bluuebunny/crossref_metadata_2025 huggingface dataset:
Ocular Blood Flow Abnormalities and Their Correlation with Body Mass Index in Obese Patients
Authors: Tufek Melek , Capraz Mustafa , Kaya Ahmet Turan , Varol Kenan , Aydın Nihat , Nalcacıoglu Pınar
Published: June 2021

PurposeTo evaluate the effects of obesity on ocular blood flow including choroidal thickness and retrobulbar blood flow values in comparison with healthy subjectsMethodsThe 102 eyes of 102 female patients were included in this prospective study.Color Doppler ultrasonography (CDU) was used to evaluate the retrobulber vessels.Choroidal thickness was measured by using the optical coherence tomography (OCT). ResultsThere was a significant difference in IOP values within the groups with the highest values in group 3 and the lowest in group 1.There was also a positive correlation between BMI and IOP. The CT was found to be statistically significantly lower in group 2 and group 3 than in the control group at all measurement points. The choroidal thickness was also statistically significantly lower in group 3 than in group 2 at the subfoveal, nasal 500 µm, and the temporal 500 and 1000 µm measurement points.The mean CRA PSV and EDV values were lower in group 2 and group 3 than in group 1, while group 3 had the lowest mean CRA PSV value among the groups. When compared to group 1, the OA EDV value was lower only in group 3 while the OA PSV value was statistically significantly lower in group 3 than in both group 2 and group 1. There was no significant difference between the groups in terms of RI and PI.ConclusionsObesity can create a predisposition to ocular pathologies both by increasing the IOP and decreasing the retrobulbar and choroidal blood flow.
Use of GIS in Hydrogeochemical Study and Quality Status From Pudukkottai District, Tamil Nadu, India
Authors: Arumugam Muruganantham , Karthikeyan Sivakumar , Kulandaisamy Prabakaran , Thangaraj Kongeswaran , Senapathi Venkatramanan , Sundaram Bangaru Priyanga , Vellaikannu Agastheeswaran , Velmayil Perumal
Published: June 2021

This study focused on hydrogeochemical characterisation and groundwater quality deterioration based on drinking, irrigation purposes in Pudukottai district. Eighty-seven groundwater samples were collected from the bore and dug wells during pre and post monsoon seasons in the year 2019. The order of mean abundance of ions is followed as C l > HCO3 > Na > SO4 > Mg > Ca > K (325.5 > 182.2 > 181.4 > 83.2 > 51.1 > 35.8> 9.1 > 8.6 > o.9 > 0.3) and Cl > Na > HCO3 > SO4 > Mg > Ca > K (415.7 > 230.3 > 198.2 > 82.9 > 53.8 > 43.4 > 14.9) in both seasons. Analytical results are used in Piper, Gibbs, Na% vs. EC, USSL, and PI to evaluate the hydrogeochemical processes. Rock water interaction and evaporation processes causing variations in hydrogeochemistry of the study area during pre and postmonsoon. Nearly 15 % of the groundwater samples were not permissible for drinking based on the standard, which is distributed in south eastern region of the study area. It is revealed from Na%, SAR, RSC, MgC and KR results that majority of the groundwater samples are fit for irrigation uses. The higher concentration of EC, TDS, Cl and Na values noted in south region due to the sea water intrusion that attributed by excess pumping in the coastal regions. The drinking water quality index (DWQI) and irrigation water quality index (IRWQI) are calculated to identify the suitability of groundwater for drinking and irrigation purposes. However, this research concludes that the groundwater quality of maximum part in the district is appropriate for drinking as well as agriculture which can be used for the sustainable growth. It is also recommended implementing the artificial recharge techniques to improve the groundwater quality.
Evaluation of A 55-Gene Classifier As A Prognostic Biomarker for Adjuvant Chemotherapy in Stage III Colon Cancer Patients
Authors: Oki Eiji , Shinto Eiji , Shimokawa Mototsugu , Yamaguchi Shigeki , Ishiguro Megumi , Hasegawa Seiji , Takii Yasumasa , Ishida Hideyuki , Kusumoto Tetsuya , Morita Masaru , Tomita Naohiro , Shiozawa Manabu , Tanaka Masafumi , Ozawa Heita , Hashiguchi Yojiro , Ohnuma Shinobu , Tada Sachiyo , Matsushima Tomoko , Hase Kazuo
Published: June 2021

