bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy of Lumbar Kinetic Chain Training for Staged Rehabilitation After Percutaneous Endoscopic Lumbar Discectomy
Authors: Lyu Zhen , Bai Jinzhu , Chen Shizheng , Liu Jiesheng , Yu Wenlong
Published: June 2021

Background

Percutaneous endoscopic lumbar discectomy (PELD) is a promising minimally invasive treatment for lumbar disc herniation (LDH). Postoperative rehabilitation can improve patient outcomes. Not only rehabilitation for surgical trauma but also rehabilitation for lumbar spine and lower kinetic chain dysfunction should be performed. The aims of this study were to investigate the efficacy of a lumbar kinetic chain training for staged rehabilitation after PELD for LDH.
Methods

Sixty LDH patients treated with PELD were retrospectively studied. After surgery, patients underwent lumbar kinetic chain training for staged rehabilitation( staged group) or regular low back rehabilitation (regular group). The staged rehabilitation programme included three phases from 2–6, 7–12, and 13–24 weeks postoperatively, and different physical therapies were performed during these phases. The low back pain visual analogue scale (VAS), JOA score, ODI, SF-36, and cross-sectional area of the lumbar multifidus on MRI were assessed, and gait analysis was performed.
Results

Thirty patients in each group were included. There were no significant differences in age or sex between the two groups at baseline (p > 0.05). The VAS score decreased and the JOA and SF-36 scores increased in both groups from baseline to 6 weeks (P < 0.05). In the staged group, compared with the regular group, the VAS and ODI scores were lower and the JOA and SF-36 scores were higher at 6 weeks (P < 0.05); the VAS and ODI scores were lower and the SF-36 score was higher at 12 weeks (P < 0.05); the SF-36 score was higher at 24 weeks (P < 0.05); the cross-sectional area of the lumbar multifidus showed no differences at 12 weeks (P > 0.05); and the left-right support ratio of gait was higher at 24 weeks (P < 0.05).
Conclusions

The staged rehabilitation programme for LDH after PELD promoted postoperative recovery, and the efficacy of lumbar kinetic chain training was higher than that of regular low back muscle exercise.
Aqueous Ammonia With Sodium Sulfite Pretreatment For Enhancing Enzymatic Saccharification and Bioethanol Production of Sugarcane Bagasse
Authors: Zeng Minxia , Tang Baoying , Li Peijin , Liang Zhiquan , Li Xiaozhen , Wang Jue , Lin Jianghai , Xiao Wenjuan , Xu Yuan , Huang Shiqing , Liu Zehuan
Published: June 2021

Background: Bioethanol is considered as a promising alternative fuel. Lignocellulosic biomass can be used for the production of bioethanol, but its recalcitrant structure makes it difficult to be utilized. Thus, proper pretreatment is a crucial step to break this structure and enhance enzymatic saccharification. Aqueous ammonia with sodium sulfite pretreatment (AAWSSP) was first applied to enhance the enzymatic saccharification and bioethanol production of sugarcane bagasse (SCB) in this research.Results: Response surface methodology was applied to optimize the conditions of pretreatment. Under optimal parameters, 16.92 g/L of total sugar concentration (P1 SCB: 202.08℃, 11.06% aqueous ammonia, 13.37% sodium sulfite, 1.22 h) and 0.51 g/g of total sugar yield (P2 SCB: 199.47℃, 10.17% aqueous ammonia, 13.11% sodium sulfite, 1.17 h) were achieved, respectively. The results of ethanol fermentation showed that separate hydrolysis and fermentation performed better than that of simultaneous saccharification and fermentation, and the maximum ethanol yields of 143.30 g/kg for P1 SCB and 145.33 g/kg for P2 SCB, were obtained, respectively. Conclusions: This research indicated that aqueous ammonia and sodium sulfite in pretreatment solution might have a synergistic effect on delignification and enzymatic saccharification. AAWSSP might be a prospective method for enhancing enzymatic saccharification and bioethanol production of SCB, which provided new guidance for the bio-refinery of lignocellulose.
Role of Interferon Regulatory Factor 7 in Corneal Endothelial Cells After HSV-1 Infection
Authors: Ohtani Fumie , Miyazaki Dai , Shimizu Yumiko , Haruki Tomoko , Yamagami Satoru , Inoue Yoshitsugu
Published: June 2021

Viral infections of the cornea including herpes simplex virus 1 (HSV-1) cause visual morbidity, and the corneal endothelial cell damage leads to significant visual impairment. Interferon regulatory factor 7 (IRF7) has been identified as a significant regulator in corneal endothelial cells after an HSV-1 infection. To examine the role played by IRF7, the DNA binding domain (DBD) of IRF7 of human corneal endothelial cells (HCEn) was disrupted. An RNAi inhibition of IRF7 and IRF7 DBD disruption (IRF7 ∆DBD) led to impairment of IFN-β production. Impaired IFN-β production by IRF7 ∆DBD was regained by IRF7 DNA transfection. Transcriptional network analysis indicated that IRF7 played a role in antigen presentation function of corneal endothelial cells. When the antigen presentation activity of HCEn cells were examined for priming of memory CD8 T cells, IRF7 disruption abolished the anti-viral CTL response, which was dependent on major histocompatibility complex (MHC) class I.To further examine roles of IRF7 in CTL induction as acquired immunity, contribution of IRF7 to MHC class I-mediated antigen presentation was assessed. Analysis of IRF7 ∆DBD cells indicated that IRF7 has previously unrecognized role in MHC class I induction, and viral infection induced-MHC class I induction was abolished by IRF7 disruption.Collectively, the IRF7 in corneal endothelial cells not only contributes to type I IFN response, but also mediates viral infection-induced MHC class I upregulation and priming of CD8 arm of acquired immunity.
Phase Transition Dielectric Properties in Order-disorder Antiferroelectric NH4(H2PO4) (ADP) Crystal
Authors: Khan Muzaffar Iqbal , Upadhyay Trilok Chandra
Published: June 2021

