bluuebunny/crossref_metadata_2025 huggingface dataset:
The Method of Measuring Carbon Sinks Based on the Changes of oxygen concentration in Forest Canopy
Authors: XING CHANGSHAN , LV JIANG , SHI YUN
Published: December 2021

Measuring Forest Carbon Sinks is becoming a popular topic as the need of many countries’ carbon neutrality plans. We demonstrate a simple and accurate method of Forest Carbon Sinks measurement. By observing the daily average oxygen concentration in the canopy, we found it presented a parabolic distribution from Spring to Fall in a year. The forest finished the cycle from releasing oxygen and sequestrating carbon dioxide to using oxygen and releasing carbon dioxide in this period. We calculated the carbon sequestration of the forest was 101.39t/hm2/y, the Carbon Sink was 15.09t/hm2/y by calculating the changes of oxygen concentration in a growth cycle, the Carbon Sink is 16.29% of the carbon sequestration.
Nodal Positive Breast Cancer and Its Regional Lymph Node Involvement
Authors: Maennle Heidrun , Frank Matthias , Momm Felix , Siebers Jan Willem
Published: December 2021

Purpose: In breast cancer, the lymph node status is of prognostic importance and a decisive factor in therapy planning. This study shows the distribution of lymph nodes metastases of node-positive breast cancer patients. Risk factors for lymph node metastases are described.Methods: 2095 patients with primary breast cancer were analyzed. Analysis included descriptive analysis (median, standard deviation, ranges) and statistical analysis (Chi², discriminant analysis).Results: The nodal stage was positive in 39.4% of all patients and negative in 60.6%. If the nodal stage was positive, only 1 lymph node was involved in 36% of the patients; more than 1 lymph node was involved in 64% of the patients. With an increasing number of lymph node metastases in level I, the probability of an involvement in level III also increases (F 437.845, p = .000). Other indicators are evidence of hemangiosis (F 247.728, p = .000) or lymphangiosis (F 167.368, P = .000). Despite <10 affected lymph nodes, 3.4% of the patients had nodal stage N3 due to level III involvement.Conclusion: Even with only a small number of lymph node metastases in level I higher lymphatic stations are often affected. The data cannot lead to a decision regarding an operation or radiation indication, but they can better substantiate the risk for certain therapy decisions.
Whole-Transcriptome Analysis of Serum L1CAM-Captured Extracellular Vesicles Reveals Neural And Glycosylation Changes In Autism Spectrum Disorder
Authors: Qin Yannan , Cao Li , Zhang Haiqing , Cai Shuang , Zhang Jinyuan , Guo Bo , Wu Fei , Zhao Lingyu , Li Wen , Ni Lei , Liu Liying , Wang Xiaofei , Chen Yanni , Huang Chen
Published: December 2021

The pathophysiology of autistic spectrum disorder (ASD) is not fully understood and there are no diagnostic or predictive biomarkers. Extracellular vesicles (EVs) are cell-derived nano-sized vesicles, carrying nucleic acids, proteins, lipids and other bioactive substances. As reported, serum neural cell adhesion molecule L1 (L1CAM)-captured EVs (LCEVs) can provide reliable biomarkers for neurological diseases; however, little is known about the LCEVs in children with ASD. In this study, serum samples were collected from 100 ASD children and 60 age-matched typically developed (TD) children. LCEVs were isolated and characterized meticulously. Whole-transcriptome of LCEVs was analyzed by lncRNA microarray and RNA-Sequencing. All raw data was submitted on GEO Profiles, and GEO accession numbers is GSE186493. RNAs expressed differently in LCEVs from ASD sera vs. TD sera were screened, analyzed, and further validated. A total of 1418 mRNAs, 1745 lncRNAs and 11 miRNAs were differentially expressed, and most of them were down-regulated in ASD. Most RNAs were involved in neuron- and glycan-related networks implicated in ASD. The levels of EDNRA, SLC17A6, HTR3A, OSTC, TMEM165, PC-5p-139289_26, and hsa-miR-193a-5p changed significantly in ASD. In conclusion, whole-transcriptome analysis of serum LCEVs reveals neural and glycosylation changes in ASD, which may help detect predictive biomarkers and molecular mechanisms of ASD, and provide reference for diagnoses and therapeutic management of the disease.
Chemical Route Manufactured ZnO Nanoparticles And Their Biological Accumulation
Authors: Bouloudenine M. , Laala-Bouali H. , Djeddou K. , Bououdina M. , Grara N.
Published: December 2021

ZnO nanocrystalline powder was successfully synthesized via co-precipitation method coupled with high annealing treatment. X-ray diffraction analysis revealed that the NPs have a pure hexagonal wurtzite structure with a mean crystallite size of approximately 59 nm. FESEM observations along with EDS analysis indicated the formation of fine particles in the nanoscale regime, with hexagonal shape and high purity. Both Raman and photoluminescence characterizations confirmed the high crystalline and the optical quality of the synthesized ZnO NPs. The assessment of the impact of ZnO-based nanoparticles and their effects on body and bioaccumulative bioindicators of pollution, Helix aspersa snails was performed in order to preserve the safe development of nanotechnology.
The Development of Task Sharing Policy and Guidelines in Kenya
Authors: Kinuthia Rosemary , Verani Andre , Gross Jessica , Kiriinya Rose , Hepburn Kenneth , Kioko Jackson , Langat Agnes , Katana Abraham , Waudo Agnes , Rogers Martha
Published: December 2021