Background
Adjuvant chemotherapy reduces the recurrence risk in stage III colon cancer (CC). However, better prognostic and predictive biomarkers are required to stratify patients for treatment. We constructed a 55-gene classifier (55GC) and investigated its utility for classifying patients with stage III CC.
Methods
We retrospectively identified patients with stage III CC aged 20–79 years who received adjuvant chemotherapy with or without oxaliplatin during 2009–2012.
Results
Among 938 eligible patients, 203 and 201 patients who received adjuvant chemotherapy with and without oxaliplatin, respectively, were selected by propensity-score matching. Of these, 95 patients from each group were analyzed and their 5-year relapse-free survival (RFS) rates with and without oxaliplatin were 73.7% and 77.1%, respectively. The hazard ratios for 5-year RFS for adjuvant chemotherapy (fluoropyrimidine), with or without oxaliplatin, were 1.241 (95% CI, 0.465–3.308; P = 0.67) and 0.791 (95% CI, 0.329–1.901; P = 0.60), respectively. Stratification using the 55GC revealed that 52 (27.3%), 78 (41.1%), and 60 (31.6%) patients had microsatellite instability (MSI)-like, chromosomal instability (CIN)-like, and stromal subtypes, respectively. The 5-year RFS rates were 84.3% and 72.0% in patients treated with and without oxaliplatin, respectively, for the MSI-like subtype (HR, 0.495; 95% CI, 0.145–1.692; P = 0.25). No RFS rate differences were noted in CIN-like or stromal subtypes. Stratification by cancer sidedness for each subtype showed improved RFS only in left-sided primary cancer treated with oxaliplatin for the MSI-like subtype (P = 0.007). The 5-year RFS rates for the MSI-like subtype in left-sided cancer were 100% and 53.9% with and without oxaliplatin, respectively.
Conclusions
Subclassification using 55GC and tumor sidedness revealed increased RFS of patients within the MSI-like subtype with stage III left-sided CC treated with fluoropyrimidine with oxaliplatin relative to those treated without oxaliplatin. However, the predictive power of 55GC subtyping alone did not reach statistical significance in this cohort, warranting larger prospective studies.
Trial registration:
The study protocol was registered in the University Hospital Medical Education Network (UMIN) clinical trial registry (UMIN study ID 000023879).
Role Playing Is a Useful Method for Teaching Physical Examinations
Authors: Mamaghani Ebrahim Aliafsari , ahmadzadeh sharareh
Published: June 2021

Introduction: The role playing, if well organized and planned, can be a good way to teach practical lessons and acquire communication skills for nursing students. The purpose of this study was to investigate the effect of role playing education in the course of assessing the health status of nursing students.Methods: This study was conducted as a scholarship research in the period of 4 semesters from 2018-2021. It is noteworthy that about 25 nursing students were studying in each semester. In this way, the instructor performed the process of taking the patient's history or examination on a student playing as the patient. The students then repeated the same test on each other in pairs. Satisfaction and confidence forms were filled out by students after the course. Retesting and obtaining feedback from instructors and clinical nurses were used to assess the durability of the materials and their application.Findings: Students’ satisfaction with this teaching method was higher than satisfaction level in students not experiencing this method who had passed this course in the usual way, and an increase was observed as 2.8 ± 0.7 in the students' average scores. Students' confidence and ability to perform physical examinations at the clinic improved based on feedback received from ward nurses and instructors in later semesters. In addition, comprehension of adult and senior courses in later semesters was easier for students trained in this way.Discussion: Studies show the effect of role playing teaching method in improving learning motivation and problem solving skills and communication skills in students. The consistency between the results of the present study with the results of other studies leads us to recommend the use of this educational method in other medical sciences courses, which require practical skills and self-confidence of students in bed. Medical education officials and practitioners can take valuable steps in this direction by recommending and emphasizing the use of this method in improving the teaching and learning of such courses.
Exposure to Ambient Air Pollutions and Upper Respiratory Tract Infection in Zhengzhou City, China: A Approximate Five-Year Surveillance Study
Authors: Lin Shan-shan , He Hui hui , Jia Rui , Du Juan , Ma Ning yi , Qian Meng dan , Wang Yan , Huang Hui min , Kong De qi , Li Ya
Published: June 2021

Background: Studies indicated that air pollutions were associated with respiratory disease have with a lag exposure–response relationship, but not linear. However, few evidences in Zhengzhou, one of the most polluted cities for China.Method: Upper respiratory tract infection (URTI) outpatient visits in the hospital, meteorological parameters and air pollutions data were obtained from October 28, 2013 to May 1, 2018 and were used for evaluating the risk effects of the air pollutants with a distributed lag non-linear model (DLNM), including the stratified analysis of gender and age.Result: 475013 cases were included, with obvious seasonal fluctuations,higher in cool/cold and lower in warm. Every increase of 10μg/m3 of PM2.5, PM10, SO2, NO2 and CO showed similar impacts on URTI outpatient visits in different genders and age sub-groups,within 0 to15 days of lag. PM10, SO2 and NO2 had the strongest immediately risk at lag 0 [RRPM10: 1.0011, 95%CI (1.0002-1.0020); RRSO2: 1.0084, 95%CI (1.0039-1.0130); RRNO2: 1.0149, 95%CI: (1.0111-1.0188), respectively], while PM2.5 and CO got highest risk at lag 15 days [RRPM2.5: 1.0014, 95%CI (1.0003-1.0025); RRCO: 1.0002, 95%CI: (1.0001-1.0003), respectively]. In addition, calculating overall accumulated effects of each 10μg/m3 increase in PM10, SO2, NO2, and CO was greater in females than in males, as well as greater in the adolescents (aged 0-18 years) and elderly (aged ≥ 60 years) than in adults (aged 19-59 years), except CO was greater in the adolescents and adults than in the elderly. No significant cumulative effects were found in PM2.5. O3 levelwasno significant correlation withURTI outpatient visits throughout the lag period.Conclusions: Our results indicated that PM10, SO2, NO2 and CO had strong immediate and lag cumulative effects in the females, adolescents, and elderly. PM2.5 has lag effects but has no significant lag cumulative impact effects on gender and age.
Role of Plasmatic and Urinary Concentration of Tenofovir Disoproxil Fumarate in a Cohort of Patients Affected by Chronic Hepatitis B
Authors: Boglione Lucio , De Benedetto Ilaria , Dodaro Valentina , Chiecchio Marta , De Nicolò Amedeo , Perri Giovanni Di , D’Avolio Antonio
Published: June 2021