A modified four sublattice pseudospin lattice coupled model Hamiltonian by adding extra spin-lattice interaction, direct spin-spin interaction has been used to study dielectric properties for ammonium dihydrogen phosphate (ADP) crystal. Using the double-time temperature-dependent Green’s function method, the expressions for soft mode frequency, dielectric permittivity and loss tangent have been derived. By fitting the model values of various physical parameters, the thermal variations of the above quantities are calculated and compared with the experimental results. Our theoretical obtained results are in good agreement with experimental data.
Endovascular Management of Portal Vein Obstruction in Hepatobiliary Cancer Patients.
Authors: Ferral Hector , Alonzo Marc J , Datri Jewell , Marsh Robert , Talamonti Mark S.
Published: June 2021

Background:Obstruction of the splenoportal or mesoportal venous system occurs in approximately 15-25 % of patients with hepatobiliary malignancies. These patients are prone to develop obstruction of the portal and mesenteric veins both because of local factors (tumor compression, stenosis after surgery) and systemic factors (hypercoagulability). Diagnosis requires a high index of clinical suspicion because symptoms may be non-specific and directly attributed to the existing malignancy. Cross-sectional imaging methods (contrast-enhanced CT scan and MRI) are key to diagnosis. The best treatment strategy has not been established. The purpose of this article is to describe a single center experience in the endovascular management of portal and mesenteric venous obstruction with metallic stent placement on patients with hepatobiliary neoplasms.Results:IRB approved, HIPAA compliant study. Retrospective review of medical and imaging records of 21 consecutive patients with hepato-biliary malignancy who underwent endovascular portal vein recanalization and stent placement between January 2012 and March 2020. Clinical diagnoses were pancreatic cancer (n=19), colon cancer metastatic to the liver (n=1) and cholangiocarcinoma (n=1). The presenting symptoms were: ascites (n=5), abdominal pain, portal vein thrombosis, abnormal liver function tests and ascites (n=4), abdominal pain and ascites (n=4), abdominal pain and diarrhea (n=3), gastrointestinal bleed (n=3) and abdominal pain (n=2). Study results are presented in means and percentages. Stent patency and patient survival are presented with Kaplan-Meier method. The technical success rate was 100%. Self-expandable and balloon-expandable stents were placed. A transhepatic approach was used in 20 cases (95.2%); trans-splenic access in one. Primary stent patency was 95.2%, 84%, and 68% at 1, 3 and 6 months respectively. All stent occlusions were caused by tumor progression. A total of 80% of patients reported symptomatic improvement. Patient survival at 10 months was 40%. The early death rate was 4.76%. Portal vein perforation with massive bleeding was seen in one patient and managed with self-expandable stent-graft placement. There were no bleeding complications from the percutaneous tracts.ConclusionEndovascular recanalization with stent placement is safe with high technical and clinical success. Stent patency is acceptable and determined by disease progression.
Dysfunction of Apoptosis and Autophagy Correlates with Local Recurrence in Esophageal Squamous Cell Carcinoma After Definitive Chemoradiation
Authors: Qiu Hu , Song Haixia , Luo Man , Ke Shaobo , Shi Wei , Chen Jiamei , Zhao Wensi , Luo Hesheng , Chen Yongshun
Published: June 2021

Objective: Definitive chemoradiotherapy (dCRT) is one of the standard treatments for esophageal squamous cell carcinoma (ESCC), but local recurrence is the main cause of treatment failure. The changes in apoptosis and autophagy in recurrent tumors of patients with ESCC following dCRT have been poorly estimated. Thus, this study aimed to investigate the expressions of key regulators of apoptosis and autophagy in matched paired samples of primary and recurrent ESCC. Methods: The medical records of patients with locally advanced ESCC who developed local recurrence after dCRT were reviewed, and the expression profiling of apoptosis-related genes, cell apoptosis, autophagy and autophagy-related proteins were detected in normal esophageal squamous epithelium and paired samples of primary and recurrent ESCC.Results: A total of 126 patients were enrolled, and 52.4% of them had stage III disease. The 1-, 3- and 5-year local recurrence-free survival (LRFS) rates were 54.8, 19.8 and 14.3%, respectively, with a median LRFS of 13.0 months. Patients with T2 tumor or stage II disease showed a significantly prolonged LRFS compared with that of patients with T3-4 tumor or stage III disease. The Apoptotic Machinery key genes expression profiling identified 5 upregulated and 7 downregulated apoptosis-related genes in recurrent tumors compared with their expression levels in the matched primary ESCC tumors. High expression of CD40, TRAF4 and BCL2A1, and low expression of CARD6 and TNFRSF21 were associated with increased risk of early local recurrence after dCRT. No differences in apoptotic index between primary and recurrent samples were detected. However, typical morphological features of autophagosomes and elevated LC3-II protein expression were detected in recurrent tumor samples, and positive LC3-II expression was correlated with increased risk of early local recurrence.Conclussion: Our findings indicated that apoptosis and autophagy dysfunction correlated with early local recurrence in patients with locally advanced ESCC receiving dCRT. Further studies are necessary to understand the biology of tumor recurrence in esophageal cancer.
East Asian Summer Monsoon Precipitation Response to Variations in Upstream Westerly Wind
Authors: Son Jun-Hyeok , Seo Kyong-Hwan
Published: June 2021

