bluuebunny/crossref_metadata_2025 huggingface dataset:
Joint 2D SSA with GSVD and binary linear programming based image super-resolution
Authors: Huang Ziyin , Chan Yui-Lam , Ling Bingo Wing-Kuen , Ye Huan
Published: February 2021

This paper proposes a joint two dimensional (2D) singular spectrum analysis (SSA) with the generalized singular value decomposition (GSVD) and the binary linear programming based method for performing the super-resolution. For a given low resolution image, first both the upsampling operation and a lowpass filtering are applied on each column of the image to obtain an enlarged image. Second, apply the 2D Hankelization to both the low resolution image and the enlarged image to obtain their corresponding trajectory matrices. Third, both the GSVD and the 2D de-Hankelization are applied to these two trajectory matrices to obtain their corresponding sets of the de-Hankelized 2D SSA components. Here, it is proved that the exact perfect reconstruction is achieved. In order to enhance the high frequency contents of the enlarged image, the selection of the de-Hankelized 2D SSA components is formulated as a binary linear programming problem. Computer numerical simulation results show that the proposed method outperforms the state of art methods.
Peripheral neurological involvement in Shiga toxin-producing Escherichia coli-hemolytic uremic syndrome (STEC-HUS) as a rare complication with a positive outcome in two consecutive children – Case Report
Authors: Santangelo Luisa , Netti Giuseppe Stefano , Torres Diletta Domenica , Piscopo Giovanni , Carbone Vincenza , Losito Luciana , Milella Leonardo , Lasorella Maria Luigia , Conti Pasquale , Gagliardi Delio , Chironna Maria , Bresin Elena , Trabacca Antonio , Ranieri Elena , Giordano Mario
Published: February 2021

Background. The Neurological involvement is the most common extra-renal complication of Shiga toxin-producing Escherichia coli-hemolytic uremic syndrome (STEC-HUS). On brain magnetic resonance examination, main neurological signs encompass acute lesions of the basal ganglia and the white matter, which could usually regress after Eculizumab infusion. In contrast, STEC-HUS-related peripheral nervous system (PNS) involvement is very rare and, when occurring, it requires a careful management of neurological sequelae and an intensive multidisciplinary neuro-rehabilitation program.Case presentation. Here, we present two cases of severe and complicated STEC-HUS patients with PNS-involvement who successfully required therapeutic treatment and an intensive multidisciplinary neuro-rehabilitation program.In both cases, PNS-involvement followed the recovery from STEC-HUS-related severe central neurological damage and manifested mainly with marked bilateral motor deficit and hyporeflexia/areflexia in the lower limbs. The peripheral polyneuropathy was treated with immune-suppressive therapy (methylprednisolone pulses, i.v. immunoglobulins, therapeutic plasma exchange), followed by a prolonged intensive neuro-rehabilitation program. After 8 months of neuro-rehabilitation, both patients gained complete functional recovery.Conclusions. PNS involvement during STEC-HUS is a rare event and potentially leading to severe disability. A timely clinical assessment is mandatory to set up a prompt therapeutic and neuro-rehabilitation program and to obtain a complete clinical and functional recovery.
Application of super-resolution convolutional neural network technique to improve the quality of soft-tissue window cone-beam CT images
Authors: Fukuda Motoki , Ariji Yoshiko , Nitoh Munetaka , Nozawa Michihito , Kuwada Chiaki , Nishiyama Masako , Funakoshi Takuma , Fujita Hiroshi , Katsumata Akitoshi , Ariji Eiichiro
Published: February 2021

Objectives

To assess the feasibility of using a super-resolution convolutional neural network to improve the quality of cone-beam computed tomography (CBCT) images for visualizing soft-tissue structures.
Methods

Multidetector computed tomography (CT) images of 200 subjects who were assessed for the status of an impacted third molar were collected as training datasets. CBCT images of 10 subjects who were also examined with CT were collected as testing datasets. The training process used a modified U-Net and bone and soft-tissue window CT images. After creating a model to convert bone images to soft-tissue images, CBCT images were provided as input and the model outputted estimated CBCT images. These estimated CBCT images were then compared with soft-tissue window CBCT and CT images, using slices through approximately the same anatomical regions. Image evaluation was performed with subjective observations and histogram descriptions.
Results

The visibility of soft-tissue structures was improved by the technique, with high visibility being attained in the submandibular region, although visibility remained a little obscured in the maxillary region.
Conclusions

The feasibility of a deep learning-based super resolution technique to improve the visibility of soft-tissue structures on estimated CBCT images was verified.
A numerical simulation of realistic top coal caving intervals under different top coal thicknesses in longwall top coal caving working face
Authors: Liu Chuang , Li Huamin
Published: February 2021

