bluuebunny/crossref_metadata_2025 huggingface dataset:
Sensory Transmission is Bi-directionally Modulated by Astrocytic Ca2+ in Barrel Cortex of Behaving Mice
Authors: Gu Simeng , Wang Wei , Zhang Kuan , Feng Rou , Li Naling , Smith Nathan A. , Dong Wei , Wu Erxi , Peng Weiguo , Hirase Hajime , Huang Jason H. , Wang Fushun
Published: February 2021

The authors have requested that this preprint be removed from Research Square.
Modeling the Impact of COVID-19 on Retina Clinic Performance
Authors: Sethi Karan , Levine Emily S. , Roh Shiyoung , Marx Jeffrey L. , Ramsey David J
Published: February 2021

Background: COVID-19, a highly contagious respiratory virus, presents unique challenges to ophthalmology practice as a high-volume, office-based specialty. In response to the COVID-19 pandemic, many operational changes were adopted in our ophthalmology clinic to enhance patient and provider safety while maintaining necessary clinical operations. The aim of this study was to evaluate how measures adopted during the pandemic period affected retina clinic performance and patient satisfaction, and to model future clinic flow to predict operational performance under conditions of increasing patient and provider volumes. Methods: Timestamps were extracted from the electronic medical records of in-person retina encounters from March 15 to May 15, 2020 and compared with the same period in 2019 to assess patient flow through the clinical encounter. Patient satisfaction was evaluated by Press Ganey patient experience surveys obtained from randomly selected outpatient encounters. A discrete-events simulation was designed to model the clinic with COVID-era restrictions to assess operational performance under conditions of increasing patient and provider volumes.Results: Retina clinic volume declined by 62% during the COVID-19 health emergency. Average check-in-to-technician time declined 79%, total visit length declined by 46%, and time in the provider phase of care declined 53%. Of note, patient satisfaction regarding access nearly doubled during the COVID-period compared with the prior year (p < 0.0001), while satisfaction with overall care and safety remained high during both periods. A model incorporating COVID-related changes demonstrated that wait time before rooming reached levels similar to the pre-COVID era by 30 patients per provider in a 1-provider model and 25 patients-per-provider in a 2-provider model (p < 0.001). Capacity to maintain distancing between patients was exceeded only in the two 2-provider model above 25 patients-per-provider.Conclusions: Clinic throughput was optimized in response to the COVID-19 health emergency. Modeling these clinic changes can help plan for eventual volume increases in the setting of limits imposed in the COVID-era.
Association Between Elevated Cardiac Troponin Level and Clinical Outcomes in Patients with Infective Endocarditis: A Meta-Analysis
Authors: Ling Yunfei , Chai Zheng , Li Tiange , Cao Zhongze , Chen Kerun , Qian Yongjun
Published: February 2021

Background: Infective endocarditis is a serious infection associated with high mortality. Timely intervention is paramount to achieve a favorable prognosis in patients with Infective endocarditis. At present, the correlation between cardiac troponin level and Infective endocarditis prognosis is not well established.Methods: Pubmed, Embase, and Cochrane databases were systematically searched for studies examining the relationship between elevated serum cardiac troponin concentration and prognosis in patients with IE. Literature screening, data extraction and quality appraisal were undertaken by two independent reviewers.Results: A total of 7 relevant studies were included in this study. Patients with elevated troponin were significantly associated with higher incidences of in-hospital mortality [OR=5.87, 95% CI (3.37,10.21)], one-year mortality [OR=3.28, 95% CI (1.01,10.62)], surgery or valve replacement [OR=2.18, 95% CI (1.36,3.51)], symptoms of central nervous system (CNS) [OR=3.28, 95% CI (1.01,10.62)], and cardiac abscesses [OR=3.28, 95% CI (1.01,10.62)]. There was no significant correlation between elevated troponin and incidence of renal failure, embolization, or cerebrovascular events in patients with Infective endocarditis.Conclusion: Elevated cardiac troponin in patients with Infective endocarditis is associated with higher risks of several adverse clinical outcomes. Therefore, these patients would warrant a more aggressive approach and early intervention in clinical management to improve prognosis.
Internal Structural Connections in the Popliteal Muscle Tendon Complex and Their Clinical Significance
Authors: Jiang WenBin , Sun Shi-Zhu , Song Ting-Wei , Li Chan , Tang Wei , Xu Fei , Yu Sheng-Bo , Sui Hong-Jin
Published: February 2021

