bluuebunny/crossref_metadata_2025 huggingface dataset:
Quantitative determination of energy potential of refuse derived fuel from the waste recovered from Indian landfill
Authors: Cheela V R Sankar , John Michele , Dubey Brajesh
Published: August 2020

Landfills are urban stocks and resource reservoirs for potential energy recovery. The purpose of this study is to evaluate the amount of energy that could be recovered from aged waste (around 5 - 20 years old) recovered from landfills. Investigations were conducted on the physical and chemical properties of refuse-derived fuel (RDF) prepared from recovered landfill waste (RLW) in Andhra Pradesh, India. Waste characterization studies included determination of waste composition, proximity analysis, ultimate analysis, and energy content. The moisture content ranged between 25.70 to 31.30%, however, no trend was observed with age. In the ultimate analysis, the percentage of carbon increased from 42.94% to 71. 66% with the age of the samples, this is due to an increase in the plastic content over time. The calorific value of the recovered landfill waste ranged from 10.35 MJ/kg to 21.83 MJ/kg. From the findings, it can be summarized that the RDF can potentially be utilized as a feedstock for the recovery of energy from RLW. The results from this study will assist policy makers and local authorities in designing and developing strategies for resource and energy recovery from landfills in different urban cites across the globe.
Virulent Secondary Metabolites of Entomopathogenic Bacteria, Xenorhabdus and Photorhabdus, Inhibit PLA2 to Suppress Host Insect Immunity
Authors: Mollah Md. Mahi Imam , Kim Yonggyun
Published: August 2020

Background: Xenorhabdus and Photorhabdus are entomopathogenic bacteria that cause septicemia and toxemia in insects. They produce secondary metabolites to induce host immunosuppression. Their metabolite compositions vary among bacterial species. Little is known about the relationship between metabolite compositions and the bacterial pathogenicity. The objective of this study was to compare pathogenicity and production of secondary metabolites of 14 bacterial isolates of Xenorhabdus and Photorhabdus. Results: All bacterial isolates exhibited insecticidal activities after hemocoelic injection to Spodoptera exigua (a lepidopteran insect) larvae, with median lethal doses ranging from 168.8 to 641.3 CFU per larva. Bacterial infection also led to immunosuppression by inhibiting eicosanoid biosynthesis. Bacterial culture broth was fractionated into four different organic extracts. All four organic extracts of each bacterial species exhibited insecticidal activities and resulted in immunosuppression. These organic extracts were subjected to GC-MS analysis which predicted 182 compounds, showing differential compositions for 14 bacteria isolates. There were positive correlations between total number of secondary metabolites produced by each bacterial culture broth and its bacterial pathogenicity based on immunosuppression and insecticidal activity. From these correlation results, 70 virulent compounds were selected from secondary metabolites of high virulent bacterial isolates by deducting those of low virulent bacterial isolates. These selected virulent compounds exhibited significant immunosuppressive activities by inhibiting eicosanoid biosynthesis. They also exhibited relatively high insecticidal activities. Conclusion: Virulence variation between Xenorhabdus and Photorhabdus is determined by their different compositions of secondary metabolites, of which PLA2 inhibitors play a crucial role.
Analysis of Sinmap in Landslide Susceptibility Mapping of Coonoor Watershed, Nilgiris, India
Authors: Saravanan Subbarayan , Jesudasan Jacinth Jennifer , Singh Leelambar , Devanantham Abijith
Published: August 2020

Landslide susceptibility mapping is crucial for risk management in mountainous Nilgiris district, Tamil Nadu, India. In this study, the spatially distributed Stability INdex MAPping (SINMAP) model was used to develop a landslide susceptibility model for Coonoor watershed, which is based on a steady-state hydrologic model coupled with an infinite-slope stability equation. Shuttle Radar Topography Mission (SRTM) digital elevation model was utilized to compute the slope and other topographic parameters. In-situ data collection and laboratory tests were executed to estimate the hydro-geotechnical parameters. A detailed field study was conducted, and 35 samples were taken from the landslide locations to perform laboratory tests to find the geotechnical parameters. Also, an inventory landslide map was generated to evaluate the model performance. Statistical results of SINMAP show that, under the fully saturated condition, 58.96% of the region was found to be stable, 16.79% moderately stable, 8.72% quasi-stable and 15.24% unstable. The Area under the Curve (AUC) value of the predicted result is 72.3% which infer that the underlying predictors perform good in classifying the outcome. Thus, the considered parameters in the model have played its part well in the classification of the region based on its stability.
Salivary Melatonin in Oral Squamous Cell Carcinoma Patients: A Cross-sectional Study
Authors: Salaric Ivan , Karmelic Ivana , Lovric Jasna , Bazdaric Ksenija , Rozman Marko , Cvrljevic Igor , Zajc Ivan , Brajdic Davor , Macan Darko
Published: August 2020

