bluuebunny/crossref_metadata_2025 huggingface dataset:
Bilateral Chylothorax Following Left Neck Dissection and Literature Review
Authors: Kimizuka Sachiko , Yamada Hiroyuki , Kawaguchi Koji , Horiuchi Toshikatsu , Takeda Akira , Hamada Yoshiki
Published: July 2021

BackgroundAlthough chyle leakage may occur in the neck when the thoracic duct is damaged during cervical dissection, it is extremely rare for the chylothorax alone to leak chyle into the thoracic cavity. Case presentationWe report a case of bilateral chylothorax without chyle cervical leakage after left neck dissection, wherein partial left upper jaw resection and left radical neck dissection were performed in a 46-year-old woman who was diagnosed with left upper gingival cancer. The thoracic duct was ligated and cut during surgery and, although no obvious leakage of lymph was observed, dyspnea and cough reflex during deep inhalation were observed from the 3rd postoperative day. Approximately 600 mL of yellowish-white pleural effusion was aspirated during bilateral thoracentesis, and chylothorax was diagnosed based on clinical findings and biochemical analysis results. The patient was put on a low-fat diet on the 4th postoperative day, and a total of 3 neck drains were removed 8 days after the operation. Conclusions﻿Pleural effusion disappeared on imaging examination 16 days after thoracentesis and 5 years and 6 months have passed since the operation. At this time, there has been no evidence of tumor recurrence, metastasis, or pleural effusion.
Acute Hepatitis B Associated Neuromyopathy
Authors: Maramattom Boby Varkey
Published: July 2021

A 67 year old man presented with abdominal discomfort and jaundice for 1 month with difficulty in walking with severe pain in both thighs of 3 days duration. He was a diabetic and hypertensive on medications. There was no history of HMG CoA reductase inhibitor use. On examination he had icterus and grade 2 power in the proximal upper and lower limbs. Deep tendon reflexes were inelicitable. On day 1, CRP was 37mg/L and liver function tests were deranged [ Total Bilirubin 16 mg%, direct 14.3mg%, SGOT [920 U/L], SGPT [590 U/L], Alkaline Phosphatase 276.5 U/L. Serum CPK levels [9768 U/L], LDH [979 U/L] and Ferritin [7264 ng/ml] were elevated on day 2. ANA profile was negative. Leptospiral antibody, dengue serology and SARS-CoV2 RT-PCR were negative. Hepatitis B serology was compatible with an acute infection. On day 3, nerve conduction studies showed an axonal sensory-motor polyneuropathy predominantly involving the lower limbs. F waves were absent. Fibrillations and positive waves were picked up from the Tibialis anterior muscles bilaterally. He was started on IVIG 2gm/kg x 5 days. On day 4, his CPK levels increased to >42,000 U/L and he was shifted to the ICU and started on forced alkaline diuresis. Urine myoglobin was positive.. On day 6, MRI whole body muscle STIR imaging showed patchy ill-defined STIR hyperintensities involving the muscles of the gluteal, pelvic girdle muscles, both thighs and leg muscles with fascial edema. The muscles of the upper limbs and shoulder girdles also showed patchy STIR hyperintensities. Diffuse subcutaneous oedema was noted in the soft tissue of the thighs, legs and abdominal wall. Over the next few days, the weakness in the upper limbs worsened and he developed a weak cough. He did not consent to a lumbar puncture or muscle biopsy. Over the next 9 days, his liver function tests and CPK levels gradually normalised. He was also started on Entacavir. By day 10, his upper limb and distal lower limb had improved to grade 4/5 power and he was able to stand with support and he was discharged.
A Method for Quantifying Cervical Sagittal Morphology Using the Cervical Sagittal Triangle Area Coefficient
Authors: Guo Yingjun , Wang Han , Liu Hao , Wang Beiyu , Ding Chen , Meng Yang , Yang Yi
Published: July 2021

BackgroundA series of methods, which use angle to quantitatively evaluate cervical sagittal morphology cannot objectively reflect the advantages and disadvantages in some cases. In this study, we try to use the area methods to supplement it in above cases.MethodsThe Cobb angle, range of motion (ROM) of C2-7, and antero-posterior diameter of atlas (C1-APD) were measured at neutral, flexion, and extension X-ray radiographs of the cervical spine in all 191 patients. Patients were divided into Group A and Group B according to whether their cervical sagittal morphology can be objectively quantified with Cobb angle. Pearson correlation analysis was used to compare the consistency of the results, paired t-test was used to compare the dispersion coefficient, receiver operator characteristic (ROC) curve was used to evaluate the diagnostic value.ResultsThe C5 vertebra was used as the vertex to construct the cervical sagittal triangle, and according to the different selection of the other two points, the triangle was further divided into four types. The Area Coefficient (AC) was defined as "\(\text{A}\text{C}=\frac{\left(\text{A}\text{r}\text{e}\text{a} \text{o}\text{f} \text{s}\text{a}\text{g}\text{i}\text{t}\text{t}\text{a}\text{l} \text{t}\text{r}\text{i}\text{a}\text{n}\text{g}\text{l}\text{e}\right)}{{\text{C}1-\text{A}\text{P}\text{D}}^{2}}\)". In Group A, whose cervical sagittal morphology could be objectively quantified with Cobb angle, the AC showed greatly consistency, while in Group B, it was less consistent. AC results have stronger predictive value for clinical symptoms in Group B. The dispersion coefficients of the results measured by the four area methods are significantly smaller than the Cobb angle. The results of quantifying cervical ROM by area methods were also in good agreement with Cobb angle.ConclusionCompared with Cobb angle, AC has better objectivity, stability, and clinical significance.
Cd5+ Diffuse Large B Cell Lymphoma of the Liver Presenting as Cholestatic Transaminitis.
Authors: Latef Taroob Jawad , Bilal Muhammad , Malleshappa Sudeep Siddappa , Loke Chandravathi
Published: July 2021