From spring to summer, the East Asian summer monsoon (EASM) rainband migrates northwestward. During summer, East Asian countries experience extensive precipitation due to the EASM rainband, but the springtime monsoon rainband lies over the Pacific. The seasonal evolution of the EASM rainband is influenced by the mechanical effect of the Tibetan Plateau, and seasonal changes in the westerly wind speeds impinging on the Tibetan Plateau are a key driver of this process. In this study, using interannual variability of the upstream zonal wind speed, the dynamical mechanism for the interannual variations of the EASM precipitation is revealed based on the topographically forced stationary Rossby wave theory. The dynamical mechanism regulating interannual variability in the EASM rainband is essentially the same mechanism that drives the seasonal evolution of the climatological EASM rainband. If the westerly winds impinging on the Tibetan Plateau are stronger (weaker) than average, then the EASM rainband shifts eastward (westward). Large variations in the upstream westerly wind during May induced considerable interannual variation in the zonal location of the rainband (up to a 20–30º shift). The westerly wind speed exhibited less variations in June and July, resulting in a smaller zonal shift of approximately 10º.
The Study of Key Tongue Features for Prediabetes Risk and Diabetes Risk using Principal Component Analysis and Logistic Regression
Authors: Li Jun , Li Jiacai , Hu Xiaojuan , Tu Liping , Shi Yulin , Bi Zijuan , Zhou Changle , Cui Ji , Xu Jiatuo
Published: June 2021

Background: Carrying out routine diabetes risk assessment and prediction is conducive to controlling the incidence of diabetes. Previous studies have confirmed that tongue features can reflect changes in glucose metabolism. We want to find the key tongue features related to glucose metabolism for early warning of prediabetes and diabetes. This will benefit the prevention and control of diabetes.Methods: We investigated 719 subjects in Shuguang Hospital affiliated with Shanghai University of TCM in Shanghai, China, during the August 2018 – December 2019 period. We used PCA to reconstruct 25 new features on the basis of the original features, and used logistic regression to analyze these new features. Based on the factor loading method, we associate the new features with the original features. Finally, we determined the key tongue features and change patterns related to prediabetes risk and diabetes risk.Results: For the prediabetes, TB-ASM, TC-ASM and TB-Cr are protective factors. TB-CON, TC-CON, TB-MEAN, TC-MEAN, TB-ENT and TC-ENT are risk factors. For the diabetes, TB-a, TB-S, TB-Cr, TB-b and TC-b are protective factors, and Per-all and TB-Cb are risk factors. Conclusion: The PCA eliminates the redundancy of original features and refines the original features. The PCA combined with logistic regression found the key tongue features reflecting glucose metabolism, and clarified the significance of the changes in these tongue features in the prediabetes and diabetes population. This study provides a research foundation for using tongue features to implement early warning of diabetes risk.
Factors Influencing the Degree of Physician-pharmacists Collaboration within governmental Hospitals of Jigjiga Town, Ethiopia
Authors: Gemmechu Workineh Diriba , Eticha Endalkachew Mekonnen
Published: June 2021

Background: Inter-professional collaboration can improve medication safety, patient outcome and minimize healthcare costs. This study aimed to explore the degree of collaboration and factors influencing collaboration between the physicians and pharmacists within the public hospitals of Jigjiga town, Ethiopia. Methods: A cross-sectional study was conducted among 149 participants in the two governmental hospitals of the Jigjiga town with a response rate of 79.87%. The collaborative working relationship model and the physician-pharmacist collaborative instrument with three main exchange domains (trustworthiness, role specification, and relationship initiation) and collaborative care items were used. An independent sample t-test was used to compute the differences of the mean scores of physician-pharmacist collaborative instrument domains and collaborative care. Separate multiple regression was employed to assess factors influencing collaborative care for pharmacists and physicians. Results: This study showed that pharmacists reported higher mean of collaborative care (10.66 ± 4.75) than physicians (9.17 ± 3.92). The multiple regression indicated that area of practice influence both professionals’ collaborative practice. A significant association between collaborative care and the two PPCI domains (trustworthiness and relationship initiation for the physicians; role specification and relationship initiation for pharmacists) was established. Conclusion: The study showed that the collaboration between the physicians and pharmacists was sub-optimal and the exchange variables had a significant influence on their collaboration.
Performance Evaluation of a PET Insert for Preclinical MRI in Standalone PET and Simultaneous PET-MRI Modes
Authors: Emvalomenos Gaelle , Trajanovska Sofie , Pham Binh T.T. , Doughty Peter , Burnet Jerome , Smith Isabelle , Garipov Ruslan , Gregoire Marie-Claude , Sunn Nana , McGrath John , Meikle Steven Richard
Published: June 2021

Background: This study aimed to evaluate the performance of a preclinical PET insert in three configurations: as a standalone unit outside the MRI bore, inside the bore of a cryogen-free 3T MRI and, finally, while performing simultaneous PET/MRI studies.Methods: The PET insert consists of 2 rings of 6 detectors, each detector comprising 8x12 SiPMs reading out dual offset layers of pixelated LYSO crystals with a 1.4mm pitch. The inner diameter is 60mm, transaxial Field of View (FoV) 40mm and axial FoV 98mm. Evaluation was based on NEMA NU 4-2008 guidelines with appropriate modifications. Spatial resolution and sensitivity were measured inside and outside the MR bore. Image quality, count rate and quantitative performance were measured in all three configurations. The effect of temperature stability on PET sensitivity during fast spin echo sequences was also evaluated. B0 field homogeneity, T1 and T2 relaxation times were measured using a water-filled phantom, with and without simultaneous PET operation. Finally, PET and MRI scans of a mouse injected with 10 MBq [18F]NaF and a mouse injected with 16 MBq [18F]FDG were performed in sequential and simultaneous modes. Results: Peak absolute sensitivity was 10.15% with an energy window of 250-750 keV. Absolute sensitivity values outside and inside the MR bore with MR idle agreed to within 0.1%. Outside the MR bore spatial resolution was 1.21/1.59 mm FWHM (radial/tangential) 5mm from the centre of the FoV which compared well with 1.19/1.26mm FWHM inside the MR bore. There were no substantial differences between all three scan configurations in terms of peak NEC rate (175 kcps at 17MBq), scatter or random fractions. Uniformity and recovery coefficients were also consistent between scanning modes. B0 field homogeneity and T1 and T2 relaxation times were unaltered by the presence of the PET insert. No significant differences were observed between sequential and simultaneous scans of the animals.Conclusion: We conclude that performance of the PET insert and MRI system are not significantly affected by scanning mode.
Water Quality, Soil Characteristics and Vegetation Diversity Along Effluent-dominated Rivers in Western Rajasthan, India
Authors: Singh Genda , Nagora P.R. , Haksar Parul , Mishra Deepak
Published: June 2021