BACKGROUND: Around 55% of oral squamous cell carcinoma (OSCC) patients are diagnosed in the advanced stage. Poor sleep quality has been associated as a potential risk factor for several malignancies, including head and neck cancers. Melatonin’s role in circadian rhythm is well documented, as are its’ anti-oxidant, oncostatic and anti-inflammatory properties. The purpose of this study is to determine salivary melatonin (MLT) levels in OSCC patients, compare the salivary MLT levels with those in healthy individuals and compare the salivary and serum levels in OSCC patients. Furthermore, the aim is to evaluate sleep quality and to investigate the potential relationship between sleep quality and salivary MLT levels in OSCC patients. METHODS: Unstimulated and stimulated saliva were sampled from patients with T1N0M0 and T2N0M0 OSCC (N=34) and 33 sex and age matched healthy subjects. Serum samples were taken from 11 OSCC patients. Detailed medical history was taken before sampling and sleep quality measured using Pittsburgh Sleep Quality Index (PSQI) questionnaire. RESULTS: Melatonin levels in UWS and SWS were significantly higher in the OSCC group. Sleep quality was significantly lower in patients with OSCC (U=249.50; P = 0.0001). ROC analysis was found to be significant (P <0.001) in evaluating the MLT concentration limit in diagnosing OSCC. CONCLUSIONS: The expected relationship between sleep quality and salivary MLT levels in OSCC patients was not observed. Salivary melatonin could present a potential OSCC biomarker. However, larger prospective studies should validate the clinical utility of MLT as an OSCC biomarker.
Discontinuation and Switching of Postpartum Contraceptive Methods Over Twelve Months in Burkina Faso and the DRC: A Secondary Analysis of the Yam-Daabo trial
Authors: Coulibaly Abou , Millogo Tieba , Baguiya Adama , Tran Nguyen Toan , Yodi Rachel , Seuc Armando , Cuzin-Kihl Asa , Thieba Blandine , Landoulsi Sihem , Kiarie James , Mashinda Désiré , Kouanda Seni
Published: August 2020

Introduction: Women who use contraceptive methods sometimes stop early, use methods intermittently or switched contraceptive methods. All these events (discontinuations and switching) contribute to the occurrence of unwanted and close pregnancies. This study aimed to explore contraceptive discontinuation and switching during the Yam-Daabo project to measure the effect of interventions on the continuation of contraceptive methods use.Methods: We conducted a secondary analysis of the Yam-Daabo trial data. We choose the discontinuation and switching of a modern contraceptive method as outcome measures. We performed a survival analysis by using the Stata software package to estimate the effect of the interventions on contraceptive discontinuation. We also studied the main reasons for discontinuation and switching.Results: In total, 637 out of the 1,120 women used at least one contraceptive method (of any type), with 267 women in the control and 370 in the intervention group. Modern methods were used by 179 women of control group compared to 279 women of intervention group with 24 and 32 who discontinued, respectively. We observed no statistically significant association between interventions and modern methods discontinuation and switching. However, the discontinuation of modern methods was higher in pills and injectables users than implants and IUDs users. The pooled data comparison showed that, in reference to the women who had not switched while using a modern method, the likelihood of switching to a less or equal effectiveness method among the women of the control group was 3.8(95% CI: 1.8-8.0) times the likelihood of switching to a less or equal effectiveness method among the women of the intervention group. And this excess was statistically significant (p<0.001). The main reason for discontinuation and switching was method-related (141 over 199), followed by partner opposition with 20 women.Conclusion: The results of this study show no statistically significant association between interventions and modern methods discontinuation. Discontinuation is more related to the methods themselves than to any other factor. It is also important to set up specific actions targeting women's partners and influential people in the community to counter inhibiting beliefs.Trial registration: Pan African Clinical Trials Registry (PACTR201609001784334, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=1784).
Development and Validation of a Gene-panel-based Nomogram for Prediction of Lymph Node Metastasis in Esophageal Squamous Cell Carcinoma
Authors: Wu Xuejie , Chen Donglai , Wang Wenjia , Ye Fei , Sang Yonghua , Chen Yongbing , Yang Wentao
Published: August 2020

Background: Esophageal squamous cell carcinoma (ESCC) is one of the main histological subtypes of esophageal cancer. This study aimed to develop a gene-panel-based nomogram for identification of lymph node metastasis (LNM) in ESCC patients.Methods: RNA sequencing profiles of ESCC patients were obtained from the Gene Expression Omnibus (GEO) database and The Cancer Genome Atlas (TCGA) database. A bioinformatic approach was employed to investigate differentially expressed genes (DEGs) between ESCC patients with LNM and those without. A 4-DEGs panel was eventually identified and integrated with clinical characteristics to construct a nomogram for predicting LNM. Predictive performance of the nomogram was further evaluated by calibration curves and concordance index (C-index). Results: A total of 179 ESCC patients with 32059 genes from the GEO dataset were included. Among these genes, 3524 DEGs were correlated with lymph node involvement. Meanwhile, TCGA dataset containing 93 ESCC patients was obtained, in which 82 DEGs were selected out of 18416 genes. Among the 11 communal DEGs, four genes were identified to be (ALG3, CPOX, LMLN, PSMD2) associated with LNM. A nomogram was established by integrating the four-gene panel and three clinical characteristics including T stage, G stage and tumor location. The nomogram exhibited good performance with C-indices of 0.710 and 0.693 in the GEO and TCGA datasets, respectively. Conclusion: Our novel 4-gene-based nomogram displayed its value in prediction of LNM in ESCC patients, which may be helpful in determining treatment approach for early-stage ESCC patients.
Exploring Adaptations and Successful Implementation of Traditional Healers as Adherence Partners for People Living with HIV in Rural Mozambique: A Qualitative Assessment
Authors: Audet Carolyn M , Pettapiece-Phillips Mariah , Salato Jose
Published: August 2020

