bluuebunny/crossref_metadata_2025 huggingface dataset:
Gamma-glutamyl transferase and risk of all-cause and disease-specific mortality: a nationwide cohort study
Authors: Cho Eun Ju , Jeong Su-Min , Chung Goh Eun , Yoo Jeong-Ju , Cho Yuri , Lee Kyu-na , Shin Dong Wook , Kim Yun Joon , Yoon Jung-Hwan , Han Kyungdo , Yu Su Jong
Published: September 2022

Background: Population-based data regarding the prognostic implication of gamma-glutamyl transferase (GGT) have been inconsistent. We examined the association of GGT with all-cause and disease-specific mortality.
Methods:Using the Korean nationwide database, we included 9,687,066 subjects without viral hepatitis or cirrhosis who underwent a health examination in 2009. Subjects were classified into three groups by sex-specific tertile of serum GGT levels. The underlying causes of death were classified by 10th Revision of the International Classification of Diseases codes.
Results: During the median follow-up period of 8.3 years, 460,699 deaths were identified. All-cause mortality increased as serum GGT levels became higher (hazard ratio [HR], 95% confidence interval [CI]: 1.05, 1.04–1.05 in the middle tertile, and 1.33, 1.32 – 1.34 in the high tertile) compared to the low tertile of serum GGT levels. Similar trends were observed for cardiovascular disease (CVD) (HR, 95% CI: 1.07, 1.05–1.09 in the middle tertile, 1.29, 1.26–1.31 in the high tertile), cancer (HR, 95% CI: 1.08, 1.07–1.10 in the middle tertile, 1.38, 1.36–1.39 in the high tertile), respiratory disease (HR, 95% CI: 1.10, 1.08–1.13 in the middle tertile, 1.39, 1.35–1.43 in the high tertile), and liver disease mortality (HR, 95% CI: 1.74, 1.66–1.83 in the middle tertile, 6.73, 6.46–7.01 in the high tertile). Regardless of smoking, alcohol consumption and history of previous CVD and cancer, a higher serum GGT levels were associated with a higher risk of mortality.
Conclusions: Serum GGT levels may be useful for risk assessment of all-cause and disease-specific mortality in general population.
Causes of death in female patients with bladder cancer after local tumor excision and radical cystectomy: A Contemporary, US Population–Based Analysis
Authors: Lyu Qian , Nie Yu , Yuan Jiazheng , Wang Dong
Published: September 2022

Surgery is one of the most important treatments for bladder cancer, including local tumor excision and radical cystectomy. At present, studies on the causes of death for contemporary survivors, especially women, who have received different surgical treatments are limited. Therefore, the study used a population-based cohort study in the United States from 2000-2017 to analyze causes of death for women who underwent local tumor excision or radical cystectomy stratified by demographics and tumor stage. standardized mortality ratios (SMRs) were calculated based on general population data. In total, 24040 female patients who underwent surgical treatments were assessed. Of those 20780 patients undergoing local tumor excision, 36.6% died of bladder cancer, while 63.4% died of other causes. The risk of death from all causes increased in comparation to the general population (SMR, 1.85; 95% CI, 1.82-1.87), and the most common non-tumor cause of death was from heart diseases (16.2%; SMR, 1.13; 95% CI, 1.09-1.16). Among women who receive radical cystectomy, 82.3% of deaths occurred within 5 years after surgery. 66.9% deaths resulted from bladder cancer, and the risk of death from all causes significantly higher than that in the general people (SMR, 4.67; 95% CI, 4.51-4.84). Moreover, the risk of death from non- bladder cancer causes also increased, in particular, such as septicemia (SMR,3.09; 95% CI, 2.13-4.34). Causes of death during bladder cancer survivorship after surgery vary by patient and tumor characteristics, and these data provide information regarding primary care for women during postoperative cancer survivorship.
Electro-Thermal Design for Broadband Balanced Terahertz Tripler
Authors: Wei Haomiao , Zhang Yong , Cui Jianhang , Liu Xiaoyu , Wang Li , Chen Yang
Published: September 2022