In the process of longwall top coal caving, the selection of the top coal caving interval along the advancing direction of the working face has an important effect on the top coal recovery. To explore a realistic top coal caving interval of the longwall top coal caving working face, longwall top coal caving panel 8202 in the Tongxin Coal Mine is used as an example, and 30 numerical simulation models are established by using Continuum-based Distinct Element Method (CDEM) simulation software to study the top coal recovery with 4.0 m, 8.0 m, 12.0 m, 16.0 m, 20.0 m and 24.0 m top coal thicknesses and 0.8 m, 1.0 m, 1.2 m, 1.6 m and 2.4 m top coal caving intervals. The results show that with an increase in the top coal caving interval, the single top coal caving amount increases. The top coal recovery is the highest with a 0.8 m top coal caving interval when the thickness of the top coal is less than 4.0 m, and it is the highest with a 1.2 m top coal caving interval when the coal seam thickness is greater than 4.0 m. These results provide a reference for the selection of a realistic top coal caving interval in thick coal seam caving mining.
Comprehensive analysis on expression profile and prognostic values of SYTs family members and their methylation in gastric cancer
Authors: Yang Mei-feng , Long Xing-xing , Hu Hong-sai , Bin Yu-ling , Wang Li-sheng , Yao Jun , Chen Xuan-ming , Wu Ben-hua , Li De-feng
Published: February 2021

Background: Synaptotagmins (SYTs) family members, consisting of 17 isoforms, paly crucial roles in the development and progression of human cancer. However, there is few studies on the expression and prognostic values of SYTs family in gastric cancer (GC). Methods: We comprehensively evaluate the expression, methylation, prognosis and immune significance of SYTs family members through bioinformatics analysis from the online databases in GC. Results: The expressions of SYT4, SYT9 and SYT14 were up-regulated, and negatively associated with their methylation levels in GC. Both SYT4, SYT9 and SYT14 overexpression and their hypomethylation levels contributed to unsatisfactory overall survival (OS) and progression-free survival (PFS) in GC. Moreover, the low expression levels of methylation cg sites (cg02795029, cg07581146, cg15149095, cg19922137, cg25371503, cg26158959, cg02269161, cg03226737, cg08185661, cg16437728, cg22723056 and cg24678137) were significantly correlated with unfavorable OS and PFS in GC. Furthermore, the expression of SYT4, SYT9 and SYT14 played a pivotal role in immune cells infiltration in GC. Conclusion: SYT4, SYT9 and SYT14 might be potent prognostic indictors and promising immunotherapy targets for the patients with GC.
Electronic Medical Record and Clinical Evaluation of Two Patient Cohorts at Risk of Hypophosphatasia: Family History is an Underutilized Tool to Diagnose Patients with Rare Disease
Authors: Peroutka Christina , Beck Natalie M , Gough Ethan , Marzinke Mark , Hoover-Fong Julie
Published: February 2021

Background: Family history (FH) is a powerful tool in screening and testing for chronic disease, oncologic conditions, and other genetic diagnoses, and is dependent upon observing patterns of features inherited across generations. Despite acceptance of FH as a fundamental part of a genetic medicine evaluation, there are limited data in other medical fields about its utility and benefit to patients. Methods: We evaluated two patient populations at-risk of a rare metabolic condition-- hypophosphatasia (HPP)—for the quality and quantity of FH data in their medical records. Population 1 was derived from patients seeking evaluation for a low bone density diagnosis at the Johns Hopkins Greenberg Center for Skeletal Dysplasias (GCSD); population 2 was identified through a targeted electronic medical record (EMR) query of low serum alkaline phosphatase (AP) measurements obtained through the Johns Hopkins Clinical Laboratory. Results: In population 1 (n = 38), 27 (71%) were confirmed to have HPP. Of these, 14 (52%) presented with FH information in the EMR from 3 or more family members, and in 4 (15%) FH was suggestive of HPP. In population 2 (n=348), a similar proportion of subjects had 3 or more family members mentioned in the EMR (183 or 53%), but only 3 subjects (1%) included sufficient detail to determine that the family history was suggestive of HPP. Notably, once all patients in population 1 completed a medical genetics evaluation and HPP was confirmed, 20 (74%) had probable affected family members identified through obtaining and analyzing a pedigree. After cascade testing was offered to these family members, 17 patients (71%) from population 1 had at least one family member with HPP confirmed at a molecular level. Conclusions: Based on these results, we propose that a full genetic medicine evaluation of those subjects from population 2 at highest risk of HPP would confirm HPP in many of them and identify similarly affected family members. We propose that taking a FH refines the diagnostic precision for patients with low bone density and identifies affected family members, and that HPP is likely more prevalent than previously thought.
Effect of the dose regimen on the serum amisulpride concentration and simulation of concentration reference ranges based on population pharmacokinetics
Authors: Li Lu , Li Lin , Huang Shan-Qin , Lu Hao-Yang , Xiao Tao , Chen Hong-Zhen , Xie Huan-Shan , Shang De-Wei , Wen Yu-Guan
Published: February 2021

Aims

This study aims to determine the factors associated the large variability and provided the concentrations reference ranges for different dose ranges.
Methods

A retrospective study was conducted in a psychiatric hospital. The factors associated with the serum amisulpride concentration were examined using multiple linear regression analysis. A comparison of serum amisulpride concentrations among different dose regimens was conducted via analysis of covariance. The amisulpride concentration range for different dosing regimens was simulated using the population pharmacokinetics of Chinese patients with schizophrenia using the Monte Carlo method.
Results

In total, 472 samples from 291 patients were examined to determine the factors associated with amisulpride concentrations. Multiple linear regression analysis indicated that age and the daily dose were positively correlated with the serum drug concentration, whereas male gender and sampling time before the last administration were negative correlated with its concentration. The serum amisulpride concentration significantly differed among the dose regimens. Using an established amisulpride population pharmacokinetic model, the simulated trough concentrations exceeded 320 ng/mL for most regimens with daily doses greater than 600 mg/day.
Conclusion

