronary artery from the left sinus of Valsalva, who developed right
ventricular infarction due to the compression of the right coronary
artery between the aorta and pulmonary artery trunk.
Percutaneous Closure of Post Myocardial Infarction Ventricular Septal Rupture in an Unstable Hemodynamic State, Using an Unconventional Internal Jugular venous access;
Authors: alizadeh behzad , ramezani javad , zargaran bita
Published: September 2021

We report a 56-year-old woman with multiple cardiovascular risk factors
who initially present with chest discomfort. She underwent successful
primary percutaneous coronary intervention (PCI) on left anterior
descending and right coronary artery . Few hours later and after the
hemodynamic deterioration of patient,
Head and Neck Tuberculosis associated to Sarcoidosis : A Case Report.
Authors: Mediouni Azza , Najjar Sabrine , Boukriba Seif , Chelly Beya , chahed houda , Besbes Ghazi
Published: September 2021

The distinction between tuberculosis and sarcoidosis presents sometimes
a clinical challenge. Their sequential occurrence in the same patient is
uncommon. We present the case of a 42-year-old female with a proven
diagnosis of tuberculous lymphadenitis who has developed successively
nasal tuberculosis and pulmonary and liver sarcoidosis.
Molecular Hydrogen as an Adjuvant Therapy May be Associated with Increased Oxygen Saturation and Improved Exercise Tolerance In a COVID-19 patient
Authors: LeBaron Tyler , Singh Ram , Halabi Ghazi , Fatima Ghizal , Rai Richa , Tarnava Alex
Published: September 2021

COVID-19 is associated with respiratory failure and subsequent hypoxia.
New therapies that reduce hypoxia are urgently needed. Molecular
hydrogen (H2) therapy may reduce inflammation, oxidative stress, and
hypoxia. This case report suggests that hydrogen-rich water (HRW)
increases oxygen saturation increase exercise tolerance in a patient
with COVID-19-like symptoms.
Clinical Approach to a child with Poikiloderma: A case report
Authors: Shrestha Samir , Agrawal Sudha
Published: September 2021

Rothmund-Thomson Syndrome is a rare autosomal recessive condition
presenting usually in infancy that can be diagnosed based on time of
onset, spreading and appearance of the poikiloderma.The purpose of
reporting this case is to highlight the clinical approach to a child who
presents with the features of poikiloderma.
Non-islet-cell tumor hypoglycemia as first manifestation of an advanced hepatocellular carcinoma
Authors: Rojbi Imen , Elhaj Wiem Ben , Mchirgui Nadia , jrad myriam , Nacef Ibtissem Ben , khiari karima
Published: September 2021

Non-islet cell tumor hypoglycemia (NICTH) is a rare but severe
complication of malignancy. We present the case of 55 year old man who
was admitted for severe hypoglycemia. The diagnosis of insulinoma was
ruled out. After clinical work-ups, we made the diagnosis of metastatic
HCC with production of IGF-2.
Isolated Tuberculosis liver abscess in an immunocompetent patient.
Authors: sallam yazan , Jasim Dr. Ramsey , Qasem Nabeel , Kloub Mohammad
Published: September 2021

Tuberculous (TB) infection remains one of the leading causes of death,
especially in developing countries. TB liver involvement is a rare
extrapulmonary manifestation of TB and is usually found as a secondary
involvement to TB of the lung. Here we are presenting a case of Isolated
TB liver abscess.
Local and global existence in L^{p} for the inhomogeneous nonlinear Schrödinger equation
Authors: Wang deng , Yang Han
Published: September 2021

This paper investigates the local and global existence for the
inhomogeneous nonlinear Schrödinger equation with the nonlinearity
λ|x|^{-b}|u|^{β}u. It is
show that a global solution exists in the mass-subcritical for large
data in the spaces L^{p}, p < 2 under some suitable
conditions on b,β and p. The solution is established using a
data-decomposition argument, two kinds of generalized Strichartz
estimates in Lorentz spaces and a interpolation theorem.
Drug induced Diabetes Mellitus (DIDM) in Pediatric Acute Lymphoblastic Leukemia (ALL): Approach to diagnosis and management
Authors: Handattu Koushik , Sharma Lokesh , Vijayasekharan Kalasekhar , K Vasudeva , Aroor Shrikiran , Sudhanshu Siddhnath
Published: September 2021