Background: The global critical shortage of health workers prevents expansion of healthcare services and universal health coverage. Like most countries in sub-Saharan Africa, Kenya’s healthcare workforce density of 13.8 health workers per 10,000 population falls below the World Health Organization (WHO) recommendation of at least 44.5 doctors, nurses, and midwives per 10,000 population. In response to the health worker shortage, the WHO recommends task sharing, which is a strategy to alleviate the burden on certain health workers through the redistribution of tasks. To improve the utilization of human and financial health resources in Kenya for HIV and other essential health services, the Kenya Ministry of Health (MOH) in collaboration with various institutions developed national task sharing policy and guidelines (TSP). To advance task sharing, this article describes the process of developing the Kenya TSP. Methods: The development and approval of Kenya’s TSP occurred from February 2015 to May 2017. The U.S. Centers for Disease Control and Prevention (CDC) allocated funding to Emory University through the United States President’s Emergency Plan for AIDS Relief (PEPFAR) Advancing Children’s Treatment initiative. After obtaining support from leadership in Kenya’s MOH and health professional institutions, the TSP team conducted a desk review of policies, guidelines, scopes of practice, task analyses, grey literature, and peer-reviewed research. Subsequently, a policy advisory committee was established to guide the process and worked collaboratively to form technical working groups to draft the policy.Results: The collaborative, multidisciplinary process led to the identification of gaps in service delivery resulting from health workforce shortages. This facilitated the development of the Kenya TSP, which provides a general orientation of task sharing in Kenya. The guidelines list priority tasks for sharing by various cadres as informed by evidence, such as HIV testing and counseling tasks. The TSP documents were disseminated to all county healthcare facilities in Kenya.Conclusions:Task sharing could increase access to healthcare services in resource-limited settings. To advance task sharing, TSP and clinical practice could be harmonized, and necessary adjustments made to other policies that regulate practice. Revisions to pre-service training curricula could be conducted to ensure health professionals have the requisite competencies to perform shared tasks. Monitoring and evaluation could ensure that task sharing is implemented appropriately to ensure quality outcomes.
Uncovering the Genetic Diversity of Giardia Isolates from Outbreaks in New Zealand
Authors: Ogbuigwe Paul , Biggs Patrick J. , Garcia-Ramirez Juan Carlos , Knox Matthew A. , Pita Anthony , Velathanthiri Niluka , French Nigel P. , Hayman David T. S.
Published: December 2021

BackgroundGiardia is one of the most common causes of diarrhoea in the world and is a notifiable disease in New Zealand. Recent advances in molecular techniques, such as PCR and Sanger sequencing, have greatly improved our understanding of the taxonomic classification and epidemiology of this parasite. However, there has been an inability to identify shared subtypes between samples from the same epidemiologically linked cases, due to samples showing multiple dominant subtypes within the same outbreak when characterised using Sanger sequencing. MethodsHere, NGS was employed to uncover the genetic diversity within samples from sporadic and outbreak cases of giardiasis that occurred in New Zealand between 2010 and 2018. ResultsThis strategy exposed the significant diversity of subtypes of Giardia present in each sample. The utilisation of NGS and metabarcoding at the glutamate dehydrogenase (gdh) locus enabled the identification of shared subtypes between samples from shared outbreaks, providing a better understanding of the epidemiology of outbreaks of giardiasis in New Zealand.ConclusionsNext-generation sequencing technologies provides a superior tool, when compared to consensus sequencing technologies, for capturing the genetic diversity of Giardia within hosts. This study showed that infections in humans are frequently mixed, with multiple subtypes present in each host.
Neural Underpinning of Japanese Particle Processing in Non-native Speakers
Authors: Kasai Chise , Sumiya Motofumi , Koike Takahiko , Yoshimoto Takaaki , Maki Hideki , Sadato Norihiro
Published: December 2021

Grammar acquisition by non-native learners (L2) is typically less successful and may produce fundamentally different grammatical systems than that by native speakers (L1). The neural representation of grammatical processing between L1 and L2 speakers remains controversial. We hypothesized that working memory is the primary source of L1/L2 differences, and operationalized working memory is an active inference within the predictive coding account, which models grammatical processes as higher-level neuronal representations of cortical hierarchies, generating predictions (forward model) of lower-level representations. A functional MRI study was conducted with L1 Japanese speakers and highly proficient Japanese learners requiring oral production of grammatically correct Japanese particles. Selecting proper particles requires forward model-dependent active inference as their functions are highly context-dependent. As a control, participants read out a visually designated mora indicated by underlining. Particle selection by L1/L2 groups commonly activated the bilateral inferior frontal gyrus/insula, pre-supplementary motor area, left caudate, middle temporal gyrus, and right cerebellum, which constituted the core linguistic production system. In contrast, the left inferior frontal sulcus, known as the neural substrate of verbal working memory, showed more prominent activation in L2 than in L1. Thus, the active inference process causes L1/L2 differences even in highly proficient L2 learners.
Novel Metallochromic Hydrazone-Based Chemosensor Toward Colorimetric Paper Strip For Selective Detection Cu2+
Authors: Sharmoukh Walid , Abdelrahman Meram S. , Elkhabiry Shaban , Khattab Tawfik
Published: December 2021