Background:The popliteal muscle-tendon complex (PMTC) belongs to the deep structure of the posterolateral complex (PLC) of human knee, which plays an important role in the posterolateral stability of the knee joint. At present, the anatomical relationship between the popliteal muscle and its adjacent structures remains controversial, especially the posterior cruciate ligament (PCL) and popliteal muscle. The revealation of anatomical connection between the popliteus muscle and its deep structures could provide an anatomical basis for the reconstruction of the PLC injury.Methods: To observe and analyze the relationship between popliteal muscle and the PCL, posterior meniscofemoral ligament (PMFL), lateral meniscus and articular capsule (AC). The dissection of 7 cases of adult human knee joint fixed with formalin, and 9 cases of sagittal P45 plastinated section of the knee joint were involved in this study. Results: For the popliteal muscle, the anatomical dissection showed that at the posterior edge of the platform of the lateral condyle of the tibia, at the tendon-muscle transition, from medial to lateral, separately sent out: dense connective tissue to connect with the PCL, dense fiber bundles to connect with the PMFL, and dense connective tissue band to connect the lateral meniscus. Meanwhile, the results of the P45 section revealed that the popliteal muscle fascia ran superiorly over the posterior edge of the tibialintercondylar eminence, andturned forward to be integrated into the PCL. Laterally, near the posterior edge of the lateral tibial plateau, the popliteal tendon penetrates through the articular capsule, where two dense fiberous bundleswere given off upwards by the popliteal tendon: one was the ventral fiber bundle,which ran superiorly over the posterior edge of the tibial plateau and then moved forwards to connect with the lateral meniscus; the dorsal fibersbundle ascended directly and participated in the AC.Conclusion: Popliteus muscle was connected with PCL, AC, lateral meniscus, and PMFL via the dense connective tissues near its tendon-muscle transition.
Extending the Straight Leg Raise Test for Improved Clinical Evaluation of Sciatica: Reliability of Hip Internal Rotation and Ankle Dorsiflexion
Authors: Pesonen Janne , Shacklock Michael , Rantanen Pekka , Karttunen Lauri , Mäki Jussi , Kankaanpää Markku , Airaksinen Olavi , Rade Marinko
Published: February 2021

Background: The straight leg raise (SLR) is the most commonly applied physical tests on patients with sciatica, but the sensitivity and specificity ratings for disc hernia and neural compression leave areas for improvement. Hip internal rotation tensions the lumbosacral nerve roots and ankle dorsiflexion tensions the sciatic nerve along its course. We added these movements to the SLR (extended SLR=ESLR) as structural differentiators and tested inter-rater reliability in patients with LBP, with and without sciatica.Methods: Forty subjects were recruited to the study by the study controller (SC), 20 in the sciatic group and in the control group. Two independent examiners (E1&E2) performed the ESLR and did not communicate to the subjects other than needed to determine the outcome of the ESLR. First, SLR was performed traditionally until first responses were evoked. At this hip flexion angle, a location-specific structural differentiation was performed to confirm whether the emerged responses were of neural origin. Cohen’s Kappa score (CK) for interrater reliability was calculated with sensitivity and specificity to detect sciatic patients was calculated.Results: CK of the ESLR result between the independent examiners was 0.85. CK between SC/E1 was 0.90, and 0.95 between SC/E2. Sensitivity and specificity to detect sciatic patients were 0.95 and 0.98, respectively.Conclusions: ESLR with the addition of location-specific structural differentiation is a reliable and repeatable tool in discerning neural symptoms from musculoskeletal in patients with radiating low back pain. We recommend adding these movements to the standard SLR with aim of improving diagnostic efficacy.
Predictive Value of Prognostic Nutritional index and Systemic Immune‐Inflammation Index on Tumor Progression in Bladder Cancer Patients with After Radical Cystectomy
Authors: zhou jiatong , xu xitong , liu ranlu
Published: February 2021

OBJECTIVES: The purpose of this study was to explore the predictive value of preoperative prognostic nutritional index(PNI) and systemic immune‐inflammation index(SII) for local tumor stage in bladder cancer(BC) after radical cystectomy(RC).METHODS: We researched our database between April 2011 and October 2019. There were 195 BC patients who underwent RC. The PNI and SII were calculated using preoperative blood sample results. The predictive value of SII and PNI was analysed with univariate and multivariate Cox regression models. Significant P was P<0.05.RESULTS: Of patients, all patients were males with a mean age of 67.94±8.97years. Mean serum albumin was 42.13±4.28(g/L), mean PNI score was 51.29±6.09 and mean SII was 661.67±506.22. Multivariable Cox regression analysis demonstrated that PNI scores and SII could not play a significantly predictive factor between muscle invasive bladder cancer(MIBC) and non-muscle-invasive bladder cancer(NMIBC). While we also found PNI was an independent risk factors for predicting tumor stagep(pT＜3a and pT≥3a).CONCLUSIONS: Our research revealed that preoperative low PNI but not SII could be used as an independent factor to predict worse pathologically stage(pT≥3a). We still need future studies with large cohorts to identify our results.
Inorganic and Lead-free CsBi3I10 Thin Film Solar cell Prepared by Single-source Thermal Evaporation
Authors: Lan Huabin , Chen Xingye , Fan Ping , Liang Guangxing
Published: February 2021

All inorganic lead-free halide perovskites have attracted much attention due to their non-toxic and good band gap. In this paper, we first prepared all inorganic lead-free perovskite CsBi3I10 thin films by single source thermal evaporation deposition. The results show that CsBi3I10 thin films prepared by single source thermal evaporation have layered structure, high purity hexagonal phase and high crystallinity, which are consistent with the theoretical calculation results. The surface of the thin film was compact and uniform, and had high homology with the crystal structure of the evaporation source material. After annealing, the crystallinity of the film was further improved. The band gap of the CsBi3I10 thin film calculated was 1.83 eV, Perovskite solar cells based on CsBi3I10 thin films exhibit an efficiency of up to 0.84%. These results indicate that the proposed single source thermal evaporation method has the potential to prepare high efficiency inorganic lead-free perovskite solar cells.
Clinical Implications of CA 125 Elevation in Patients with Cardiac Amyloidosis: An Observational Study
Authors: Li Muzheng , Wu Zhijian , Tudahun Ilyas , Lin Qiuzhen , Liu Na , Liu Jiang , Wang Yingmin , Chen Mingxian , Chen Yaqin , Qi Nenghua , Zhu Qingyi , Li Wei , Tang Jianjun , Liu Qiming
Published: February 2021