Differences in dose regimens and daily doses contributed to the large variation of the serum amisulpride concentration. The currently recommended reference does not ensure the attainment of appropriate therapeutic concentrations.
Healing of rectal advancement flap for anal fistula in patients with and without Crohn’s disease: a retrospective cohort analysis
Authors: Seifarth Claudia , Lehmann Kai S. , Holmer Cristoph , Pozios Ioannis
Published: February 2021

Background

Surgical closure of anal fistulas with rectal advancement flap is an established standard method, but in some cases, it has a high degree of healing failure. There are few studies in literature with a small number of cases examining differences between patients with and without Crohn's disease (CD). The aim of this study was to identify risk factors for anal fistula healing failure after advancement flap between patients with cryptoglandular fistulas and patients with CD.
Methods

From January 2010 to October 2020, 155 rectal advancement flaps (CD patients = 55, non-CD patients = 100) were performed. Patients were entered into a prospective database and retrospectively analyzed for healing rates.
Results

Median follow up was 189 days (95 % CI: 109–269). Overall complication rate was 5.8 %. Total healing rate for all rectal advanced flaps was 56 %. CD patients were younger (33 vs. 43 years, p < 0.001), more often female (76 vs. 30 %, p < 0.001), had more immunosuppressant medication (65 vs. 5 %, p < 0.001), more vaginal fistulas (29 vs. 8 %, p = 0.001) and more protective stomas (49 vs. 2 %, p < 0.001) than patients without CD. However, there was no difference in the healing rate of patients with or without CD (47 % vs. 60 %, p = 0.088).
Conclusions

Patients with anal fistulas without and with Crohn’s disease have the same healing rate. Although patients with CD differ in their patient-specific characteristics, no independent factors for the occurrence of anal fistula healing failure could be determined.
Trial registration:

Not applicable due to the retrospective study design.
Second to fourth digit (2D:4D) ratio and their relationships among first-time mother-and-child population in Ghana
Authors: Banyeh Moses , Amidu Nafiu , Quaye Lawrence
Published: February 2021

The study aimed to determine the 2D:4D digit ratios and their relationships in a paired mother-and-child population. This was a cross-sectional study from December 2020 to January 2021. Digit ratios were measured by computer-assisted analysis (GIMP). Outcome variables were compared by < mean versus ≥ mean of digit ratios. The study involved 84 mother-and-child pairs (male: 45). The mean ± SD age of mothers was 23.5 ± 3.58 years. The median (IQR) age of female children was 111(51–180) days and males, 74 (44–190) days. The mean ± SD right-hand 2D:4D ratio was 0.94 ± 0.04 for mothers, 0.91 ± 0.04 for female and 0.90 ± 0.04 for male children. The mean ± SD left-hand 2D:4D ratios were 0.93 ± 0.04 for mothers, 0.92 ± 0.04 for female and 0.93 ± 0.05 for male children. Male and female children did not differ in their 2D:4D digit ratios, but males showed leftward bias. Mothers’ right-hand digit ratio correlated with that of daughters’ (r = 0.52, P = 0.001) and sons’ (r = 0.38, P = 0.011). Serum alanine transferase (ALT) levels were positively associated with ≥ mean 2D:4D ratios of the right [aOR: 1.081(1.009–1.159)] and the left-hand [aOR:1.198(1.084–1.325)] of mothers. A mother’s height could be predicted from their 2D:4D ratios. These findings support the heritability of 2D:4D ratios. We, however, recommend further studies.
The differential expression and regulatory networks of ceRNAs in umbilical cord blood sample of chromosome 22q11.2 deletion syndrome
Authors: Zhang Ruohan , Tang Donge , Xue Wen , Gan Qing , Zou Yaoshuang , Jing Huanyun , Dai Yong , Chen Jiejing
Published: February 2021

Background: Chromosome 22q11.2 deletion (CH22qD) syndrome is the most common human deletion syndrome. Competing endogenous RNAs (ceRNAs) have miRNA binding sites that are capable of competitively binding miRNAs and inhibiting miRNA regulation of target genes. Results: We identified differently expressed miRNAs, circRNAs, lncRNAs and mRNAs of CH22qD, and we analysed the results by using GO analysis, KEGG pathway analysis and network regulation analysis. Conclusions: These analyses may predict the effects of chromosomal microdeletions.
Manuscript title: The effect of three dimensional printing hinged ankle foot orthosis in chronic stroke patients
Authors: Fu Jimmy Chun-Ming , Li Cyuan-Fong , Hsiao Yu-Hsuan , Sheen Feng-Zu , Chen Yi-Jen , Chen Chia-Hsin
Published: February 2021