A solid-state sensor was developed for the determination of copper ions (Cu2+) in aqueous media using tricyanofuranhydrazone as a spectroscopic probe and a paper sheet as the hosting strip. A new tricyanofuranhydrazone-based colorimetric chemosensor (TCFH) was synthesized for selective detection of Cu2+ in aqueous environments. The synthesis strategy of TCFH involved an azo-coupling process between the diazonium salt of 8-aminoquinoline and an active methyl-bearing tricyanofuran (TCF) heterocyclic moiety. The molecular structure of the prepared TCFH chemical sensor was verified with FT-IR, 1H and 13C NMR, as well as elemental analysis. Due to intramolecular charge transfer, TCFH chromophore demonstrated pronounced solvatochromism depending on the solvent polarity. Changes in both color and UV-vis absorption spectra demonstrated by the developed chemosensor proved that TCFH can be utilized to detect Cu2+ in the presence of other competing metallic cations and anions. The synthesized TCFH probe, which contains a hydrazone recognition moiety, demonstrates dramatic solvatochromic activity and high selectivity at the microlevel of copper ions with a color shift from yellow to purple. Mechanisms accounting for both metallochromic and solvatochromic activities were explored. Moreover, test strips of TCFH were successfully developed and applied for the detection of copper ions at different concentrations in aqueous media. The colorimetric properties of the prepared TCFH-immobilized paper strips were investigated by CIE Lab chromogenic parameters, colorimetric strength (K/S) and UV-Vis absorbance spectra. The metallochromic paper strip exhibited a detection limit at the ppm range. The best detection of Cu2+ was achieved in the pH range of 6.6-7.4 demonstrating an immediate color switch from yellow to purple relying on the total content of Cu2+. Scanning electron microscopy (SEM) was applied to characterize the deposition of tricyanofuranhydrazone onto the surface of the paper strip.
Exploration of Social-economic and Environmental Impacts on Lung Cancer Mortality in 94 Countries With Artificial Neural Network and Random Decision Tree Analysis
Authors: Wu Xiu , Zhang Jinting , Denise Blanchard-Boehm
Published: December 2021

BackgroundSince lung cancer is the biggest killer in cancer families, extremely threatening to human health, an understanding of social-economic and environmental impacts on lung cancer mortality (LCM) is imperative to improve patient psychological health and potentially mitigate lung cancer incidences and multimorbidity. Figuring out key indicators in social-economic and environment impacts which are sensitive to LCM on spatial-temporal scales contributes to preclinical control and systemic treatments for lung cancer with standard chemotherapy agents are still relatively ineffective. MethodsBased on lung cancer mortalities in 94 countries within a decade (2006-2016), this research appropriately dissects social-economic, demographic, and environmental independent variable effects using Artificial Neural Network (ANN) and CRT Random Decision Tree algorithms (CRT-CRT-RDF).ResultsWith the two methods comparison, the similarity is that education and carbon emission were two etiologies. Education in low and middle countries of lung cancer was related with total ecological footprint and total population. Carbon emission in extreme countries was linked to ecological forestland footprint. Spatial-temporal analysis postulated China and the U.S were the two largest countries whereas China and India were the two fastest countries of LCM growth. Both models have a high precision of prediction (96.1% of CRT-CRT-RDF and 98.4% of ANN).ConclusionsThis research will facilitate preventive lung cancer services, prioritize the geographical allocation of lung cancer investment for WHO, and provide evidence for shrinking carbon emission and deforestation.
An Efficient Chromatin Immunoprecipitation (ChIP) Protocol for Studying Histone Modifications in Peach Reproductive Tissues
Authors: Canton Monica , Farinati Silvia , Forestan Cristian , Joseph Justin , Bonghi Claudio , Varotto Serena
Published: December 2021

BackgroundPerennial fruit trees display a perennial growth behaviour characterized by an annual cycling between growth and dormancy, with complex physiological features. Rosaceae fruit trees represent excellent models for studying not only the fruit growth/patterning, but also the progression of the reproductive cycle depending upon the impact of climate conditions. In addition, the current development of high‐throughput technologies is starting to have an important impact on Rosaceae tree research for investigating genome structure and function as well as (epi)genetic mechanisms involved in important developmental and environmental response processes during fruit tree growth. Among the epigenetic mechanisms, chromatin remodelling mediated by both histone modifications and other chromatin-related processes play a crucial role in gene modulation, controlling gene expression process. A very useful technique to investigate the chromatin states in plants and their dynamics is chromatin immunoprecipitation (ChIP), generally applied for studies on chromatin states and enrichment in post transcriptional modifications (PTMs) of histone proteins. Results Because peach is a model in Rosaceae family for studies in bud formation, dormancy and organ differentiation for climacteric fruits, in our work, we primarily established specific protocols for chromatin extraction and immunoprecipitation in reproductive tissues of peach Prunus persica. Subsequently focused our investigations on the role of two chromatin marks, namely trimethylation of histone H3 at lysine in position 4 (H3K4me3) and trimethylation of histone H3 at lysine 27 (H3K27me3) on modulating specific gene expression. Bud dormancy and fruit growth were investigated in a nectarine genotype called Fantasia as a model system. ConclusionsHere we presented general strategies to systematically optimize ChIP protocols for buds and mesocarp tissues and analyzed the correlation between gene expression and chromatin mark enrichment/depletion. Confirming like histone modifications are implicated in regulating bud dormancy progression and the core ripening genes.
Acupuncture-Related Therapies for Ovulatory Disorders: A Systematic Review and Bayesian Network Meta-Analysis Protocol
Authors: Zhou Hang , Yan Li , Yang Yi , Zhang ShuGuang , Zheng XiaoYan , Wang Huan , Deng LinWen
Published: December 2021

