bluuebunny/crossref_metadata_2025 huggingface dataset:
Biodiesel Supply Chain Network Design Under Hybrid Uncertainties: A Novel Multi-objective Robust Fuzzy Stochastic Approach
Authors: Rezaei Mohsen
Published: August 2021

In the biofuel supply chain, there may be various and hybrid uncertainties that, if ignored, can lead to inefficient network design. In this study, a multi-objective robust fuzzy stochastic programming (MORFSP) model is proposed for designing biodiesel supply chain network (BSCN) under different and hybrid uncertainties. This model simultaneously minimizes total cost of the BSCN and total environmental impacts of activities of the network. Fixed costs and environmental impact of opening facilities are described as fuzzy variables. Demands, supplies, other costs and environmental impacts are considered as fuzzy scenario based variables. The proposed MORFSP model considers different risks, including possibilistic variability and scenario variability related to economic and environmental objective functions, and unsatisfied demand costs. This model is applied in a real case study to design a BSCN in Iran. Waste cooking oil (WCO), and some non-edible plants like Salvia lerifolia (SL) and Jatropha Curcas L. (JCL) are considered as sources of producing biodiesel. The proposed approach used for designing a four-echelon, multi-period, and multi-product, of BSCN. The results show the effectiveness of the proposed model for designing the BSCN under hybrid uncertainties.
Helios Expressing Regulatory T Cells are Correlated with Decreased IL-2 Producing CD8 T Cells and Antibody Diversity in Mozambican Individuals Living Chronically HIV-1
Authors: Chissumba Raquel Matavele , Magul Cacildo , Macamo Rosa , Monteiro Vânia , Enosse Maria , Macicame Ivalda , Cumbane Victória , Bhatt Nilesh , Viegas Edna , Imbach Michelle , Eller Leigh Anne , Polyak Christina S. , Kestens Luc , Jani Ilesh
Published: August 2021

Background: Human immunodeficiency virus type 1 (HIV-1) causes impairment of T and B cell responses, which begins during the acute phase of infection and is not completely restored by antiretroviral treatment. Regulatory T cell (Tregs) can improve overall disease outcome by controlling chronic inflammation, but may also suppress beneficial HIV-1 specific immune responses. We analyzed immune alterations, including Tregs, and their clinical significance in Mozambican people living chronically with HIV-1 (PLWH-C). Results: In PLWH-C, the proportion of total Tregs was positively correlated with the proportion of IL-2+CD4 T cells (r=0.647; p=0.032) and IL-2+IFNg+CD8 T cells (r=0.551; p=0.014), while the Helios+Tregs correlated inversely with levels of IL-2+CD8 T cells (r= -0.541; p=0.017). Overall, PLWH-C, with (82%) or without virologic suppression (64%), were seronegative for at least HIV-1 p31, gp160 or p24, and the breadth of antibody responses was positively correlated with proportions of CD38+HLA-DR+CD8 T cells (r=0.620; p=0.012), viral load (r=0.452; p=0.040) and inversely CD4 T cells count (r=-0.481; p=0.027). Analysis of all individuals living HIV-1 showed that the breadth of HIV-1 antibody responses was inversely correlated with the proportion of Helios+Tregs (r=-0.45; p=0.02). Conclusion: Among Mozambican patients living with HIV-1, seronegativity to some HIV-1 proteins is common mostly in virologically suppressed individuals. Low diversity of HIV-specific antibodies is correlated to indicators of disease control during ART. Elevation in the proportion of Helios+Tregs is related to a reduction of CD8 T expressing intracellular IL-2 but may contribute to impairment of B cell function.
Effect of Hip Abductors and Lateral Rotators Muscle Strengthening on Pain and Functional Outcome in Patients with Patellofemoral Pain: Systematic Review and Meta-Analysis
Authors: Alammari Abdulaziz , Spence Nicola , Narayan Amitesh , Karnad Shreekanth D , Ottayil Zulfeequer Chundan
Published: August 2021

Background: This study systematically reviews and Meta-analyses the best-published evidence on the therapeutic value of strengthening hip abductors and lateral rotators muscles for the treatment of Patellofemoral Pain (PFP) with a presumptive hypothesis that strengthening hip muscles stabilises the patellofemoral joint, relieves pain and enhances knee functions.Methodology: Electronic database searches of Medline, EMBASE, CINAHL, PEDro and PubMed Central between January 1994 and September 2019 using PICOS tool. The methodological quality of the selected studies was appraised individually using the 20-item McMaster Critical Review Form for Quantitative Studies. Supplemental quality appraisal of randomized controlled clinical trials performed using the Cochrane Collaboration's 'Risk of bias' quality criteria. Data on patient population demographics, interventions, duration of intervention and outcome measures were extracted, summarized in evidence tables and descriptive analysis made. Pooled effects size from appropriate RCTs was determined by meta-analysis under both fixed and random-effects models.Results: All included fourteen studies demonstrated that hip muscles strengthening resulted in improved pain and knee function. All RCTs, except one, demonstrated that hip muscles strengthening is superior to quadriceps strengthening. Of the five RCTs accessing the surplus effect of hip-quad versus quadriceps strengthening, four suggested that hip-quad strengthening is superior over the standard quadriceps strengthening alone to improve PFP and knee function.Conclusion and Implications: In patients with PFP, strengthening of hip abductors and lateral rotators have greater therapeutic significance than the conventional quadriceps exercises in improving knee pain and function both in the short- and long term. However, caution is required, because a standardized hip-quad protocol is yet to be developed, which warrants further studies. Systematic review registration:There was no protocol prepared and no amendments were present. This systematic review is registered under Open Science framework, with following registration digital object identifier 10.17605/OSF.IO/CWZ8V
The Advanced Performance of Microbial Consortium for Simultaneous Utilization of Glucose and Xylose to Produce Lactic Acid Directly from Dilute Sulfuric Acid Pretreated Corn Stover
Authors: Sun Yaqin , Li Xiaoying , Wu Lida , Li Yi , Li Fan , Xiu Zhilong , Tong Yi
Published: August 2021