The aim of this study was the evaluation of plasmatic and urinary therapeutic drug monitoring (TDM) of tenofovir disoproxil fumarate (TDF) in a cohort of patients affected by chronic hepatitis B (CHB). In 68 enrolled patients eGFR was 68 ml/min in naive, while in adefovir dipivoxil (ADV) pretreated patients was 55.5 ml/min (p<0.001). The HBV E genotype was related to lower TDF level (β= -0.698, p<0.001). Urinary TDF concentration was related to ADV pretreatment (β=0.829, p<0.001). TDF urinary concentrations maybe useful in clinical management of CHB patients with older age and previous treatment with ADV.
Seismic and Structural Health Monitoring Systems For Large Dams: Theoretical, Computational and Practical Innovations
Authors: Oliveira Sérgio , Alegre André , Carvalho Ezequiel , Mendes Paulo , Proença Jorge
Published: June 2021

Over the past decade, monitoring systems for Seismic and Structural Health Monitoring (SSHM) have been assuming a greater role in the safety control of large concrete dams. In this article, the dynamic behavior of two large arch dams equipped with SSHM systems is analyzed, in order to present some of the main theoretical, computational and practical innovations developed recently for the improvement of large dams’ continuous dynamic monitoring using SSHM systems. The case studies are two large arch dams that have been under continuous dynamic monitoring over the last ten years: Cabril dam (132 m high), the highest dam in Portugal, and Cahora Bassa dam (170 m high), located in Mozambique, one of the highest dams in Africa. The Seismic and Structural Health Monitoring (SSHM) systems installed in both dams have similar schemes and were designed to continuously record acceleration time series in several locations at the upper part of the dam body and near the dam-foundation interface, using uniaxial and triaxial accelerometers. Specific software was developed for monitoring data analysis, including automatic modal identification, to obtain natural frequencies and mode shapes, for automatic detection of vibrations induced by seismic events, to be distinguished by those caused by other operational sources, and for comparison between results retrieved from measured vibrations and numerical results obtained from computational 3DFE models. The numerical analyses are carried out using a 3DFE program for linear and non-linear dynamic analysis of concrete dams, based on a solid-fluid coupled formulation to simulate the dam-reservoir-foundation system, considering the dam-water dynamic interaction and the propagation of pressure waves throughout the reservoir. The most significant experimental results from continuous dynamic monitoring are presented for Cabril dam and Cahora Bassa dam and compared with numerical results, with emphasis on the evolution of natural frequencies over time, on vibration mode shapes for various water levels, and, finally, on the measured accelerations during seismic events. Furthermore, the main results of non-linear seismic response simulations, considering joint movements and concrete damage, are also presented for both dams in order to assess their seismic performance, using an intensifying seismic accelerogram prepared for Endurance Time Analysis.
Look Over the Horizon - Chicken Linkage Disequilibrium is Much More Complex Over Much Longer Distance than Previously Appreciated
Authors: Lipkin Ehud , Fulton Janet E. , Smith Jacqueline , Burt David W. , Soller Morris
Published: June 2021

BackgroundAppreciable Linkage Disequilibrium (LD) is commonly found between pairs of loci close to one another, decreasing rapidly with distance between the loci. This provides the basis studies to map Quantitative Trait Loci Regions (QTLRs), where it is custom to assume that the closest sites to a significant markers are the prime candidate to be the causative mutation. Nevertheless, Long-Range LD (LRLD) can also be found among well-separated sites. LD blocks are runs of genomic sites all having appreciable LD with one another. High LD and LRLD are often separated by genomic sites with which they have practically no LD. Thus, not only can LD be found among distant loci, but also its pattern may be complex, comprised of fragmented blocks. Here, chicken LRLD and LD blocks, and their relationship with previously described Marek’s Disease (MD) QTLRs, were studied in an F6 population from a full-sib advanced intercross line, and in eight commercial pure layer lines. Genome wide LRLD was studied in the F6 population by random samples of non-syntenic and syntenic marker pairs. To illustrate the relationship with QTLRs, LRLD and LD blocks in and between the MD QTLRs were studied by all possible marker pairs.Results LRLD was defined as r2 ≥ 0.7 over a distance ≥ 1 Mb, and 1.5% of all syntenic marker pairs were classified as LRLD. Complex fragmented and interdigitated LD blocks were found, ranging over distances from a few hundred to a few millions bases. Vast high, long-range, and complex LD was found between two of the MD QTLRs. Cross QTLRs STRING networks and gene interactions suggested possible origins of the exceptional LD between these two QTLRs.ConclusionsAll sites with high LD with a significant marker should be considered as candidate for the causative mutation, but, unlike the custom assumption, the causative mutation is not necessarily the one closest to the significant marker. Rather, the present results show that it can be located at a much larger distance from a significant marker than previously appreciated, beyond closer mutations. Thus, LRLD range and LD block complexity must be accounted for while interpreting genetic mapping studies.
Evaluation of Paramedic Views of Their Role in Ambulance Based Clinical Trials: An Interview Study
Authors: Armstrong Stephanie , Phung Viet-Hai , Siriwardena Aloysius Niroshan , Langlois Adèle
Published: June 2021