Aims: The level of serum carbohydrate antigen 125 (CA 125) elevated is a common finding in patients with cardiac amyloidosis in clinical practice. It is unclear whether CA 125 is correlated with cardiac amyloidosis. The aim of this study was to systematically evaluate the clinical implications of CA 125 elevation in patients with cardiac amyloidosis.Methods and Results: We enrolled 101 patients diagnosed with cardiac amyloidosis at the Second Xiangya Hospital, 41 patients with acute decompensated heart failure (AHF) and 39 patients with multiple myeloma (MM) who were confirmed to have no cardiac amyloidosis served as control group, respectively. In 101 patients with cardiac amyloidosis, 58 (57%) patients had elevated serum CA 125 levels, which the mean age was 61.2 ± 11.4 years. Patients with high CA 125 were more likely to present with polyserositis ( 79.3% vs 60.5%, p = 0.03) , higher levels of hemoglobin (117.22 ± 21.87 g/L vs. 106.07 ± 25.15 g/L, p = 0.01), serum potassium (4.17 ± 0.49 mmol/L vs. 3.98 ± 0.41 mmol/L, p = 0.05), low density lipoprotein-cholesterol (2.98 ± 1.65 mmol/L vs. 2.22 ± 1.10 mmol/L, p = 0.01), and cardiac troponin T (115 pg/mL vs. 59.52 pg/mL, p = 0.005) . The serum CA 125 levels were significantly higher in cardiac amyloidosis than AHF and MM. The median overall survival for patients with elevated and normal serum CA125 were 5 and 20 months, respectively (p = 0.012). According to multivariate Cox hazard analysis, CA 125 (HR 1.002, 95%CI 1.000-1.004, p = 0.020) contributed to all-cause mortality. The time-dependent receiver operating characteristic was used to reflect the accuracy of different biomarkers in predicting overall survival at various time points by the area under the curve (AUC). CA 125 has no worse prediction accuracy than cardiac troponin T, NT-proBNP and LDH according to the AUC.Conclusions: The prevalence of elevated serum CA 125 levels is more than 50% in patients with cardiac amyloidosis. As an independent prognostic predictor, highly serum CA 125 values indicated the lower overall survival and the accuracy of predicting prognosis was not inferior to the other biomarkers.
Novel method using DW-MRI and ADC images to guide stereotactic biopsy for the diagnosis small primary angiitis of the central nervous system: A case report
Authors: Su Xu , Han Liang , Li Mengxing , Wang Zhengming , Gao Jiadui , Tian Yu , Du Chao
Published: February 2021

Objective

To determine the role of diffusion-weighted magnetic resonance imaging (DW-MRI) and apparent diffusion coefficient (ADC) imaging to guide stereotactic biopsy for the diagnosis of intracranial angiitis.
Case presentation

In a 28-year-old woman who had experienced inactive headache and right limbs numbness for 4 days, preoperative magnetic resonance (MR) scanning, enhanced scanning, diffusion tensor imaging, magnetic resonance spectroscopy, diffusion-weighted imaging (DWI), and ADC image scanning were performed. Stereotactic biopsy was performed in one target where the area of edema detected with MR FLAIR, and two targets where the area shown as a high-value and a lower-value area in the DWI/ ADC image. Pathological examinations together with computed tomographic and enhanced MRI scans were conducted after surgery. A preoperative enhanced MRI scan showed a uniform low-intensity lesion in the patient’s left centrum semiovale, with a volume of 3.1 cm3. The DWI and ADC images showed uneven high-intensity signals and different ADC values in the lesion area, respectively. During surgery, tissues around the lesion and the lesion center were sampled at the three selected targets. The postoperative pathological diagnosis was primary angiitis of the central nervous system, and the patient was given anti-inflammatory medication and hormone therapy. The 3-year follow-up confirmed that the patient had recovered well, with a Glasgow Outcome Scale score of 5.
Conclusion

DW-MRI and ADC images can be reliably used to determine the location of small intracranial lesions, and guide stereotactic biopsy to facilitate the diagnosis of primary vasculitis of the central nervous system.
NUT Midline Carcinoma as a Primary Lung Tumor Treated With Anlotinib Combined With Palliative Radiotherapy: a Case Report
Authors: Jiang Jin , Ren Yikun , Xu Chengping , Lin Xing
Published: February 2021

Background: NUT (nuclear protein in testis) midline carcinoma (NMC) is a rapidly progressive tumor arising from midline structures. Recent cases have reported that the poor prognosis with a median survival of 6.7 months and a 2 years overall survival of 19% due to limited treatment. Based on the effect of arotinib on inhibiting tumor growth and angiogenesis. We present one patient case treated with anlotinib and radiotherapy.Case presentation: Here, we describe a 33-year old patient who complained of cough and chest pain and was diagnosed as a pulmonary NMC through CT scan, FISH and immunohistochemistry. In addition, we initially demonstrated that anlotinib combined with palliative radiotherapy could significantly prevent the tumor growth in a pulmonary NMC.Conclusion: The report indicated that anlotinib combined with palliative radiotherapy could inhibit the tumor progression in a pulmonary NMC, which may provide a combined therapy to pulmonary NMC in the future.
Cloning and expressions of chop in loach (Misgurnus anguillicaudatus) and its response to hydrogen peroxide (H2O2) stress
Authors: Li Hui , Kang Minxin , Sun Shouxiang , Gao Jian , Jia Zhiying , Cao Xiaojuan
Published: February 2021