Corticosteroids and L-asparaginase used in the treatment of pediatric
acute lymphoblastic leukemia (ALL) results in Drug induced Diabetes
Mellitus (DIDM). Literature on the management of DIDM among children
with ALL is sparse and the diagnostic criteria for pediatric diabetes
should be carefully applied considering the acute and transient nature
of DIDM during ALL therapy. Insulin remains the standard of care for
DIDM management and the choice of Insulin regimen (standalone Neutral
Protamine Hagedorn (NPH) or basal bolus) should be based on the type and
dose of steroids used for ALL and the pattern of hyperglycemia. A modest
glycemic control (140-180 mg/dl) to achieve euglycemia and prevent
hypoglycemia would be the general approach. This review is intended to
suggest a evidence based practical guidance in the diagnosis and
management of DIDM during pediatric ALL therapy.
Principal Component Analysis and Support Vector Machine on Ice Entrainment Through a Sluice Gate
Authors: Liang Naisheng , Tuo Youcai , Deng Yun , He Tianfu
Published: September 2021

The entrainment and accumulation of ice floes in front of the sluice
gates are closely related to the water transport efficiency and safe
operation of the channel during an ice period. A flume study is carried
out for a sluice gate with free outflow. A framework of stacking
ensemble models is used to analyze the data, which consists of a
two-level structure including the principal component analysis (PCA) and
the support vector machine (SVM) algorithms. Based on the mechanism of
ice floe accumulation, ten input characteristics of the machine learning
(ML) model are selected. The PCA method is used to eliminate redundant
information. The first principal component, with a contribution rate of
71.76%, and the second principal component, with a contribution of rate
15.64%, are extracted as the inputs of the SVM model, and the state of
the floating ice in front of the gate is used to determine the
classification labels. The 5-fold cross-validation method is used to
train the model. The training results showed that the Gaussian radial
basis functions (RBF) were the optimal kernel function. The performance
of the developed model is measured using area under curve (AUC),
accuracy (Acc) and F1-score (F1) values as statistical indicators. The
results showed that the established PCA-SVM model improves the Bernoulli
naive Bayes (Bernoulli NB) classifier and K-nearest neighbors’ algorithm
(KNN) models. It increasing the AUC value by 11% and 5%, the Acc value
by 16% and 17%, and the F1 value by 17% and 2%, respectively.
Binding of the kringle-2 domain of human plasminogen to streptococcal PAM-type M-protein causes dissociation of PAM dimers
Authors: Ayinuola Olawole , Ayinuola Yetunde , Qiu Cunjia , Lee Shaun , Ploplis Victoria , Castellino Francis
Published: September 2021

M-protein (PAM) largely contributes to the pathogenesis of Pattern D
Group A Streptococcus pyogenes (GAS). However, the mechanism of complex
formation is unknown. In a system consisting of a Class II PAM from
Pattern D GAS isolate NS88.2 (PAMNS88.2), with one K2hPg binding
a-repeat in its A-domain, we employed biophysical techniques to analyze
the mechanism of the K2hPg/PAMNS88.2 interaction. We show that
apo-PAMNS88.2 is a coiled-coil homodimer (M.Wt. ~80 kDa)
at 4°C - 25°C, and is monomeric (M.Wt. ~40 kDa) at 37°C,
demonstrating a temperature-dependent dissociation of PAMNS88.2 over a
narrow temperature range. PAMNS88.2 displayed a single tight binding
site for K2hPg at 4°C, which progressively increased at 25°C through
37°C. We isolated the K2hPg/PAMNS88.2 complexes at 4°C, 25°C, and 37°C
and found molecular weights of ~50 kDa at each
temperature, corresponding to a 1:1 (m:m) K2hPg/PAMNS88.2 monomer
complex. hPg activation experiments by streptokinase demonstrated that
the hPg/PAMNS88.2 monomer complexes are fully functional. The data show
that PAM dimers dissociate into functional monomers at physiological
temperatures or when presented with the active hPg module (K2hPg)
showing that PAM is a functional monomer at 37°C.
Experiencial Learning; Learning Abilities That Enhance Problem Solving Ability
Authors: Bwegyeme Jacinta , Munene John C.
Published: September 2021