This study aimed at analysing water quality of effluent-dominated seasonal rivers and its impacts on soil and vegetation. Effluent-inflicted, river-edge and non-polluted areas were selected at 5 places along Luni, Bandi and Jojari rivers in western Rajasthan. Water of rivers exhibited high pH (7.6-8.6), electrical conductivity (EC 2.45-38.3 dSm-1), total dissolved and suspended solids, alkalinity and Na (1.50-30.00 gL-1), K, Ca and Mn (25.2-2439.3 µgL-1) concentrations and low NH4-N (1.08-20.69 mgL-1), NO3-N (0.44-9.10 mgL-1) and PO4-P (3.10-13.40 mgL-1). Most variables were highest for Luni and lowest for Bandi River. Cu, Co, Se, Cd and Pb concentrations were <180 µgL-1. Soil pH, EC and PO4-P were highest along Bandi, whereas NH4-N, NO3-N and K were highest along Jojari River in both 0-30 and 30-60 cm soil layers. Effluent-inflicted soils exhibited high pH, EC and PO4-P, whereas non-polluted soils showed high NH4-N, NO3-N and K availability. These soil variables decreased downstream. Plant species number ranged between 34 along Luni and 20 along Jojari (total 10 trees, 10 shrubs and 29 herbaceous). Species richness (R) and diversity (H’) of trees were highest along Bandi. Shrubs and herbaceous R, H’ and evenness (e’) were high along Luni. Least diverse vegetation was along Jojari. Non-polluted area exhibited high tree R and H’, whereas river-edge showed high herbaceous R and H’. Effluent-inflicted area showed high salts and low diversity, but dominated by Aeluropus lagopoides, Paspalum virgatum, Phragmites karka, Tamarix ericoides, etc., which can be used in restoring such degraded urban areas.
Case Report: A 46-Year-Old Man With Giant Pseudoaneurysm of the Left Superficial Femoral Artery
Authors: Deng Jianying , Du Junjie
Published: June 2021

Introduction: Pseudoaneurysm is a complication caused by vascular injury, which is more common in firearm injuries, stab wounds, iatrogenic injuries, etc. Clinically, femoral pseudo-artery caused by intravenous drug abuse is not uncommon, but giant pseudoaneurysms are relatively rare. Case presentation: A 46-year-old man presented with a 6-month history of a pulsating mass in the left groin, which was aggravated with pain for 3 days. The patient has a history of intravenous drug use for more than half a year. Six months ago, the patient found a lump in the left groin, and no special treatment was given.Three days ago, the mass in the patient's left groin suddenly enlarged with severe pain. The patient then came to our hospital for treatment, and ultrasound revealed a pseudoaneurysm in the left femoral artery.CTA of the lower extremity arteries suggested a huge pseudoaneurysm in the left femoral artery. To avoid the rupture of the huge pseudoaneurysm of the left superficial femoral artery, we implemented emergency interventional surgery. The operation was successful and the patient recovered well after the operation.Conclusions: In order to avoid the rupture of a huge pseudoaneurysm of the femoral artery, emergency interventional surgery is an option. However, considering that pseudoaneurysms caused by intravenous drug abuse are often associated with fungal infections, surgery is still the best choice.
Investigation on Granular Medium Forming Formability of TA1 Titanium Alloy Cylinder-Shaped Parts
Authors: Hu Biao , Cai Gaoshen , Fu Jubo , Xin Yanxi , Liu Kangning , Lang Lihui
Published: June 2021

In order to investigate the formability of the granular medium forming (GMF), based on the Mohr-Coulomb constitutive model with the tri-axial compression test of granular medium and the true stress-strain curves of TA1 titanium alloy from uniaxial tensile tests, the numerical simulation of TA1 titanium alloy sheet deep drawing with finite element method was performed, and the deep drawing tests were also carried out. Simulation analysis and test results show that the GMF process is suitable for titanium alloy sheets, and can effectively improve the uniformity of the wall thickness of the formed parts, reduce the tendency of wrinkles and improve the forming quality.
Oryeongsan (Wulingsan) Ameliorates Impaired ANP Secretion of Atria from Spontaneously Hypertensive Rats
Authors: Kim Hye Yoom , Ahn You Mee , Na Se Won , Jang Youn Jae , Kang Dae Gill , Lee Ho Sub , Cho Kyung Woo
Published: June 2021