C/EBP [CCAAT/enhancer-binding protein]-homologous protein gene (chop) which plays an important role in endoplasmic reticulum stress-induced apoptosis, was investigated here by RACE and qPCR in an aquaculture animal for the first time. The full-length cDNA sequences of loach (Misgurnus anguillicaudatus) chop were 2533bp, encoding 266 amino acids. chop revealed obvious changes in transcriptions during different early life stages of the loach, and the highest appeared at the 8-cell stage. Among different tissues, loach chop predominantly expressed in gill, spleen and gonad. Then, we performed a hydrogen peroxide (H2O2, a common-used disinfectant) stress trial to explore the role of loach chop, and three different concentrations (0 µM, 50 µM and 100 µM) of H2O2 were set. After the stress, half of the loaches from 100 µM group were dead, whereas all loaches from the other two groups were alive. Meanwhile, the activities of CAT, SOD and GPX decreased obviously with the extension of stress time and increased H2O2 concentration. The expression levels of gill chop in loaches from 100 µM group were significantly higher than those from the other two groups at the 12th hour to 24th hour. atf4 and bax, two proapoptotic genes, significantly up-regulated in 100 µM group compared with the other two groups at the 18th hour and 24th hour. While the expression profiles of an antiapoptotic gene bcl2 basically presented an opposite trend. These results indicated a close relationship between H2O2 stress and fish apoptosis, and loach chop played an important role in response to the stress.
Genome characterization of Zucchini yellow mosaic virus infecting cucurbits reveals the presence of a new genotype in Trinidad & Tobago in the Caribbean region
Authors: Chinnaraja Chinnadurai , Kollam Mounika , Ramsubhag Adesh , Jayaraj Jayaraman
Published: February 2021

Zucchini yellow mosaic virus is a potyvirus, which is becoming a serious pathogen of pumpkin and other cucurbits in Trinidad and Tobago and the entire Caribbean region. In this study, four Zucchini yellow mosaic virus (ZYMV) isolates infecting pumpkin in Trinidad and Tobago were characterized by complete genome sequencing for the first time. Phylogenetic analyses of the isolates showed variability of 5.9–6.0 % nt and 7.7–7.9 % aa sequences with the most closely related isolates NAT and AG (Israel) and SE04T (Slovakia). Based on the variations in complete genome as well as gene sequences, a new genotype designated ZYMV-Trini is proposed for these isolates. Among the gene sequences of ZYMV-Trini isolates, maximum variations were noticed in HC-Pro gene with 20.8 % aa sequence divergence from their closest relatives whereas the least variations were with the NIb, P3 and CP genes (1.8 to 2.2 % aa divergence). This study also proved that transmission of ZYMV can also occur through seeds (2 %), but this was less common than transmission via the aphid species Aphis gossypii. The progression of ZYMV in pumpkin seedlings was quantified by RT-qPCR which showed a rapid surge in viral load after 37 days. From the recombination analyses, it could be concluded that isolates SE04T from Slovakia, NAT from Israel and AG from Israel have major contributions in the genome architecture of ZYMV-Trini isolates.
Development of novel hybrid machine learning models for monthly thunderstorm frequency prediction over Bangladesh
Authors: Azad Md. Abul Kalam , Islam A R M Towfiqul , Rahman Md. Siddiqur , Ayen Kurratul
Published: February 2021

Accurate thunderstorm frequency (TSF) prediction is of great significance under climate extremes for reducing potential damages. However, TSF prediction has received little attention because a thunderstorm event is a combination of intricate and unique weather scenarios with high instability, making it difficult to predict. To close this gap, we proposed a novel hybrid machine learning model through hybridization of data pre-processing Ensemble Empirical Mode Decomposition (EEMD) with two state-of-arts models namely artificial neural network (EEMD-ANN), support vector machine (EEMD-SVM) for TSF prediction at three categories of yearly frequencies over Bangladesh. We were demarcated the yearly TSF datasets into three categories for the period 1981–2016 recorded at 28 sites; high (March-June), moderate (July-October), and low (November-February) TSF months. The performance of the proposed EEMD-ANN and EEMD-SVM hybrid models was compared with classical ANN, SVM, Autoregressive Integrated Moving Average (ARIMA). EEMD-ANN and EEMD-SVM hybrid models showed 8.02%-22.48% higher performance precision in terms of root mean square error (RMSE) compared to other models at high, moderate and low-frequency categories. Eleven out of 21 input parameters were selected based on the Random Forest (RF) variable importance analysis. The sensitivity analysis results showed that each input parameter was positively contributed to building the best model of each category and thunderstorm days are the most contributing parameters influencing TSF prediction. The proposed hybrid models outperformed the conventional models where EEMD-ANN is the most skillful for high TSF prediction, and EEMD-SVM is for moderate and low TSF prediction. The findings indicate the potential of hybridization of EEMD with the conventional models for improving prediction precision. The hybrid model developed in this work can be adopted for TSF prediction in Bangladesh as well as different parts of the world.
The Lucernic Behaviour of Gravity
Authors: Rodrigues Ednardo Moreira
Published: February 2021