Background: Implementing evidence-based interventions to improve adherence to antiretroviral therapy (ART) is essential to controlling the HIV epidemic in sub-Saharan Africa. Evidence-based community health worker interventions address barriers to medication retention by shifting the task from overburdened health facilities and emphasizing a more patient-centered approach in a comfortable location. Methods: We employed traditional healers to implement an evidence-based community health worker program for people living with HIV (PLHIV) in rural Mozambique. Participants received support services for 2 months after their first positive test. Healers were trained to provide counseling, HIV education, support with disclosure, and advocacy at the health unit. We interviewed 23 PLHIV and conducted focus groups with 19 traditional healers to explore implementation fidelity and identify unplanned adaptations made during the program. Results: Healers and PLHIV report counseling, HIV education sessions, and support with disclosure were largely delivered with fidelity. Due to the extreme poverty in the region, healers reported the need to add additional messages to support people who needed to take medication but had no food to mitigate the side effects. Patient advocacy at the health center proved difficult to implement. Negative attitudes towards PLHIV and traditional healers led to participants reporting extremely poor treatment by health care providers; the lack of respect made it difficult for healers to assist PLHIV with issues like long wait times, lost patient identification cards, or enduring medication side effects. Healers adopted directly observed therapy as an unplanned strategy to support non-adherent PLHIV.Conclusion: Given low levels of literacy and substantially different views on disease causation, healers delivered most core components of the intervention with fidelity. Healers attempted to implement the patient advocacy component but resistance from health care providers proved challenging. Future efforts will need to develop more effective strategies to overcome negative healer-clinician dynamic. Clinical Trials Registry: Name of the registry: Traditional Healers as Adherence Partners for Persons Living with HIV in Rural Mozambique (PLHIV). Trial registration number: NCT03076359. Date of registration: 3/6/2017, retrospectively registered. URL of trial registry record: https://clinicaltrials.gov/ct2/show/NCT03076359?cond=Hiv&cntry=MZ&draw=2&rank=7
Application of Modified Green Algae Nannochloropsis sp. as Adsorbent in the Sequential Adsorption of Methylene Blue and Cu(II) Cations in Solution
Authors: Buhani  , Wijayanti Tri Agus , Suharso  , Sumadi
Published: August 2020

Biomass of algae is a very potent adsorbent for absorbing liquid waste containing heavy metals and organic dyes. This study purposes to confirm the ability of adsorbents from green algae Nannochloropsis sp. modified with silica (ASN) and followed by coating magnetite particles (ASN-MPs) to absorb simultaneously the mixture of methylene blue (ME) and Cu(II) cations in aqueous solution. Simultaneous sorption of ME and Cu(II) cations to ASN and ASN-MPs was carried out by the Batch method with the interaction pH condition 7, contact time (15–120 minutes), and initial concentrations of ME and Cu(II) cations (0.1–1.0 mmol·L− 1). The simultaneous sorption parameters of ME and Cu(II) cations by ASN-MPs trend to comply the pseudo-second-order kinetics model by rate constant values for pseudo-second-order (k2), respectively 8.98 × 10− 3 and 9.78 × 10− 3 (g·mmol− 1·min− 1). The ME adsorption pattern and Cu(II) cations in the competition on ASN-MPs adsorbents, each tends to follow the Freundlich and Langmuir adsorption isotherms. Based on adsorption data, Cu(II) cations have a greater adsorption rate and capacity (qexp) compared to ME at the same contact time and initial concentration. Modified adsorbent from algae Nannochloropsis sp. with silica matrix and magnetite particle coating, is an adsorbent that has a high effectiveness in the collective sorption of ME and Cu(II) cations. Therefore, these adsorbents can be used for the adsorption of cation mixtures of heavy metals and organic dyes that are cationic in solution.
Unmet Healthcare Needs of Elderly in Iran: A Case Study
Authors: Piroozi Bakhtiar , Abdullah Farman Zahir , Bolbanabad Amjad Mohamadi , Amerzadeh Mohammad , Rezaei Satar , Moradi Ghobad , Bidarpour Farzam , Afkhamzadeh Abdorrahim , Gholami Jamshid
Published: August 2020

Background: The aim of this study is to investigate the status of perceiving need, seeking behavior and utilization of health services in the elderly population of Sanandaj (west of Iran).Methods: This is a cross-sectional study conducted on 800 elderly people in Sanandaj. Subjects were selected using multistage sampling and data were collected using self-report questionnaires. A multivariate logistic model with odds ratios (ORs) was used to determine the relationship of independent variables with seeking perceived need. Also, Concentration Index was used to measure the inequality in using health services. Results: The perceived need for outpatient (during the last 30 days) and inpatient healthcare (during the last 12 months) were 69.7% and 29.7%, respectively. Among them unmet need for outpatients and inpatients healthcare was 46.6% and 17%, respectively. Having health insurance (adjusted OR 12.08; 95% confidence interval [CI] 1.04-140.11), middle economic status (adjusted OR 5.18; 95% CI 1.30-20.51), and age group between 65-70 years (adjusted OR 7.60; CI 1.42-40.61) increased the chances of seeking inpatient care and age group between 60-65(adjusted OR 0.41; 95% CI 0.18-0.95)reduced the chances of seeking outpatient care. There was also inequality in using outpatient health services, concentrated in the Rich population.Conclusion: The elderly population suffers from unmet healthcare needs, especially in outpatient services. The most important reason for not seeking outpatient services was financial barriers and for inpatient services was self-medication. So, designing targeted policies and interventions to address barriers in conversion of need to demand in the elderly population is essential.
Cross Sectional Survey of Pakistani Muslims Coping Health Anxiety through Religiosity during COVID-19 Pandemic
Authors: Mahmood Qaisar Khalid , Sohail Malik Muhammad , Akram Muhammad Babar
Published: August 2020