Problem solving is one of the most critical aspects of an organization and a well thought out approach to problem solving has a direct correlation to an organization performance. The study sought to establish the effect of the four Kolb learning abilities (Concrete experience, reflective observation, abstract conceptualization and active experimentation) on problem solving ability of the administrators in a university setting in the academic registrar’s department. A cross sectional survey design was employed. The population consisted of all administrators in the Academic Registrar’s department registrar’s department in four Universities in Uganda.  Using Kreicjie and Morgan Sample size determination table, out of the population of 191 administrators, a sample of 123 was drawn and 103 responded. Simple random sampling was employed to give equal chance to every administrator in the department .The findings indicate a significant association between all the Kolb learning abilities and problem solving while abstract conceptualization and active experimentation are predictors of problem solving. It is recommended that administrators in universities and similar organisations should be trained in abstract conceptualization and active conceptualization skills to enhance their problem solving ability.  It is also recommended that further research be conducted in a larger sample of administrators.
Estilos de aprendizagem dos estudantes da disciplina de endodontia de uma universidade privada no sul do Brasil
Authors: Kublitski Prescila Mota de Oliveira , Tomazinho Paulo Henrique , Tomazinho Flávia Sens Fagundes , Brancher João Armando , Leonardi Denise Piotto , Gabardo Marilisa Carneiro Leão
Published: September 2021

Foram avaliados os estilos de aprendizagem dos estudantes de Endodontia de um curso de graduação em Odontologia, por meio do Índice de Estilos de Aprendizagem de Felder-Soloman. Participaram 144 estudantes, dos turnos matutino e noturno, entre maio e junho de 2016. Destes, 80,6% eram do gênero feminino e 68,5% do turno da manhã. A média de idade foi de 22,94 anos e a mediana de notas na disciplina foi de 6,52. Os estilos predominantes foram sensorial, visual, ativo e sequencial, respectivamente. A correlação entre idade e turno, e a intensidade de cada estilo de aprendizado não tiveram diferença estatisticamente significativa (p ˃ 0,05). As mulheres foram mais sensoriais e os homens mais visuais (p = 0,010). Na correlação entre média anual e estilos, houve diferença significativa para o sensorial e o intuitivo (p < 0,001). A maioria teve preferência mista entre os estilos de aprendizagem, independentemente do turno.
Dos aspectos históricos aos tensionamentos de inclusão do povo preto no contexto contemporâneo
Authors: Vieira Leandro Costa , Sebástian Heredero Eladio
Published: September 2021

Este ensaio teórico buscou traçar um recorte no espaço/tempo do século XX em que o movimento social do povo preto enfrenta uma revolução em busca de respeito e a minimização dos processos de racismo, discriminação e preconceito que subjugam estes como marginais e, por assim ser discriminados constantemente. Apontamos momentos da história da sociedade brasileira e suas adequações organizativas numa referência eurocêntrica, em normas e, a militância negra, com suas idiossincrasias como essencial para o reconhecimento de que as diferenças existem e precisam impreterivelmente ser debatidas. Finalizamos o ensaio com uma análise crítica/reflexiva acerca das políticas sociais dos governos mais recentes buscando e reconhecimento da inclusão como peça-chave de empoderamento, protagonismo e compreensão do lugar do povo preto na história A educação como um dos atos da inclusão é pautada no texto de maneira que atravessa o processo reflexivo/crítico e de militância na ordem social do mundo contemporâneo.
Effects of Ar-He shielding gas mixture on mechanical and metallurgical properties of weld metal in laser welding of 6061 T6 aluminium alloy
Authors: Gündoğdu İş Emine , Yılmaz Muharrem
Published: September 2021

In this study, a 6 mm-thick 6061 T6 aluminum alloy was welded using fiber laser welding, and its mechanical and metallurgical properties were investigated. Full penetration autogenous welds were made at a constant laser power of 4.95 kW using a continuous-wave fiber laser and focal positions of −4 mm. In addition, the shielding gas content was changed for weldments welded at different travel speeds (mm s−1). Accordingly, welding speeds were 50, 40, 35, 25, and 20 mm s−1, and the shielding gas contents were 100% argon (Ar), 10% helium (He) + 90% Ar, 30% He + 70% Ar, 50% He + 50% Ar, and 75% He + 25% Ar. Then, macro and micro images were taken, and some mechanical properties (hardness, tensile test, and bending test) were examined. As a result, the change in shielding gas content and welding speed has provided significant variations in the welding joints. Decreases in mechanical properties were detected due to the coarsening of the precipitates. On the other hand, the narrowness of the weld seam and HAZ obtained in laser welding, compared to traditional welding methods, minimizes this disadvantage.