Background：Ovulation disorders (ODs) are major cause of infertility. Many clinical studies have shown that acupuncture is potentially useful in the treatment of ODs. In this context, the present study aims to evaluate the effectiveness and safety of different acupuncture therapies through systematic review and Bayesian network meta-analysis (NMA). Methods： A comprehensive literature search until June 2021 will be carried out in the following databases: PubMed/MEDLINE, Cochrane Library, Science Net, EBSCO, EMBASE, China National Knowledge Infrastructure (CNKI), Wanfang database, VIP database, and China biomedical database (CBM). Randomized controlled trials (RCTs) meeting the eligibility criteria based on PICO elements will be included. The main outcomes will be ovulation rate, pregnancy rate and changes in female reproductive hormones. The secondary outcome will be the prevalence of adverse events directly related to acupuncture. Cochrane bias risk assessment tool (RoB 2.0) will be used to evaluate the quality of the selected literature. Stata, Aggregate Data Drug Information System (ADDIS)and BUGS will be used to manage the data. Discussion: The results of this study can provide evidence to the effectiveness and safety of acupuncture therapy for ODs. However, large-scale, case-control studies with rigorous designs are required to provide even more accurate evidence.Systematic review registration: This agreement has been registered in INPLASY（https://inplasy.com/）,the registration ID is INPLASY202160078.
Access to and Barriers to Access for Essential Medicines in Nephrology and Related Non-Communicable Diseases: A Scoping Review Protocol
Authors: Wong Michelle Mon Yee , Calice-Silva Viviane , Tannor Elliot K. , Nakoul Georges , Kumar Vivek , Hafidz Muhammad Iqbal Abdul , Chanchlani Rahul , Chen Titi , Ekrikpo Udeme E. , Francis Anna , Kalyesubula Robert , Karam Sabine , Pereira-Kamath Nikhil , Wijewickrama Eranga , Sanger Stephanie , Jha Vivekanand
Published: December 2021

Objective: This scoping review aims to understand the extent of evidence regarding: 1) access to essential medicines, 2) barriers to access, and 3) interventions to improve access for chronic kidney disease (CKD) and related non-communicable diseases (NCDs). Introduction: Access to essential medicines for treatment of NCDs is lacking in low- and low-middle income countries. In nephrology, access to essential medicines is especially important to reduce risk of CKD progression, as kidney replacement therapy is unavailable or cost-prohibitive in many regions of the world. As part of the International Society of Nephrology Emerging Leaders Program’s mandate to improve health promotion and access to prevention and management of kidney diseases globally, this scoping review serves as an initial step towards designing implementation studies to improve access to essential medicines. Inclusion criteria: Articles of any study design involving populations with chronic kidney disease, cardiovascular disease, hypertension, and/or diabetes will be included. The core concept of essential medicines will encompass access to essential medicines, barriers to access, and interventions to improve access. All geographical regions and all World Bank Income categories will be considered. Methods: Methods for this scoping review are based on the Joanna Briggs Manual for Evidence Synthesis. MEDLINE, EMBASE, Web of Science, CENTRAL will be searched. Included studies will be restricted to English language. Screening of title/abstract of each article and subsequent review of retrieved full-text articles will be performed by one reviewer, followed by a second reviewer checking the excluded lists for accuracy. A data extraction tool will be customized using Covidence software. Data will be summarized narratively, and in tabular and diagrammatic format. Studies assessing barriers to access or interventions to improve access will be categorized by patient-level, provider-level, organization-level, community/regional-level, and national/health policy-level.
Lanthanide Europium MOF Nanocomposite as the Theranostic Nanoplatform for Microwave Thermo-Chemotherapy and Fluorescence Imaging
Authors: Zhao Lirong , Zhang Wei , Wu Qiong , Fu Changhui , Ren Xiangling , Lv Kongpeng , Ma Tengchuang , Chen Xudong , Tan Longfei , Meng Xianwei
Published: December 2021