Background: Lignocellulosic feedstocks have attracted much attention as an alternative carbon source for lactic acid (LA) production with the advantages of ready availability, sustainability, and renewability. However, the production of LA from lignocellulose faces at least two major technical obstacles. The inhibitors derived from pretreatment of lignocellulose inhibit the growth of microorganism used in downstream hydrolysis and fermentation processes. In addition, most LA producers cannot to ferment pentose sugars and have carbon catabolite repression (CCR) effect. Microbial consortium with great robustness can use complex feedstocks displaying high bioconversion efficiency and has received great attention nowadays.Results: in this study, a thermophilic LA producing consortium DUT50 was enriched and employed to enhance the utilization of corn stover (CS). Enterococcus was the dominant family, accounting for 93.66% abundance in DUT50, and the abundance of Lactobacillus, Bacillus, Lactococcus and Trichococcus, accounted for 2.68% in total. This consortium was highly resistant to inhibitors up to 10.90 g/L derived from pretreatment of CS, metabolized hexose and pentose simultaneously without CCR effect. Based on consortium promising features, an efficient process of simultaneous saccharification and co-fermentation (SSCF) was developed to produce LA from acid-pretreated corn stover. The economical route avoided the operations of solid–liquid separation and detoxification. The key influential factors, including dry biomass and cellulase loading, corn steep liquor powder concentration, and the pre-hydrolysis time were investigated and optimized. The highest LA titer of 71.04 g/L with a yield of 0.49 g/g-CS was achieved at a dry biomass loading of 20% (w/v). This is the reported highest LA production from non-detoxified acid-pretreated corn stover via the SSCF process without wastewater generation. The interaction mode of Enterococcus was collaboration while the low abundance of Lactobacillus and Bacillus might metabolize xylose efficiently via the pentose phosphate pathway.Conclusions: Our results demonstrated the potential advantage of symbiosis and provided a feasible and economical route to produce LA from lignocellulosic biomass in industrial scale.
Antibacterial and Anti-Virulence Effects of Furazolidone on Trueperella Pyogenes and Pseudomonas Aeruginosa
Authors: Chen Qin , Zhao Kelei , Li Heyue , Liu Kanghua , Li Jing , Chu Yiwen , Prithiviraj Balakrishnan , Yue Bisong , Zhang Xiuyue
Published: August 2021

Background: Trueperella pyogenes and Pseudomonas aeruginosa are two important bacterial pathogens closely relating to the occurrence and development of forest musk deer respiratory purulent disease. Although T. pyogenes is the causative agent of the disease, the subsequently invaded P. aeruginosa will predominate the infection by producing a substantial amount of quorum-sensing (QS)-controlled virulence factors, and co-infection of them usually creates serious difficulties for veterinary treatment. In order to find a potential drug that targets both T. pyogenes and P. aeruginosa, the antibacterial and anti-virulence capacities of 55 compounds, which have similar core structure to the signal molecules of P. aeruginosa QS system, were tested in this study. By performing a series of in vitro screening experiments to assess the effects of these compounds.Results: We identified that furazolidone could significantly inhibit the growth of mono-cultured T. pyogenes or in the co-culture with P. aeruginosa. Although the growth of P. aeruginosa could also be moderately inhibited by furazolidone, the results of phenotypic identification and transcriptomic analysis further revealed that furazolidone had remarkable inhibitory effect on the biofilm production, motility, and QS system of P. aeruginosa. Moreover, furazolidone could efficiently protect Caenorhabditis elegans from P. aeruginosa infection under both fast-killing and slow-killing conditions.Conclusions: This study reports the antibacterial and anti-virulence abilities of furazolidone on T. pyogenes and P. aeruginosa, and provides a promising strategy and molecular basis for the development of novel anti-infectious drugs to dealing with forest musk deer purulent disease, or other diseases caused by T. pyogenes and P. aeruginosa co-infection.
Parameter Adaptive Sliding Mode Trajectory Tracking Strategy With Initial Value Identification For Swing In A Hydraulic Construction Robot
Authors: hou Jingwei , Zhao Dingxuan , Zhang Zhuxin
Published: August 2021

A novel trajectory tracking strategy is developed for the swing DOF with double actuated cylinder in a hydraulic construct robot. When the work object is grabbed and unload, the inertia parameter of swing varies greatly and the estimation algorithm is commonly insufficient. Aiming at this feature, a novel nonlinear hydraulic dynamics model is established for the double actuated hydraulic cylinder in the system and a robust adaptive control strategy with parameter adaptive estimation is designed to improve the trajectory tracking performance. Aiming at the problem of insufficient convergence speed of the identification algorithm, a method of robotic gravity identification combined with stereo vision information is proposed to obtain the mass and moment of inertia parameters of the working object so that the initial value is close to the real value. Simulations and experiments are presented to validate the effect of the novel strategy.
Construction of a Competing Endogenous RNA Network and Identification of Potential Regulatory Axes in Gastric Cancer Chemoresistance
Authors: Yang Xian-Zi , Ma Lei , Fang Shu-Xian , Song Ye , Zhu Si-Yu , Jin Chuan , Liu Wei , Lu Qin , Zeng Li-Si , Cui Shu-Zhong
Published: August 2021