BackgroundThree-dimensional printing (3DP) is a promising technique utilized in orthosis fabrication, including ankle foot orthosis for stroke patients. However, the effects on ankle biomechanics remains unclear. ObjectivesTo compare the plantar pressure distribution and patient’s subjective experience in chronic stroke patients during 3DP hinged ankle foot orthosis (3DP-HAFO) and anterior ankle foot orthosis (A-AFO) walking MethodsTen patients with first-ever unilateral stroke were enrolled in this study. All patients performed 10-meter walk test in 3 different conditions, including 3DP-HAFO walking, A-AFO walking, and bare foot walking. The plantar pressure parameters including contact area, maximum force, and peak pressure were collected using Pedar X insole system. Gait asymmetry analysis of the plantar pressure parameters was conducted. Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST) was used for patient’s satisfaction.Results3DP-HAFO walking revealed significant increase in medial midfoot peak pressure compared to bare foot walking. Gait asymmetry analysis illustrated more even medial midfoot contact area during 3DP-HAFO walking compared to bare foot walking while A-AFO walking did not. In QUEST survey, 3DP-HAFO outweighs A-AFO in fitting and durableness. Conclusions3DP-HAFO may improve ankle instability and gait asymmetry in chronic stroke patients.
Garlic (Allium sativum Linn) Mitigates Experimentally induced Hepatotoxicity and Nephrotoxicity in Commercial Chickens
Authors: OLADELE OMOLADE ABODUNRIN , Nottidge Helen Oyebukola , Esan Oluwaseun Olanrewaju , Bakre Adetolase Azizat
Published: February 2021

Intoxication as well as infectious and metabolic diseases resulting in liver and kidney damage are major causes of losses in poultry species. While there are no specific drugs for reversal of pathophysiology of the liver and kidney, certain herbs such as garlic have been shown to improve livability of livestock and poultry. Its probable potential at enhancing the functionality of these organs in the face of injuries/insults by intoxication was investigated. Chicken subgroup supplemented with 0.25% garlic-meal and administered 300mg/kg acetaminophen at 8week-old (G1; n=25) and subgroup without acetaminophen (G2; n=25), those not supplemented and without acetaminophen (NG2; n=25) and those not initially supplemented but administered acetaminophen and later supplemented (NG1g; n=20) had higher Newcastle disease vaccinal antibody titers (8.0±0.25, 7.5±0.24, 7.6±0.23, 8.14±0.31, respectively) in comparison with subgroup without supplementation and administered acetaminophen (NGI; n=25 - 7.13±0.38). Serum protein levels had a similar pattern. AST levels (U/L) were significantly higher (p<0.05) in acetaminophen subgroups G1 (79.4±5.79) and NG1 (83.7±7.5) than their respective controls G2 (75.1±7.85) and NG2 (65.2±6.84) with no corresponding increase in CK levels. At 2-, 7- and 14-days post-administration of acetaminophen (paa), creatinine (mg/dl) was significantly higher in G1 (1.44±0.01, 1.42±0.01, 1.44±0.02) and NG1 (1.47±0.01, 1.51±0.01, 1.47±0.01) than in G2 (1.16±0.05, 1.23±0.01, 1.26±0.06) and NG2 (1.31±0.06, 1.29±0.02, 1.31±0.05). A similar pattern was observed at 21 days paa. Clinical signs and pathological lesions associated with toxic dose of acetaminophen in liver and kidneys were reversed (NG1g). Thus, exhibiting the potential of garlic in protection against hepatorenal damage or injury.
Structural Characterization and Dielectric Properties of the Effect of Carbon Nanotubes and Silicon on AA2024 Metal Matrix Composites
Authors: Mani Muniyappan , Natesan Iyandurai
Published: February 2021

This research work focus on the formation of AA2024-carbon nanotubes-silicon hybrid metal matrixcomposites. Structure morphology, structural characterization, elemental identification and dielectric properties of AA 2024 in the presence of carbon nanotubes, silicon andits combinations at various proportions was evaluated using SEM, XRD, EDX and Hioki 3532-50 LCR Hi-Tester. A two-stage stir casting method was used for the fabrication of AA2024 hybrid metal matrix composites. It was observed that the size of the AA 2024 + 4% CNT + 2% Si composite wasfound to be 23.6 nm, this shows enhanced results than other composites prepared. Dielectric properties of composites were characterized as a function of composition and frequency. It was found that the dielectric constant, dielectric loss and dissipation factor decreases smoothly with an increase of reinforcements and also frequency.
A New Prediction Model of Patient Satisfaction After Total Knee Arthroplasty and The Roles of Different Score Systems: A retrospective cohort study
Authors: Liu Jinyu , Yang Yi , Wan Shengcheng , Yao Zhenjun , Zhang Yueqi , Zhang Ying , Shi Peng , Zhang Chi
Published: February 2021