In this work it is proposed a scientific line of reasoning called Lucernics which aims to describe natural phenomena in terms of properties of light. It also carries out an analysis about how gravity could be intermediated by virtual particles similar to photons, namely guardions. It also proposes that massive bodies are sinks of guardions. When a massive body absorbs guardions from vacuum fluctuations, dark guardions are emitted. A dark guardion is a virtual particle which carries momentum in a direction opposite to its displacement. The time-derivative of this momentum describes a possible attractive force between massive particles which emit them. This derived force was compared to Newtonian gravitational force and the caliber constant obtained was equal to Planck's mass. This same study was done for electrostatic force, obtaining Planck's charge as a caliber constant. Newton's gravitational constant and Einstein's field equation were decomposed, and it also proposes a Lucernic Field Equation. The phenomena that this equation could describe will be discussed in future works.
Security-enrichment of an asymmetric optical image encryption-based devil’s vortex Fresnel lens phase mask and lower upper decomposition with partial pivoting in gyrator transform domain
Authors: - Anshula , Singh Hukum
Published: February 2021

An asymmetric optical cryptosystem to encrypt images using devil’s vortex Fresnel lens (DVFLs) phase masks and lower upper decomposition with partial pivoting (LUDPP) is proposed in gyrator transform domain. The proposed cryptosystem utilizes DVFLs which are the complex phase masks designed using the combination of a phases of devil’s lens (DL), vortex lens(VL), and Fresnel lens (FL). LUDPP is an operation used to decompose the matrix and is utilized to supersede the phase-truncation (PT) task in the traditional phase-truncated Fourier transform (PTFT). Hence, the proposed method is immune to the attacks to which the PTFT-based cryptosystems are vulnerable. The cryptosystem is asymmetric as both the encryption and decryption processes are different along with different keys. The private keys generated during the encryption process are utilised in the decryption process to retrieve the original image. The encryption and decryption process can be realised with both the digital and the modified optical architecture. In order to show the strength and robustness of the proposed encryption, a conspire numerical simulation was performed.
Influence of H. Pylori and Sex on Leukocyte Differentials
Authors: Fukui Yuri , Yamanaka Hiroyuki , Kitamura Noboru , Takei Masami , Iwamoto Maho , Moriyama Mitsuhiko , Kato Kimitoshi , Maejima Mamoru , Shirinskaya Natalia , Matsukawa Yoshihiro
Published: February 2021

Background: Influence of Helicobacter pylori infection and sex difference on leukocyte differentials was insufficiently understood. We therefore conducted the current study to evaluate influence of H. pylori and sex on peripheral leukocyte differentials as well as influence of Helicobacter pylori eradication. Methods: Dyspeptic patients and persons asked to examine gastroduodenal lesions at medical check were included. Total leukocytes, differentials, and anti-H.pylori IgG antibody were measured. Those change after eradication was also measured. H. pylori infection was assessed by anti-H. pylori IgG antibody, rapid urease test, and pathologic findings. H. pylori-uninfected patients and non-dyspeptic/seronegative persons were regarded as negative controls. Results: Totally 374 patients and 299 controls were evaluated, and 167 patients were successfully eradicated. Peripheral counts of neutrophil and monocyte elevated with H. pylori infection: 3221.7+/-1108.7 vs. 2911.9+/-1027.3/μL and 307.5+/-130.5 vs. 281.5+/-106.4/μL, (p­=.0002 and .0054). Compared to females, males manifested elevated counts of every leukocyte, but the difference was insignificant in basophil (p=.0089, 0.0316, <.0001, and .0384 for neutrophil, lymphocyte, monocyte, and eosinophil, respectively). After eradication, counts of neutrophil, lymphocyte, and monocyte declined: 3111.0+/-966.8 to 2785.1+/997.2/μL, 1905.9+/-603.2 to 1831.6+/-613.5/μL, and 293.1+/-113.3 to 264.3+/-93.6/μL by 2 months (p=<.0001, .0189, and .0004). In contrast, eosinophil counts elevated from 123.2+/-97.0 to 139.8+/-115.4 by 2 months, and to 159.6+/-132.8/μL by 6 months (p=.0349 and <.0001). Conclusions: We confirmed increases in neutrophils and monocytes in H. pylori-infected patients. Successful eradication reduced peripheral counts of neutrophil, lymphocyte, and monocyte, whereas it increased eosinophil counts. Males manifested elevated counts of every leukocyte, comparing to females. H. pylori infection influences systemic immune response and may not predispose to allergic disorders.Trial registration: The study protocol was registered on UMIN (University hospital Medical Information Network system) in Japan (R000017345) in 2014.
SARS-CoV-2 European resurgence foretold: interplay of introductions and persistence by leveraging genomic and mobility data
Authors: Lemey Philippe , Ruktanonchai Nick , Hong Samuel , Colizza Vittoria , Poletto Chiara , Broeck Frederik Van den , Gill Mandev , Ji Xiang , Levasseur Anthony , Sadilek Adam , Lai Shengjie , Tatem Andrew , Baele Guy , Suchard Marc , Dellicour Simon
Published: February 2021