Background: The development of chemoresistance is one of the leading causes of chemotherapy failure in gastric cancer (GC). Emerging evidence highlights the multifunctional role of noncoding RNAs (ncRNAs) in GC chemoresistance. However, the comprehensive expression profile and competing endogenous RNAs (ceRNAs) regulatory network between ncRNAs and mRNAs in GC chemoresistance remain unanswered.Methods: GC cell line MGC-803 was employed to create cisplatin-resistant MGC-803/DDP cells by continuous exposure to increasing doses of cisplatin. The whole-transcriptome sequencing (RNA sequencing) was performed to comprehensively analyze the differentially expressed (DE) lncRNAs, miRNAs and mRNAs in MGC-803/DDP and MGC-803 cells. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were conducted to investigate the biological functions implicated with the DEncRNAs. Then, the cisplatin-resistant-related ceRNA network and potential regulatory axes were constructed by bioinformatic analysis.Results: We successfully generated cisplatin-resistant GC cell line MGC-803/DDP. Differential expression analysis showed that a total of 1,936 DElncRNAs, 2,194 DEmRNAs and 174 DEmiRNAs were identified. Functional enrichment analysis indicated that those DEncRNAs were mainly involved in neuroactive ligand-receptor interaction, drug metabolism, Hippo signaling pathway, cAMP pathway and P53 pathway. Subsequently, the cisplatin-resistant-related ceRNA network consisting of 71 DElncRNAs, 121 DEmRNAs and 8 DEmiRNAs was constructed with the widely accepted vital chemo-resistant-related genes and signaling pathways. In addition, two constructed regulatory axes (include FAM66C/miR-129-5p/7 mRNAs and SFTA1P/miR-206/FN1 or NRP1) were successfully validated by the Genomic Data Commons (GDC) GC data.Conclusion: Our study has shown that differentially expressed ncRNAs have complex and intricate interactions in the cisplatin resistance of GC. The novel ceRNA network and the potential regulatory axes may provide the most comprehensive view of GC chemoresistance to date. Our findings uncovered potential biomarkers for prognostic prediction and novel therapeutic targets for reversing cisplatin resistance in GC.
Accuracy of the Community Maternal Danger Score Algorithm for Predicting Pregnant Women Requiring Skilled Birth Attendants and at High-risk for Mortality
Authors: Bola Rajan , Ujoh Fanan , Ukah Ugochinyere Vivian , Lett Ronald
Published: August 2021

BackgroundHigh rates of maternal mortality in low-and-middle-income countries (LMICs) are associated with the lack of skilled birth attendants (SBAs) at delivery. Risk analysis tools may be useful to identify pregnant women who are at risk of mortality in LMICs. We sought to develop a low-cost maternal risk tool, the Community Maternal Danger Score (CMDS), to identify pregnant women who need an SBA at delivery.MethodsTo design the CMDS algorithm, an initial literature review was conducted to identify predictors of the need for an SBA. Medical records of women who delivered at the Federal Medical Centre in Makurdi, Nigeria (2019-2020) were examined for predictors identified from the literature review. Outcomes associated with the need for an SBA were recorded: caesarean section, postpartum hemorrhage, eclampsia, and sepsis. A maternal mortality ratio (MMR) was determined. Multivariate logistic regression analysis and area under the receiver operating curve (AUC) were used to assess the predictive ability of the CMDS algorithm.ResultsSeven factors from the literature predicted the need for an SBA: age (under 20 years of age or 35 and older), parity (nulliparity or grand-multiparity), BMI (underweight or overweight), fetal size (less than 35cm or 40cm and over), adverse obstetrical history, signs of pre-eclampsia, and co-existing medical conditions. These factors were recorded in 589 women of whom 67% required an SBA (n=396) and 1% died (n=7). The MMR was 1,189 per 100,000 (95%CI: 478-2,449). Signs of pre-eclampsia, obstetrical history, and co-existing conditions were highly associated with the need for an SBA. Age was found to interact with parity, suggesting that the CMDS requires adjustment for younger multigravida and older primigravida women. The CMDS algorithm had an AUC of 0.73 (95%CI: 0.69-0.77) for predicting whether women required an SBA, and an AUC of 0.85 (95%CI: 0.67-1.00) for in-hospital mortality.ConclusionsThe CMDS is a low-cost, evidence-based tool that uses 7 risk factors assessed on 589 women from Makurdi. Non-specialist health workers can use the CMDS to standardize patient assessment and encourage pregnant women to seek an SBA in preparation for delivery, thus improving care in countries with high rates of maternal mortality.
Sex Differences in the Nonlinear Association Between BMI and LDL Cholesterol in Middle-Aged and Older Adults: Results from two Nationally Representative Surveys of China
Authors: Li Haibin , Ma Jiahui , Zheng Deqiang , Li Xia , Guo Xiuhua , Wang Jing , Su Pixiong
Published: August 2021