BACKGROUNDAlthough total knee arthroplasty (TKA) is efficacious treatment for end-stage osteoarthritis, ~20% patients are dissatisfied with the results. We determined which factors contribute to patient satisfaction and compared the various scoring systems before and after surgery.METHODSIn this retrospective cohort study, 545 patients were enrolled and were evaluated preoperatively and 1 year postoperatively. Patient demographics, as well as scores for Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Short Form (SF)-12, and 1989 Knee Society Clinical Rating System (KSS) were recorded preoperatively and postoperatively. The possible predictors were introduced into a prediction model. Scores for overall satisfaction and 2011 Knee Society Score(KSS) were also assessed after total knee arthroplasty to identify the accuracy and agreement of the systems.RESULTSThere were 134 male patients and 411 female patients, with an overall prevalence of satisfaction of 83.7% 1 year after surgery. A history of surgery(p<0.001) , 1989 KSS and SF-12 were of the utmost importance in the prediction model, whereas the WOMAC score had a vital role postoperatively(change of WOMAC pain score, p<0.001; change of WOMAC physical function score, p<0.001; postoperative WOMAC pain score, p=0.004). The agreement between assessment of overall satisfaction and 2011 KSS satisfaction assessment was general(Kappa=0.437>0.4, p<0.001). CONCLUSIONA history of surgery, preoperative 1989 KSS and preoperative SF-12 influenced patient satisfaction after primary total knee arthroplasty. We recommend WOMAC (particularly the subscale score of pain) to reflect the overall patient satisfaction postoperatively.
Temporal evolution of inflammation and neurodegeneration with alpha-synuclein propagation in Parkinson’s disease mouse model
Authors: Lai Thuy Thi , Kim Yun Joong , Nguyen Phuong Thi , Koh Young Ho , Nguyen Tinh Thi , Ma Hyeo-il , Kim Young Eun
Published: February 2021

Alpha-synuclein (αSyn) propagation has been determined to play a key role in the pathomechanism of Parkinson’s disease (PD), but neurodegeneration and the involvement of inflammation in its pathologic progression are yet to be well understood with regard to temporal relationship. In this study, by means of PD mouse model injected with intrastriatal αSyn preformed fibril (PFF), the temporal evolution of αSyn propagation, inflammation, and neurodegeneration was explored in the perspective of the striatum and the whole brain. In the PFF-injected striatum, inflammatory responses including the microglia and astrocyte were activated at the earliest stage and reduced with time, and the phosphorylated form of αSyn accumulation increased behind it. Thereafter, the degeneration of striatal dopaminergic neurons became significant with the conspicuity of behavior phenotype. Similar pattern of forefront eruption of inflammation and following αSyn propagation was noted in the opposite striatum, which was not injected with PFF. Meanwhile, in analyzing the whole brain, inflammatory responses were determined to have activated at the earliest stage, and the soluble αSyn expression then increased concurrently. Inflammatory response decreased afterward, and the accumulation of the insoluble form of αSyn increased behind it. Our results suggested that the inflammatory response may precede the accumulation of the pathologic form of αSyn; thereafter, the neurodegeneration and motor dysfunction followed αSyn proliferation in PD mouse model. From this model, recognizing the temporal relationship between inflammation, αSyn propagation, and neurodegeneration may be helpful in establishing PD animal model and monitoring the effect of interventional therapy.
Peripheral members create and core members integrate: cooperation pattern of members in networks during co-creations
Authors: Yang Kunhao , Fujisaki Itsuki , Ueda Kazuhiro
Published: February 2021

Cooperation has become the principal way in which creative activities are carried out in modern society. Previous research has shown that in the cooperation of creative activities (i.e., co-creation), different participants can play two completely different roles: some participants are the originators who generate initial contents, and others are the revisors who provide revisions or coordination. In this research, we investigated the different participants’ roles (i.e., the originator vs the revisor) in co-creations and how these roles affected the final cooperation-group outcome. By using cooperation networks to represent the cooperative relationships among participants, we found that peripheral members (i.e., those in the periphery of the co-operation networks) and core members (i.e., those in the centre of the co-operation networks) played the roles of originators and revisors, respectively, mainly affecting the quantity versus the quality of creative outcomes. These results were robust across three different datasets and three different indicators defining core and peripheral members. Our results uncover the cooperation pattern in co-creations and advance the understanding of how co-creations occur in networks.
The mediating effects of quality of life, depression, and generalized anxiety on perceived work barriers for people diagnosed with Neurofibromatosis Type 1
Authors: Buono Frank D , Sprong Matthew E , Paul Erina , Martin Staci , Larkin Kaitlyn , Garakani Amir
Published: February 2021

Background

Neurofibromatosis Type 1 (NF1) is a genetic disorder that presents with physical symptoms that can negatively impact numerous areas of one’s life, including occupational and psychological functioning, with decreased quality of life compared to a normative population. The purpose of the current study was to explore the impact of psychological factors (anxiety and depression), along with quality of life and hope on employment barriers between those with NF1 and matched controls.
Methods

A total of 212 individuals were stratified into two groups (NF1 and matched controls) using a cross-sectional design that collected a one-time response.
Results

A mediation analysis in which total barriers to employment success on the differences between groups with quality of life, anxiety and depression as the mediators, and levels of employment hope as the co-variates were examined. The results did confirm a direct (.001) and indirect (< .001) relationship between work barriers with NF1 to matched controls, and with quality of life, anxiety, and depression.
Conclusions

The current article demonstrates that quality of life can directly be affected by perceived barriers of employment within the NF1 population, while extending existing research by providing insight on the impact of quality of life on employment. Poorer mental health observed amongst people with a genetic disease can impact barriers of employment and quality of life.
Intramedullary Well-Differentiated Osteosarcoma: Imaging and Pathologic Findings in a Group of 17 Patients
Authors: Han Shu-Man , Wu Yuan , Wen Jin-Xu , Wu Tian-Hao , Sun Tao , Yu Bao-Hai , Wu Wen-Juan , Gao Bu-Lang
Published: February 2021