Background: Oryeongsan (ORS), a herbal medicine formula, has long been used for the treatment of impaired body water balance in Asian countries. Recently, it was shown that ORS modulates the renin-angiotensin system (RAS). Purpose of the present study was to determine characteristics of atrial ANP secretion and effects of ORS on the secretion in the atria from spontaneously hypertensive rats (SHR). Methods: WKY-V treated with vehicle, SHR groups treated with vehicle (SHR-V), ORS (SHR-ORS), and losartan as a positive control (SHR-LOS). Experiments were performed in perfused beating atria (1.3 Hz) allowing atrial distension, acetylcholine (ACh) stimulation, and serial collection of atrial perfusates. The secreted ANP concentration was measured using radioimmunoassay. Interstitial fluid (ISF) translocation was measured using [3H]inulin clearance. Results: Stepwise increase in atrial distension by 1.1, 2.0, and 2.7 cmH2O above basal distension further increased ANP secretion proportionally in the atria from WKY-V, but the response was significantly suppressed in the atria from SHR-V. Cardiomyocyte ANP release, the first step of atrial ANP secretion, was suppressed in the atria from SHR-V compared to those from WKY-V (-8.02 ± 2.86, -15.86 ± 2.27, and -20.09 ± 3.62%; n = 8, vs. 8.59 ± 2.81, 15.65 ± 7.14, and 38.12 ± 8.28%; n = 8; p < 0.001 for all stepwise distension, respectively). Subacute treatment with ORS reversed the suppressed ANP release in atria from SHR-ORS (6.76 ± 3.92, 9.12 ± 2.85, and 28.79 ± 1.79% for SHR-ORS; n = 5 vs. SHR-V; n = 8; p = 0.01, p < 0.001, p < 0.001, respectively). The effects of ORS were comparable to those of losartan. ISF translocation was not significantly different between groups except SHR-V. ACh-induced ANP secretion and cardiomyocyte ANP release were also suppressed in the atria from SHR-V and ORS reversed the suppression. These findings were accompanied with accentuation of the AT1 receptor expression and suppression of the AT2/Mas receptor, M2 mACh receptor and GIRK4 expression in the atria from SHR-V. Further, treatment with ORS or losartan reversed the expressions. Conclusions: These results show that ANP secretion is suppressed in the atria from SHR in association with accentuation of AT1 receptor and suppression of AT2/Mas receptor and KACh channel expression. ORS ameliorates impaired ANP secretion through improving cardiomyocyte ANP release with modulation of the cardiac RAS and muscarinic signaling. These findings provide experimental evidence which supports the role of ORS in the regulation of atrial ANP secretion in the atria from SHR.
Epidemiological Characteristics of Rubella in Beijing Haidian District of China, 2005 - 2020
Authors: Yu Susu , Peng Xinyue , Wu Fan , Yang Jiani , Zhou Cheng , Zhang Luyun , Lin Hui , Wei Zhisheng , Zhang Wenjuan
Published: June 2021

Background: This study aimed to investigate the epidemiological characteristics of rubella in Beijing Haidian District of China, from 2005 to 2020, providing scientific basis for controlling the prevalence of rubella and the congenital rubella syndrome (CRS). Methods: Data were collected via the legal infectious disease report cards from medical institutions in Beijing Haidian District during 2005 to 2020. The descriptive epidemiological methods plus statistic analysis were used to analyze the distribution of rubella in terms of population, time and region. Results: In total, there were 994 cases of rubella in Beijing Haidian District, with an average annual incidence of 1.81/100,000 population. The majority of patients were at the age from 15 to 29 years old, accounting for 63.4%. And the sex ratio of male-to-female was 1.45:1. The rubella had a feature of spatial aggregation and appeared in all the regions in Haidian District. In 2007, Haidian District was hitted by rubella with the highest incidence up to 8.37/100,000, in the past 16 years. The peak incident of rubella was in May of that year, accounting for 74.8%. The majority of rubella patients were students and employees (70.1%) mainly due to the gathering. According to Joinpoint regression model, rubella would still exist in the next three years with 2-5 new cases per year. Conclusions: The number of rubella in Haidian District showed a downshift trend from 2008 to 2014 and then a sporadic distribution till 2020. Yet this disease was not completely eliminated, it is quite impending to improve the awareness of rubella and their health literacy mentally and physically in the whole population by means of the policy issuing from government.
Somatostatin Analogs in Patients with Zollinger Ellison Syndrome (ZES): An Observational Study
Authors: Massironi Sara , Cavalcoli Federica , Peracchi Maddalena , Elvevi Alessandra , Quatrini Maurizio , Invernizzi Pietro
Published: June 2021

PURPOSE: Zollinger Ellison syndrome (ZES) is a rare syndrome caused by gastrin hypersecretion from a gastrinoma. Gastrinoma treatment has two goals: the control of the gastrin-excess state and the control of tumor growth. While therapy for the syndrome is univocally based on proton pump inhibitors, the one for disease control is still debated. We here aimed at evaluating the role of SSAs in the control of tumor progression in a series of ZES patients.METHODS: A retrospective analysis of a prospectively collected database of ZES patients, followed and managed from 1990 to 2019, was performed. The patients' clinical, pathological, treatment, and follow-up data were analyzed. Data regarding SSAs therapy start, dosage, duration, and side effects were collected.RESULTS: 33 patients with ZES were diagnosed. Fourteen patients (42%) had a G1 NEN, five had G2 (15%), none had G3. Fifteen patients (45%) had metastatic disease. Overall, 12 (36%) underwent SSAs therapy. The median treatment duration was 36 months. Eight patients (67%) had a sustained response to SSA, four (33%) showed an early progression, with a significant difference in terms of PFS between the two groups (84 vs 2 months, p=0.004). No differences in terms of OS and PFS were observed between the two groups, despite the proportion of metastatic patients was greater in the SSA-treated group (75% vs 29% in the non-treated group, p=0.01). CONCLUSION: Present data support the use of SSAs in ZES, considering that gastrinoma is mainly a well-differentiated low-grade tumor (G1 or G2), with a high expression of somatostatin receptors.
MCMV based vaccine vectors expressing full-length viral proteins provide long-term humoral immune protection upon a single-shot vaccination
Authors: Cicin-Sain Luka , Kim Yeonsu , Zheng Xiaoyan , Eschke Kathrin , Chaudhry M. Zeeshan , Bertoglio Federico , Tomic Adriana , Hoffmann Markus , Bar-On Yotam , Boehme Julia , Bruder Dunja , Ebensen Thomas , Brunotte Linda , Ludwig Stephan , Messerle Martin , Guzmán Carlos , Mandelboim Ofer , Hust Michael , Pöhlmann Stefan , Jonjic Stipan
Published: June 2021