Background: The association between body mass index (BMI) and low-density lipoprotein cholesterol (LDL-C) in middle-aged and older man and women was understudied. We aimed to explore whether there were sex differences in this relationship in a large sample of Chinese adults.Methods: Participants in the China Health and Retirement Longitudinal Study (CHARLS, 2011-2012) (n=7485) and the China Health and Nutrition Survey (CHNS, 2009) (n=4788) were cross-sectionally investigated. Generalized additive models with a smooth function for BMI and a smooth-factor interaction for BMI with sex were performed and stratified by age and metabolic syndrome. Segment linear splines regressions were fitted to calculate the slopes with the different breakpoints.Results: Among the 12273 participants aged 45 to 75 years, 5780 (47.1%) were males. The nonlinear relationship between BMI and LDL-C was observed in females and males (P interaction <0.001). The slopes of the BMI and LDL-C association changed (P <0.001) at BMI 22.5 kg/m2 in females and 27.5 kg/m2 in males. Below these BMI breakpoints, LDL-C increased 2.14 (95% CI: 1.42 to 2.86) and 1.77 (95% CI: 1.43 to 2.11) mg/dL per kg/m2, respectively. In females, there was a plateau at BMI values of 22.5-27.5 kg/m2, and then gradually increased after a BMI of 27.5 kg/m2. However, LDL-C declined -1.84 (95% CI: -3.01 to -0.66) mg/dL per kg/m2 above BMI of 27.5 kg/m2 in males. The pattern of sex and BMI-LDL-C association was similar in all age groups but modified by the number of metabolic syndrome criteria.Conclusions: The BMI and LDL-C relationship was inverted U-shaped in males and approximately linear in females.
Combined Effects of Dyslipidemia and Obesity Parameters on The Estimated Glomerular Filtration Rate in a Middle-Aged Population
Authors: Wang Xichang , Wang Haoyu , Gao Xiaotong , Han Yutong , Teng Weiping , Shan Zhongyan , Lai Yaxin
Published: August 2021

BackgroundSome studies have reported that chronic kidney disease (CKD) or the estimated glomerular filtration rate (eGFR) is significantly associated with metabolic-related parameters, such as dyslipidemia and obesity. However, whether eGFR will change under the superposition of multiple specific metabolic indicators remains unclear.MethodsSix hundred forty-six community residents aged 45–60 years without overt renal dysfunction were recruited in this cross-sectional study. eGFR was calculated by measuring serum creatinine. The visceral fat area (VFA) and subcutaneous fat area (SFA) were assessed by magnetic resonance imaging (MRI). The body mass index (BMI) and waist-hip ratio (WHR) were also evaluated. Additionally, we tested the subjects' blood lipid levels to diagnose dyslipidemia.ResultsCompared with the subjects with neither dyslipidemia nor obesity, men with both dyslipidemia and high obesity indices, such as BMI, WHR and VFA, showed a significantly lower mean eGFR; women with dyslipidemia with high WHR, VFA or SFA also showed a significantly lower mean eGFR. With the superposition of dyslipidemia and obesity indices such as BMI and SFA, the eGFR level showed a significant decreasing trend in men; the eGFR level also showed a significant decreasing trend in women but with the superposition of dyslipidemia plus WHR or SFA. Although an independent association between metabolic variables and eGFR was not found except for BMI, some of the combined effects of each variable were related to eGFR decline. Double positivity for dyslipidemia and high obesity indices such as BMI and VFA were significant independent risk factors for eGFR reduction in men. Additionally, double positivity for dyslipidemia and high WHR were significant independent risk factors for eGFR reduction overall.ConclusionsThe combined effect of dyslipidemia and high obesity indices is significantly related to the decline in eGFR. The association is more profound in men.
Pain control according to the periprostatic nerve block site in magnetic resonance imaging/transrectal targeted prostate biopsy
Authors: Yoo Jeong Woo , Koo Kyo Chul , Chung Byung Ha , Lee Kwang Suk
Published: August 2021

INTRODUCTIONWe analyzed the intensity of pain at each site of systemic prostate biopsy (SBx) and compared the intensity of pain among magnetic resonance (MRI)-targeted transrectal biopsies according to the periprostatic nerve block (PNB) site.METHODSWe collected data from 229 consecutive patients who had undergone MRI-targeted biopsy. Patients were stratified into two groups according to the site of PNB (base versus base and apex PNB). Pain was quantified at the following time points: probe insertion, injection at the prostate base, injection at the prostate apex, MRI cognitive biopsy (CBx), MRI/transrectal ultrasound fusion biopsy (FBx), SBx, and 15 minutes after biopsy.RESULTSFor all biopsy methods, the average pain were significantly higher in the base PNB group than in the base and apex PNB group (CBx, p < 0.001; FBx, p = 0.015; SBx, p < 0.001). In the base and apex PNB group, FBx was significantly more painful than SBx (p = 0.024). Overall, regardless of the PNB site, pain at the anterior sites was more than that at the posterior sites in FBx (p = 0.039).CONCLUSIONSBase and apex PNB provided better overall pain control than base-only PNB in all biopsy methods. In the base and apex PNB group, FBx was more painful than CBx and SBx.
The Acute Toxicity of Thulium to Hyalella Azteca and the Influence of Toxicity Modifying Factors.
Authors: Loveridge Alexandria , Smith D. Scott , McGeer Jim C.
Published: August 2021