A 72-year-old male with nonspecific symptoms was found to have pancytopenia and transaminitis. The pancytopenia began to improve early in the hospital course without specific treatment. A liver biopsy, obtained later to determine the etiology of the transaminitis, eventually confirmed CD5+ diffuse large B cell lymphoma (DLBCL). DLBCL typically presents with painless lymphadenopathy and constitutional symptoms although it may also present as a rapidly enlarging mass in any part of the body. However, in rarer cases its presentation can be misleading. Conditions such as HLH or viral infections, can confound a patient’s presentation and delay the diagnosis. High index of suspicion is warranted for the diagnosis of DLBCL in atypical cases to prevent mortality associated with late diagnosis. Early recognition and biopsy of involved organ, in the absence of clear etiology, is vital for timely diagnosis and prompt treatment to achieve a favorable cure rate. CD5+ DLBCL may have unusual involvement of extra nodal organs such as the liver and may need further investigations.
Orbital infarction syndrome in a COVID-19 associated Internal carotid artery occlusion
Authors: MARAMATTOM BOBY VARKEY
Published: July 2021

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Causal Deep Learning on Real-world Data Reveals the Comparative Effectiveness of Anti-hyperglycemic Treatments
Authors: Belthangady Chinmay , Giampanis Stefanos , Stedden Will , Alves Paula , Chong Stephanie , Knott Charlotte , Jankovic Ivana , Norgeot Beau
Published: July 2021

Type 2 Diabetes is associated with severe health outcomes, the effects of which are responsible for approximately 1/4 of total U.S. healthcare spending. Current treatment guidelines endorse a massive number of potential anti-hyperglycemic treatment options in various permutations and combinations. Personalized strategies for optimizing treatment selection are lacking. Real-world data from a nationwide population of over one million diabetics was analyzed to evaluate the comparative effectiveness of more than 80 different treatment strategies ranging from monotherapy up to combinations of five concomitant classes of drugs across each of 10 clinical subgroups defined by age, insulin dependence, and number of other chronic conditions. A causal deep learning approach developed on such data allows for more personalized recommendations of treatment selection. Significant differences were observed in blood sugar reduction between patients receiving high vs low ranked treatment options and that less than 2% of the population is on a highly ranked treatment. This method can be extended to explore treatment optimization of other chronic conditions.
The Relationship between Sleep Hygiene, Mood, and Insomnia Symptoms in Men with Prostate Cancer
Authors: Galvin Kathleen T. , Garland Sheila N. , Wibowo Erik
Published: July 2021

PurposeInsomnia symptoms are commonly experienced by men after prostate cancer (PCa) treatment. Here we explored how sleep hygiene behaviours and psychological symptoms are associated with insomnia symptoms in PCa patients.MethodsAn online survey was posted on social media and sent to mailing lists of PCa and general cancer organisations. The survey collected information on demographic, sleep hygiene and psychological symptoms using validated questionnaires. ResultsData from 142 participants were compared based on the absence (age = 68.3 ± 8.9 years) and presence (age = 66.6 ± 9.0 years) of insomnia symptoms. Participants with insomnia symptoms had significantly higher levels of anxiety, depression, fatigue, and daytime sleepiness as well as poorer sleep hygiene than those without insomnia symptoms. Control variables (age, comorbidities, ADT experience and BMI) accounted for 12.5% of the variance in insomnia symptoms. Adding sleepiness, fatigue, anxiety, depressive symptoms to the model explained an additional 45.1% of the variance in insomnia symptoms. Further, including the sleep hygiene item “I think, plan, or worry when I am in bed” and “I sleep in an uncomfortable bedroom” explained an additional 3.6% of the variance in insomnia symptoms. Conclusions﻿Poor sleep hygiene, fatigue, daytime sleepiness, anxiety, depressive symptoms were all associated with worse insomnia symptoms in PCa patients. Improving sleep hygiene and treating psychological conditions may potentially help prevent and/or alleviate insomnia symptoms in PCa patients.
Stress and Coping Among Unmarried Pregnant University Students in South Africa
Authors: Phiri Thandiwe Msipu , Nyamaruze Patrick , Akintola Olagoke
Published: July 2021

Background: The improvement of maternal and child health (MCH) outcomes is an important part of the sustainable development goals (SDGs). MCH remains an important issue globally as the SDGs have not yet been achieved in most countries. Young women in universities are likely to experience unintended pregnancy due to the risky sexual behavior in tertiary institutions which is characterized by lack of condom and/or contraceptive use and coercion. Pregnant young women in an academic environment are susceptible to stressors associated with unintended pregnancy and academic demands of universities. However, very little is known about the stress and coping among young people in tertiary institutions who get pregnant during the course of their studies and choose to keep the pregnancy. Methods: Participants were purposively selected among pregnant students and those in the puerperal period at the time of the study. Semi-structured qualitative interviews were undertaken to explore the experiences of pregnancy and early motherhood, with particular focus on the various stressors experienced and possible coping strategies employed by students. The data were audio-recorded and transcribed verbatim, then analysed using thematic analysis. Results: The findings show that pregnancy and early motherhood was an experience that came with a lot of stress emanating from fear of parents’ reactions, academic pressure, financial constraints, relationship problems with male partners and experiences of social stigma. Participants used emotion-focused and problem-focused coping strategies to deal with the stressors confronting them during and after their pregnancy.Conclusion: The experiences of pregnant students are multifaceted and generally characterised by financial crisis, academic challenges, shame, strenuous relationships and transitioning into a new identity. A multipronged approach to healthcare for pregnant students that focus on comprehensive antenatal services, health education, health promotion, psychosocial interventions including academic counselling will have positive outcomes for adolescent mothers and their children.
Zincum Metallicum an Homeopathic Drug Alleviates Zn-Induced Toxic Effects, Promotes Plant Growth and Antioxidants Capacity in Lepidium Sativum
Authors: BOUDALI Ghazwa , Ghnaya Tahar , BEN-ABDALLAH Saoussen , CHALAH Abdala , SEBEI Abdelaziz , OUIRGHI Zeineb , CHAFFEI-HAOUARI Chiraz
Published: July 2021