The authors have requested that this preprint be removed from Research Square.
A Systematic Review of Educational Interventions and Their Impact on Empathy and Compassion of Undergraduate Medical Students 
Authors: Menezes Prianna , Guraya Shaista Salman , Guraya Salman Yousuf
Published: February 2021

BackgroundA compassionate and patient-centred care leads to improved clinical outcomes. Promoting empathy and compassion of medical students is a forerunner of their wellbeing, emotional stability, and a patient-centred care. However, there is slender evidence about best educational interventions that can inculcate empathy and compassion skills. Our objective was to conduct a systematic review of research evaluating the associations between spectrum, effectiveness, frequency of teaching modalities and their outcomes on compassion and empathy to highlight best practices. MethodsWe searched the Web of Science, PubMed, Scopus, and EBSCO Host. Selected studies were required to have used unique educational interventions for promoting empathy and compassion of medical students.ResultsWe analysed 24 articles from the initial yield of 2,861. Twenty-two were quantitative studies with a mean of 12.8 on MERSQI. Twelve were randomized controlled trials while 5 measured outcomes with single group pre- and post-tests. There was no association found between duration, frequency and complexity of an educational intervention and its effectiveness. Twenty used multimodality curricula, and of those 18 reported statistically significant positive improvement in empathy, while 3 of 4 single modality were effective. Only three studies looked for long-term effects of educational interventions. Fourteen studies evaluated Kirkpatrick’s level one (self-reported knowledge), 2 level three (behaviour), and 6 level four (patient outcomes). We identified six major educational constructs of teaching empathy and compassion; communication, mindfulness, early clinical exposure, technology-enhanced learning, comics and arts and culture. ConclusionOur review couldn’t identify a standard teaching construct in place and highlighted that different teaching tools carry similar impact in promoting compassion and empathy and a sustainable program rather than a single training activity is essential.
Liquefaction and Reliquefaction Resistance of Saturated Sand Deposits Treated with Sand Compaction Piles
Authors: Padmanabhan Gowtham , Kumar Ganesh
Published: February 2021

To mitigate liquefaction and its associated soil deformations, ground improvement techniques were adopted in field to reinforce saturated sand deposits. Sand Compaction Pile (SCP) is one such popular proven treatment to improve liquefaction resistance of sandy deposits. Installation of sand compaction piles improves soil density and rigidity which further enhance seismic resistance against liquefaction and this was well evident from past field observations. However, studies involving SCP performance during repeated shaking events were not available/limited. In this study, using 1-g uniaxial shaking table a series of shaking experiments were performed on SCP treated and untreated sand deposits having 40% and 60% relative density subjected to repeated incremental acceleration loading conditions(i.e. 0.1g – 0.4g at 5 Hz frequency).Parameters such as improvement in soil resistance and relative density, generation and dissipation of excess pore water pressures, maximum observed foundation settlement and soil displacement and variation in cyclic stress ratio were evaluated and compared. Seismic response of liquefiable sand deposits found to be improved significantly due to SCP installation together with occurrence of continuous soil densification under repeated loading. The experimental observations suggested that SCP can perform better even at repeated shaking events.
Determining Optimal Temperature Combination for Effective Pretreatment and Anaerobic Digestion of Corn Stalk
Authors: Li Juan , Li Xiujin , Wachemo Akiber Chufo , Zuo Xiaoyu
Published: February 2021

Temperature is one of the important factors affecting both chemical pretreatment and anaerobic digestion (AD) process of corn stalk (CS). In this work, the combined ways between pretreatment temperature (40℃ and 60℃) and AD temperature (35℃ and 55℃) were selected to investigate the AD performance for sodium hydroxide (NaOH) pretreated CS. Three organic loading rates (OLRs) of 1.6, 1.8 and 2.0 g·L-1·d-1 were studied within 255 days using continuously stirred tank reactors (CSTR). The results revealed that temperature of 40°C was considered as an appropriate for pretreatment whether in mesophilic or thermophilic anaerobic digestion systems. On the other hand, temperature of 35°C and 55°C were chosen as the optimal AD temperatures for lower and higher OLRs, respectively. This study provides a significant insight for exploring the effects of temperatures on the pretreatment and AD of CS.
Prognostic significance of preoperative serum inflammation markers in patients with male breast cancer
Authors: Li Xing , Xiong Zhengchong , Wang Jin , Fu Juan , Xie Xinhua , Xie Xiaoming
Published: February 2021

BackgroundThere were no predictive prognosis factors of serum in male breast cancer, while breast cancer is a heterogeneous disease. The purpose of our study was to determine the prognostic implications of the pretreatment neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and lymphocyte-to-monocyte ratio (LMR) in the serum of patients with male breast cancer. Methods：We retrospectively identified an random cohort of male breast cancer patients treated at the Sun Yat-Sen University Cancer Center between Jan1, 1996 and Dec31, 2016. A number of 108 patients had a different inflammation markers recorded pre-operation. Survival status was retrieved from our cancer center registry and phone follow-up. Cox proportional hazards regression model were used to analyze the disease-free survival (DFS) and overall survival (OS). Results：Among these patients in this study, 13 (12%) had disease recurrence, and 7 (6.5%) patients appeared distant metastasis. No statistically significant association of the preoperative NLR, PLR or LMR level with patients’ different outcomes was found. Conclusions: In short, we were unable to establish a connection between preoperative inflammation biomarkers and male breast cancer patients’ survival. Neither NLR, PLR nor LMR is useful for predicting prognosis in male breast cancer patients, and prospective studies to evaluate the above biomarkers as a simple prognostic trail is necessary.
The role of anogenital distance in the incidence risk of prostate cancer in China
Authors: zhou jiatong , liu ranlu
Published: February 2021