This study aims to investigate the role of religiosity in coping with health anxiety during the outbreak of COVID-19, a deadliest pandemic of century which is still affecting billions of lives globally. Using online survey method, the researchers collected the data from 408 Pakistani Muslim respondents. Health anxiety and religious coping were measured through seven items Likert scales. Psychometric analysis showed that both scales, health anxiety (Cronbach’s alpha ά=.87, composite reliability CR=.869) and religious coping (Cronbach’s alpha ά=.893, composite reliability CR=.888), showed good internal consistency. Path analysis, structural equational modeling performed, was performed. All the fit indices (GFI=.932, CFI=.954, TLI=.941, RMSEA=.073 & RMR=.035) were within acceptable limit. The regression results indicated that those who were suffering with health anxiety opted religious coping (β=.54, R2=.29, p<.001). These findings can be helpful for psychiatrists, physicians and researchers to understand psychological complications pertaining infectious diseases.
Construction of a Genetic Map by Resequencing and Specific Locus Amplified Fragment sequencing (SLAF-seq) for QTL fine mapping of plant height in upland cotton (Gossypium hirsutum L.)
Authors: Qiao Wenqing , Yan Gentu , Wang Ning , Huang Qun
Published: August 2020

Background: Gossypium hirsutum (upland cotton), the most widely cultivated cotton species in the world, is an important raw material for the textile industry. Using high-throughput sequencing to construct high-density genetic maps can be widely used in quantitative trait locus (QTL) mapping and molecular marker-assisted breeding.Results: In this study, an F2 population was used to construct a genetic map by parental resequencing and progeny SLAF-seq. The F2 population consisted of Gossypium hirsutum L. cultivars: CCRI 49 and 396289. The genetic map contained 4,607 single nucleotide polymorphisms markers, which overlapped a total length of 3,063.4 cM with an average genetic distance of 0.898 cM between adjacent markers. A high-density genetic map was used to map the QTLs of plant height in four environments. 16 QTLs were obtained, which could explain 2.07%–19.04% of the phenotypic variation. A total of 1,028 candidate genes were identified in the confidence interval and were categorized according to function through cluster of orthologous groups analysis, gene ntology analysis, and Kyoto Encyclopedia of Genes and Genomes analysis. Within the QTLs confidence interval, the D05 chromosome(ChrD05) was finely mapped using Mutmap-like strategy, and the reliability was validated by qRT-PCR of 18 candidate genes . Finally, we obtained 14 candidate genes that are most likely to be related to plant height.Conclusions: This study provides a successful application of parental sequencing and progeny SLAF-seq strategy in the genetic map of upland cotton in an F2 population. This study provides theoretical support for molecular marker-assisted breeding and plant height-heterosis in upland cotton and provides a fine mapping scheme for QTLs. In addition, the combination of multiple analytical methods also provided a solution for QTL fine mapping.
Design and Experimental Investigation of a Novel Spiral Microfluidic Chip to Separate Wide Size Range of Micro-Particles
Authors: Tabatabaei Seyed Ali , Zabetian Mohammad
Published: August 2020

Isolation of microparticles and biological cells on microfluidic chips has received considerable attention due to their applications in numerous areas such as medical and engineering fields. Microparticles separation are of great importance in bioassays owing to the need for a smaller sample and device size, and lower manufacturing costs. In this study, we first explain the concepts of separation and microfluidic science along with their applications in the medical sciences, and then, a conceptual design of a novel inertial microfluidic system is proposed and analyzed. The PDMS spiral microfluidic device was fabricated, and its effects on the separation of particles with sizes similar to biological particles were experimentally analyzed. This separation technique can be used in the process of separating cancer cells from the normal ones in the blood samples. These components required for testing were selected, assembled, and finally, a very affordable microfluidic kit was provided. Different experiments were designed, and the results were analyzed using appropriate software and methods. Separator system tests with polydisperse hollow glass particles (diameter 2–20 µm), and monodisperse Polystyrene particles (diameter 5,15 µm), and the results exhibit an acceptable chip performance with 86 percent of efficiency for both monodisperse particles and polydisperse particles. The microchannel collects particles with an average diameter of 15.8 µm, 9.4 µm, and 5.9 µm at the Proposed reservoirs. This chip can be integrated into a more extensive point-of-care diagnostic system to test blood samples.
Evolutionary processes involved in the emergence and expansion of an atypical O. sativa group in Madagascar.
Authors: Ahmadi Nourollah , Ramanantsoanirina Alain , Santos João D. , Frouin Julien , Radanielina Tendro
Published: August 2020