Background: Prehospital ambulance-based research is a relatively new and growing field, with paramedics increasingly being asked to take on a new research role. We sought to understand paramedic perceptions of this role with particular emphasis on the ethical challenge of gaining consent and enrolling patients onto clinical trials in this setting. Methods: We undertook semi-structured interviews with paramedics who were actively involved in recruiting and consenting patients to UK trials. Participants were questioned on their views about the ethical considerations in clinical trials including different consent processes and perceived barriers to research. Participants were chosen because they had enrolled at least one patient to a clinical trial within the 12 months prior to the interview taking place. Results: Fifteen paramedics from East Midlands NHS Ambulance Trust UK (EMAS) were interviewed. Analysis highlighted seven themes: barriers and facilitators to participation; benefits of research; consent methods; future trials; managing patient participants; problems with consent; and reasons why paramedics participate (or not). Paramedics were generally comfortable with gaining consent for research and most did not see this as an additional burden. However, excessive paperwork and the prolonged handover times needed for paramedics to participate in research were seen to be problematic. All paramedics interviewed felt that research was important for advancing their practice and ensuring better outcomes for patients as a result of evidence-based practice. Conclusions: Our findings highlight the need for future trials to consider how to minimize impact on the operational practice of paramedics through the use of existing processes that reduce additional paperwork and time pressures on paramedics.
Towards An Effective Collaboration Between South Western Sydney Local Health District and Local Councils: Insights From The Qualitative Study
Authors: Kovai Vilas , Mahjabeen Zeenat , Arjunan Punitha , Jalaludin Bin
Published: June 2021

Background

Urban planning is of fundamental use in promoting a healthy urban environment, prompting increased collaboration between public health and local government planning authorities. A major challenge to the success of this co-operation, however, is the difficulty of ensuring that the views of the health sector are, ultimately, reflected in planning policy. To facilitate this, a qualitative study was designed by Population Health, South Western Sydney Local Health District (SWSLHD) in 2016.
Objective

The aim of the study was to investigate ways in which SWSLHD could be engaged with councils in the urban planning processes of local councils in south-western Sydney to promote a healthy urban environment.
Methods

Qualitative data was collected from 14 in-depth interviews with staff representing five local councils: Bankstown, Camden, Liverpool, Campbelltown, and Fairfield. The data was thematically analysed using inductive and deductive reasoning by applying NVivo software.
Results

While councils recognise the potential value of consultation (and partnership) with SWSLHD, the fact is that the status quo is one of limited communication and the absence of any clearly defined process for collaboration. Councils perceive knowledge gaps in relation to basic issues such as who provides what services to whom and how to access services from health experts related to evidence based local government level data.
Implications:

The study demonstrated that a shift in provision of public health evidence that has local applicability in a timely manner on issues of mutual concern, and proactive and ongoing consultations between SWSLHD and councils would enable effective engagement, coordinated and sustained actions.
Adult Onset Alexander Disease Presenting as Psychogenic Polydipsia Induced Recurrent Hyponatremia as the Initial Symptom: A Case Report.
Authors: Li Honghao , Yu Jing , Guo Shougang
Published: June 2021

BackgroundAlexander disease (AxD, OMIM 203450) is a rare and generally fatal disorder of the central nervous system associated with heterozygous mutations in glial fibrillary acidic protein (GFAP) gene. Neuroradiological and clinical features of adult onset AxD is characterized by involvement of hindbrain structures. Psychiatric manifestations and extensive white matter lesions are very sparse in adult onset AxD.Case presentationWe diagnosed a female with AxD presenting with recurrent hyponatremia caused by psychogenic polydipsia as initial symptom at the onset age of 52-year-old. Neurological examination revealed slightly cognitive decline and brisk deep tendon reflex (DTR) in bilateral lower limbs. The symptoms commonly seen in adult onset AxD such as pseudobulbar signs, ataxia and spasticity were not found in the clinical course of disease. Her mother and elder brother had a history of schizophrenia. The patient has had a history of compulsive water drinking as well as personality change in recent years. Her brain magnetic resonance imaging (MRI) showed extensive involvement of white matter without atrophy of medulla oblongata and cervical spinal cord. The next generation DNA sequencing (NGS) showed a likely pathogenic nonsense mutation C1237C>T(pR413*) in GFAP-ε isoform.ConclusionsOur report enriches the understanding of familial adult onset AxD. Our case also contributes to evidence of pathogenicity of the variants in GFAP-ε as the cause of adult onset AxD.
Association Between Immune-Related Hypothyroidism and Survival Outcomes in Patients with Head and Neck Cancer Treated with Nivolumab
Authors: Hata Kojiro , Sasaki Keiichi , Watanabe Hiroyuki , Ikeda Munehiko , Tsuji Toshikazu , Ishida Shigeru , Ikebe Mio , Kumagai Ayako , Ozawa Nana , Matsukane Ryosuke , Nagata Kenichiro , Suetsugu Kimitaka , Tajima Soichiro , Yamada Takaaki , Egashira Nobuaki , Matsuo Mioko , Yasumatsu Ryuji , Nakagawa Takashi , Ieiri Ichiro
Published: June 2021