This paper presents a comprehensive electro-thermal (E-T) design method applied to the circuit design of the multipliers, which intends to improve the design flexibility and simulation reliability of the broadband frequency multiplier.The design method is divided into two steps: a self-consistent electro-thermal model and an external matching circuit. The self-consistent electro-thermal model consists of three parts: the steady-state thermal model, the thermal separation variable model, and the three-dimensional (3-D) electromagnetic (EM) model. The electro-thermal model is suitable for application in hybrid integrated circuit, because the thermal correction is only carried in simulation. There is no additional diode and temperature-controlled equipment cost in thermal parameters extraction. Then, a formula-based impedances network named linear embedding impedances is set as external wideband response instead of single frequency point embedding impedance. This two-step design method enables the nonlinear I-V thermal correction, circuit matching design and their coupling simulation in circuit level. Based on the design approach, a balanced 225–300 GHz frequency tripler with AlN substrate has been designed and manufactured. The output consistency of simulated and measured results reachs up to 82% and the S11 basically better than -10 dB across the wideband of 225-300 GHz.
Improving the malignancy prediction of breast cancer based on the integration of radiomics features from dual-view mammography and clinical parameters
Authors: Zhou Chenyi , Xie Hui , Zhu Fanglian , Yan Wanying , Yu Ruize , Wang Yanling
Published: September 2022

Purpose We developed a radiomics strategy that incorporating radiomics features extracted from dual-view mammograms and clinical parameters for identifying benign and malignant breast lesions, and validated whether the radiomics assessment can improve the accurate diagnosis of breast cancer.
Methods A total of 380 patients with 621 breast lesions utilizing mammograms on craniocaudal (CC) and mediolateral oblique (MLO) views were randomly allocated into the training (n=486) and testing (n=135) sets in this retrospective study. A total of 1184 and 2368 radiomics features were extracted from single-position ROI and position-paired ROI, respectively. Clinical parameters were then combined for better prediction. The recursive feature elimination (RFE) and least absolute shrinkage and selection operator (LASSO) methods were used to select optimal predictive features. Random forest algorithm was used to conduct the predictive model, and the performance was evaluated with area under the receiver operating characteristic (ROC) curve (AUC), sensitivity, specificity and accuracy.
Results After preprocessing, 467 radiomics features and clinical parameters remained in the single-view and dual-view models. The random forest model using a combination of dual-view radiomics and clinical parameters achieved a favorable performance (area under curve [AUC]: 0.804, 95% confidence interval [CI]: 0.668-0.916) in the distinction of benign and malignant breast lesions, which outperformed single-view model and model without clinical parameters.
Conclusions Incorporating with radiomics features of dual-view (CC&MLO) mammogram, age, breast density and type of suspicious lesions can provide a non-invasive approach to evaluate the malignancy prediction of breast lesions, which can facilitate clinical decision making.
Metabolomic analysis on the mechanism of nanoselenium alleviating cadmium stress and improving the chili pepper nutritional value
Authors: Li Dong , Zhou Chunran , Li Jia-Qi , Dong Qinyong , Miao Peijuan , Lin Yongxi , Cheng Haiyan , Wang Yuwei , Luo Luna , Pan Canping
Published: September 2022

Selenium (Se) can maintain rhizosphere soil-plant homeostasis and regulate signaling molecules to mitigate cadmium (Cd) toxicity. However, no systematic studies on the intervention of nano-selenium (nano-Se) in regulating non-target metabolites and fruit nutritional components in pepper plants under Cd stress were investigated. This study researched the effects of Cd-contaminated soil stress and nano-Se (1, 5, and 20mg/L) on the metabolic mechanism, fruit nutritional quality, and volatile organic compounds (VOCs) composition of pepper plants. The screening of differential metabolites in roots and fruits involved mostly amino acid metabolic pathways and capsaicin production pathways. Amino acid in roots (Pro, Trp, Arg, and Gln) and fruits (Phe, Glu, Pro, Arg, Trp, and Gln) were dramatically elevated by nano-Se biofortification. The expression of phenylpropane-branched fatty acid pathway genes (BCAT, Fat, AT3, HCT,and Kas) was induced by nano-Se (5 mg/L), which increased capsaicin (29.6%), nordihydrocapsaicin (44.2%), and dihydrocapsaicin (45.3%) levels. VOCs (amyl alcohol, linalool oxide, E-2-heptaldehyde, 2-hexenal, ethyl crotonate, and 2-butanone) related to crop resistance and quality were enhanced remarkably with the enhancement of nano-Se concentration. Therefore, nano-Se can improve the health of pepper plants by stimulating the expression of the capsaicin metabolic pathway and modulating the amino acid and VOCs contents.
Multifactorial analysis of postoperative rebleeding in patients with spontaneous supratentorial intracerebral hemorrhage： a single-center experience
Authors: Song Ping , Lei Pan , Cai Qiang , Li Zhiyang , Wei Hangyu , Zhou Long , Cheng Li , Wang Wenju , Chen Qianxue , Luo Ming
Published: September 2022