The demand for rare earth elements (REEs) is growing and as a result, environmental exposure is a concern. The objective of this research was to evaluate the acute toxicity of Tm to Hyalella azteca and to understand the potential for toxicity modification by dissolved organic matter (DOM) and the cations Ca2+, Mg2+ and Na+. Standard methods were followed for 96 h static exposures in a medium with a hardness of 60 mg CaCO3/L, pH of 7.3 at 23°C. H azteca neonates (2-9 d of age) were used and in unmodified media the LC50 concentration was 3.4 µM (95% CI 2.9-3.9 µM; 573 µg/L (482-663)) based on measured dissolved concentrations at the end of the test. Tests done with different concentrations of Ca (0.25, 0.5 and 1.5 mM) did not show consistent trends and there was no clear evidence of a protective effect from Ca. Variations in Na (0.26, 0.5 and 1.6 mM) resulted in no significant changes in toxicity. Similarly, Mg (0.07, 0.14 and 0.4 mM) did not result in significant changes in LC50 values, except for a reduction in toxicity for measured total Tm at the lowest Mg concentration. Our results indicate that Tm toxicity is not influence by cationic competition (Ca, Na and Mg). Dissolved organic matter (sourced from Luther Marsh ON) offered significant protection against Tm toxicity. Additions over 3 mg DOC/L resulted in significantly increased LC50 values. This study contributes toward understanding the toxicity of Tm and the importance of considering dissolved organic matter in estimating the potential for environmental risk of REEs.
Mating-Type and Sexual Differentiation of Phytophthora Colocasiae in Japan
Authors: Feng Wenzhuo , Hieno Ayaka , Otsubo Kayoko , Suga Haruhisa , Kageyama Koji
Published: August 2021

In Japan, Phytophthora colocasiae causes the leaf blight of taro, which has resulted in huge losses since 2015. To investigate the causes of disease persistence and expansion, it is important to clarify the basic properties of this pathogen. We collected in total 317 P. colocasiae isolates from 99 fields in 7 prefectures during 2014 to 2020. The mating-type of each isolate was examined, and two or more isolates which were collected in single fields or taro leaves were selected to analyze the mating-type complexity. We found five kinds of mating types were identified: heterothallic A1 and A2, self-fertile (SF) A1, A2 and A1/A2 types, and a complex and diverse distribution of mating-types was present in one field or leaf. In addition, the stability of each mating-type was analyzed by single hyphae, zoospore and zoosporangium. The results suggested that the SF isolates were shown to be genetically unstable, while heterothallic isolates had a stable property. In the pathogenicity test of different mating-type isolates, heterothallic A1 isolates were less pathogenic than heterothallic A2 and SF isolates. However, there was no relationship between the pathogenicity and the growth rate on culture medium.
Myocardial Perfusion Spect Findings In Postcovid Period
Authors: Araz Mine , Soydal Cigdem , Sütçü Gizem , Demir Burak , Özkan Elgin
Published: August 2021

Purpose: To investigate if i) the risk of ischemia on Myocardial Perfusion Scan (MPS) ii) number of coronary angiographies (CAG) performed iii) necessity for invasive (stent implantation or coronary artery by-pass grefting (CABG)) or medical treatment increased in patients infected with COVID-19.Methods:Patients who were referred to MPS between August 2020-April 2021 with a history of active symptomatic Covid-19 infection (confirmed by PCR positivity) in the last 6 months were involved in the study group. Age-and gender matched control group was composed of randomly chosen patients who attended for MPS between January 2019 – September 2019, before pandemic. Frequency of ischemia, CAG, invasive or medical treatments were compared between groups. Results:Ischemia was reported more frequently in the study group (p<0.001). In clinical evaluation, regardless of the MPS results, the necessity for invasive evaluation with CAG and treatment (either medical therapy or invasive interventions), was higher in the study group (p=0.006 and p=0.015). It was also true for patients with abnormal MPS results (p=0.008 and p=0.024) but not for the patients with ischemia (p=0.29 and p=0.06).Conclusion:There exists a significant increase in the frequency of ischemia on MPS, undergoing CAG, stent implantation or CABG and initiation of medical therapy in patients with a history of Covid-19 infection in the last 6 months. MPS is a reliable method in patients who present with cardiovascular symptoms in the late COVID period.
Improving the Production of 9,21-di​hydroxy-​20-​methyl-pregna-​4-​en-​3-​one from Phytosterols in Mycobacterium Neoaurum by Modifying Multiple Genes and Improving the Intracellular Environment
Authors: Yuan Chen-Yang , Ma Zhi-Guo , Zhang Jing-Xian , Liu Xiang-Cen , Du Gui-Lin , Sun Jun-Song , Shi Ji-Ping , Zhang Bao-Guo
Published: August 2021

BackgroundSteroid drugs are particularly important for disease prevention and clinical treatment. However, traditional chemical methods are rarely implemented during the whole synthetic process to generate steroid intermediates due to the intricate steroid structure. Novel steroid drug precursors and their ideal bacterial strains for industrial production have yet to be developed. Among these, 9-OH-4-HP is a potential steroid drug precursor for the synthesis of corticosteroids. In this study, a combined strategy of blocking Δ1-dehydrogenation and the C19 pathway as well as improving the intracellular environment was investigated to construct an effective 9-OH-4-HP-producing strain.ResultsA Δ1-dehydrogenation-deficient strain of wild-type Mycobacterium neoaurum DSM 44074 produces 9-OH-4-HP with a molar yield of 4.8%. hsd4A, encoding a β-hydroxyacyl-CoA dehydrogenase, and fadA5 encoding an acyl-COA thiolase, were separately knocked out to block the C19 pathway in the Δ1-dehydrogenation-deficient strain. The two engineered strains could accumulate 0.59 g L-1 and 0.47 g L-1 9-OH-4-HP from 1 g L-1 phytosterols. Furthermore, hsd4A and fadA5 were knocked out simultaneously in the Δ1-dehydrogenation-deficient strain. The 9-OH-4-HP production from the Hsd4A and FadA5 double-deficient strain was 11.9% higher than that of the Hsd4A -deficient strain and 40.4% higher than that of the strain with FadA5 deficiency, and its selectivity reached 94.9%. Subsequently, the catalase katE from Mycobacterium and an NADH oxidase, nox, from Bacillus subtilis were overexpressed to improve the intracellular environment. Ultimately, 9-OH-4-HP production reached 3.58 g L-1 from 5 g L-1 phytosterols, and the selectivity of 9-OH-4-HP improved to 97%.Conclusionhsd4A and fadA5 are key enzymes in the C19 pathway for phytosterol side chain degradation. Deletion of hsd4A and fadA5 could almost entirely block the C19 pathway. Improving the intracellular environment of Mycobacterium during phytosterol bioconversion could accelerate the conversion process and enhance the productivity of target sterol derivatives.
Optimizing Care Coordination to Address Social Determinants of Health Needs for Dual-Use Veterans
Authors: Sjoberg Heidi , Lui Wenhui , Rohs Carly , Ayele Roman , McCreight Marina , Mayberry Ashlea , Battaglia Catherine
Published: August 2021