Background

Immune-related hypothyroidism (irHT) triggered by nivolumab is known to affect drug efficacy in patients with non-small cell lung cancer (NSCLC). However, it is unclear whether there is an association between the drug efficacy and nivolumab-induced irHT in recurrent and/or metastatic head and neck cancer (R/M HNC). Hence, we retrospectively investigated the relationship between irHT and treatment outcomes in R/M HNC patients treated with nivolumab.
Methods

Patients with R/M HNC who received nivolumab monotherapy between April 2017 and June 2019 were selected. Those receiving levothyroxine treatment and with thyroid-stimulating hormone (TSH) levels > 10 µIU/mL before nivolumab administration were excluded. irHT was defined as one measurement of free T4 (FT4) < 0.8 ng/dL and/or TSH > 10 µIU/mL or as two successive abnormal levels of FT4 and/or TSH after nivolumab administration. To assess therapeutic efficacy, nivolumab-treated patients were divided into two groups: with or without irHT [irHT (+) and irHT (−) groups, respectively].
Results

Of the 31 nivolumab-treated patients, 14 developed irHT. The median time to onset was 76 days (17–274 days). The median overall survival was 704 days (95% confidence interval [CI], 223–not reached) in the irHT (+) group and 244 days (95% CI, 170–342) in the irHT (−) group (hazard ratio (HR) = 0.33, p = 0.0259). The median progression-free survival was 197 days (95% CI, 103–not reached) in the irHT (+) group and 105 days (95% CI, 52–151) in the irHT (−) group (HR = 0.32, p = 0.0115). The disease control rate was significantly higher in the irHT (+) group than in the irHT (−) group (78.6% vs. 35.3%; p = 0.0292). Although there was no difference in the incidence of grade 3 serious immune-related adverse events (irAEs) between the two groups, the incidence of multiple irAE events in each patient (50.0% vs. 5.9%; p = 0.0109) was significantly higher in the irHT (+) group than that in the irHT (−) group.
Conclusions

Our results suggest that the development of irHT, similarly to NSCLC, is associated with improved survival outcomes in R/M HNC patients treated with nivolumab.
Error Identification Method of Five-Axis Machine Tool Based on Sample Test Method
Authors: Lv xuehu , Guo qianjian , Yuan wei , Wang wenhua , Zhu yuqi , Wang haotian
Published: June 2021

In order to improve the predictive ability of the error model of the five-axis machine tool, an indirect error measurement (IEM) method of the five-axis machine tool based on the sample test method was proposed, and the optimized design of the stepped axis sample was completed. By inversely calculating the spatial error model of the machine tool, the function analysis relationship between the sample machining error and different error terms of the machine tool was established, and then the dynamic errors of the machine tool in different machining states were obtained. The reliability and practical effects of the method was verified through experiments. The results showed that the proposed IEM method was in good agreement with the laser measurement method. The predictive ability of the error model of the five-axis machine tool can be improved by using the IEM method, thereby more machining accuracy of the machine tool will be ensured.
Flood Hazard Mapping Using Exploratory Regression Model in GIS Domain
Authors: Ahmad Imran , Fenta Assefa , Dar Mithas , Halefom Afera , Tashome Aseret , Andualem tesfa
Published: June 2021

In this study, attempt has been made to understand the spatial distribution of flood hazard and flood risk in the Awash basin, Ethiopia. Awash basin has been chosen because it’s in continuous threat spatially and temporally. Eight determinant factors of flood hazard (viz., elevation, slope, rainfall, drainage density, landuse, soil type, wetness index and lineament density) were studied as independent variables. Each factor was reclassified into four classes and each was weighted according to its susceptibility towards the hazard. For example topographic lows were given the highest weight of 4; whereas topographic highs were given the lowest weight of 1. All the independent variables were overlaid in GIS domain to get the final spatial distribution of hotspots of flood hazard. Exploratory regression analysis showed that the existing landuse is the dominant factor influencing the flood vulnerability. A total of 31 models were generated using Exploratory regression in GIS domain. Model number 31 was found to be the best fit model with the highest Adjusted R2 value of 0.839539 and the least Akaike’s Information criterion value of 1536.866. Spatial autocorrelation tool run on the standard residuals yields the Z score and p value of 0.742522 and 0.457771 respectively; indicating that the residuals were neither clustered nor dispersed. Spatial extents of flood hazard and flood risk along with the priority for spatial planning in the Awash basin is digested well in this study.
Does Financial Toxicity Exist Amongst Adult Cancer Survivors Treated with Curative-Intent Radiotherapy? A Pilot Study from Singapore
Authors: Ng Ivy Weishan , Yuen Kah Hung , Meng Tian , Tan Chuan Chien , Yeo Chong Ming , Tey Chee Seong Jeremy , Soon Yu Yang , Ho Cho Hao Francis , Yoong Su-Yin Joanne , Gibbons Brent , Vellayappan Balamurugan A
Published: June 2021

Background

Cancer survivors may experience financial toxicity (FT) arising from diagnosis, treatµent, and potential employment loss. The prevalence of FT in the context of Singapore healthcare model is unknown. We investigate if higher out of pocket (OOP) expenditure correlates positively with FT, and if higher FT correlates with a worse quality of life (QoL).
Methods

In this pilot study, a cross-sectional survey was administered to survivors of nasopharyngeal or breast cancer, at National University Hospital Singapore. Patients’ FT and QOL were measured using the COmprehensive Score on financial Toxicity (COST) and Functional Assessment of Cancer Therapy: General (FACT-G). Two multivariate regression models estimated (i) the association between FT and a range of variables and (ii) FT and QOL.
Results