Spontaneous supratentorial intracerebral hemorrhage (SSICH) is an acute cerebrovascular disorder with high morbidity and mortality rates, Treatment of primary cerebral hemorrhage is controversial. However, postoperative rebleeding (or hematoma expansion) is a potential complication that can result in devastating progressive neurologic deterioration and high morbidity and mortality rates. It is also an inevitable and serious complication, which can result in progressive neurologic deterioration and death. The incidence of rebleeding 19.39% was found in our study and the results suggest that admission GCS score, irregular hematoma morphology on preoperative CT, poor postoperative blood pressure control, hematoma location, and surgical method were all risk factors of postoperative rebleeding. 3D Slicer-assisted neuroendoscopic surgery may be the most effective treatment for many patients with SSICH.
Coppice reintroduction in the Czech Republic: extent, motivation and obstacles
Authors: Kozdasová Anežka , Batista Lucie Galčanová , Hédl Radim , Szabó Péter
Published: September 2022

Coppicing was a widespread form of forest management in European broadleaved forests. While it is still practised in south-eastern Europe, in central and western Europe it was almost completely replaced by high forest management. Currently there are increasing efforts to reintroduce coppice management into former coppice woods. However, little comprehensive knowledge is available about the extent of coppice reintroduction and the processes governing it on larger spatial scales. In this paper, we created a list of coppice reintroduction sites in the Czech Republic and conducted qualitative data analysis through semi-structured interviews to understand what motivated site managers to start with coppicing and what obstacles they have had to face. Results show that coppice reintroduction is still in its beginnings, carried out at altogether eight sites. The main motivation of site managers is nature conservation, while the most important obstacles are practical issues, such as legislative barriers or lack of workforce. Other motivating factors identified in European countries (production of renewable energy source and potential for rural employment) have so far played a minor role in the Czech Republic. We conclude that a major challenge for future forest policies will be to utilise the economic experiences of regions with active coppicing to foster the spread of coppice woods in order to combine renewable energy production with biodiversity conservation.
Spinal Level Contribution to Nerves of the Lumbar Plexus- A Systemic Review
Authors: Ahmed Aws Emad , Millard Jonathan A.
Published: September 2022

The lumbar plexus originates from the lumbar spinal cord providing sensation to the anterolateral abdominal wall and lower limbs. Primary motor components of the plexus include the femoral and obturator nerves, which innervate the anterior and medial compartments of the thigh, respectively. The plexus typically consists of four ventral segments (L1-L4) (73%); however, it can also consist of five segments (L1-L5) (21%), or even six segments (T12-L5) (6%). The furcal nerve of L4 typically ramifies to both the lumbar and sacral plexuses. An increase in laparoscopic surgeries, especially retroperitoneal approaches, made the areas around the psoas major muscle of major concern. Surgeons operating around the area should be aware of the natural variations in the lumbar plexus to avoid injuries. In this systematic review, we reviewed up to 1248 lumbar plexus variations in the literature. A comprehensive search was carried out using PRISMA guidelines to access the literature published about spinal levels. The femoral nerve was found to originate from L2-L4 in 83% of the cases. The obturator nerve was found to originate from L2-L4 in 83% of the cases. The accessory obturator nerve was found 14% of the time. The ilioinguinal nerve was found to originate from L1 in 81% of the cases. The iliohypogastric nerve was found to originate from L1 in 83% of the cases. The lateral femoral cutaneous nerve was found to originate from L2 and L3 in 72% of the cases. Finally, the genitofemoral nerve was found to originate from L1 and L2 in 81% of the cases.
Mini-abstract
Knowledge about the natural variations of nerves of the lumbar plexus is of major importance for operating surgeons in the abdomen or pelvis to avoid injuries to the nerves.
Experimental study on the interaction between Al and P in Si solution
Authors: Han Linjun , He Qian , Wu Jijun , Ma Wenhui
Published: September 2022