Global pandemics by influenza or coronaviruses cause severe disruptions to the public health and lead to severe morbidity and mortality. Vaccines against these pathogens remain a medical need. CMV (cytomegalovirus) is a β-herpesvirus that induces uniquely robust immune responses, where outstandingly large populations of antigen-specific CD8+ T cells are maintained for a lifetime. Hence, CMV has been proposed and investigated as a novel vaccine vector expressing antigenic peptides or proteins to elicit protective cellular immune responses against numerous pathogens. We generated two recombinant murine CMV (MCMV) vaccine vectors expressing the hemagglutinin (HA) of influenza A virus (MCMVHA) or the spike protein of the severe acute respiratory syndrome coronavirus 2 (MCMVS). A single shot of MCMVs expressing either viral protein induced potent neutralizing antibody responses, which strengthened over time. Importantly, MCMVHA vaccinated mice were protected from illness following challenge with the influenza virus, and we excluded that this protection was due to effects of memory T cells. Conclusively, we show here that MCMV vectors do not only induce long-term cellular immunity, but also humoral responses that provide long-term immune protection against clinically relevant respiratory pathogens.
A Validation Study of the Greek Version of the Toronto Empathy Questionnaire in Medical Students and a Measurement of Their Empathy
Authors: Voultsos Polychronis , Papana Angeliki , Chatzinikolaou Fotios , Deliliga Aspasia
Published: June 2021

Aims and objectivesEmpathy is an important key driver of any therapeutic relationship. It is beneficial not only to the patients, but also to physicians. Enhancing physician’s empathy should be an important goal of medical education. As there is a literature gap regarding the topic of empathy among medical students in Greece, this study aims to contribute to filling this gap.MethodsA cross-sectional study was conducted. The (validated in Greece) Greek version of Toronto 52‐item empathy 6-point Likert-scale was administered to all the medical students in the Aristotle University of Thessaloniki, in Greece. In addition, participants were asked to provide information regarding their socio-demographics. A demographic comparison was conducted.ResultsThe preliminary validation of the Greek version of the Toronto Composite Empathy Scale (TCES) demonstrated acceptable validity and reliability among medical students and could be further tested in larger samples of medical students. The overall reliability analysis of the TCES questionnaire is high (Cronbach's α = 0.895, Sig. from Hotelling’s T-Squared Test < 0.000). The mean total score of empathy showed that students have a moderately high empathy. The 52‐item TCES, 26 for the personal (Per) setting and another 26 for professional (Pro) life, equally divided into cognitive (Cog) and emotional (Emo) empathy in each case. It was found that there is a statistically significant difference in means between the Per-Cog and Per-Emo settings (Sig < 0.001), the Pro-Cog and Pro-Emo (Sig < 0.001), the Per-Cog and Pro-Cog (Sig = 0.004), and the Per-Emo and Pro-Emo (Sig < 0.001). Females had significantly higher empathy scores (mean score 208.04) than males (mean score 192.5) on the Per-Cognitive, Per-Emo and Pro-Emo subscales. Furthermore, a positive correlation was found between empathy and factors such as love for animals, interest in medical ethics, belief in God, having an ill person in the family, class year or carrier intention.ConclusionsThe Toronto Composite Empathy Scale (TCES) is applicable to medical students. For the most part our findings were consistent with previous literature. However, we identified some nuances that might draw researchers’ attention.
Infection Prevention Strategies in COVID-19 Units Highly Protective While Primary Risks to Healthcare Professionals Come From Coworkers and the Community
Authors: Gohil Shruti , Quan Kathleen , Madey Keith , King-Adelsohn Suzanne , Tjoa Tom , Tifrea Delia , Crews Bridgit , Monuki Edwin , Khan Saahir , Schubl Sebastian , Bittencourt Cassiana , Detweiler Neil , Chang Wayne , Willis Lynn , Khusbu Usme , Saturno Antonella , Rezk Sherif , Figueroa Cesar , Jain Aarti , de Assis Rafael , Felgner Philip , Edwards Robert , Hsieh Lanny , Forthal Donald , Wilson William , Stamos Michael J , Huang Susan
Published: June 2021