BackgroundVeterans increasingly utilize both the Veteran’s Health Administration (VA) and non-VA hospitals (dual-users). Dual-users are at increased risk of fragmented care and adverse outcomes and often do not receive necessary follow-up care addressing social determinants of health (SDOH). We developed a Veteran-informed social worker-led Advanced Care Coordination (ACC) program to decrease fragmented care and provide longitudinal care coordination addressing SDOH for dual-users accessing non-VA emergency departments (EDs) in two communities. MethodsACC had four core components: 1) Notification from non-VA ED providers of Veterans’ ED visit; 2) ACC social worker completed a comprehensive assessment with the Veteran to identify SDOH needs; 3) Clinical intervention addressing SDOH up to 90 days post-ED discharge; and 4) Warm hand-off to Veteran’s VA primary care team. Data was documented in our program database.We performed propensity matching between a control group and ACC participants between 4/10/2018 – 4/1/2020 (N-=161). A joint survival model using Markov Chain Monte Carlo technique was employed for 30-day outcomes. We performed Difference-In-Difference analyses on number of ED visits, admissions, and primary care physician (PCP) visits 120-day pre/post discharge.ResultsWhen compared to a matched control group ACC had significantly lower risk of 30-day ED visits (Hazard Ratio (HR)=0.61, 95% Confidence Interval (CI)=(0.42, 0.92)) and a higher probability of PCP visits at 13-30 days post-ED visit (HR=1.5, 95% CI=(1.01, 2.22)). Veterans enrolled in ACC were connected to VA PCP visits (50%), VA benefits (19%), home health care (10%), mental health and substance use treatment (7%), transportation (7%), financial assistance (5%), and homeless resources (2%). ConclusionWe developed and implemented a program addressing dual-users’ SDOH needs post non-VA ED discharge. Social workers connected dual-users to needed follow-up care and resources which reduced fragmentation and adverse outcomes.
Histopathological, Radiological and Demographic Factors Predicting the Response to Neoadjuvant Therapy for Rectal Cancer
Authors: YILDIRIM Emine , Bektas Sibel , Pelen Zekeriya , Yanik Irem , Er Ahmet Muzaffer , Cengel Ferhat , Gumuskaya Perihan Ozkan
Published: August 2021

Background/aimWhile the treatment for early stage rectal cancer is surgery, when a diagnosis is made at a locally advanced stage, it is recommended to start treatment with neoadjuvant chemoradiotherapy. Therefore, it is important to determine which patients will respond best to neoadjuvant treatment. The aim of this study was to investigate which hematological, histopathological, and radiological parameters can predict the response to chemoradiotherapy. Methods and materialsA retrospective examination was made of 43 patients who underwent surgery following neoadjuvant chemoradiotherapy because of locally advanced stage rectal cancer. Demographic data were collected from the patient files, and the radiological, histopathological and laboratory findings before neoadjuvant chemoradiotherapy were compared with the findings after treatment. ResultsIn the postoperative evaluation, a pathological complete response was determined in 25.50% of the patients. Lymphovascular invasion, perineural invasion and absence of necrosisis were seen to be statistically related to major response (p<0.05), and in patients where the tumor was closer than 6cm to the anal verge, the response was betterConclusionWhen the findings were examined, histopathological lymphovascular invasion, perineural invasion, the presence of necrosis, and the anal verge distance were evaluated as parameters predicting the response to neoadjuvant chemoradiotherapy in rectal cancer.
The Possible use of Equivalent Homogeneous Subsoil Models for 1D Seismic Response Analyses in Seismic Microzonation Studies
Authors: Fabozzi Stefania , Dario Albarello , Alessandro Pagliaroli , Massimiliano Moscatelli
Published: August 2021

The possibility is here explored to use an ‘equivalent’ homogeneous configuration to simulate 1D seismic response of heterogeneous engineering-geological bodies when relatively weak seismic impedance contrasts (150 m/s) only exist above the seismic bedrock. This equivalent configuration is obtained by considering an equivalent Vs value the harmonic average of the actual Vs values and a linear combination of G/G 0 and D curves relative to the lithotechnical components present in the actual configuration. To evaluate feasibility of this approach, a wide set of numerical simulations was carried out by randomly generating subsoil layering including sequences of alternating thin layers of geotechnical units ( e.g., sands and clays) each characterized by a characteristic nonlinear curve. Outcomes of these simulations are compared with those provided by considering a single homogeneous layer characterized by equivalent nonlinear curves obtained as a weighted average of the original curves. By comparing the heterogeneous and the homogeneous columns seismic response in terms of amplification factors and fundamental period, the results confirm the possibility to model a 1D column characterized by a generic lithostratigraphic succession with an equivalent one without introducing significative errors that, at least for the studied cases, do not exceed the 6%. This conclusion is substantially confirmed by extending the comparison to a real case, i.e. the 113 m-thick heterogeneous soil profile at Mirandola site (Norther Italy), presented in the last part.
Smoking Is a Risk Factor for Pahcychoroid-related Disorders in Asian Patients: a Case Control Study
Authors: Kamao Hiroyuki , Araki Syunsuke , Goto Katsutoshi , Matsuno Kento , Mizukawa Kenichi , Miki Atsushi , Kiryu Junichi
Published: August 2021