Backgrounds:
Microwave sensitization nanoplatform, integrating multiple functional units for improving tumor selectivity, is of great significance for clinical tumor microwave therapy. Lanthanide europium metal organic framework materials (EuMOF) are expected to be a theranostic nanoplatform owing to its specific luminescent properties and microwave sensitization properties. However, it is difficult to be applied to complex biological systems for EuMOF due to its rapid degradation induced by the solvent molecular and ionic environment. In this work, a luminescent EuMOF nanocomposite (EuMOF@ZIF/AP-PEG, named EZAP) was designed, which brought the multifunctional characteristics of microwave sensitization, fluorescence imaging and drug loading.
Results
Lamellar EuMOF was synthesized by a hydrothermal method. Through the charge adsorption mechanism, the zeolite imidazole framework (ZIF) structure was densely assembled on the surface of EuMOF to realize the protection. Then, through in-situ apatinib drug loading and PEG modification, EZAP nanocomposite was finally obtained. Apatinib (AP) was a kind of chemotherapy drug approved by Food and Drug Administration for clinical use. PEG modification increased long-term circulation of EZAP nanocomposite. The physical and chemical structure and properties of EuMOF@ZIF (EZ) were systematically represented, indicating the successful synthesis of the nanocomposite. The toxic and side effects were negligible at a safe dose. The growth of human liver cancer cells and murine liver cancer cells in vitro was significantly inhibited, and the combined microwave-thermal therapy and chemotherapy in vivo achieved high anti-cancer efficacy. Moreover, EZAP nanocomposite possessed bright red fluorescence, which had good ability for tumor imaging in tumor-bearing mice in vivo.
Conclusion
Therefore, EZAP nanocomposite showed high microwave sensitization, excellent fluorescence properties and good drug loading capacity, establishing a promising theranostic nanoplatform for tumor therapy and fluorescence imaging. This work proposes a unique strategy to design for the first time a multifunctional nanoplatform with lanthanide metal organic frameworks for tumor treatment and diagnosis in the biological application.
Changes in the Number of Newly Diagnosed Lung Cancer Patients Before and During the COVID-19 Pandemic: A single-Center Experience
Authors: Gul Sule , Uysal Mehmet Atilla , Çifter Atilla , Niksarlıoğlu Elif Yelda Özgün , Bilici Deniz
Published: December 2021

This study was conducted to determine whether there was an effect on the hospital admissions of newly diagnosed lung cancer (NDLC) patients in Turkey during the COVID-19 pandemic. In this retrospective study, NDLC patients were recorded from the Hospital Information Management System between January,1 2015-December, 31, 2020, at our tertiary hospital. The number of NDLC patients diagnosed in 2020 was compared with each year of 2017-2019. Between 2017 and 2020, 15,150 NDLC cases were analyzed. The number of NDLC patients by year were; 4,030 patients in 2017, 4,004 patients in 2018, 4,391 patients in 2019, and 2,725 in 2020, respectively. In 2020, NDLC patients decreased by 38%, 32%, 32% compared to 2019, 2018, and 2017, respectively. The late admission of lung cancer patients might result in the advanced stage, missing the chance for surgery, and decreased survival. Precautions should be considered to diagnose and treat lung cancer patients in specialized centers during a pandemic due to epidemic diseases such as COVID-19.
Expectation Identity of the Hypergeometric Distribution and Its Application in the Calculations of High-Order Origin Moments
Authors: Wang Yuan-Quan , Zhang Ying-Ying , Liu Jia-Lei
Published: December 2021

We provide a novel method to analytically calculate the high-order origin moments of a hypergeometric distribution, that is, the expectation identity method. First, the expectation identity of the hypergeometric distribution is discovered and summarized in a theorem. After that, we analytically calculate the first four origin moments of the hypergeometric distribution by using the expectation identity. Furthermore, we analytically calculate the general kth (k=1,2,…) origin moment of the hypergeometric distribution by using the expectation identity, and the results are summarized in a theorem. Moreover, we use the general kth origin moment to validate the first four origin moments of the hypergeometric distribution. Next, the coefficients of the first ten origin moments of the hypergeometric distribution are summarized in a table containing Stirling numbers of the second kind. Moreover, the general kth origin moment of the hypergeometric distribution by using the expectation identity is restated by another theorem involving Stirling numbers of the second kind. Finally, we provide some numerical and theoretical results.
Factors associated with differential community prevalence of hepatitis E in two sub-counties in Kitgum District in Northern Uganda: A comparative cross-sectional study
Authors: Aloyo Judith , Kiguli Juliet , Garimoi Christopher Orach , Ikoona Eric Nzirakaindi , Kitara David Lagoro
Published: December 2021

Background: Hepatitis E is one of the leading causes of acute viral hepatitis worldwide. During 2009, an epidemic of hepatitis E resulted in 10,437 infections and 167 deaths in Kitgum district.Objective: To investigate factors associated with the differential community prevalence of hepatitis E in two sub-counties in Kitgum District.Methods: We conducted a community survey during the 4th-31st of May 2012 in two Sub Counties in Kitgum District in Northern Uganda. A total of 474 heads of household were recruited using a probability proportional to size through multistage and random sampling methods. Two hundred thirty-four (49.26%) heads of household were from Mucwini, and 241 (50.74%) were from Kitgum Matidi Sub Counties. The questionnaire had an internal validity of Cronbach’s α=0.85. The study was approved by a local IRB. STATA version 10.0 was used for data analysis, and a p-value less than 0.05 was considered significant.Results: The prevalence of hepatitis E was significantly higher in Mucwini Subcountry 97 (41.99%) than in Kitgum Matidi 63 (26.47%); χ2=12.6; p=0.000. Factors associated with differential prevalence were hand washing after latrine use with Adjusted Odds Ratio (AoR)=0.23,95%CI:0.110-0.646; p=0.003; frequency of communal hand washing AoR=0.53,95%CI:0.330-0.860; p=0.01; patients’ handling by health workers AoR=1.91,95%CI:1.410-2.610; p<0.001; frequency of village health meetings held AoR=0.69,95%CI:0.56-0.85; p<0.001 and awareness of the cause of Hepatitis E AoR=1.42, 95%CI:0.710-1.880; p=0.015.Conclusions: Factors associated with the differential community prevalence of hepatitis E in the two communities were poor personal hygiene, poor community practices and a low level of community awareness about the virus. District and health authorities should put in place measures to improve personal and household hygiene and strengthen community health education on hepatitis E.
Numerical Investigation of the Combined Slot Effect on the Erosion Pattern Around a Combination of Spur Dikes in Series
Authors: Hosseini Khosrow , Nayyer Shahab , Kheirkhahan Mehran , Mousavi Sayed-Farhad
Published: December 2021