The effect of impurity interactions on impurity removal efficiency in metallurgical grade silicon (MG-Si) was studied and analyzed to provide a new idea for removing impurities from MG-Si. This paper provides theoretical support for the removal of nonmetallic impurity P during the metallurgical purification and preparation of crystalline silicon. The interaction between Al and P in liquid silicon were investigated by directional solidification. The effects of different pull-down speeds, refining temperatures, holding times and Al contents on the distributions Al and P were investigated. The experimental results of the directional solidification of the Si-P-Al ternary system showed that from the bottom to the top of the sample, the contents of Al and P gradually increased. This phenomenon verifies the accuracy of the activity interaction coefficient between Al and P in the Si-P-Al ternary system calculated by the model. The mutual attraction between Al and P was also confirmed.
Visceral Adipose Tissue-directed Human Kallistatin Gene Therapy Improves Adipose Tissue Remodeling and Metabolic Health in Obese Mice
Authors: Wu Ya , Jiang Yu , Guo Jia-qi , Qian Ling-lin , Ji Jing-jing , Ji Zhen-jun , Yang Zi-wei , Ma Gen-shan , Yao Yu-yu
Published: September 2022

Background: Adipose tissue remodeling is a dynamic process pathologically expedited in the obese state and related to obesity-associated disease progression closely. This study aimed to explore the effects of human kallistatin (HKS) on adipose tissue remodeling and obesity-related metabolic disorders in mice fed with a high-fat diet (HFD).
Methods: Adenovirus-mediated HKS cDNA (Ad.HKS) and empty adenovirus (Ad.Null) were constructed and injected into the epididymal white adipose tissue (eWAT) of 8-week old male C57B/L mice. The mice were fed with normal or HFD for 28 days. The body weight and major lipid in circulation were then detected. Intraperitoneal glucose tolerance test (IGTT) and insulin tolerance test (ITT) were also performed. Oil-red O staining was used to assess the extent of lipid deposition in the liver. Immunohistochemistry and HE staining were used to measure HKS expression and adipose tissue morphology. Western blot and qRT-PCR were used to evaluate the expression of adipose function- related factors.
Results: Compared with the Ad.Null group, HKS was highly expressed in serum and eWAT at the end of the experiment. Compared with Ad.Null mice, Ad.HKS mice had lower body weight and decreased serum and liver lipid levels after four weeks of HFD feeding. IGTT and ITT showed that HKS treatment maintained balanced glucose homeostasis. Additionally, inguinal white adipose tissue (iWAT) and eWAT in Ad.HKS mice contained more number of smaller size adipocytes and had less macrophage infiltration than Ad.Null group. HKS significantly increased the mRNA levels of adiponectin, vaspin, and eNOS. In contrast, HKS decreased RBP4 and TNFα levels in the adipose tissues. Western blot results showed that local injection of HKS significantly upregulated the protein expressions of SIRT1, p-AMPK, IRS1, p-AKT, and GLUT4 in eWAT.
Conclusions: HKS injection in eWAT improves HFD-induced adipose tissue remodeling and function, thus significantly improving weight gain and dysregulation of glucose and lipid homeostasis in mice.
Clinical Features and Risk Factors of Uveitis in Korean Children with Juvenile Idiopathic Arthritis
Authors: Kim Jinsoo , Kwon Soonil , Kim Kwang Nam , Kim Han Wool , Park In Won , Cho Bum-Joo
Published: September 2022

This study investigated the clinical features and risk factors of uveitis in Korean children having juvenile idiopathic arthritis (JIA). Medical records of JIA patients who were diagnosed between 2006 and 2019 and followed up for ≥1 year were retrospectively reviewed. Patients were classified into two groups by the development of JIA-associated uveitis (JIA-U), and various factors were analyzed for the risk of developing uveitis. JIA-U developed in 30 (9.8%) of 306 JIA patients. Mean age at the first uveitis occurrence was 12.4 ± 5.7 years, which was 5.6 ± 3.7 years after the JIA diagnosis. The common JIA subtypes in the uveitis group were oligoarthritis-persistent (33.3%) and enthesitis-related arthritis (30.0%). The patients with oligoarthritis-persistent developed JIA-U more frequently than those without (20.0% vs. 7.8%; P = 0.016), and those with systemic arthritis developed uveitis less than those without (3.6% vs. 12.2%; P = 0.024). The uveitis group had baseline knee joint involvement more frequently (76.7% vs. 51.4%), which increased the risk of uveitis during follow-up (P = 0.008). The final visual acuity of JIA-U was tolerable (0.041 ± 0.103 logMAR). In Korean children with JIA, JIA-U may be associated with oligoarthritis-persistent subtype and the knee joint involvement.
First record of the rarely known squat lobster, Allomunida magnicheles Baba, 1988 (Decapoda: Anomura: Galatheoidea: Galatheidae) from the Indian Ocean
Authors: Tiwari Shivam , Padate Vinay P. , Cubelio Sherine Sonia , Osawa Masayuki
Published: September 2022