Background: Anogenital distance（AGD） can be used as a biomarker to indirectly indicate androgen levels during the sexual maturation of mammals. In order to gain a deeper understanding of the association between the AGD and the risk of prostate cancer(PCa), we performed this studyMaterials: A total of 107 patients undergoing perineal prostate biopsy from November 2019 to August 2020 were enrolled. All patients diagnosed 57 PCa patients and 50 benign prostatic hyperplasia(BPH) patients through perineal prostate biopsy in our hospital . The anus to the posterior base of the scrotum (AGDAS) and the cephalad insertion of the penis (AGDAP) of all patients were measured before prostate biopsy.Result: The mean age of patients with PCa was 69.46 ± 7.52 and the mean age of patients with BPH was 67.38± 8.26. We did not find a significant association between age and BMI in the risk of PCa(all p＞0.05). Besides, there was no significant association between AGD and the risk of PCa(p＞0.05). we only discovered that PSA could play an important role in the development of PCa.Conclusion: AGD may not play an important role in predicting the incidence risk of PCa. we still need a large-scale prospective study to explore the ture association between AGD and the incidence of PCa.
Evaluation of Human Fecal Calprotectin Detection Kits and Their Potential use as Non-Invasive Intestinal Biomarker of Infectious Enterocolitis in Pigs
Authors: Barbosa Jéssica , Rodrigues Lucas , Columbus Daniel , Aguirre Juan , Harding John , Cantarelli Vinícius , Costa Matheus O.
Published: February 2021

Background: Fecal calprotectin is largely applied as a non-invasive intestinal inflammation biomarker in human medicine. Previous studies in pigs investigated the levels of fecal calprotectin in healthy animals only. Thus, there is a knowledge gap regarding its application during infectious diarrhea. This study investigated the usefulness of fecal calprotectin as a biomarker of intestinal inflammation in Brachyspira hyodysenteriae and Salmonella Typhimurium infected pigs. Results: Fecal samples from pigs with colitis (n=18) were collected from animals experimentally inoculated with B. hyodysenteriae G44 or from sham-inoculated controls. Fecal samples from pigs with enteritis (n=14) were collected from animals inoculated with Salmonella enterica serovar Typhimurium or from sham-inoculated controls. For both groups, fecal samples were scored as: 0 = normal; 1 = soft, wet cement; 2 = watery feces; 3 = mucoid diarrhea; and 4 = bloody diarrhea. Fecal calprotectin levels were assayed using a sandwich ELISA, a turbidimetric immunoassay and a point-of-care dipstick test. Fecal calprotectin levels were greater in colitis samples scoring 4 versus ≤ 4 using ELISA, and in feces scoring 3 and 4 versus ≤ 1 using immunoturbidimetry (P < 0.05). No differences were found in calprotectin concentration among fecal scores for enteritis samples, regardless of the assay used. All samples were found below detection limits using the dipstick method.Conclusions: Fecal calprotectin is a potential non-invasive biomarker of infectious colitis, but it is not suitable for detection of enteritis. While practical, the use of commercially available human presents sensitivity limitations. Further studies are needed to validate the field application of calprotectin as a marker.
The Implementation of Healthy Start-Départ Santé intervention in Canadian Childcare Centres: A Realist Evaluation
Authors: Muhajarine Nazeem , Fick MA Fiona , McRae Daphne N
Published: February 2021

BackgroundHealthy Start-Départ Santé (HSDS) is a 10-month, bilingual (English and French) program which aims to educate childcare centre staff about the activity and nutritional needs of young children, as well as teaching them how to incorporate healthy practices into their daily routines. This study examines “How, for whom, and in what contexts is the HSDS intervention effectively implemented and sustained in early learning childcare centers?”MethodsWe conducted a realist evaluation to assess the HSDS program. After formulating an initial program theory (described in a previously published paper) we tested and refined the theory using interview data from childcare centre directors and staff. Purposive sampling was used to recruit centres with differing characteristics (levels of engagement with HSDS, length of time since training, and geographic and cultural diversity in clientele). Twenty-five interviews from 23 centres were completed. Participants were asked questions directly related to the program theory (e.g., Does the program line up with your personal values and goals around healthy child development?) to confirm, refute, or refine elements of the initial theory. Interviews were coded by context, mechanisms, and outcomes and separated according to the stages of Training, Implementation, and Sustainability. Codes specific to physical activity and nutrition were created. NVivo 11 was used for data management. ResultsOur study found that the HSDS program was effectively implemented and sustained when staff had positive attitudes toward the program, identified with its goals and values, and were willing to actively participate in activities. Other key components for staff included a sense of responsibility for child health, increased understanding of the benefits of promoting healthy behaviours, and access to resources in support of behavioural change. For children, the program was successful when they had multiple opportunities to be physically active and try a variety of foods, and when they could develop competence in physical activities. ConclusionsThe HSDS final program theory can be tailored to various contexts and/or similar programs to facilitate improved physical activity and healthy eating in childcare centres.
Anxiety and depression associated cardiovascular health behaviors among patients with hypertension
Authors: Liu Jiao , Tang Weiming , Yang Yan , Luo Dan , Zeng Na , Liang Yunsheng
Published: February 2021