Modifying the river course for flood control, prevention of bed erosion, bank protection, and the regulation of river width are among the goals of spur dikes incorporation. The common spur dikes have simple (I), L and T geometrical shapes. The present research has been conducted to reduce the scour depth in front of the spurs dikes and improve the sedimentation conditions for the LTT combination of spur dikes in series by investigating different combinations of slots in the body of the spur dike; using numerical methods. The slot dimension was taken equal to 10% of the effective area of the spur dike body. Finally, the (LS-W-Wi, TS-W, TS-W-Wi) combination contained the slots in the web and wing of the first and third spur dike also the slot at the web of the middle spur dike was found as the best combination of slots. This combination conducted to reduce the scour depth about 6.8% and increase the deposition about 52% comparing by the spurs dikes without slots. Reducing the scour depth and increasing the sedimentation rate of materials between the spurs dikes. Also, the maximum scour depth decreases up to 20%. The results revealed that the presence of slots in spur dike structures and their different positions have complicated and considerable influences on the form and morphology of the erodible bed which could be the topic for further researches.
Multi-Wavelength Analytical Ultracentrifugation of Biopolymer Mixtures and Interactions
Authors: Demeler Borries , Henrickson Amy , Gorbet Gary , Savelyev Alexey , Kim Minji , Ding Xiaozhe , Hargreaves Jason , Gradinaru Viviana , Schultz Sarah , Kothe Ute
Published: December 2021

Multi-wavelength analytical ultracentrifugation (MW-AUC) is a recent development made possible by new analytical ultracentrifuge optical systems. MW-AUC is suitable for a wide range of applications and biopolymer systems and is poised to become an essential tool to characterize macromolecular interactions. It adds an orthogonal spectral dimension to the traditional hydrodynamic characterization by exploiting unique chromophores in analyte mixtures that may or may not interact. Here we illustrate the utility of MW-AUC for representative classes of challenging biopolymer systems, including interactions between mixtures of different sized proteins with small molecules, mixtures of loaded and empty viral AAV capsids contaminated with free DNA, and mixtures of different proteins, where some have identical hydrodynamic properties, all of which are difficult to resolve with traditional AUC methods. We explain the improvement in resolution and information content obtained by this technique compared to traditional single- or dual-wavelength approaches. We discuss experimental design considerations and limitations of the method, and address the advantages and disadvantages of the two MW optical systems available today, and the differences in data analysis strategies between the two systems.
Evaluation of an enhanced training package to support clinical trials training in low and middle income countries (LMICs): experiences from the Born Too Soon Optimising Nutrition study
Authors: Mitchell Eleanor Jane , Aluvaala Jalemba , Bradshaw Lucy , Daniels Jane P , Kumar Ashok , Opira Jacqueline , Oliver Mary , Pallotti Phoebe , Qureshi Zahida , Swinden Richard , Were Fredrick , Ojha Shalini
Published: December 2021

Background

Training is essential before working on a clinical trial, yet there is limited evidence on effective training methods. In low and middle income countries (LMICs), training of research staff was considered the second highest priority in a global health methodological research priority setting exercise.
Methods

We explored whether an enhanced training package in a neonatal feasibility study in Kenya and India, utilising elements of the train-the-trainer approach, altered clinicians and researchers’ clinical trials knowledge. A lead “trainer” was identified at each site who attended a UK-based introductory course on clinical trials. A two-day in-country training session was conducted at each hospital. Sessions included the study protocol, governance, data collection and ICH-Good Clinical Practice (GCP). To assess effectiveness of the training package, participants completed questionnaires at the start and end of the study period, including demographics, prior research experience, protocol-specific questions, informed consent and ICH-GCP.
Results

Thirty participants attended in-country training sessions and completed baseline questionnaires. Around three quarters had previously worked on a research study, yet only half had previously received training. Nineteen participants completed questionnaires at the end of the study period. Questionnaire scores were higher at the end of the study period, though not significantly so. Few participants ‘passed’ the informed consent and ICH-Good Clinical Practice (GCP) modules, using the Global Health Network Training Centre pass mark of ≥ 80%. Participants who reported having prior research experience scored higher in questionnaires before the start of the study period.
Conclusions