In this study, we investigated the effect of Zincum Metallicum (ZM) on zinc (Zn) toxicity in the plant species Lepidium sativum. We focused on growth, Zn uptake and numerous biochemical parameters. Seedlings were hydroponically subjected during 7 days to 0.05, 500, 1000, 1500 and 2000 µM Zn2+, in the absence or presence of 15ch or 9ch ZM. In the absence of ZM, Zn induced negative effect on growth especially at the dose of 2mM. Zn induced also chlorosis, reduced total chlorophyll and/or carotenoid content and increased the level of malondialdehyde (MDA). Under Zn-toxicity (500, 1000 and 1500 µM), the superoxide dismutase (SOD), catalase (CAT), gaiacol peroxidase (GPX) and glutathione reductase (GR) activities were increased and/or unaltered, while at 2000 µM Zn affected the activity of these enzymes. At the highest Zn level (2 mM), proline and total polyphenols and flavonoids contents were markedly induced in leaves and roots of L. sativum. Additionally, the supply of ZM in the nutrient medium considerably ameliorated the plant growth, photosynthetic pigments and the studied non-enzymatic antioxidant molecules and enzymatic activities against Zn induced-oxidative stress. Our data suggest that the potential homeopathy properties of ZM may be efficiently involved in the restriction of Zn-induced oxidative damages, by lowering Zn accumulation and translocation in the leaves and roots of Lepidium sativum.
Virtual Reality: Medical Students' Thoughts & Perspectives on the Pandemic & Chaos: A Twin City Survey
Authors: Nadeem Sana , Inam Shazia , Hayat Uzma , Imran Shazia , Saga Zarmina
Published: July 2021

The authors have requested that this preprint be removed from Research Square.
Generating Quantum Random Numbers Using Entanglement in Low Earth Orbit
Authors: Reezwana Ayesha , Islam Tanvirul , Bai Xueliang , Wildfeuer Christoph , Ling Alexander , Grieve James
Published: July 2021

We describe the implementation of a quantum random number generator (QRNG) on-board a nanosatellite deployed to low Earth orbit (LEO). The generator samples shot noise from an entangled photon-pair source based on spontaneous parametric down conversion, linking the entropy of the QRNG to fluctuations in the vacuum field. We present analysis of data acquired in lab-based acceptance testing as well as on-orbit, and use the source to implement a prototype for an off-grid randomness beacon.
Methylome and Transcriptome Analyses of Soybean Response to Bean Pyralid Larvae
Authors: Zeng Wei-Ying , Tan Yu -Rong , Long Sheng-Feng , Sun Zu-Dong , Lai Zhen-Guang , Yang Shou-Zhen , Chen Huai-Zhu , Qing Xia-Yan
Published: July 2021

Background: Bean pyralid is an important leaf-feeding insect which affects soybean production. DNA methylation can control the networks of gene expressions, and it plays an important role in the growth, development, and responses to biotic stress. However, the genome-wide DNA methylation profile of the soybean resistance to bean pyralid has not been reported so far. Results: Using whole-genome bisulfite sequencing (WGBS) and RNA-sequencing (RNA-seq), we analysed the highly resistant material (Gantai-2-2) and highly susceptible material (Wan82-178), under the conditions of 0 h and 48 h feeding by bean pyralid larvae, to clarify the molecular mechanism of the soybean resistance and explore its insect-resistant genes. We identified 2,194, 6,872, 39,704, and 40,018 differentially methylated regions (DMRs), as well as 497, 1,594, 9,596, and 9,554 differentially methylated genes (DMGs) in the HRK0/HRK48, HSK0/HSK48, HSK0/HRK0, and HSK48/HRK48 comparisons, respectively. We found that 265 differentially expressed genes (DEGs) were negatively correlated with the DMGs, there were 34, 49, 141, and 116 negatively correlated genes in the HRK0/HRK48, HSK0/HSK48, HSK0/HRK0, and HSK48/HRK48 comparisons, respectively. The MapMan cluster analysis results indicated that negatively correlated genes in the pathways, such as protein biosynthesis and modification; primary metabolism; secondary metabolism; cell cycle, cell structure and component; RNA biosynthesis and processing, and so on. Finally, the PS-PCR and qRT-PCR were used to validate the expression patterns of several genes and the results showed an excellent agreement with deep sequencing. Conclusions: Through the analysis of global methylation and transcription, we speculated that the expression levels of CRK40; CRK62; STK; L-type lectin-domain containing receptor kinase VIII.2; CesA; CSI1; fimbrin-1; KIN-14B; KIN-14N; KIN-4A; cytochrome P450 81E8; BEE1; ERF; SPATULA; bHLH25; bHLH79; GATA26, were regulated by methylation, and they may potentially play important roles in the soybean responses to bean pyralid larvae. Our results laid a foundation for revealing the occurrence mechanism of soybean response to bean pyralid at the level of DNA methylation.
Hydrofracturing in Situ Stress Measurements in Itabirite Brazilian Ferriferous Quadrilater, and their Limitations
Authors: Penido Henrique de Andrade , de Figueiredo Rodrigo Peluci , de Assis André Pacheco , Torres Vidal Félix Navarro , Sotomayor Juan Manuel Girao , Guimarães Alessandro
Published: July 2021