63% of our cohort of 76 patients experienced mild-moderate FT. Overall, the mean COST and FACT-G scores are 18.0 (out of 44) and 68.3 (out of 108), respectively. There was a positive correlation between COST and FACT-G scores (r = 0.45). We did not find any significant association between OOP and FT. Predictors for FT included government-subsidized housing, lower education levels, hiring a formal caregiver, and the need for household members to take on extra employment.
Conclusion

Greater FT correlates with a decline in QoL. Lower socio-economic patients are at higher risk of FT. OOP was not directed related to FT, likely in view of the effective means-tested subsidies. Additional resources should be considered for this at-risk population. Based on our pilot study, our methodology to quantify FT and OOP can be scaled up to other cancer primaries.
Ecosystem Services Assessment, Trade-Off and Bundles in the Yellow River Basin, China
Authors: Yang Jie , Xie Baopeng , Tao Wenqian
Published: June 2021

Understanding ecosystem services (ESs) and their interactions will help to formulate effective and sustainable land use management programs.This paper evaluates the water yield (WY), soil conservation (SC), carbon storage (CS) and habitat quality (HQ), taking the Yellow River Basin as the research object, by adopting the InVEST (Integrated Valuation of Ecosystem Services and Trade Offs) model. The Net Primary Productivity (NPP) was evaluated by CASA (Carnegie-Ames-Stanford approach) model, and the spatial distribution map of five ESs were drawn, the correlation and bivariate spatial correlation were used to analyze the trade-off synergy relationships between the five ESs and express them spatially. The results show that NPP and HQ, CS and WY are trade-offs relationship, and other ecosystem services are synergistic. The trade-off synergy shows obvious spatial heterogeneity. Driven by different factors, the leading ecological function services in the Yellow River Basin can be divided into three areas, and WY and SC service leading functional areas are mainly distributed in HQ and CS service leading functional areas and NPP service leading functional areas.The results of functional bundles are obviously affected by natural conditions such as land use/cover types and climate in the Yellow River Basin, which can provide the basis for the Yellow River Basin to regulate ESs and maximize benefits.
Transdisciplinarity of India's Master's Level Public Health Programmes: Evidence from Admission Criteria of the Programmes Offered Since 1995
Authors: Ilangovan Kumaravel , Muthappan Sendhilkumar , Govindarajan Keerthiga , Vairamani Vignesh , Venkatasamy Vettrichelvan , Ponnaiah Manickam
Published: June 2021

Background
In Indian subcontinent, Master's level public health (MPH) programmes attract graduates of diverse academic disciplines from health and non-health sciences alike. Considering the current and futuristic importance of the public health cadre, we described them and reviewed their transdisciplinarity status based on MPH admissibility criteria 1995 to 2021.
Methods
Using a search strategy, we abstracted information available in the public domain on MPH and their admissibility criteria. We classified disciplines specified for admission into Science, Social sciences and Arts, Health and Non-health categories. We described the MPH programmes by location, type of institutions, course duration, pedagogical methods, specialisations offered, and nature of admission criteria statements. We calculated descriptive statistics for eligible educational qualifications for admission to MPH programmes.
Results
Overall, 74 Indian institutions offered 88 MPH programmes. We included 85 for review. These programmes represent 50% increase (n = 44) from that of 2016-17. They are mostly concentrated in 21 provinces and union territories of India. These programmes stated that they admit candidates of but not limited to "graduation in any life sciences", "three-year bachelors degree in any discipline", “graduation from any Indian universities”, and "graduation in any discipline". Of the 72 institutions, 14 admit multidisciplinary academic graduates in their 16 programmes. Except three institutions from public sector, 69 provide MPH admission opportunities to multidisciplinary health and non-health academic graduates.
Conclusion
Our review suggests that India's MPH programmes are less transdisciplinary. India's Master's level public health programmes should transcend to be more inclusive and admit graduates of various academic educational backgrounds.
Analysis and Real-Time Implementation of IoT in Autism
Authors: Afzal Muhammad Javaid , Ashraf Muhammad Waseem , Tayyaba Shahzadi , Javaid Farah
Published: June 2021

The present study comprises the importance and use of IoT, smart home, peer-to-peer, and some other different technologies for the betterment of mankind. Artificial intelligence and machine learning are becoming more and more popular in IoT-based smart homes and other techs. The IoT framework has been used to provide a predictable, concrete, and self-paced learning environment and encourages excellent visual information processing. These techs are also useful for special children with autism. They need smart homes, peer-to-peer networking, robot therapy, and wearable techs. In this paper, the authors presented a unique FLC simulation for the behavior of a child with moderate autism. This simulation shows that how IoT, smart home, peer-to-peer technology, ABA therapy, robot therapy, and wearable techs can bring comforts in the life of a child with autism. All of them have long lasted impacts in producing social skills in an ASD person. The 3D graphical figures presented the graphical analysis of a child’s social behavior. The simulation presented 50% betterment change in the social behavior of children and this can be increased up to 87% by using intensive therapies. It is also verified by Mamdani’s method. A real-time implementation of a boy with autism has shown significant improvements in his social skills.
Gene-Based Association Tests Using GWAS Summary Statistics and Incorporating eQTL
Authors: Cao Xuewei , Wang Xuexia , Zhang Shuanglin , Sha Qiuying
Published: June 2021