An enhanced training package can improve knowledge of research methods and governance though only small improvements in mean scores between questionnaires completed before and at the end of the study period were seen and were not statistically significant. This is the first report evaluating a clinical trial training package in a neonatal trial in LMICs. Due to the Covid-19 pandemic, research activity was paused and there was a significant time lapse between training and start of the study, which likely impacted upon the scores reported here. Given the burden of disease in LMICs, developing high-quality training materials which utilise a variety of approaches and build research capacity, is critical.
Statins’ safety and impact on the clinical outcomes in COVID-19 critically ill patients: A Multicenter, Cohort Study
Authors: Sulaiman Khalid Al , Aljuhani Ohoud , Korayem Ghazwa B. , Altebainawi Ali F. , Harbi Shmeylan Al , Shaya Abdulrahman Al , Badreldin Hisham A. , Kensara Raed , Harthi Abdullah Al , Alghamdi Jahad , Alawad Ahad , Alotaibi Rand , Kharbosh Abdullah , Muqati Hessa Al , Alhuwahmel Abdulmohsen , Almusallam Mohammed , Albarrak Ghada , Sulaihim Ibrahim Al , Alanazi Bader , Al-Dosari Bodoor S. , Vishwakarma Ramesh , Alsaeedi Alawi S. , Ghamdi Ghassan Al , Al-Dorzi Hasan M
Published: December 2021

Background The cardiovascular complications of Severe Coronavirus Disease 2019 (COVID-19) may be attributed to the hyperinflammatory state leading to increased mortality in patients with COVID-19. Statins are known to have pleiotropic and anti-inflammatory effects and may influence viral transmission along with their cholesterol-lowering activity. Thus, statin therapy is potentially a potent adjuvant therapy in COVID-19 infection. This study investigated the association of statin use on the outcome of critically ill patients with COVID-19. MethodsA multicenter, retrospective cohort study of all adult critically ill patients with confirmed COVID-19 admitted to Intensive Care Units (ICUs) between March 1, 2020, and March 31, 2021. Eligible patients were classified into two groups based on statin use during ICU stay and were matched with a propensity score based on patient’s age and admission APACHE II and SOFA scores. The primary endpoint was in-hospital mortality, while 30 days Ventilator-free days (VFDs) and ICU complications were secondary endpoints. ResultsA total of 1049 patients were eligible; 502 patients were included after propensity score matching (1:1 ratio). The 30-day (hazard ratio 0.75 (95% CI 0.58, 0.98), P=0.03) and in-hospital mortality (hazard ratio 0.69 (95% CI 0.54, 0.89), P=0.004) were significantly lower in patients who received statin therapy on multivariable cox proportional hazards regression analysis. Moreover, patients who received statin had a lower risk of hospital-acquired pneumonia (OR 0.48(95% CI 0.32, 0.69), P=<0.001), lower levels of markers of inflammation on follow up and no increased risk of liver injury. ConclusionThe use of statin during ICU stay in COVID-19 critically ill patients may have a beneficial role and survival benefits with a good safety profile.
Anti-endometriotic Effects of Ceratonia Siliqua L. Pod on Endometrial Mesenchymal Stromal/stem Cells Isolated from Women with Endometriosis-associated Infertility
Authors: Khodabandeh Zahra , Jahromi Bahia Namavar , Hashemi Atefe , Afshar Alireza , Baghban Neda , Hessami Kamran , Mohebbi Gholamhossein , Barmak Alireza , Jamhiri Iman , Zare Shahrokh , Badr Parmis , Iraji Ida , Poordast Tahere , Khoradmehr Arezoo , Tamadon Amin
Published: December 2021

The authors have requested that this preprint be removed from Research Square.
Multiple Primary Cancer and Survival after Lumpectomy with or without Radiotherapy for Ductal Carcinoma in Situ: A Propensity- Score-Matching Study
Authors: Li Yitong , Ouyang Dengjie , Chen Qitong , Hong Tao , Yi Wenjun
Published: December 2021

Background: Radiotherapy combined with breast-conserving surgery is widely performed in patients with ductal carcinoma in situ (DCIS). This research was conducted to evaluate the use of radiotherapy to reduce the risk of multiple primary cancer (MPC) and mortality in DCIS patients.Methods: 108,416 patients first diagnosed with DCIS between 1998 and 2015 who received lumpectomy in the Surveillance, Epidemiology, and End Results (SEER) 18 database were included. Age, race, year of diagnosis, laterality, pathologic grade, surgery, radiation, estrogen receptor status, progesterone receptor status, tumor size and vital status were extracted. A comparison of lumpectomy vs. lumpectomy plus radiotherapy was performed using 1:1 propensity score-based matching.Results: Of the 108,416 patients, 39,039 patients were treated with lumpectomy alone, and 69,377 were treated with lumpectomy and radiotherapy. The adjusted hazard ratio (HR) for death was 0.801 and 0.7444 for occurrence of MPC in the lumpectomy and radiotherapy vs. lumpectomy alone groups, respectively. Conclusion: Lumpectomy plus radiotherapy is associated with a significant reduction in mortality and risk of MPC, mainly second primary BC. Younger patients, Black women with high-grade tumors were likely to benefit most. Radiotherapy reduced the risk of occurrence rather than the mortality of MPC patients to reduce the overall mortality.
ON MULTISCALE DAMAGE MODELLING OF HETEROGENEOUS MATERIALS USING NONLOCAL CONTINUUM THEORY
Authors:   Faculty of Mechanical Engineering and Naval Architecture, University of Zagreb, Sorić Jurica , Lesičar Tomislav , Putar Filip , Tonković Zdenko ,   AVL-AST d.o.o.
Published: December 2021