Following the first wave of SARS-CoV-2 infections in spring 2020, Europe experienced a resurgence of the virus starting late summer that was deadlier and more difficult to contain. Relaxed intervention measures and summer travel have been implicated as drivers of the second wave. Here, we build a phylogeographic model to evaluate how newly introduced lineages, as opposed to the rekindling of persistent lineages, contributed to the COVID-19 resurgence in Europe. We inform this model using genomic, mobility and epidemiological data from 10 West European countries and estimate that in many countries more than 50% of the lineages circulating in late summer resulted from new introductions since June 15th. The success in onwards transmission of these lineages is predicted by SARS-CoV-2 incidence during this period. Relatively early introductions from Spain into the United Kingdom contributed to the successful spread of the 20A.EU1/B.1.177 variant. The pervasive spread of variants that have not been associated with an advantage in transmissibility highlights the threat of novel variants of concern that emerged more recently and have been disseminated by holiday travel. Our findings indicate that more effective and coordinated measures are required to contain spread through cross-border travel.
Cerebrovascular risk factors are the predictive factor for ischemic cerebrovascular diseases in patients with Philadelphia chromosome (Ph)–negative myeloproliferative neoplasms: a case control study
Authors: Wen Shirong , Zhang Wenxiao , Fei Yiping , Guan Ke , Zhao Hui , Song Peng , Ye Xiangmei , Cao Fenglin , Zhou Jin , Pan Yujun
Published: February 2021

Background: The ischemic cerebrovascular disease (ICVD) is major thrombotic complication of Philadelphia chromosome (Ph)-negative myeloproliferative neoplasms (Ph-negative MPNs) which included essential thrombocythemia (ET), polycythemia vera (PV) and primary myelofibrosis (PMF) leading to high disability and mortality rates. However, risk factors attributable to ICVD in Ph-negative MPNs patients are still not understood. This study aimed to identify risk factors for ICVD in Ph-negative MPNs. Methods: Patients with Ph-negative MPNs were divided into ICVD and non-ICVD groups. The demographic, biochemical, genetic parameters (JAK2V617F and CALR mutations) were assessed. The association between these factors and ICVD was assessed using logistic regression analysis.Results: One hundred eighty five Ph-negative MPNs patients (82 ET, 78 PV, and 25 PMF) were recruited，and 57 (30.8%) had ICVD which was higher than recently published data. The higher prevalence of hypertension(59.6% vs 32.0%), smoking(22.8% vs 6.3%), drinking(22.8% vs 6.3%), JAK2V617F mutation(78.9% vs 63.3%), the percentage of neutrophils( 78.76% vs 71.73%)， the lower prevalence of CALR mutation(3.2% vs 22.2%) and the percentage of basophils(0.82% vs 1.40%) were found in the ICVD group comparing with the non-ICVD group. The frequency of ICVD events was significantly higher in patients with JAK2V617F mutation than in those without (35.7% and 20.3%, P=0.034). Multivariate logistic regression analysis showed that hypertension (OR=2.464, 95%CI 1.218-4.983, p=0.012) and smoking (OR=5.426, 95%CI 1.919-15.340, p=0.001) were significantly positively associated with ICVD events. For ET patients, both smoking (OR=4.414, 95%CI 1.079-15.685, p=0.038) and increased percentage of neutrophils (OR=1.080, 95%CI 1.019-1.144, p=0.009) were independently associated with ICVD incidence. Hypertension (OR=4.647, 95%CI 1.215-17.781, p=0.025), smoking (OR=6.065, 95%CI 1.083-33.951, p=0.040), and increased percentage of lymphocytes (OR=1.039, 95%CI 1.002-1.078, p=0.039) were all positively correlated with ICVD risk in PV patients. Conclusions: Our data suggest that hypertension, smoking, higher percentage of neutrophils and lymphocytes rather than JAK2V617F and CALR mutations may be associated with an elevated risk of ICVD in Ph-negative MPNs patients, although the relative role of each factor may vary in the individual subgroup. Additional studies of large patient cohorts will be essential to validate these findings.
High PRMT6 expression Associated With Prognosis and Immune Infiltration in Glioma
Authors: Yang Yi , Wang Zhenshuang , Long Shengrong , Huang Jinhai , Xu Chengran , Yao Mingze , Li Lun , Li Guangyu
Published: February 2021

Background

Glioma is characterised by easy invasion of surrounding tissues, high mortality and poor prognosis. Moreover, the prognosis of glioma is getting worse and worse with the increase of grade, which is not optimistic. Therefore, biological markers for glioma are needed in clinical to detect and evaluate the situation and prognosis of patients with glioma. In many studies, we have found that the protein arginine methyltransferase 6 (PRMT6) expression is elevated in various tumors, which is associated with prognosis of patient. However, there has been no report or study on the role of PRMT6 in glioma.
Methods

In this study, we used various tumor-related databases to analyze the mechanism of PRMT6 in tumors, especially gliomas, from bioinformatics, and carried out relevant experimental verification with tumor tissues extracted from patients during surgery. Besides, we analyzed the relationship between PRMT6 expression and immune infiltration and immune-related cells, and discussed the possible mechanisms. We also discussed the role of PRMT6 expression in glioma from mutation, clinical indicators, enrichment analysis, and immunohistochemical results.
Results

PRMT6 is significantly differentially expressed in multiple tumors, which is associated with survival and prognosis. Especially in gliomas, the PRMT6 expression gradually increased with the grade increasing. Besides, PRMT6 can be used as an independent prognostic risk factor in the nomogram and has been verified in various databases.
Conclusions