Although genome-wide association studies (GWAS) have been successfully applied to a variety of complex diseases and identified many genetic variants underlying complex diseases, there is still a considerable heritability of complex diseases that could not be explained by GWAS. One alternative approach to overcome the missing heritability caused by the genetic heterogeneity is gene-based analysis, which considers the aggregate effects of multiple genetic variants in a single test. Another alternative approach is transcriptome-wide association study (TWAS). TWAS aggregates genomic information into functionally relevant units that map to genes and their expression. TWAS is not only powerful, but can also increase the interpretability in biological mechanisms of identified trait associated genes. In this study, we propose two powerful and computationally efficient gene-based association tests, Overall and Copula. These two tests aggregate information from three traditional types of gene-based association tests and also incorporate expression quantitative trait locus (eQTL) data into GWAS using GWAS summary statistics. Overall utilizes the extended Simes procedure and Copula utilizes the Gaussian copula approximation-based method. We show that after a small number of replications to estimate the correlation among the integrated gene-based tests, the P values of these two methods can be calculated analytically. Simulation studies show that these two tests can control type I error rate very well and have higher power than the tests that we compared. We also apply these two methods to two schizophrenia GWAS summary datasets and two lipids GWAS summary datasets. The results show that these two newly developed methods can identify more significant genes than other methods we compared with.
Validation of a Redundant Robotic Manipulator for Shoulder in Vitro Biomechanical Testing.
Authors: Moissenet Florent , Rastoll Clément , Gonzalez David , Foukia Noria , Lauria Michel , Armand Stéphane , Beaulieu Jean-Yves , Holzer Nicolas
Published: June 2021

Cadaveric joint simulators are commonly used to explore native and pathological joint function as well as to test medical devices. Recently, robotic manipulators have been proposed as a new gold standard for in vitro biomechanical testing as they offer higher possibilities than Universal Testing Machines in terms of degrees of freedom (DOF). However, current protocols remain conducted in extra-corporal conditions by fixing one segment of a diarthrodial joint while mobilising the other segment. Moreover, induced motions are commonly not specimen-specific and do not respect related joint kinematic constraints and physiologic boundaries. In this study, using a 7 DOF redundant robotic manipulator, an intra-corporal condition protocol was defined. This protocol allows 1) the analysis of the shoulder girdle full kinematic chain, 2) the replication of specimen-specific humerus motions initially induced by an operator. On the 10 shoulders tested, the robotic manipulator was able to perform requested end-effector motions with a reliability of 0.28 ± 0.57 mm and 0.15 ± 0.25°, and a fidelity of 0.27 ± 0.56 mm and 0.22 ± 0.28°. This protocol will be used in the future to explore joint function as well as to test medical devices, on the shoulder girdle and potentially other joints.
Patients with Borderline and Avoidant Personality Disorders in the Pandemic Their Mental Distress During the Covid-19 Crisis in Norway
Authors: Zahl Kjell-Einar , Pedersen Geir , Eikenaes Ingeborg Ulltveit-Moe , Stänicke Line Indrevoll , Wilberg Theresa , Baltzersen Åse-Line , Pettersen Mona , Hummelen Benjamin , Arnevik Espen , Johansen Merete Selsbakk , Kvarstein Elfrida Hartveit
Published: June 2021

Background

Even if people with mental disorders are vulnerable, few authors have studied patients with personality disorders (PDs) in the pandemic. We wanted to examine and compare mental and social distress among patients with borderline PD (BPD) and avoidant PD (AvPD) during the first wave of Covid-19.
Methods

In Summer 2020 a survey was distributed to 1120 patients referred to PD treatment units in Norway, with questions on social situation, mental distress, and changes in mental health after the lockdown. Among 133 responders we studied 40 patients with BPD and 30 with AvPD as their only PD.
Results

70% of the patients in both groups were more alone than before the pandemic, more than 40% felt lonelier, and 50% more aggressive. Both PD groups reported high levels of depression and anxiety, many with suicidal thoughts, and worries about health issues. Several BPD patients reported an improvement in some issues compared to the AvPD patients, with more initiative and energy.
Conclusions

Both PD groups reported increased levels of distress in the first wave of the pandemic. AvPD patients were not less distressed in their social isolation, but a significant group of BPD patients reported less distress in the first months of the pandemic.
Cubic 3D Chern photonic insulators with orientable large Chern vectors
Authors: Devescovi Chiara , Garcia-Diez Mikel , Robredo Iñigo , de Paz Maria Blanco , Bradlyn Barry , Mañes Juan Luis , Vergniory Maia , Garcia-Etxarri Aitzol
Published: June 2021