The present study reports the rarely recorded species of the family Galatheidae, Allomunida magnicheles Baba 1988, based on material from the Indian Exclusive Economic Zone. The specimens attached to an unidentified soft coral of the genus Dendronephthya Kükenthal, 1905, were collected using a Smith McIntyre grab from the depth of 52 m in the southwestern Bay of Bengal. Allomunida magnicheles was known only from the Sulu Sea and Tañon Strait, the Philippines; the present specimens greatly extend the distribution range of the species westwards to the Indian Ocean. Morphological description and intraspecific variations of A. magnicheles are provided.
Temporal variability of Loa loa microfilaremia
Authors: Campillo Jérémy T. , Hemilembolo Marlhand C. , Louya Frederic , Bikita Paul , Pion Sebastien D. S. , Boussinesq Michel , Missamou Francois , Chesnais Cédric B.
Published: September 2022

Background
The diurnal periodicity of Loa loa microfilaremia is well known but few studies have documented the short-term and long-term stability of microfilarial density. It seems stable over time at the community level, but significant variations have been observed at the individual level.
Methods
We assessed the temporal variability of L. loa microfilaremia at 5-days, 1-month and 16-months intervals and analyzed the influence of sex, age, level of microfilaremia, temperatures and time of sampling on this variability.
Results
At the community level, L. loa microfilaremia is very stable over time at 5-days, 1-month and 16-months intervals (Pearson correlation coefficients of 0.92, 0.91 and 0.78, respectively, all three with a P < 0.001). However, some individuals had significant variations of up to ± 50% of their initial microfilaremia at 5-days (33.0%), 1-month (36.5%) and 16-months (62.6%) interval, even in individuals with an initial microfilaremia density > 20,000 mf/mL (7.7, 23.1 and 41.4%, respectively for 5 days, 1 month and 16 months). We do not highlight any external factors that have a major impact on this variability.
Conclusion
Although at the community level, microfilaria density is very stable, we highlight some individuals with large variations both in the short- and long-term, which may have an important impact on onchocerciasis control campaigns and on longitudinal studies evaluating the impact of an intervention on L. loa microfilaremia.
Clinical characteristics and survival analysis of a large cohort of Light Chain amyloidosis: a single center real-world study
Authors: Xie Weiwei , Wang Qian , Zhou Fude , Wang Suxia , Sun Yuhua , Cen Xinan , Ren Hanyun , Qiu Zhixiang , Dong Yujun
Published: September 2022

Light chain (AL) amyloidosis is a plasma cell dyscrasia characterized by the tissue deposition of misfolded amyloid fibrils, leading to progressive organs dysfunction. We retrospectively analyzed 335 patients with AL amyloidosis in the First Hospital of Peking University from January 2011 to December 2021 to describe the real-world clinical characteristics and prognosis of the patients with AL amyloidosis in China. Patients (median age, 60 years) were diagnosed with multi-organ involvement of kidney (92.8%), heart (57.9%), liver (12.8%). 55.8% of patients were treated with chemotherapy, 63.4% of whom achieved hematologic response (≥ very good partial response). Only 18.2% of the patients received autologous stem cell transplant (ASCT), who were younger and less likely to have cardiac involvement. The median overall survival of patients with AL amyloidosis was 77.5 months. The level of brain natriuretic peptide, percentage of bone marrow plasma cell and total bilirubin were identified as independent prognostic factors for survival. Albeit the younger age and high ratio of renal involvement might contribute to the favorable prognosis of this cohort, the role of novel agents and ASCT is also discernible. This real-world research will provide a panoramic impression on the progress of AL amyloidosis in China.
Design, synthesis, and biological studies of the new cysteine-N-arylacetamide derivatives as potent urease inhibitor
Authors: Montazer Mohammad Nazari , Asadi Mehdi , Moradkhani Fatemeh , Omrany Zinat Bahrampour , Mahdavi Mohammad , Amanlou Massoud
Published: September 2022