Our results indicate that high PRMT6 expression is a potential biomarker for predicting prognosis and progression of glioma.
Koos Grade IV Vestibular Schwannomas: Considerations on a consecutive series of 60 cases. Searching for the Balance Between Preservation of Function and Maximal Tumor Removal
Authors: Mastronardi Luciano , Campione Alberto , Boccacci Fabio , Scavo Carlo Giacobbo , Carpineta Ettore , Cacciotti Guglielmo , Roperto Raffaelino , Sufianov Albert , Zomorodi Ali
Published: February 2021

Purpose Koos Grade IV vestibular schwannomas (VS) (maximum diameter >3cm) compress the brainstem and displace the fourth ventricle. Microsurgical resection with attention to the right balance between preservation of function and maximal tumour removal is the treatment of choice.Methods Our series consists of 60 consecutive patients with unilateral VS, operated on from December 2010 to July 2019. All patients underwent microsurgical removal via the retrosigmoid approach. The adherence of VS’ capsule to surrounding nervous structures and the excessive tendency of tumor to bleed during debulking, because of a redundant vascular architecture, was evaluated by reviewing video records. Microsurgical removal of tumor was classified as total (T), near-total (NT: residue<5%), subtotal (ST: residue 5-10%) or partial (P: residue>10%).Results Maximal mean tumor diameter was 3,97cm (SD±1,13; range 3,1-5,8cm). Preoperative severely impaired hearing or deafness (AAO-HNS Classes C-D) was present in 52 cases (86,7%). Total or NT resection was accomplished in 46 cases (76,7%), 65,8% in cases with and 95,4% without tight adhesion of capsule to nervous structures (p<0,001). Endoscopic-assisted microsurgical removal of VS in the IAC was performed in 23 patients: in these cases a T resection was obtained in 78,3% versus 45,9% of microsurgery only (p<0,001).The capsule of VS was tightly adherent to nervous structures in 63,3% of patients, whereas hypervascular high-bleeding tumors represented 56,7%. Hearing preservation was possible in 2 out of 8 patients with preoperative class B hearing. At last follow-up, 34 patients (56,7%) had a normal postoperative FN outcome (HBI), 9 (15,0%) were HBII, 8 (13,3%) HBIII, and 9 (15,0%) HBIV. Total-NT resection of solid and low-bleeding VS, without tight capsule adhesion was associated with better FN outcome. Mortality was zero; permanent complications were observed in 2 cases (diplopia, hydrocephalus), transient in 9.Conclusions Microsurgery of Koos Grade IV VS seems to be associated with more than acceptable functional results, with high rate of T and NT removal of tumor. Long-term FN results seem to be worse in patients with cystic Koos Grade IV VS, in cases with tight capsule adherences to nervous structures and in high-bleeding tumors.
Enhanced Cancer Starvation Therapy via Autophagy Inhibition With a Functional Dendritic Mesoporous Organosilicon Nanoagent
Authors: Wu fan , Liu yang , Cheng hui , Meng yun , Yi yan , Xiao jinrong , Liu yanyan , Wu yelin
Published: February 2021

Glucose oxidase (GOx) can effectively catalyze glucose intogluconic acid and hydrogen peroxide (H2O2) in the presence of O2, which is considered as an attractive starvation strategy for cancer therapy. However, the autophagy phenomenon protects tumor cells from starvation therapy, limiting the therapy effect, thus autophagy inhibition could be used as a troubleshooting method to enhance tumor starvation therapy. Herein, biodegradable dendritic mesoporous organosilicon nanoagent (DMON) was used as the nanocarrier to deliver GOx and 3-MA (an autophagyinhibition agent), designed as DMON@GOx/3-MA. T his formulation could have a synergetic effect on autophagy inhibition and starvation therapy. All in vitro and in vivo results demonstrated that autophagy inhibition obviously enhanced the efficacy of starvation therapy, leading to tumor growth suppression. Our strategy will provide a new way to enhance the efficacy of starvation cancer therapy.
Natural Course of Myopic Traction Maculopathy and Factors Influencing Progression and Visual Acuity
Authors: Li Shiwei , Li Tingting , Wang Xiangning , Cai Xuan , Lu Bin , Chen Yan , Liu Chang , Wu Qiang
Published: February 2021

Background: To describe the natural course of myopic traction maculopathy (MTM) and determine predictive factors for its progression and visual prognosis.Methods: This retrospective observational study included 113 MTM patients (147 eyes). Best-corrected visual acuity (BCVA) measurements and optical coherence tomography findings were recorded.Results: Over a mean follow-up of 38.2 ± 11.1 months, 58 of 147 eyes (39.5%) progressed. The progression rate of outer schisis prominently located in the fovea or posterior staphyloma was significantly higher than that of outer schisis prominently located in paravascular areas (P = 0.0006). MTM with partial posterior vitreous detachment during the follow-up progressed more rapidly than MTM without (P = 0.0461). Patients with older age (>65 years), and defects in the ellipsoid zone (EZ) had worse BCVA at the last visit (P = 0.0281, and P = 0.0433). Multiple linear regression analysis showed that BCVA and defects in the EZ at baseline were significantly associated with the final BCVA (P < 0.0001 and P = 0.0259, respectively).Conclusion: MTM has a high possibility for progression. Outer schisis located predominantly in the fovea or posterior staphyloma or with partial posterior vitreous detachment exhibits rapid progression. The integrity of the EZ is related to visual prognosis.
Floods in Provence-Alpes-Côte D'azur and Lessons for French Flood Risk Governance
Authors: Kougkoulos Ioannis , Merad Myriam , Cook Simon J. , Andredakis Ioannis
Published: February 2021