Background: Early evaluations of healthcare professional (HCP) COVID-19 risk occurred during insufficient personal protective equipment and disproportionate testing, contributing to perceptions of high patient-care related HCP risk. We evaluated HCP COVID-19 seropositivity after accounting for community factors and coworker outbreaks.Methods: Prior to universal masking, we conducted a single-center retrospective cohort plus cross-sectional study. All HCP 1) seen by Occupational Health for COVID-like symptoms (regardless of test result) or assigned to 2) dedicated COVID-19 units, 3) units with a COVID-19 HCP outbreak, or 4) control units from 01/01/2020-04/15/2020 were offered serologic testing by an FDA-authorized assay plus a research assay against 67 respiratory viruses, including 11 SARS-CoV-2 antigens. Multivariable models assessed the association of demographics, job role, comorbidities, care of a COVID-19 patient, and geocoded socioeconomic status with positive serology.Results: Of 654 participants, 87 (13.3%) were seropositive; among these 60.8% (N=52) had never cared for a COVID-19 patient. Being male (OR 1.79, CI 1.05-3.04, p=0.03), working in a HCP-outbreak unit (OR 2.21, CI 1.28-3.81, p<0.01), living in a community with low owner-occupied housing (OR=1.63, CI=1.00-2.64, p=0.05), and ethnically Latino (OR 2.10, CI 1.12-3.96, p=0.02) were positively-associated with COVID-19 seropositivity, while working in dedicated COVID-19 units was negatively-associated (OR 0.53, CI=0.30-0.94, p=0.03). The research assay identified 25 additional seropositive individuals (78 [12%] vs. 53 [8%], p<0.01).Conclusions: Prior to universal masking, HCP COVID-19 risk was dominated by workplace and community exposures while working in a dedicated COVID-19 unit was protective, suggesting that infection prevention protocols prevent patient-to-HCP transmission.
Bitmap and Vectorial Hologram Recording by Using Femtosecond Laser Pulses
Authors: Kotsiuba Yurii , Hevko Ihor , Bellucci Stefano , Gnilitskyi Iaroslav
Published: June 2021

In this paper, we present two approaches for recording a quasi-hologram on the steel surface by femtosecond laser pulses. The recording process is done by rotating the polarization of the laser beam by a half-wave plate or a spatial light modulator (SLM), so we can control the spatial orientation of the formed laser-induced periodic surface structures (LIPSS). Two different approaches are shown, which use vector and bitmap images to record the hologram. For the first time to our knowledge, we managed to record a hologram of a bitmap image by continuously adjusting the laser beam polarization by SLM during scanning. The developed method can sabstantially improve hologram recording technology by increasing its speed, reducing the price, and eliminating complex processing procedures.
Upregulation of TCF21 Inhibits Migration of Adrenocortical Carcinoma Cells
Authors: Kremer Jean Lucas , Auricino Thais Barabba , Passaia Bárbara dos Santos , Lotfi Claudimara Ferini Pacicco
Published: June 2021

Background: Adrenocortical carcinomas (ACC) are rare and aggressive cancer. Our previous study has revealed that the transcription factor 21, TCF21, is downregulated in ACC and regulates steroidogenic factor 1 (SF-1) binding to the SF-1 E-box promoter. In addition, it could be found that TCF21 is a predictor of Overall Survival (OS) in adult carcinomas. Methods: In this study, it was investigated the correlation between TCF21 expression and the promoter methylation status in adrenocortical tumor cells, carcinomas and adenoma. The biological function and potential molecular mechanism of TCF21 restoration in migration and invasion of ACC cells was examined. Results: We could be demonstrated a negative correlation between the level of TCF21 expression and methylation of its promoter in adenoma and carcinoma cells indicating the epigenetic control of TCF21 expression. It was also demonstrated that the expression of TCF21 inhibits migration and invasion in the ACC cell lines, H295R and SW-13 cells, using, respectively, plasmid transfection and CRISPR system to express TCF21. Furthermore, it could be investigated the TCF21 function as tumor suppressor probably through Kisspeptin 1 (KISS-1) expression and Epithelial-Mesenchymal Transition (EMT) reversion, as well as the modulation of several metalloproteinases in ACC cells. Conclusions: Our results suggest that enhancement of TCF21 expression levels may be a potential strategy to revert invasive abilities in adrenocortical carcinomas.
Producing Hollow Shafts in a New Horizontal Mill by Novel Flat-Knifing Cross-Wedge Rolling With Single Guide
Authors: Lin Longfei , Wang Baoyu , Shen Jinxia , Liu Tao
Published: June 2021

To meet the requirement of lightweight, there are increasing solid shafts being designed to be hollow in transportation industry. In this study, a novel method of flat-knifing cross-wedge rolling (FCWR) with single guide is proposed including a modified roller, a horizontal mill and a single-guide structure, and its key problems are studied by numerical simulations and experimental tests. A mathematical model of FCWR roller is established, which reveals the wedge length of rollers is effectively reduced by modifying knifing wedge from normalized roller. Further, a horizontal multifunctional mill is invented and constructed to carry out the FCWR experiment with single guide. According to the results from the numerical simulations and corresponding experiments, it is observed that the typical defects of hole expansion and knifing groove are absolutely avoided because the improved flat-knifing wedge produces a radial force to shrink the inner hole and avoid the deformation concentration of the outer surface during knifing stage. Moreover, the single guide rolling performed in the horizontal mill efficiently improve rolling stability because the workpiece is restricted into a smaller workspace. To the authors’ knowledge, all these integrated improvements of FCWR roller, single guide rolling and horizontal mill are innovative, which are of great engineering significance to manufacture hollow shafts on account of the advantages of avoiding forming defect, reducing roller diameter, improving rolling stability and simplifying mill structure.
Projecting the Effects of Land Subsidence and Sea Level Rise on Storm Surge Flooding in Coastal North Carolina
Authors: Johnston Jeremy , Cassalho Felicio , Miesse Tyler , Ferreira Celso
Published: June 2021