An overview of the modelling of quasi-brittle as well as ductile damage is given. The multiscale procedure employing the nonlocal continuum theory is described in more detail. The softening is introduced at the microlevel in the microstructural volume element and after that the homogenization procedure state variables are mapped at the macrolevel material point via the scale transition approach. In the case of quasi-brittle softening the C1 continuous finite element discretization is applied at both micro- and macrolevel. At the modelling of ductile damage response, the macrolevel is also discretized by the C1 finite element formulation, while the microscale utilizes quadrilateral mixed finite elements employing the nonlocal equivalent plastic strain and gradient-enhanced elastoplasticity. All approaches presented are verified in the standard examples.
Social media usage and competitive advantage of nascent agro-allied firms
Authors: Eze Ikechukwu , Agbaeze Emmanuel , Isichei Ejikeme , Eke Chinonso
Published: December 2021

The clear decreasing survival rate of nascent firms and their inability to compete favorably owing to increasing competition in their internal and external environment was the motivation for this study. Hence, the paper addressed fundamental issues on nascent firms’ competitiveness through examining the direct and indirect influence of social media usage and technological infrastructure capability, respectively. Sample data of 265 nascent firm managers in the agro-allied sector were collected and analyzed with the aid of Hayes Regression Process Macro. The results showed that social media positively affects the competitive advantage of nascent firms. Further, the study found that technological infrastructure capability significantly affects the competitive advantage of nascent firms. The study found that technological infrastructure capability positively mediates the relationship between social media usage and nascent agro-allied firms’ competitive advantage. The study advances the need for a change in the way nascent firms adopt social media and advocate that the use of social media can be supported through developing a gradual knowledge of technological innovation that is within the confines of the firms’ resources.
The patient's order as a separate manifestation of his will
Authors: Korobtsova Nataliia
Published: December 2021

The article analyzes the issues of the patient's will in medical relations, it is proved that it is due to the expression of will to the proposed treatment (consent or refusal) that the patient is a full active participant in this relationship. However, his inability to express his will, temporary or irreversible, caused by the development of the disease, the peculiarity of its course may be an obstacle to determining his real desire for future treatment, medical intervention and jeopardize the violation or inability to exercise the patient's right to consent or refuse medical intervention. To avoid this, there is a certain legal institution in the legislation of a number of countries around the world, through which it is possible to plan your treatment in advance, to refuse it, in case of inability to do so in the future.

In some legal systems, this institution has different names - "wishes made earlier", "medical will", "patient's will", "power of attorney to make decisions on health care", "patient orders" and so on. The paper analyzes the content of this institute, considers the views of scholars on it, made a comparative analysis with the legal construction of the "testament" and concluded that there are significant differences between these constructions, which makes it impossible, from the author's point of view, to call this will "testament". . It is proposed to consider such a will as one of the patient's rights - "patient order", which is made in writing by an adult - the patient, regardless of the type and stage of the disease in case of possible future inability to consent to medical examination, intervention or treatment. The patient has at his disposal not only his will for the future (list of medical procedures that are allowed to be performed in relation to his health, which are not), but also the case when it can be used (for example, coma, autonomic state). It is impossible to conclude it through a representative, because in this case the will of the patient is unknown. This order is executed by proxies (relatives, close persons, representatives, doctors, etc.).

Despite the fact that in Ukraine today this legal institution is absent, the main directions of recoding of civil legislation indicate the possibility of its appearance in the updated legislation
Surrogacy in international private law and public law aspects
Authors: Chevychalova Z. V.
Published: December 2021

The proposed article is devoted to the issue of surrogacy in its international private law and public law aspects. The complexity and multidimensionality of issues, the emergence of which is due to the birth of children as a result of agreements on surrogacy, have been investigated. Taking into account the three main approaches to the problem of surrogacy existing in the world, namely: the first is a number of states and organizations that categorically deny the very possibility of trade in the context of surrogate motherhood, noting that the child is not talking about any deal; the second approach is that a significant number of stakeholders express concern about the potential merger of surrogate motherhood and child trafficking, which could lead to the criminalization of surrogate mothers and future parents, as well as possible violations of the right to sexual and reproductive health; the last group is a number of states and organizations that have spoken out in favor of a complete prohibition of surrogacy without any restrictions, the consequences of such approaches have been analyzed.
Within the framework of this article, the author considers it appropriate to cite the position of the UN Special Rapporteur on the sale of children and the sexual exploitation of children, including child prostitution, child pornography and the production of other materials on sexual abuse of children, the Permanent Bureau of the Hague Conference on Private International Law, as well as the European Court of Justice on human rights on the issues considered.
The article draws a number of conclusions. First of all, compliance with the recommendations of the Special Rapporteur requires the adoption of urgent measures to prevent violations of the rights of all participants in a surrogacy relationship due to their vulnerability. Also, regarding the lack of regulation of these legal relations at the level of law within the jurisdiction of Ukraine, the author expresses his opinion about the certain justification of such a situation until a unified normative act is adopted based on the results of the work of the Hague Conference on Private International Law. Harmonization of legal norms at the national and international levels will allow in the future to avoid conflicts in relations of cross-border surrogacy, taking into account the issues of child trafficking, non-discrimination and the right to health of children born through surrogacy, citizenship, name and family ties in the framework of respect for the child’s right to preserve his identity, as well as access to information on origins and rights to family life, etc