France experiences catastrophic floods on a yearly basis, with significant societal impacts. In this paper, we employ a historical assessment of catastrophic past flood events in the Provence-Alpes-Côte d'Azur (PACA) region and perform Strengths-Weaknesses-Opportunities-Threats (SWOT)-analysis to evaluate some aspects of the French Flood Risk Governance (FRG) system and suggest improvements. Our evaluation shows that despite persistent government efforts, the impacts of flood events in the region do not appear to have lessened over time. Identical losses in the same locations (e.g. Riou de l’Argentière watershed) can be observed after repetitive catastrophic events (e.g. 2015, 2019) triggering local inhabitant protests. To avoid future disasters, we suggest that the French FRG should benefit from the following improvements: a) regular updates of the risk prevention plans and tools; b) the adoption of a Build Back Better logic instead of promoting the reconstruction of damaged elements in the same locations; c) taking into account undeclared damages into flood risk models (and not only those declared to flood insurance); d) increased communication between the actors of the different steps of each cycle (prepare, control, organise etc.); e) increased communication between three main elements of the cycle (risk prevention, emergency management and disaster recovery); f) an approach that extends the risk analysis outside the borders of the drainage basin (to be used in combination with the current basin risk models); and g) increased participation in FRG from local population. We also briefly discuss the use operational research methods for the optimisation of the French FRG.
Family Talk Versus Usual Services In Improving Child And Family Psychosocial Functioning In Families With Parental Mental Illness (PRIMERA - Promoting Research And Innovation In Mental Health Services For Families And Children): Study Protocol For A Randomised Controlled Trial
Authors: Furlong Mairead , McGilloway Sinead , Mulligan Christine , McGuinness Colm , Whelan Nuala
Published: February 2021

Background: Parental mental illness is common and can lead to dependent children incurring a high risk of developing mental disorders, physical illness, and impaired educational and occupational outcomes. Family Talk is one of the better known interventions designed to prevent the intergenerational transmission of mental illness. However, its evidence base is small, with few robust independent randomised controlled trials, and no associated process or cost evaluations. The PRIMERA (Promoting Research and Innovation in Mental hEalth seRvices for fAmilies and children) research programme involves a mixed methods evaluation of Family Talk which is being delivered in mental health settings in Ireland to improve child and family psychosocial functioning in families with parental mental illness.Methods: The study comprises a multi-centre, randomised controlled trial (RCT), with nested economic and process evaluations, to assess the clinical and cost effectiveness and implementation mechanisms of Family Talk compared to usual services. The study is being conducted in 15 adult and child mental health settings in Ireland. Families with a parent with mental illness, and children aged 5-18 years (n = 144 families) will be randomised to either the 7-session Family Talk programme (n = 96) or to standard care (n = 48) using a 2:1 allocation ratio. The primary outcomes are child psychosocial functioning and family functioning. Secondary outcomes are: understanding and experience of parental mental illness, parental mental health, child and parental resilience, partner wellbeing and service utilisation. Blind assessments will take place at pre-intervention, and at 6-, 12-month follow up.Discussion: Given the prevalence and burden of intergenerational mental illness, it is imperative that prevention through evidence-based interventions becomes a public health priority. The current study will provide an important contribution to the international evidence base for Family Talk whilst also helping to identify key implementation lessons in the scaling up of Family Talk, and other similar interventions, within routine mental health settings.Trial registration: ISRCTN Registry, ISRCTN13365858. Registered 5th February 2019. http://www.isrctn.com/ISRCTN13365858
Health services utilization of Chinese patients with Huntington's disease: A cross-sectional study
Authors: Ke Huiyi , Cao Xi , Song Yanyan , Cao Li
Published: February 2021

Background
Huntington’s disease (HD) is a hereditary disease which could have a large impact on patients’ quality of life. As the neurodegenerative disorders progress, HD patients are expected to regularly take follow-up medical visits for proper treatment. This study aimed to analyze the general situation of health services utilization of Chinese HD patients and factors associated with their adherence to follow-up medical visits.
Methods
We collected data from a questionnaire-based investigation conducted by Chinese Huntington's Disease Association. Data from 232 respondents were included to investigate whether they adhered to regular follow-up medical visits and the cause and correlates. Based on Andersen’s behavioral model, the independent variables were categorized into predisposing, enabling and need factors. The variables were analyzed by chi-square test and stepwise logistic regression analysis.
Results
31.9% of the respondents had regular follow-up medical visits over the past year. Univariate analysis showed there were significant differences with 6 factors (P < 0.05), among which, according to logistic regression, 2 enabling factors (reimbursement of health insurance, need for accompanying family members to follow-up visits) and 3 need factors (perceived stage of disease, perceived effectiveness of drugs, self-care ability) were independent influencing factors of follow-up medical behaviors of Chinese HD patients. The predisposing factors investigated here did not play a part in determining patients’ adherence to follow-up visits.
Conclusions
Poor adherence to medical visits among Chinese HD patients is derived from multiple factors, including reimbursement of health insurance, perceived stage of disease and effectiveness of drugs, need for accompanying family members and self-care ability. To promote HD patients’ health services utilization, the improvement of health insurance system, the enhancement of social support and the development of therapeutic approaches still have a way to go.