Inhibition of Helicobacter pylori urease is an effective method in the treatment of a number of gastrointestinal diseases in humans. This bacterium plays an important role in the pathogenesis of gastritis and peptic ulceration. Considering the presence of cysteine and N-arylacetamide derivatives in potent urease inhibitors, here, we designed hybrid derivatives of these pharmacophores. Therefore, cysteine -N-arylacetamide derivatives 5a-l were synthesized through simple nucleophilic reactions with good yield. In vitro urease inhibitory activity assay of these compounds demonstrated that all newly synthesized compounds exhibited high inhibitory activity (IC50 values = 0.35–5.83 µM) when compared with standard drugs (thiourea: IC50 = 21.1 ± 0.11 µM and hydroxyurea: IC50 = 100.0 ± 0.01 µM). Representatively, compound 5e with IC50 = 0.35 µM, was 60-times more potent than strong urease inhibitor thiourea. Enzyme kinetic study of this compound revealed that compound 5e is a competitive urease inhibitor. Moreover, a docking study of compound 5e was performed to explore crucial interactions at the urease active site. This study revealed that compound 5e is capable to inhibit urease by interactions with two crucial residues at the active site: Ni and CME592. Furthermore, molecular dynamics study confirmed the stability of the 5e-urease complex and Ni chelating properties of this compound.
Bundles Reduce Anastomosis Leak in Patients Undergoing Elective Colorectal Surgery a Propensity Score-matched Study
Authors: Baeza-Murcia Melody , Valero-Navarro Graciela , Pellicer-Franco Enrique , Soria-Aledo Victoriano , Mengual-Ballester Monica , Garcia-Marin Jose Andres , Betoret-Benavente Lidia , Aguayo-Albasini Jose Luis
Published: September 2022

PURPOSE: anastomosis leak still being a handicap in colorectal surgery. Bowel mechanical preparation and oral antibiotics are not a practice recommended in many clinical practice guides. The aim is to analyze the decrease in frequency and severity of postoperative complications, mainly related to anastomotic leak, after the establishment of a bundle.
METHODS: Single-center, before-after study. A bundle was implemented to reduce anastomotic leaks and their consequences. The Bundle group were matched to Pre-bundle group by propensity score matching. Mechanical bowel preparation, oral and intravenous antibiotics, inflammatory markers measure and early diagnosis algorithm were included at the bubdle.
RESULTS: The bundle group shown fewer complications, especially in Clavien Dindo´s Grade IV complications (23% vs 6.2% p<0.01), as well as a lower rate of anastomotic leakage (15.5% vs 2.2% p<0.01). A significant decrease in reinterventions, less intensive unit care admissions, a shorter hospital stay and fewer readmissions were also observed. In multivariate analysis, the application of a bundle was an anastomotic leakage protective factor (OR 0.121, p>0.05)
CONCLUSIONS: The implementation of our bundle in colorectal surgery which include oral antibiotics, mechanical bowel preparation and inflammatory markers, significantly reduces morbidity adjusted to severity of complications, the anastomotic leakage rate, hospital stay and readmissions.
Construction of an Evaluation Indexes Framework of Primary Care Competencies for Chinese General Practitioners
Authors: LU Zhanghong , ZHU Yaxin , HE Xiaoqin , JIN Song , QU Bo
Published: September 2022