Background: Anxiety and depression in hypertensive patients may lead to poor blood pressure control and increases the risk of disease mortality. Lifestyle impacts depression and anxiety. This study aimed to assess cardiovascular health behaviors (CHBs) associated with co-morbid anxiety and depression among patients with hypertension.Methods: We included 488 hypertensive patients from Changsha, China. We measured anxiety and depression using the self-rating anxiety scale (SAS), and the self-rating depression scale (SDS), respectively. CHBs (smoking, overweight/obesity, leisure physical activity (LPA), and fruit and vegetable consumption (FVC)) were assessed using the Cardiovascular Health in Ambulatory Care Research Team (CANHEART) index. We compared anxiety and depression prevalence of participants in different socio-demographic, CHBs, co-morbidities, family histories, assessed risk factors and their biological synergistic interaction.Results: The proportion of not ideal in smoking, overweight/obesity, LPA, and FVC were 63.9%, 49.8%, 30.7%, 78.3%, respectively. Displaying comorbidity of HLP and not obtaining adequate amounts of LPA were risk factors for both anxiety and depression. The synergy interaction between obtaining secondary education or less and displaying comorbidity of hyperlipidemia (HLP) for anxiety (OR=5.238, 95% CI=2.784, 9.856), and between not obtaining adequate amounts of LPA and obtaining manual labor for depression (OR=7.164, 95% CI=3.553, 14.443) was statistically significant.Conclusion: Our study indicated that doctors should pay more attention to the psychiatric health of hypertensive patients at lower education levels and with second comorbidities. More importantly, patients with hypertension working on manual jobs need to pay closer attention to how they spend their leisure time and strengthen LPA.
Clinical and Epidemiological Characteristics of COVID-19 Mortality in Saudi Arabia: A Retrospective Multi-Center Study
Authors: Alsayer Rawabi , Alsharif Hassan , Baadani Abeer AL , Kalam Kiran
Published: February 2021

Background: Coronavirus disease 2019 (COVID-19) has resulted in considerable morbidity and mortality worldwide since December 2019. This study highlights the significant burden of the COVID-19 outbreak, particularly in patients’ health and the healthcare system. This study's clinical implication provides insight into the significant death indicators among COVID-19 patients in Saudi Arabia. Exploring these indicators will help physicians triage patients, identify critically ill patients, and prioritize ICU admissions by identifying high-risk medical and clinical indicators. Methods: A multi-center retrospective study conducted among all COVID-19 mortality cases, admitted to 15 of Armed forces hospitals across Saudi Arabia regions during March – July 2020. Demographic data, clinical presentation, laboratory investigations, and complications of COVID-19 mortality cases were collected and analyzed. According to the WHO, death due to COVID-19 was classified as a direct and indirect cause of death. Results: A total of 224 COVID-19 mortality cases were included in the analysis. The mean age was 69.6614.68 years, and 142(63.4%) of the cases were male. 30% of overall COVID-19 mortalities occurred in the first 24 hours of hospital admission, while 50% of the mortalities occurred on day 10. There was a highly significant difference in the survival time (days) between cases admitted to the Intensive care unit (ICU) and general ward (p-values <.001), as well as a significant difference in the survival time (days) between the direct and indirect cause of death from COVID-19 cases (p-values 0.012). The most prevalent comorbidities were diabetes mellitus (DM) occurred in 165(73.7%), and hypertension (HTN) in 156(69.6%). Logistic regression for risk factors in all mortality cases revealed that direct mortality cases from COVID-19 are more likely to develop acute respiratory distress syndrome and acute kidney injury [OR 1.75 (CI 0.89-3.43); p=.102], [OR 1.01 (CI 0.54-1.90); p=.960]. Conclusions: The prevalence of underlying diseases DM and HTN is high among COVID‐19 mortality cases in Saudi Arabia. Multiple organ dysfunction can be observed, the most common organ damage, lungs, heart, followed by the kidney. The rising of serum ferritin, Procalcitonin, CRP, and D-dimer levels can be used as indicators of disease progression.
Economic Impact of COVID-19 on the Vulnerable Population of Bangladesh
Authors: Mahmud Sakib , Zubayer Sayed Arafat , Eshtiak Ahmed , Ahmed Ibrahim , Nasim Mahmudul Hossain
Published: February 2021

This study aims to find out the Economic condition of the vulnerable population of Bangladesh in the COVID-19 situation. This study uses the primary data of 203 respondents who were collected from all around Bangladesh using convenience and purposive sampling. In this study, a comparison of expected income in the COVID-19 situation is made with the pre-COVID-19 situation using Welch two-sample t-test, and the possible impact on Expenditure and Savings was discovered using OLS estimation. Descriptive analysis is also included considering the key economic variable of the respondents. This study finds a significant drop in income due to COVID-19 and infers that it will cause both drop-in expenditure and monthly savings, and gives an overall idea of the situation of vulnerable people in the COVID-19 situation. This study can help the stakeholders to understand the situation of the vulnerable population of Bangladesh due to COVID-19.