Understanding crops genetic diversity and the evolutionary processes that accompanied their world-wide spread is useful for designing effective breeding strategies. Madagascar Island was one of the last major Old World areas where human settlement was accompanied by the introduction of Oryza sativa. Early studies had reported the presence in the island of a rice group specific to Madagascar. Using 24K SNP, we compared diversity patterns at the whole genome and at haplotypes (30 SNP-long segments along the genome) levels, between 620 Malagasy and 1,929 Asian rice accessions. The haplotypes level analysis aimed at identifying local genotypic variations, relative to the whole genome level, using a group assignment method that relies on kernel density estimation in a Principal Component Analysis feature space. Migration bottleneck had resulted in 10–25% reduction of diversity among the Malagasy representatives of indica (G1) and japonica (G6) populations. Compared to their Asian counterpart, G1 and G6 showed slightly lower indica and japonica introgressions, suggesting the latter population had undergone less recombinations when migration to the island occurred. The origins of G1 and G6 was delineated to XI-2 indica subpopulation from the Indian subcontinent and to tropical japonica from the Malay Archipelago, respectively. The Malagasy-specific group (Gm) had a rather high gene diversity and an original haplotype pattern: much lower share of indica haplotypes, and much higher share of Aus and japonica haplotypes than G1 and indica. Its emergence and expansion are most probably due to inter-group recombination facilitated by sympatry between indica-cAus admixes and “Bulu” type landraces of G6 in the highlands of Madagascar, and to human selection for adaptation to the lowland ecosystems of the highlands. Pattern of rice genetic diversity was also tightly associated with the history of human settlement in the island. Emergence of the Gm group is associated with the latest arrivals of Austronesians, who founded the Merina kingdom in the central highlands and developed lowland rice cultivation. As an intermediary form between Aus, indica and japonica, the three pillars of O. sativa domestication, Gm represents a very valuable genetic resource in breeding for adaptation to cold tolerance in tropical highlands.
A Unified Framework to Integrate SPECT Perfusion Imaging with Dose-volume Metrics for Estimation of Radiation Pneumonitis
Authors: Li Peihan , Li Xinyi , Dai Liyan , Zheng Xiujuan , Wang Xiuying , Huang Qiu , Ma Xiumei
Published: August 2020

Background: Single photon emission computed tomography (SPECT) images provides functional information in both diagnosis and radiation therapy. This study aimed to evaluate a unified framework of different approaches and find the optimal one in integrating SPECT lung perfusion imaging into radiotherapy to estimate radiation pneumonitis.Methods: Twenty-five patients with thoracic tumors were included in this study. All patients had SPECT perfusion imaging before radiotherapeutic treatment. The SPECT images were registered to the planning computed tomography (CT) via a rigid-body transformation. Then a unified framework was presented to integrate functional information with anatomical information to generate functional dose-volume parameters. The framework contained different mapping approaches using uniform, thresholding, linear or non-linear functions. To compare the different approaches in the unified framework, the ability of predicting lung toxicity outcome was evaluated via the receiver operating characteristic (ROC) curve analysis.Results: Functional dose-volume metrics defined using the linear function achieves the highest value of area under the curve (AUC), compared to those defined with the other three types of mapping functions. With the linear mapping function, significant factors for predicting radiation pneumonia (p < 0.05) includes the functional mean lung dose (fMLD) with the threshold of 50-100% and lung volume receiving more than 30 Gy dose (fV_30) with the threshold of 60-100%, among which fMLD showed the highest prediction accuracy (AUC=0.772, threshold=50-100%). Conclusions: We proposed a framework of functional dose-volume metrics to predict the outcome of radiation pneumonitis. The metrics using the linear function outperform the others.
Validation of the BATT score for prehospital risk stratification of traumatic haemorrhagic death: Usefulness for tranexamic acid treatment criteria.
Authors: Ageron Francois-Xavier , Coats Timothy J , Darioli Vincent , Roberts Ian
Published: August 2020

Background: Tranexamic acid reduces surgical blood loss and reduces deaths from bleeding in trauma patients. Tranexamic acid must be given urgently, preferably by paramedics at the scene of the injury or in the ambulance. We developed a simple score (Bleeding Audit Triage Trauma score) to predict death from bleeding.Methods: We conducted an external validation of the BATT score using data from the UK Trauma Audit Research Network (TARN) from 1st January 2017 to 31st December 2018. We evaluated the impact of tranexamic acid treatment thresholds in trauma patients.Results: We included 104,862 trauma patients with an injury severity score of 9 or above. Tranexamic acid was administered to 9,915 (9%) patients. Of these 5,185 (52%) received prehospital tranexamic acid. The BATT score had good accuracy (Brier score=6%) and good discrimination (C-statistic 0.90; 95% CI 0.89-0.91). Calibration in the large showed no substantial difference between predicted and observed death due to bleeding (1.15% versus 1.16%; P=0.81). Pre-hospital tranexamic acid treatment of trauma patients with a BATT score of 2 or more would avoid 210 bleeding deaths by treating 61,598 patients instead of avoiding 55 deaths by treating 9,915 as currently. Conclusion: The BATT score identifies trauma patient at risk of significant haemorrhage. A score of 2 or more would be an appropriate threshold for pre-hospital tranexamic acid treatment.
Gene Expression Profiling of Orbital Muscles in Treatment-Resistant Ophthalmoplegic Myasthenia Gravis
Authors: Europa Tarin A , Nel Melissa , Heckmann Jeannine M
Published: August 2020