This article presents a first attempt to carry out measurements (magnitudes and orientations) of the in situ stress in itabirite rocks in the region of the Brazilian Ferriferous Quadrilater obtained by hydraulic fracture tests at a depth of 399 m. Previous studies available in this rock mass consider estimated values of k index (Sh / Sv), and it is not a practice adopted to carry out in situ stress tests in this region and rockmass to support geotechnical analysis. The area of study is located at a depth of 500 m in a pit; therefore, the determination of the in situ stress distribution is very important to assess the stability of the mining open pit. The activities, from the planning to the execution of the tests, and the results are presented. The rock mass under study shows the presence of different geological structures, such as banding and foliation, which resulted in difficulties with performing the tests, and only 12.5% of the tests were successful. The results contribute to understanding the strains and stresses induced by mining activities in slopes in the Brazilian Ferriferous Quadrilater and their impacts on surrounding structures. For a better determination of the regional in situ stresses in the rock mass of the Brazilian Ferriferous Quadrilater, it is recommended to perform hydraulic tests on pre-existing fractures.
Projections of Cold Air Outbreaks In CMIP6 Earth System Models
Authors: Smith Erik T. , Sheridan Scott
Published: July 2021

Historical and future simulated temperature data from five climate models in the Coupled Model Intercomparing Project Phase 6 (CMIP6) are used to understand how climate change might alter cold air outbreaks (CAOs) in the future. Three different Shared Socioeconomic Pathways (SSPs), SSP 1 – 2.6, SSP 2 – 4.5, and SSP 5 – 8.5 are examined to identify potential fluctuations in CAOs across the globe between 2015 and 2054. Though CAOs may remain persistent or even increase in some regions through 2040, all five climate models show CAOs disappearing by 2054 based on current climate percentiles. Climate models were able to accurately simulate the spatial distribution and trends of historical CAOs, but there were large errors in the simulated interannual frequency of CAOs in the North Atlantic and North Pacific. Fluctuations in complex processes, such as Atlantic Meridional Overturning Circulation, may be contributing to each model’s inability to simulate historical CAOs in these regions.
Efficacy of Osimertinib Plus Bevacizumab In Glioblastoma Patients With Simultaneous EGFR Amplification And EGFRvIII Mutation
Authors: Jaramillo-Velásquez Daniel , Cardona Andrés F. , Ruiz-Patiño Alejandro , Polo Carolina , Jiménez Enrique , Hakim Fernando , Gómez Diego F , Ramón Juan Fernando , Cifuentes Hernando , Mejía Juan Armando , Salguero Fernando , Ordoñez Camila , Muñoz Álvaro , Bermúdez Sonia , Useche Nicolas , Pineda Diego , Ricaurte Luisa , Zatarain-Barrón Zyanya Lucia , Rodríguez July , Avila Jenny , Rojas Leonardo , Jaller Elvira , Sotelo Carolina , Garcia-Robledo Juan Esteban , Santoyo Nicolas , Rolfo Christian , Rosell Rafael , Arrieta Oscar
Published: July 2021

Background: Amplification of EGFR and its active mutant EGFRvIII are common in glioblastoma (GB). While EGFR and EGFRvIII play critical roles in pathogenesis, targeted therapy with EGFR-tyrosine kinase inhibitors (TKIs) or antibodies has shown limited efficacy. To improve the likelihood of effectiveness, we targeted adult patients with recurrent GB enriched for simultaneous EGFR amplification and EGFRvIII mutation, with osimertinib/bevacizumab at doses described for non-small cell lung cancer (NSCLC). Methods: We retrospectively explored whether previously described EGFRvIII mutation in association with EGFR gene amplification could predict response to osimertinib/bevacizumab combination in a subset of 15 patients treated at recurrence. The resistance pattern in a subgroup of subjects is described using a commercial NGS panel in liquid biopsy.Results: There were ten males (66.7%), and the median patient’s age was 56 years (range 38-70 years). After their initial diagnosis, 12 patients underwent partial (26.7%) or total resection (53.3%). Subsequently, all cases received IMRT and concurrent and adjuvant temozolomide (TMZ; the median number of cycles 9, range 6-12). The median follow-up after recurrence was 17.1 months (95% CI 12.3-22.6). All patients received osimertinib/bevacizumab as a second-line intervention with a median progression-free survival (PFS) of 5.1 months (95% CI 2.8-7.3) and overall survival (OS) of 9.0 months (95% CI 3.9-14.0). The PFS6 was 46.7%, and the overall response rate (ORR) was 13.3%. After exposure to the osimertinib/bevacizumab combination, the main secondary alterations were MET amplification, STAT3, IGF1R, PTEN, and PDGFR.Conclusions: While the osimertinib/bevacizumab combination was marginally effective in most GB patients with simultaneous EGFR amplification plus EGFRvIII mutation, a subgroup experienced a long-lasting meaningful benefit. The findings of this brief cohort justify the continuation of the research in a clinical trial. The pattern of resistance after exposure to osimertinib/bevacizumab includes known mechanisms in the regulation of EGFR, findings that contribute to the understanding and targeting in a stepwise rational this pathway.
Assessment of Malnutrition in Emergency Laparotomy Patients. A QIP Highlights Simple Measures To Improve Early Recognition and Optimisation of High-Risk Patients.
Authors: Raslan Charef , Tomalieh Feras , Lasheen Omar , Siddique Khurram
Published: July 2021