Time Reversal Symmetry (TRS) broken topological phases provide gapless surface states protected by topology, regardless of additional internal symmetries, spin or valley degrees of freedom. Despite the numerous demonstrations of 2D topological phases, few examples of 3D topological systems with TRS breaking exist. In this article, we devise a general strategy to design 3D Chern insulating (3D CI) cubic photonic crystals in a weakly TRS broken environment with orientable and arbitrarily large Chern vectors. The designs display topologically protected chiral and unidirectional surface states with disjoint equifrequency loops. The resulting crystals present the following novel characteristics: First, by increasing the Chern number, multiple surface states channels can be supported. Second, the Chern vector can be oriented along any direction simply changing the magnetization axis, opening up larger 3D CI/3D CI interfacing possibilities as compared to 2D. Third, by lowering the TRS breaking requirements, the system is ideal for realistic photonic applications where the magnetic response is weak.
Factors Associated With Successful Publication for Systematic Review Protocol Registration: an Analysis of 397 Registered Protocols.
Authors: Minh Le Huu Nhat , Le Huu-Hoai , Tawfik Gehad Mohamed , Makram Omar Mohamed , Tieu Thuan , Tai Luu Lam Thang , Shahin Karim Mohamed , Abozaid Ali Ahmed-Fouad , Shah Jaffer , Nam Nguyen Hai , Huy Nguyen Tien
Published: June 2021

Background: Meta-analyses are on top of the evidence-based medicine pyramid, yet many of them are not completed after they are begun. Many factors impacting the publication of meta-analysis works have been discussed, and their association with publication likelihood has been investigated. These factors include the type of systematic review, journal metrics, h-index of the corresponding author, country of the corresponding author, funding sources, and duration of publication. In our current review, we aim to investigate these various factors and their impact on the likelihood of publication. A comprehensive review of 397 registered protocols retrieved from five databases was performed to investigate the different factors that might affect the likelihood of publication. These factors include the type of systematic review, journal metrics, h-index of the corresponding author, country of the corresponding author, funding sources, and duration of publication.Results: We found that corresponding authors in developed countries and English-speaking countries had higher likelihoods of publication: 206/320 (p=0.018) and 158/236 (p=0.006), respectively. Our models of multivariable logistic regression analysis revealed that two main factors impact the publication outcome: updated protocol status of the published review paper (OR: 1.7, 95% CI: 1.0-2.8, p=0.037) and external funding (OR: 2.1, 95% CI: 1.2-3.8, p=0.01). However, corresponding authors’ location in developed countries (OR: 1.7, 95% CI: 0.8-3.4, p=0.139) and English-speaking countries (OR: 1.5, 95% CI: 0.9-2.6, p=0.1) were insignificant determinants.Conclusion: Meta-analyses continue to be on top of the evidence hierarchy, rendering them the key to informed clinical decision-making. Therefore, more attention should be paid to the methodological quality of this type of publication.
In vitro Assessment of Intra-operative and Post-operative Environment in Reducing Bladder Cancer Recurrence
Authors: TSE Ryan Tsz-Hei , ZHAO Hongda , WONG Christine Yim-Ping , KONG Angel Wing-Yan , CHAN Ronald Cheong-Kin , TO Ka-Fai , NG Chi-Fai , TEOH Jeremy Yuen-Chun
Published: June 2021

Urinary bladder cancer is a common cancer worldwide. Currently, the modality of treating and monitoring bladder cancer is wide. Nonetheless, the high recurrence rate of non-muscle-invasive bladder cancer after surgical resection is still unsatisfactory. Hereby, our study demonstrated whether the intra-operative and post-operative environments will affect bladder cancer recurrence utilizing in vitro cell line model. Bladder cancer cell lines were submerged in four different irrigating fluids for assessing their tumorigenic properties. Our results showed that sterile water performed the best in terms of the magnitude of cytotoxicity to cell lines. Besides, we also investigated cytotoxic effects of the four irrigating agents as well as mitomycin C (MMC) in normothermic and hyperthermic conditions. We observed that sterile water and MMC had an increased cytotoxic effects to bladder cancer cell lines in hyperthermic conditions. Altogether, our results could be translated into clinical practice in the future by manipulating the intra-operative and post-operative conditions in order to lower the chance of residual cancer cell reimplant onto the bladder, which in turns, reducing the recurrence rate of bladder cancers.
A Window into the Breeding Ecology and Molt of the Eastern Black Rail (Laterallus jamaicensis jamaicensis)
Authors: Hand Christine E. , Gabel Wray , DiPetto Gabriella R. , Bonafilia Rachel E. , Znidersic Elizabeth
Published: June 2021

Knowledge of the ecology and behavior of the Eastern Black Rail (Laterallus jamaicensis jamaicensis) has remained nearly as elusive as the rail itself. Camera trapping methods facilitated the first study of breeding phenology and chick development (n = 33 broods), flightless molt phenology and duration (n = 10 adults in molt), and courtship and brood rearing behaviors. In addition, behavioral observations combined with phenology data provided evidence of pairs raising two or more broods during a breeding season. Conservation and management efforts for the Eastern Black Rail should take into consideration periods of vulnerability such as incubation, brood rearing and flightless molt, which coincide with increasingly severe and frequent coastal flooding events and hurricanes. To effectively develop conservation strategies to ensure the persistence of the Eastern Black Rail, it is necessary to understand factors key to the fecundity and survival of the subspecies.
Most natural-forming calcites precipitate at isotopic equilibrium
Authors: jie Yuan
Published: June 2021

Based on thermodynamic equilibrium isotope fractionation theory, this letter reasonably understands the clumping 13C-18O (Δ47 ), as well as carbon and oxygen isotope fractionation in calcites with extremely slow-growing rates from Devils Hole and Laghetto Basso (Corchia Cave) at atomic level with solid physical precipitation models and quantum-mechanical backgrounds. It is found that most calcites in nature precipitate in at equilibrium.