Background: Unbiased in silico approaches applied to genome-wide data prioritized putative functional gene variants associating with treatment-resistant ophthalmoplegic myasthenia gravis (OP-MG). Although altered expression of genes harbouring these variants, or associated pathways, were shown in patient-derived myocyte models, gene expression in orbital-derived muscle was required to test the validity of the predictions. Methods: We sampled orbicularis oculi muscle (OOM) and one paralysed extraocular muscle (EOM) from six individuals with OP-MG during blepharoptosis and re-alignment surgeries, respectively. For controls, the OOMs were sampled from four individuals without myasthenia undergoing surgery for non-muscle causes of ptosis, and one non-paralysed EOM. Using a qPCR array, expression of 120 genes was compared between OP-MG and control OOMs, profiling putative “OP-MG” genes, genes in related biological pathways and genes reported to be dysregulated in MG cases or experimental MG models, and in EOMs of cases with strabismus. Normalization was performed with two stable reference genes. Differential gene expression was compared between OP-MG and control samples using the ΔΔCT method. Co-expression was analysed by pairwise correlation of gene transcripts to infer expression networks. Results: Overall, transcript levels were similar in OOMs and EOMs (p=0.72). In OOMs, significant downregulated expression of eight genes was observed in OP-MG cases compared with controls (>2-fold; p≤0.016), including TFAM, a mitochondrial transcription factor, and genes related to the following pathways: atrophy signalling; muscle regeneration and contraction; glycogen synthesis; and extracellular matrix remodelling. Several microRNAs, known to be highly expressed in EOMs, are predicted to regulate some of these genes. Co-expression analyses of gene-pairs suggested high interconnectedness of gene expression networks in OP-MG muscle, but not controls (r>0.96, p<0.01). Significant inverse directions of gene-pair correlations were noted in OP-MG vs controls OOM networks (r≥0.92, p<0.001) involving most OP-MG genes overlapping prominently with muscle atrophy/contractility and oxidative metabolism genes. Conclusions: The gene expression in orbital muscles derived from OP-MG individuals compared with normal controls, support the pathogenic hypothesis previously generated from whole genome sequence analyses. Repression of gene transcripts in OP-MG orbital muscle implicate tissue-specific regulatory mechanisms, which may inform future biomarker discovery approaches.
Leukemia mortality in children from Latin America: Trends and predictions to 2030
Authors: Torres-Roman J. Smith , Valcarcel Bryan , Guerra-Canchari Pedro , Santos Camila Alves Dos , Barbosa Isabelle Ribeiro , Vecchia Carlo La , McGlynn Katherine A. , de Souza Dyego Leandro Bezerra
Published: August 2020

Background
Reports suggest that Latin American and Caribbean (LAC) countries have not achieved the downward mortality trends in leukemia seen in other countries. However, updated trends remain largely unknown in the region. Given that leukemia is the leading cause of cancer-related death in LAC children, we aimed to evaluate mortality trends in children (0-14y) from 15 LAC countries for the period 2000–2017 and to predict mortality until 2030.
Methods
We retrieved cancer mortality data through the World Health Organization Mortality Database. Age-standardized (world standard population) rates were computed for LAC countries. Joinpoint regression analysis was used to examine trends in the mortality rates of leukemia and provide an estimated annual percent change (EAPC). Nordpred was utilized for the calculation of predictions until 2030.
Results
Between 2013 and 2017, the highest mortality rates were reported in Venezuela, Ecuador, Nicaragua, Mexico, and Peru. Upward mortality trends were reported in Nicaragua (EAPC by 1.2% in boys, and EAPC by 2.0% in girls), Panama (EAPC by 1.8% in boys, and by 2.7% in girls), and Peru (EAPC by 1.4% in both sexes). Puerto Rico experienced large declines in mortality among both boys (APC by − 9.7%), and girls (EAPC by − 6.0%). Forecasting models predicted that leukemia mortality between 2015 and 2030, will increase in Argentina, Ecuador, Guatemala, Panama, Peru, and Uruguay.
Conclusion
Leukemia mortality is predicted to increase unless efforts are made to intervene. Interventions include addressing the inequities in health care diagnosing cases earlier,, avoiding treatment abandonment, and proper supportive care such as infection control programs will reduce the mortality in a great proportion.
Evaluation and GWAS of radicle gravitropic response in a core rice germplasms population
Authors: lou qiaojun , Li Qingsong , Feng Fangjun , Joynson Ryan , Yang Yunan , Luo Lijun , Chen Liang
Published: August 2020

Gravitropism is one of the primary determinants of root development, facilitating root penetration into soil and subsequent absorption of water and nutrients. In this study, the gravitropism of 226 Chinese rice micro-core accessions and drought-resistant core accessions were assessed. The average value of gravitropic response speed of radicle roots was 41.05°/h in the population ranging from 16.77°/h to 62.83°/h. We observed a highly significant difference in gravity response speed between Indica (42.49°/h) and Japonica (39.71°/h) subspecies with p-value < 0.002. The correlation analysis showed that the gravitational response speed of radicle roots was significantly positively correlated with the number of deep roots (correlation coefficient = 0.16), the growth speed of radicle roots (correlation coefficient = 0.21) and the drought resistance coefficient (correlation coefficient = 0.14). Using genome-wide association analysis (GWAS), 4 QTLs(quantitative traits) associating with gravitropic response speed were identified on chromosome 4,11 and 12. From within these intervals 5 candidate genes were screened for qPCR verification in 6 extreme rice varieties, demonstrating that gene LOC_Os12g29350 may regulate gravitropism negatively and confirming it’s candidacy for further study.
Prediction of Potential Prognostic Tumor Markers of Re-ascites After Chemotherapy for Ovarian Cancer Based on LC/MS Method ​
Authors: Liu Miao , Liu Yu , Jing Yixin , Zhao Shuang , Yang Shujia , Zhang Nan , Jin Shi , Li Yafei , Weng Mingjiao , Yang Yongheng , Feng Hua , Jin Xiaoming , Kong Dan
Published: August 2020