BackgroundCigarette smoking has been reported as a risk factor for the development of neovascular age-related macular degeneration (nAMD). However, the associations between cigarette smoking and subtypes of drusen and nAMD were incomplete, as it lacked consideration of pachydrusen or no significant drusen. Therefore, this study intended to reveal the associations between cigarette smoking and subtypes of drusen and nAMD.PurposeTo evaluate the associations between cigarette smoking and subtypes of drusen and nAMD in an Asian population.MethodsThis retrospective case-control study included 189 eyes in 189 patients with treatment-naïve nAMD, including typical AMD, polypoidal choroidal vasculopathy (PCV), and type 3 neovascularization. The patients were stratified into never-, former-, and current-smoker groups, and drusen subtypes, including no significant drusen, soft drusen, subretinal drusenoid deposits (SDDs), and pachydrusen, were analyzed in each group.ResultsThe proportions of no significant drusen and pachydrusen in the fellow eyes were significantly higher in the former- and current-smoker groups (P = 0.016 and P < 0.001), respectively. There was a significantly higher proportion of PCV in the affected eyes in the current-smoker group (P = 0.041). The proportions of SDDs in the fellow eyes and type 3 neovascularization in the affected eyes were significantly higher in the never-smoker group (P < 0.001 and P = 0.037), respectively.ConclusionEver smokers (former and current smokers) had significantly higher proportions of pachychoroid-related disorders, including no significant drusen, pachydrusen, and PCV, than nonsmokers. Thus, cigarette smoking could be a risk factor for the development of pachychoroid-dependent abnormalities.
Protecting the Public Interest when Regulating Health Professionals Providing Virtual Care: A Scoping Review Protocol
Authors: Leslie Kathleen , Myles Sophia , Adams Tracey L , Schiller Catharine , Shelley Jacob , Nelson Sioban
Published: August 2021

Background: Virtual care is transforming the nature of healthcare, particularly with the accelerated shift to telehealth and virtual care during the COVID-19 pandemic. Health profession regulators face intense pressures to safely facilitate this type of healthcare while upholding their legislative mandate to protect the public. Challenges for health profession regulators have included providing practice guidance for virtual care, changing entry to practice requirements to include digital competencies, facilitating interjurisdictional virtual care through licensure and liability insurance requirements, and adapting disciplinary procedures. This scoping review will examine the literature on how the public interest is protected when regulating health professionals providing virtual care.Methods: This review will follow the Joanna Briggs Institute (JBI) scoping review methodology. Academic and grey literature will be retrieved from health sciences, social sciences, and legal databases using a comprehensive search strategy underpinned by Population-Concept-Context (PCC) inclusion criteria. Articles published in English since January 2015 will be considered for inclusion. Two reviewers will independently screen titles and abstracts and full-text sources against specific inclusion and exclusion criteria. Discrepancies will be resolved through discussion or by a third reviewer. One research team member will extract relevant data from the selected documents and a second will validate the extractions.Discussion: Results will be presented in a descriptive synthesis that highlights implications for regulatory policy and professional practice, as well as study limitations and knowledge gaps that warrant further research. Given the rapid expansion of virtual care provision by regulated health professionals in response to the COVID-19 pandemic, mapping the literature on how the public interest is protected in this rapidly evolving digital health sector may help inform future regulatory reform and innovation.Review registration: This protocol is registered with the Open Science Framework (10.17605/OSF.IO/BD2ZX).
Myasthenia Gravis Exacerbation and Myasthenic Crisis Associated With COVID19: Case Series and Literature Review.
Authors: Rodrigues Cleonisio Leite , Freitas Hermany Capistrano , Lima Paulo Reges Oliveira , Junior Pedro Helder de Oliveira , Fernandes José Marcelino Aragão , D'Almeida José Artur Costa , Nóbrega Paulo Ribeiro
Published: August 2021

Myasthenia Gravis (MG) is an autoimmune disorder of the neuromuscular junction that can be exacerbated by many viral infections, including COVID19. Management of MG exacerbations is challenging in this scenario. We report 8 cases of MG exacerbation or myasthenic crisis associated with COVID19 and discuss prognosis and treatment based on a literature review. Most patients were female (7/8), with an average age of 47.1 years. Treatment was immunoglobulin (IVIG) in 3 patients, plasma exchange (PLEX) in 2 patients, and adjustment of baseline drugs in 3. In-hospital mortality was 25% and 37.5% in 2-month follow-up. This is the largest case series of MG exacerbation or myasthenic crisis due to COVID19 to this date. Mortality was considerably higher than in myasthenic crisis of other etiologies. Previous treatment for MG or acute exacerbation treatment did not seem to interfere with prognosis, although sample size was too small to draw definitive conclusions. Further studies are needed to understand the safety and effectiveness of interventions in this setting, particularly of PLEX, IVIG, rituximab and tocilizumab.
Evolving trends in the surgical staging of endometrial cancer patients in Germany: Analysis of a nationwide registry with special emphasis on perioperative outcomes
Authors: Roth Katrin , Kaier Klaus , Stachon Peter , Mühlen Constantin von zur , Taran Florin-Andrei , Klar Maximilian , Juhasz-Böss Ingolf
Published: August 2021