Aim Early recognition of high-risk malnourished patients is important for optimisation of nutritional status leading to better outcomes. The accurate recording of malnutrition universal screening tool (MUST) results is vital in this regard. This quality improvement project (QIP) aimed to review the quality of nutritional assessment of emergency laparotomy patients against the National Institute for Health and Care Excellence (NICE) guidelines and outline area of improvement.Method The QIP was conducted at Royal Oldham Hospital in 2019-2020 over a seven-month period. Fifty random patients were included in the first audit cycle over a 4-month period, followed by implementation of recommended changes and a re-audit of 30 patients over a 2-month period. The initial MUST scores which were calculated and documented by nursing staff were identified as the nursing staff MUST score (NSMS). To assess the accuracy of NSMS, we developed a MUST rescoring method which was performed by a senior member of the medical team and was identified as the medical team MUST rescore (MTMR). Results The initial audit showed a significant difference between NSMS and MTMR scores. According to MTMR, 23 patients (46%) had an inaccurate MUST score assessment by the nursing staff. A multidisciplinary approach using a standard online calculator were recommended. The second phase of the QIP showed an obvious improvement in the accuracy of MUST assessment. Our interventions improved the accuracy rate of MUST scores significantly (27, 54% vs 29, 96.6%, P = 0.00005).Conclusion A multidisciplinary team approach and online calculator are useful in improving the accuracy of MUST assessment in emergency laparotomy patients. This helped early involvement of the dietitian leading to improvement in morbidity and mortality.
Lipid Profile, Atherogenic Index of Plasma, and Anthropometric Measurements Among Osteoporotic Postmenopausal Sudanese Women: Possible Risk for Cardiovascular Disease
Authors: Elmugadam Abdelgadir , Elfadil Ghada A. , Hamad Abdelrahman Ismail , Aledrissy Mawahib , Altayb Hisham N. , Elshikieri Ahlam Badreldin
Published: July 2021

Background: Osteoporosis and menopausal women’s health had paucity data from Africa, especially Sub-Saharan countries. The current study aimed to assess the relationship between lipid profile, atherogenic Index of Plasma (AIP), anthropometric measurements, and the risk of cardiovascular disease (CVD) among osteoporotic Sudanese postmenopausal women.Methods: An epidemiological, cross-sectional comparative, community-based study was conducted. Postmenopausal women (n = 300), aged 47- 90 years, with an average one year postmenopause, were recruited from various centers in Khartoum State. Dual-energy X-ray absorptiometry (DEXA) was used to assess bone density. DEXA scan was interpreted in terms of T-score as per World Health Organization guidelines. Weight, height, and waist circumference were measured twice following standard protocols. In addition, fasting blood samples (5ml) were collected for the determination of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C). AIP was calculated as an indicator for CVD risk. Blood samples were assayed on the Roche/Hitachi Cobas c311 system (Roche Diagnostics GmbH, Germany). Statistical analysis was carried out using SPSS version 26. Results: The mean age of the postmenopausal women was 61.7±10.3 years, with 80 women having normal T-score and an equal number of osteoporotic and osteopenic (n = 110 each). Most women (59%) aged 47-64 years. The prevalence of osteoporosis was 36.7%. Many postmenopausal women with normal BMD suffered from general (68%) and central obesity (94%) compared with their counterparts. Hypercholesterolemia, hypertriglyceridemia, high LDL-C, hypo-HDL-C were identified among 26.4%, 31%, 16.3%, and 32.7% osteoporotic women respectively. Osteoporotic postmenopausal (36.4%) women had medium to high risk of CVD according to their AIPs. There was a significantly inverse correlation between age and HDL-C (r= -0.205; p=0.032) whereas positive association between AIP and TC (r=0.230; p=0.016), among osteoporotic women. Osteoporotic (52%) and osteopenic (42%) women had ≥2 CVD risk factors. Multiple Linear regression analysis showed T-score value decreased significantly with age and AIP and increased with BMI. Conclusion: Osteoporosis is prevalent among Sudanese postmenopausal women who are at increased risk for CVD. Necessary steps are needed for public education and wider dissemination of information about osteoporosis, CVD and their prevention.
Incidence, Aetiology and Clinical Features of Eosinophilic Pleural Effusion: A Retrospective Study
Authors: Li Minfang , Zeng Yunxiang , Li Yaqing , Jia Dan , Chen Sheng , Wang Jinlin
Published: July 2021

Background: Eosinophilic pleural effusion (EPE) is a distinct entity among pleural effusions, but its diagnostic and prognostic significance is still controversial. This study aimed to evaluate the incidence and aetiological distribution of EPE in our institution and to assess the relationship between EPE and malignancy and other underlying diseases and the relevance of the percentage of eosinophils and other laboratory parameters. Methods: A retrospective study was conducted by reviewing the medical records of 252 patients with PE from September 2017 to January 2021.Results: EPE was found in 34 (13.49%) out of 252 patients. There were 20 (58.82%) males and 14 (41.18%) females in the EPE group. The mean percentage of eosinophils in EPE (21.7%, range (10.0%-67.5%)) was significantly higher than the percentage of eosinophils in peripheral blood (5.65%, range (0%-34.60%); p<0.05). The most common cause of EPE was malignant disease (52.94%), followed by idiopathy (14.71%), parasites (8.82%), pneumonia (8.82%) and others (14.71%). Comparative analysis of patients with malignant versus nonmalignant EPE showed that patients with malignant EPE were significantly older, and had a lower white blood cell (WBC) count in the pleural fluid ( 1.8 vs 4.7 cells×109/L, p <0.05). However, the percentage of eosinophils in PE was not significantly different between malignant EPE and nonmalignant EPE (p=0.66). There was no correlation between the percentage of eosinophils in PE and peripheral blood (r =0.29; p =0.09).Conclusions: Malignant disease ranks as the leading cause of EPE. The presence of EPE should not be considered as a predictive factor of benign conditions. Pleural parasitic infestation (PPI) should be emphasized in areas with a high incidence of parasitic disease. Trial registration: GYFYY. Registration No: GYFYY20200301221. Registered time: 12 Mar 2020. Date of enrolment of the first participant to the trial: 22 March 2020.
The Influence of Energy Output And Substitution On The Environmental Impact of Waste-To-Energy Operation. Quantification By Means of A Case Study.
Authors: Boakes Elizabeth Zoe , De Voogd Jan-Kees , Wauters Guido , Caneghem Jo Van
Published: July 2021