Background: Tumor cells are not only in a state of exuberant metabolism, but also inseparable from the surrounding microenvironment for the occurrence and development of tumors. By means of metabonomics technology, the metabolic profiles of re-ascites after chemotherapy in ovarian cancer ascites microenvironment were compared, and new tumor markers were screened for the treatment and prognosis of ovarian cancer.Methods: Thirty-seven cases of ovarian cancer were selected, of which 12 cases had ovarian cancer tissues, ascites supernatant and precipitated cells. By using UHPLC-Q-TOF MS/MS and combined with HMDB database, differential metabolites are identified and then differential pathways are enriched. Results: The results revealed that 10 differential metabolites were screened between chemotherapy and no-chemotherapy groups, and 9 differential metabolites were found in chemotherapy-sensitive and chemotherapy-resistant groups, in the ascites of ovarian cancer. Among the 19 differential metabolites, 9 metabolites combined with serum CA125 were analyzed by receiver operating characteristic analyses, which showed more the predictive value of diagnosis of malignancy. Among them, Tow differential metabolites (2/9) were correlated with the expression of CA125, five differential metabolite (5/9) related enzyme genes were statistically significant in overall survival and progression free survival (PFS) analysis. Four differential metabolites (4/9) were correlated with the expression of uric acid, creatinine, γ-GGT and ALP in serum. Conclusions: The results suggest that differential metabolites are mainly involved in PPAR signal pathway, steroid biosynthesis, fatty acid metabolism, secondary bile acid biosynthesis and so on. Lipid metabolites of ovarian cancer ascites cells may promote fatty acid oxidation by activating AMPK, promote lipid synthesis through mTOR/PPAR, provide energy for cancer cells, inhibit apoptosis and promote metastasis. Thus targeted lipid metabolism signal transduction axis can inhibit ovarian cancer metastasis and drug resistance.
Trends in the Prevalence and Incidence of Anxiety and Depression in Adult Population in Iran: Findings from Kerman Coronary Artery Diseases Risk factors Study (KERCADRS)
Authors: Najafipour Hamid , Shahrokhabadi mohadeseh Shojaei , Banivaheb Ghodsyeh , Sabahi Abdolreza , Shadkam Mitra , Mirzazadeh Ali
Published: August 2020

Background: Anxiety and depression (A&D) are common mental disorders with high economical and health burdens. This study aimed to investigate the prevalence and the incidence rate of A&D and their relationship with socio-demographic and other risk factors and co-morbidities in adults living in southeastern Iran.Method: We recruited adults (15 to 80 years) in two rounds (2009-2012, 2014-2018) of a population-based cohort study called Kerman coronary artery disease risk factors study (KERCADRS) in Kerman, Iran. The age-standardized A&D prevalence was measured among all participants (n=9996) and the five-year A&D incidence rate was measured in those who were free of A&D in the first round (n = 2813). The relationship between A&D and demographic characteristics, smoking, opium use, obesity and physical activity was assessed by logistic regression models. Results: Overall, the prevalence of anxiety (48.1% to 16.4%, P-value <0.001) and depression (5.9% to 1.3% P-value <0.001) decreased between the two rounds. The highest prevalence of anxiety was among people who were unemployed (%?), smokers (%?), and opium users (%?). Young adults, women, those divorced or widowed, and those with obesity and low physical activity had a higher chance for anxiety. The five-year incidence rate (person/1000 person-years) was 15.0 for anxiety and 3.9 for depression.Conclusion: Despite the overall decrease in the prevalence of A&D, certain groups such as young adults, women, unemployed and those who smoke cigarettes or opium, people with low physical activity and obesity are in need of more targeted interventions.
A Novel Micro Gripper-based Manipulation System for a Single μLED Array
Authors: Bai Jie , Niu Ping-Juan , Er-Dan Gu , Tee Clarence-Augustine-TH
Published: August 2020

μLED has advantages in brightness, power consumption and response speed. In addition, μLED can also be used as micro sensors implanted in the body via flexible electronic skin. One of the key technology is the transfer printing of μLED. Although numerous methods have been proposed for transfer printing technology, improving the yield of μLED array is still a formidable task. In this paper, we proposed a novel method in improving the yield of μLED array, transferred by the stamping method, using an innovative design of piezoelectric driven asymmetric micro gripper. A μLED manipulation system was constructed based on a micro gripper of a three dimensional positioning system. The experimental results showed that this system could be used to manipulate μLED array.
Regional Cerebral Blood Flow As Predictor Of Response To Occipital Nerve Block In Cluster Headache
Authors: Hernandez Sonia Medina , Bakar Norazah Abu , O'Daly Owen , Makovac Elena , Miller Sarah , Renton Tara , Williams Steven , Matharu Manjit , Howard Matthew
Published: August 2020

Background: Cluster headache is an excruciating disorder with no cure. Greater occipital nerve blockades can transiently suppress attacks in approximately 50% of patients, however, its mechanism of action remains uncertain, and there are no reliable predictors of treatment response. To address this, we investigated the effect of occipital nerve blockade on regional cerebral blood flow (rCBF), an index of brain activity, and differences between treatment responders and non-responders. Finally, we compared baseline perfusion maps from patients to a matched group of healthy controls.

Methods: 21 male, treatment-naive patients were recruited while in a cluster headache bout. During a pain-free phase between headaches, patients underwent pseudo-continuous arterial spin labelled MRI assessments to provide quantitative indices of rCBF. MRIs were performed prior to and 8-to-22 days following treatment. Patients also recorded the frequency of their headache attacks in a daily paper diary. Neuropsychological assessment including anxiety, depression and quality of life measures was performed in a first, scanning free session for each patient.