Purpose

The present study compared the use and outcomes of open surgical staging, laparoscopic surgical staging and robotic-assisted surgical staging in all patients suffering from endometrial carcinoma undergoing surgery in Germany between 2007 and 2018.
Methods

All patients with the diagnosis of endometrial carcinoma undergoing open surgical staging, laparoscopic surgical staging and robotic-assisted surgical staging were identified by international classification of diseases (ICD) or specific operational codes (OPS) within the database of the German federal bureau of statistics.
Results

Between 2007 and 2018, a total of 85,204 patients underwent surgery for endometrial carcinoma. Since 2013 laparoscopy was the leading approach in the surgical staging. The use of robotic-assisted laparoscopy increased steadily since 2011 with a share of 3% in 2018. Open surgical staging was associated with a higher risk of in-hospital mortality than laparoscopic surgical staging (1.3% vs. 0.2%, p < 0.001), of prolonged mechanical ventilation (1.3% vs. 0.2%, p < 0.001), and of prolonged hospital stay (13.7 ± 10.2 vs. 7.2 ± 5.3, p < 0.001). 0.04% patients undergoing laparoscopy were converted to laparotomy. The perioperative outcomes of surgical staging by laparotomy compared with robotic-assisted were comparable. None of the robotic-assisted treated patients died or was converted into laparotomy. Costs were highest in the open laparotomy staging group, followed by robotic assisted. Conventional laparoscopic approach caused lowest costs (8286 ± 7533€ vs. 7083 ± 3893€ vs. 6047 ± 3509€).
Conclusion

The present analysis shows that conventional laparoscopy is the standard therapy of endometrial carcinoma with excellent in-hospital outcomes in clinical practice. Robotic-assisted laparoscopy is an emerging technology with convincing results similar to
Challenges in Preventive Practices and Risk Communication Towards COVID-19: A Cross-sectional Study in Bangladesh
Authors: Rahman Farah Naz , Bhuiyan MD Al Amin , Hossen Kabir , Khan Hafiz T.A , Rahman AKM Fazlur , Dalal Koustuv
Published: August 2021

BACKGROUND
Bangladesh recently experienced a COVID-19 second wave, resulting in the highest number of new cases and deaths in a single day. This study aims to identify the challenges for COVID-19 preventive practices and risk communications and associated factors among Bangladeshi adults.
METHODS
A cross-sectional survey was conducted between December 2020 and January 2021 involving 1,382 Bangladeshi adults (aged ≥ 18-years) in randomly selected urban and rural areas from all eight divisions in Bangladesh. Descriptive data analysis was conducted to highlight the challenges for preventive practices and risk communications for COVID-19. Multiple logistic regression analysis was used to determine the sociodemographic groups vulnerable to these challenges.
RESULTS
Lack of availability of protective equipment (44.4%), crowded living situations/workspaces (36.8%), inadequate information on the proper use of protective measures (21.9%), inadequate hand washing and sanitation facilities (17.6%), and negative influences of family/friends (17.4%) were identified as barriers to COVID-19 preventive practices. It was also found that males (OR = 1.3, 95% CI = 1.01,1.7), rural residents (OR = 1.5, 95% CI = 1.2,2), respondents with a low level of education: No schooling vs ≥ higher secondary (OR = 3.5, 95% CI = 2.3,5.2), Primary vs ≥ higher secondary (OR = 2.5, 95%CI = 1.7,3.8), respondents engaged in agricultural (OR = 1.7, 95%CI = 1.2,2.4), laboring (OR = 3.2, 95% CI = 2,5), and domestic (OR = 1.6, 95% CI = 1.07,2.5) works, and people with disabilities (OR = 1.7, 95% CI = 1.1,2.6) were all likely to have difficulty in practicing effective COVID-19 protective behaviors. Respondents’ education and occupation were significant predictors of inadequate understanding of COVID-19 risk communications and was identified as a problem among 17.4% of the respondents.
CONCLUSION
A substantial percentage of Bangladeshi adults have difficulty practicing COVID-19 protective behaviors and have poor comprehension of risk communications, that is particularly prevalent in rural areas and among those with low education. This research can aid policymakers in developing tailored COVID-19 risk communications and mitigation strategies to help prevent future waves of the pandemic.
Cavity and replica methods for the spectral density of sparse symmetric random matrices
Authors: Susca Vito A. R. , Vivo Pierpaulo , Kühn Reimer
Published: August 2021

We review the problem of how to compute the spectral density of sparse symmetric random matrices, i.e. weighted adjacency matrices of undirected graphs. Starting from the Edwards-Jones formula, we illustrate the milestones of this line of research, including the pioneering work of Bray and Rodgers using replicas. We focus first on the cavity method, showing that it quickly provides the correct recursion equations both for single instances and at the ensemble level. We also describe an alternative replica solution that proves to be equivalent to the cavity method. Both the cavity and the replica derivations allow us to obtain the spectral density via the solution of an integral equation for an auxiliary probability density function. We show that this equation can be solved using a stochastic population dynamics algorithm, and we provide its implementation. In this formalism, the spectral density is naturally written in terms of a superposition of local contributions from nodes of given degree, whose role is thoroughly elucidated. This paper does not contain original material, but rather gives a pedagogical overview of the topic. It is indeed addressed to students and researchers who consider entering the field. Both the theoretical tools and the numerical algorithms are discussed in detail, highlighting conceptual subtleties and practical aspects.