A Life Cycle Assessment (LCA) was conducted to evaluate the total environmental impact of state-of-the-art Waste-to-Energy (WtE) in Belgium, with respect to recovered energy utilization and addition of Carbon Capture and Storage (CCS). Four energy output scenarios were modelled on Umberto LCA software using primary data of mass and energy flows surrounding the six incinerators at the considered WtE plant, and predefined processes from the Ecoinvent 3.6 database. The normalized LCA results suggest that by utilizing all the recovered energy as steam, the WtE plant can avoid an equivalent annual environmental impact value of approximately 21200, 36800, 6700, 15800, 37000 and 6900 average European citizens in the impact categories ‘climate change’, ‘freshwater and terrestrial acidification’, ‘freshwater eutrophication, ‘photochemical ozone creation’ and ‘respiratory effects, inorganics’, ‘terrestrial eutrophication’, respectively. The ‘Electricity and Steam with CCS’ scenario resulted in the most avoided environmental impact in the impact category ‘climate change’. However, in all other impact categories, it resulted in less avoided environmental impact compared to the ‘Steam’ scenario. The comparative analysis showed that 19 out of 24 of the LCA results varied by more than 50% between two energy substitution models, thus quantifying the influence of energy substitution in LCA modelling. This study exemplifies the environmental benefit WtE technology can realize by substituting conventional energy production processes that are reliant on fossil resources, whilst performing its primary function that is reducing the volume of non-recyclable waste, destroying hazardous organic components it contains and recovering useful materials from it.
Reproductive Toxicity Induced By Benzo[a]pyrene Exposure: First Exploration Highlighting The Multi-stage Molecular Mechanism In Female Scallop Chlamys Farreri
Authors: Xu Ruiyi , Pan Luqing , Zhou Yueyao , Gao Zhongyuan , Miao Jingjing , Yang Yingying , Li Dongyu
Published: July 2021

Reproductive toxicity induced by Benzo[a]pyrene (B[a]P) exposure have received great ecotoxicological concerns. However, huge gaps on molecular mechanism still exist in bivalves. In this study, reproduction-related indicators during reproductive periods (proliferative, growth, mature, and spawn stage) were investigated in female scallops Chlamys farreri, which under gradient concentration of B[a]P at 0, 0.04, 0.4 and 4 μg/L. To elucidate the potential molecular mechanisms of reproductive toxicology, a multi-stage ovarian transcriptome analysis under 4 μg/L B[a]P exposure was also conducted. The results indicated that life-cycle exposure to 0.4 and 4 μg/L B[a]P had significantly decreased GSI and sex steroid levels. Even 0.04 μg/L B[a]P could play the wicked role on DNA integrity at mature and spawn stages. Ovarian histological sections showed the inhibitions on oocyte maturation and ovulation of B[a]P with dose-dependent effects. Through the functional enrichment analysis of DEGs from transcriptome data, 18 genes involved in endocrine disruption effects, DNA damage and repair, and oogenesis damage were selected and further determined by qRT-PCR. The down-regulate of steroidogenic and estrogen signaling pathways genes indicated the endocrine disruption mechanisms by B[a]P, which emphasized the functions of receptor independent and dependent pathways under B[a]P exposure. The variation of DNA single strand break and repair gene expressions implied there might exist the similar toxic mechanism with that in vertebrates. Gene expression data involved in cell cycle, apoptosis and cell adhesion exhibited the possibly toxic mechanisms of oogenesis caused by B[a]P. Taken together, this study is a pioneer to take advantage of genome-wide transcriptomic analysis and its corresponding reproductive indicators to explore the toxic mechanism under B[a]P exposure in bivalves. Meanwhile, some selected genes were firstly identified in bivalves, and the expression data might be useful in establishing new hypotheses and discovering new biomarkers for marine biomonitoring.
Effect of Addition of Pomegranate Peel in the Ration with or Without Polyethylene Glycol on Productive Performance of Lactating Goats
Authors: Kholif Abd El-Kader Mahmoud , Aboulfotouh Gamal Eldeen , Hassan Ola Gamal Ahmed , El-Mola Abdelalim Mohamed Abd
Published: July 2021