Results: Following treatment, patients demonstrated relative rCBF reductions in posterior temporal gyrus, cerebellum and caudate, and rCBF increases in occipital cortex. Responders demonstrated relative rCBF increases, compared to non-responders, in medial prefrontal cortex and lateral occipital cortex at baseline, but relative reductions in cingulate and middle temporal cortices. rCBF was increased in patients compared to healthy controls in cerebellum and hippocampus, but reduced in orbitofrontal cortex, insula and middle temporal gyrus.

Conclusions: We provide new mechanistic insights regarding the aetiology of cluster headache, the mechanisms of action of occipital nerve blockades and potential predictors of treatment response. Future investigation should determine whether observed effects are reproducible and extend to other headache disorders.
A Large Database Study of Hospitalization Charges and Follow-up Re-admissions in Us Lumbar Fusion Surgeries Using a Cellular Bone Allograft (CBA) Versus Recombinant Human Bone Morphogenetic Protein-2 (rhBMP-2)
Authors: Wetzell Bradley , McLean Julie B , Moore Mark A , Kondragunta Venkateswarlu , Dorsch Kimberly
Published: August 2020

BackgroundThis retrospective study of a large US healthcare system database compared initial procedure and 12-month follow-up hospitalization charges and resource utilization (lengths of stay; LOS) for lumbar fusion surgeries using either recombinant human bone morphogenetic protein-2 (rhBMP‑2) or a cellular bone allograft comprised of viable lineage-committed bone cells (V‑CBA). Potentially-relevant re-admissions during the follow-up period were also assessed.MethodsA total of 16,172 patients underwent lumbar fusion surgery using V-CBA or rhBMP-2, of whom 3,503 (21.66%) patients had follow-up re‑admission data. Initial patient, procedure, and hospital characteristics were assessed to determine confounding factors. Multivariate regression modeling compared differences in hospitalization charges (in 2018 US dollars) and LOS (in days) between the groups, as well as incidences of potentially-relevant re‑admissions during the 12‑month follow‑up period.ResultsThe adjusted mean initial procedure and 12-month follow‑up hospital charges were significantly lower in the V-CBA group versus the rhBMP‑2 group ($109,061 and $108,315 versus $160,191 and $130,406, respectively; P<0.0001 for both comparisons). This disparity remained in an ad hoc comparison of charges for initial single-level treatments only (V‑CBA = $103,064, rhBMP-2 = $149,620; P<0.0001).The adjusted mean initial LOS were significantly lower in the V‑CBA group (3.77 days) versus the rhBMP-2 group (3.88 days; P<0.0001), but significantly higher for the cumulative follow-up hospitalizations in the 12‑month follow-up period (7.87 versus 7.46 days, respectively; P<0.0001). Differences in rates of follow-up re‑admissions aligned with comorbidities at the initial procedure. Subsequent lumbar fusion rates were comparable, but significantly lower for V-CBA patients who had undergone single-level treatments only, in spite of V‑CBA patients having significantly higher rates of initial comorbidities that could negatively impact clinical outcomes.ConclusionsThe results of this study indicate that use of V-CBA for lumbar fusion surgeries performed in the US may result in substantially lower overall hospitalization charges versus rhBMP-2, with both exhibiting similar rates of 12-month re-admissions and subsequent lumbar fusion procedures.
Injury Mechanism Affects the Stability of Suture-Button Syndesmosis Fixation.
Authors: Chen Kuan-Hao , Chen Chih-Hwa , Huang Yu-Min , Lee Hsieh-Hsing , Tsuang Yang-Hwei
Published: August 2020

Background: Ankle syndesmosis injury is a common condition, and the injury mechanism can be sorted into pure-syndesmosis injury, Weber-B and Weber-C type fractures. This study aims to evaluate the treatment outcomes and stability of suture-button fixation for syndesmosis injury with different injury mechanisms. We hypothesized that injury mechanisms would alter the stability of suture-button fixation.Methods: We retrospectively reviewed 63 patients with ankle syndesmosis injury underwent surgery with TightRope (Arthrex, Naples, FL, USA) from April 2014 to February 2019. The stability of suture-button fixation with TightRope were evaluated by comparing the preoperative, postoperative, and final follow-up measurements of tibiofibular clear space (TFCS), tibiofibular overlap (TFO), and medial clear space (MCS). A subgroup analysis for each demographic group and injury type including pure-syndesmosis injury, Weber-B and Weber-C type fractures were performed. Results: Syndesmosis was effectively reduced using TightRope. After the index surgery, the tibiofibular clear space was reduced from 7.73 mm to 4.04 mm, the tibiofibular overlap was increased from 3.05 mm to 6.44 mm, and the medial clear space was reduced from 8.12 mm to 3.54 mm. However, syndesmosis widening was noted at the final follow-up, especially in Weber-C type fractures (TFCS: 3.82 to 4.45 mm, p < 0.01 and TFO: 6.86 to 6.29 mm, p = 0.04). Though widened, the final follow-up values of tibiofibular clear space and tibiofibular overlap were in the acceptable range. Postoperatively and at the final follow-up, medial clear space was found to be significantly larger in the Weber-C group than in the pure syndesmosis and Weber-B groups (p < 0.05). Conclusions: Suture-button fixation can offer anatomic reduction and dynamic fixation in syndesmosis injuries. However, when using this modality for Weber-C type fractures, more attention should be focused on the accuracy of reduction, especially of medial clear space, and rediastasis should be carefully monitored.Trial registration: This trial was retrospectively approved by TMU-JIRB. Registration number N202004122, and the date of approval was May 06, 2020.Level of evidence: III