Much of the United States Atlantic coastline continues to subside due to post glacial settlement and ground water depletion. Combined with sea level rise (SLR), this contributes to a larger relative rate of SLR regionwide. In this work, we utilize the ADvanced CIRCulation model to simulate storm surges across coastal North Carolina. Simulations of recent Hurricanes Irene (2011) and Matthew (2016) are performed considering SLR projections and land subsidence estimates for the year 2100. The model is validated against historic water level observations with generally strong agreement (mean R2 0.81, RMSE 10–31 cm). At current rates of subsidence, storm surge susceptible regions increase on the order of 30–40% by 2100 relative to near-present day conditions. Flood water redistribution leaves low-lying areas especially vulnerable, as many of which also experience increased land subsidence. Combined with SLR projections, results project more than a doubling of areal flood extent for Hurricane Irene from ~ 2,000 km2 (2011) to 5,000 km2 (2100, subsidence + 74 cm), and more than a 3-fold increase ~ 1,400 km2 (2016) to 4,900 km2 (2100, subsidence + 74 cm) for Hurricane Matthew. The expected inundation increases have substantial implications for communities and ecosystems located in coastal North Carolina.
Rhizoma Drynariae promotes the Osteogenic differentiation of Bone Mesenchymal Stem Cells by activating the Wnt/β-catenin Signaling Pathway
Authors: Shen Yi-Wei , Li Yi , Li Zuo , Yang Bing-you , Li Xue
Published: June 2021

Background: Rhizoma Drynariae (RD), a traditional Chinese medicine with pleiotropic biological activities, exerts a protective effect against age-related osteoporosis. Osteoporosis is a serious clinical problem and characterized by the deterioration in bone volume and strength, mainly due to the dysfunction of bone marrow stromal cells (BMSCs). However, it remains unclear whether RD-containing serum regulates the osteogenic differentiation of BMSCs via Wnt/β-catenin signaling pathway. Methods: The effects of RD-containing serum on the osteogenesis of BMSCs were detected via quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR), western blotting, alkaline phosphatase (ALP) activity assay and alizarin red staining. Using Dickkopf-related protein-1 (DKK1), an inhibitor of the Wnt/β-catenin signaling pathway, we examined whether RD-containing serum regulates osteoblast differentiation of BMSCs via the Wnt/b-catenin signalling pathway. Results: The results showed that RD-containing serum promoted the BMSC proliferation and ALP activities, as well as up-regulated the expression of osteogenic markers and Wnt/β-catenin pathway-related genes, i.e., runt-related transcription factor 2, Sp7, osteocalcin, β-catenin and Wnt3a, in BMSCs. Moreover, we found that RD-containing serum activated the Wnt/β-catenin pathway. Adding DKK1 to the RD-containing serum could decrease the promotion of osteogenic differentiation of RD-containing serum on BMSCs. Conclusions: Collectively, RD-containing serum could promote the osteogenic differentiation of BMSCs, and the potential mechanism may involve regulation of Wnt/β-catenin signaling.
Perspectives and Attitudes of Emergency Medicine Educators Towards E-Assessment Technologies
Authors: Berikol Göksu Bozdereli , İlhan Buğra , Oktay Cem
Published: June 2021

Background: Distance assessment and evaluation(E-assessment) has recently regained popularity with the widespread use of distance education due to the pandemic. Emergency medicine education has developed theoretical and practical models on online learning and accelerated the studies on E-assessment of competencies on emergency care. While the educatiors and trainees are promptly adapting to the distance learning platforms, several factors can affect these adoptions to e-assessment models. Our study aimed to find these factors affecting the perspectives and attitudes on the practice among emergency medicine educators. Results: A survey was conducted on ninety participants of emergency medicine educators regarding self-efficacy, self-confidence, and attitudes towards E-assessment technologies. There was a statistically significant difference between computer use skills and scores, especially regarding self-confidence (p=0.02) and self-efficacy (p=0.01). We found no significant difference in terms of attitude (p=0.877). We found that those with very good computer skills had higher self-confidence and self-efficacy for distance exams. The participants' computer use skills affected self-confidence and self-efficacy for e-assessments. There was a significant difference in self-confidence (p=0.000) and self-efficacy (p=0.001) between those with and without e-assessment experience. Furthermore, the thought that it is an effective assessment and evaluation. Regarding screen sharing, 44.4% of the participants have ethical concerns; 30% were not concerned about this issue, and 25.6% were partially concerned. There was no statistically significant difference in ethical anxiety regarding e-assessment experiencing (p=0.914).Conclusion: The proficiency in using computers, experience in teaching, and the need for training on e-assessments are the key factors that affect e-assessments in emergency medicine education. Encouragement should be necessary to achieve the goal to spread the use of e-assessments in the era of the pandemic.
Interpretable machine learning identifies paediatric Systemic Lupus Erythematosus subtypes based on gene expression data
Authors: Younes Sara , Annett Alva , Stoll Patricia , Diamanti Klev , Holmfeldt Linda , Barrenäs Fredrik , Meadows Jennifer , Komorowski Jan
Published: June 2021

Transcriptomic analyses are commonly used to identify differentially expressed genes between patients and controls, or within individuals across disease courses. These methods, whilst effective, cannot encompass the combinatorial effects of genes driving disease. We applied rule-based machine learning (RBML) models and rule networks (RN) to an existing paediatric Systemic Lupus Erythematosus (SLE) blood expression dataset, with the goal of developing gene networks to separate low and high disease activity (DA1 and DA3). The resultant model had an 81% accuracy to distinguish between DA1 and DA3, with unsupervised hierarchical clustering revealing additional subgroups indicative of the immune axis involved or state of disease flare. These subgroups correlated with clinical variables, suggesting that the gene sets identified may further the understanding of gene networks that act in concert to drive disease progression. This included roles for genes i) induced by interferons (IFI35 and OTOF), ii) key to SLE cell types (KLRB1 encoding CD161), or iii) with roles in autophagy and NF-κB pathway responses (CKAP4). As demonstrated here, RBML approaches have the potential to reveal novel gene patterns from within a heterogeneous disease, facilitating patient clinical and therapeutic stratification.