Pomegranate juice processing industries generate enormous waste in the form of peel that has been suggested and evaluated as a supplement in animal feed but pomegranate peel have high percent of tannins, So the purpose of this paper was to estimate the effect of addition of pomegranate peel (PP), detanninated pomegranate peel (DPP) and pomegranate peel with polyethylene glycol (PEG) on nutrients digestibility, goats milk yield and its composition, feed conversion and some blood parameters. Also, simple economic evaluation of the tested rations was considered.Sixteen lactating Zaraibi goats of about 3-4 years old (in their 2nd to 4th of lactation seasons with an average body weight of about 25 + 0.5 kg were used in the present study. After 14 days of parturition was randomly assigned into four groups, four animals per each tested ration (R) for 90days, R1: Control : 50% CFM + 25% Egyptian clover and 25% wheat straw, R2: Control ration+1% PP, R3: Control ration+1% PP + 20 g (PEG) and R4:Control ration+1% DPP. The results revealed that the PP contained 90.85% DM, 4.84% CP, 15.53% CF, 87.21%OM, 4.69% EE, 62.15% NFE and 15.28% tannins. No significant differences were found between the tested rations regarding nutrients digestibility except EE digestibility. Nutritive values of R2 and R3 were slightly higher than R4 and R1, respectively. Ration three (R3) was the best ration for daily milk yield and total milk yield, where R4 showed the worst one. Also, there are no significant differences for dry matter, SV and TDN intake. While, values of DCP intake were higher significantly (P<0.05), for R3 and R2 followed by R4 then R1. Regarding feed conversion, R4 was superior to other tested rations followed by R1 then R3 followed by R2. All blood serum parameters were in the normal rang which support that the healthy effect of tested additives in goats rations. It seems that R2 and R3 could be used successfully for lactating goats, but R3 is very expensive from economical point of view, where R3 was negatively economical effect, and not recommended.
Phytohormones Regulate the Non-Redundant Response of ω-3 Fatty Acid Desaturases to Low Temperatures in Chorispora Bungeana
Authors: Shi Yulan , Yang Sizhong , Yue Xiule , Zhao Zhixing , An Lizhe
Published: July 2021

To explore the contribution of ω-3 fatty acid desaturases (FADs) to cold stress response in a special cryophyte, Chorispora bungeana (C. bungeana), two plastidial ω-3 FAD genes (CbFAD7 and CbFAD8) were cloned and verified in a Arabidopsis fad7fad8 mutant, before being compared with the microsomal ω-3 FAD gene (CbFAD3) on expression profile. Though these genes were expressed in all tested tissues of C. bungeana, CbFAD7 and CbFAD8 have the highest expression in leaves, while CbFAD3 was mostly expressed in non-green tissues. Low temperatures (4, 0 and -4 ℃) resulted in significant increases in trienoic fatty acids (TAs, mainly C18:3), which were consistent with the non-redundant expression of CbFAD3 and CbFAD8 in suspension-cultured cells, and the coordination of CbFAD7 and CbFAD8 in leaves. Furthermore, the contribution of CbFAD8 increased as temperature decrease in the two tissues. Our data revealed that jasmonie acid and brassinosteroids participated in the cold-responsive expression of these genes in both tissues, and the pyhtohormone regulation in leaves was more complicated with the participation of abscisic acid and gibberellin. These results point to the hormone-regulated non-redundant contribution of ω-3 CbFADs to maintain appropriate level of TAs under low temperatures, which help C. bungeana survive in cold environments.
Combination Therapy for Cerebral Ischemia: Do Progesterone and Noscapine Provide Better Neuroprotection Than Either Alone in the Treatment ?
Authors: Kawadkar Manisha , Mandloi Avinash Singh , Singh Nidhi , Mukherjee Rajesh , Dhote Vipin
Published: July 2021

Purpose: Ischemic stroke presents multifaceted pathological outcomes with overlapping mechanisms of cerebral injury. High mortality and disability with stroke warrant a novel multi-targeted therapeutic approach. The neuroprotection with progesterone (PG) and noscapine (NOS) on cerebral ischemia-reperfusion (I-R) injury was demonstrated individually, but the outcome of combination treatment to alleviate cerebral damage is still unexplored.Methods: Randomly divided groups of rats (n=6) were Sham-operated, I-R, PG (8mg/kg), NOS (10mg/kg), and PG+NOS (8mg/kg+10mg/kg). The rats exposed to bilateral common carotid artery occlusion, except Sham-operated to investigate the therapeutic outcome of PG and NOS alone and in combination on I-R injury. Besides the alterations in cognitive and motor abilities, we estimated infarct area, oxidative stress, blood-brain barrier (BBB) permeability, and histology after treatment. Pharmacokinetic parameters like Cmax, Tmax, half-life, and AUC0-t were estimated in biological samples to substantiate the therapeutic outcomes of the combination treatment.Results: We report PG and NOS prevent loss of motor ability and improved spatial memory after cerebral I-R injury. Combination treatment significantly reduced inflammation and restricted infarction; it attenuated oxidative stress, BBB damage, and improved grip strength. Histopathological analysis demonstrated a significant reduction in leukocyte infiltration with the most profound effect in the combination group. Simultaneous analysis of PG and NOS in plasma revealed enhanced peak drug concentration, improved AUC, and prolonged half-life; the drug levels in the brain have increased significantly for both. Conclusion: We conclude that PG and NOS have beneficial effects against brain damage and, the co-administration further reinforced neuroprotection in the cerebral ischemia-reperfusion injury.
Adaptive Traffic Routing Practice for Load Balance and Congestion Control in AdHoc Network in Cloud-MANET
Authors: Dalal Surjeet , Dahiya Neeraj , Seth Bijeta , Jaglan Vivek , Malik Meenakshi , Surbhi Surbhi , Rani Uma , Le Dac-Nhuong , Hu Yu-Chen
Published: July 2021

Cloud services can dramatically improve the computing proficiency of mobile devices. Mobile operators can count on the cloud to carry out thorough computing operations such as research, data mining and multimedia handling. Load balancing and network congestion are the difficult ad hoc network tasks due to its un-predictable dynamic behavior and random topology alteration of such systems. The most important reason of data loss in wireless grids is flexibility, network congestion and channel errors. The majority of the accessible directing schemes deal with the energy efficiency, congestion and balancing overload load outstandingly. Proficient routing protocol is proposed in this manuscript which will adaptively control the network congestion and achieve load balancing in Mobile Ad Hoc Networks (MANET). The proposed technique discovers multiple alternate paths between two nodes. The cost and stability of the link and traffic load is calculated depending on the available power of the participated nodes. If the traffic load on a specific link escalates beyond the threshold value, the traffic will be distributed to other alternate links. It is clear with the simulation outcomes that the projected approach enhances the network lifespan by integrating load balancing and congestion control with energy efficient algorithm. Thereby, it reduces the packet dropping probability and node to node delay in the network and improves the system lifetime.
The Evaluation of Neutrophil to Lymphocyte Ratio in Kawasaki Disease and Its Value in Predicting IVIG Therapy Resistance
Authors: Houshmand Hamidreza , Farhadi Ramin , Sedokani Amin
Published: July 2021

Introduction: Kawasaki disease is a common systemic vasculitis of unknown cause in children and involves various organs but the main damage of this multisystemic vasculitis is mainly in the coronary arteries. Currently, the main treatments for this disease include aspirin therapy and IVIG. In the present study, we investigated the ratio of neutrophils to lymphocytes in patients with Kawasaki disease and its relationship with IVIG resistance in Kawasaki patients.Method: First, we reviewed the clinical records of patients diagnosed with Kawasaki, who received treatment at Motahari Hospital in Urmia from 2008 to 2018 (IVIG therapy). We re-examined Kawasaki diagnostic criteria for each individual before enrolling patients. Results: In our study, initially 460 cases of patients who were admitted to Motahari Hospital in Urmia between 2009 and 2019 with an initial diagnosis of Kawasaki disease were reviewed. Among them, patients who met Kawasaki diagnostic criteria were included in the final review and the rest of the cases were excluded from the study according to the exclusion criteria. Finally, out of 460 cases, 241 patients were included in the final analysis. The results indicated high blood leukocyte count (p-value = 0.013) and low urinary leukocyte count (p-value = 0.01) were directly related to response to treatment in Kawasaki patients, but age, sex, neutrophil ratio to Lymphocytes, neutrophil count, blood lymphocytes, CRP, hypoalbuminemia, ALT levels, anemia, thrombocytosis, and the time interval between onset of symptoms and treatment response to IVIG therapy in Kawasaki patients are not significantly related.Conclusion: High blood leukocyte count and low urinary leukocyte count in patients can be good criteria for predicting the prognosis of Kawasaki patients in response to IVIG, while the ratio of neutrophils to lymphocytes is not effective in this prediction.
Minimum Threshold Determination Method based on Dataset Characteristics in Association Rule Mining
Authors: Hikmawati Erna , Maulidevi Nur Ulfa , Surendro Kridanto
Published: July 2021

The process of extracting data to obtain useful information is known as data mining. Furthermore, one of the promising and widely used techniques for this extraction process is association rule mining. This technique is used to identify interesting relationships between sets of items in a dataset and predict associative behavior for new data. The first step in association rule mining is the determination of the frequent item set that will be involved in the rule formation process. In this step, a threshold is used to eliminate items excluded in the frequent itemset which is also known as the minimum support. Furthermore, the threshold provides an important role in determining the number of rules generated. However, setting the wrong threshold leads to the failure of the association rule mining to obtain rules. Currently, the minimum support value is determined by the user. This leads to a challenge that becomes worse for a user that is ignorant of the dataset characteristics. In this study, a method was proposed to determine the minimum support value based on the characteristics of the dataset. Furthermore, this required certain criteria to be used as thresholds which led to more adaptive rules according to the needs of the user. The results of this study showed that 6 from 8 datasets, obtained a rule with lift ratio > 1 using the minimum threshold value that was determined through this method.
Development and Identification of Four New Synthetic Hexaploid Wheat Lines with Solid Stems
Authors: Liang Dongyu , Zhang Minghu , Liu Xin , Li Hui , Jia Zhenjiao , Wang Dinghao , Peng Ting , Hao Ming , Liu Dengcai , Jiang Bo , Huang Lin , Ning Shunzong , Yuan Zhongwei , Chen Xuejiao , Zhang Lianquan
Published: July 2021

Stem solidness is an important agronomic trait for increasing the ability of wheat to resist lodging. In this study, four new synthetic hexaploid wheat with solid stems were developed from natural chromosome doubling of F1 hybrids between a solid-stemmed durum wheat (Triticum turgidum ssp. durum, 2n = 4x = 28, AABB) and four Aegilops tauschii (2n = 2x = 14, DD) accessions. The solid expression of the second internode at the base of the stem was stable for two synthetic hexalpoid wheat Syn-SAU-117 and Syn-SAU-119 grown in both the greenhouse and field. The lodging resistance of four synthetic solid-stem wheats is stronger than that of CS, and Syn-SAU-116 has the strongest lodging resistance, followed by Syn-SAU-119. The paraffin sections of the second internode showed that four synthetic wheat lines had large outer diameters, well-developed mechanical tissues, large number of vascular bundles, and similar anatomical characteristics with solid-stemmed durum wheat. The chromosomal composition of four synthetic hexaploid wheat was identified by FISH (fluorescence in situ hybridization) using Oligo-pSc119.2-1 and Oligo-pTa535-1. At adult stage, all four synthetic hexaploid wheat showed high resistance to mixed physiological races of stripe rust pathogen (CYR31, CYR32, CYR33, CYR34). These synthetic hexaploid wheat lines provide new materials for the improvement of common wheat.