Background: The training of general practitioners (GPs) is important for the implementation of a tiered diagnosis and treatment system and realization of Healthy China 2030. A GPs training system in line with Chinese characteristics has been established, of which the standardized residency training program is the most important part. Primary care competencies (PCC) are essential for GPs, but there is a lack of research on the evaluation of PCC for Chinese GPs.
Aim: The study was to construct a more suitable evaluation indexes framework (EIF) of PCC for Chinese GPs by using mixed methods research.
Methods: The research included three steps: (1) Selecting five representative competency frameworks from literature for description, explanation and comparison, extracting evaluation indexes for EIF, and generating an evaluation indexes pool; (2) Using one-to-one in-depth structured interviews with 12 GPs to add new evaluation indexes and generate a preliminary EIF through coding of the interview content; (3) Optimizing the evaluation indexes and determining the EIF by Delphi method consultation with 25 general practice experts.
Results: Five representative competency frameworks of GPs were compared, and sixty-five indexes were selected to establish the evaluation index pool. A preliminary EIF with 120 indexes were generated after in-depth interviews with 12 GPs. These indexeswere refined, leaving 108 indexes for the Delphi process with 25 general practice experts, which produced a final EIF of PCC for GPs including 8 level-1 indexes, 24 level-2 indexes and 76 level-3 indexes.
Conclusion: An evaluation indexes framework of primary care competencies for GPs was established in this study, which had eight level-1 indexes including theoretical knowledge, physical examination, basic skills operation, auxiliary exam interpretation, clinical reasoning, medical documents writing, communication and health management. These represent the primary care competency needs for Chinese GPs.
The Role of Mandibular Disharmony for Adult Obstructive Sleep Apnea in the Machine-learning Facial Recognition
Authors: Chen Qi , Liang Zhe , Wang Qing , Ma Chenyao , Lei Yi , Sanderson John E. , Hu Xu , Lin Weihao , Liu Hu , Xie Fei , Jiang Hongfeng , Fang Fang
Published: September 2022

Purpose: The diagnosis of obstructive sleep apnea (OSA) relies on time-consuming and complicated procedures which are not always readily available and may delay the diagnosis. With the widespread use of Artificial Intelligence, quick identification with simple clinical information and image recognition pointing at craniofacial features might be a useful tool for self-helped screening of OSA.
Methods: The subjects suspected of OSA receiving sleep examination and frontal photographing were consecutively recruited. Sixty-eight points were labelled with automated identification. An optimized model with facial features and basic clinical information was established and ten-folds cross-validation was performed. Area under the receiver operating characteristic curve (AUC) was calculated to evaluate the model’s performance using sleep monitoring as the reference standard.
Results: A total of 653 subjects (77.2% males, 55.3% OSA) were analyzed. CATBOOST was the most suitable algorithm for OSA classification with a sensitivity, specificity, accuracy and AUC of 0.75, 0.66, 0.71 and 0.76 respectively (P<0.05), which was better than STOP-Bang questionnaire, NoSAS scores and Epworth scale. And its advantage was more robust in the prediction of supine sleep apnea with a sensitivity of 0.94. Witnessed apnea by sleep partner was the most powerful variable and followed by body mass index, neck circumference, facial parameters and hypertension.
Conclusion: OSA could be identified by a machine-learning derived model with automatic recognition of facial photo for Chinese adults, which may facilitate screening of suspected subjects in a simple and quick manner by mobile application.
Clinical trial registration
Chinese Clinical Trial Registry: No. ChiCTR-ROC-17011027 (http://chictr.org.cn.)
Potentially Toxic Elements (PTE) Pollution in Apomu Suburban Area on southwestern Nigeria
Authors: Olatunji Omowunmi Stella , Adeyemi Moyosoluwa Odunayo
Published: September 2022

Potentially Toxic Elements (PTE) contaminated soils within urban areas have received global attention. However, little attention is being given to soils of suburban areas, which are also vulnerable to PTE contamination from both natural and unnatural sources. This study was conducted to determine soil quality and PTE pollution sources in soils of Apomu, Southwestern Nigeria. The concentration of PTEs was determined by subjecting soils to elemental analysis using Inductively Coupled Plasma Optical Emission Spectrometry (ICP-OES). Pollution indices and health risks were calculated. The results showed the following range of metal concentrations in ppm except for Al (%) in increasing order; Mo (0.58-12.29), Cu (16.65-687.47), Pb (28.64-368.75), Zn (0-9257.30), Ni (7.60-86.20), Mn (403-1756), Cr (26.40-107), Cd (0.20-11.34), and Fe (1.23-4.29). Geoaccumulation Index (Igeo) showed that Zn, Pb, Ni and Cu and moderately contaminated with Cd. The Enrichment Factor (EF) revealed minimal to very high enrichment of Cu and Zn; minimal to significant enrichment of Pb and As and a minimal to moderate enrichment of Ni and Co. The geochemical evaluation revealed that soils were heavily contaminated with PTEs which were sourced from geogenic and anthropogenic activities. Approximately 70% of sampling areas exhib[1]ited high potential ecological concerns. The hazard index (HI) values for children and adults were less than one (HI < 1), indicating that there was no major danger of poisoning. Carcinogenic risks for Cd, Ni, and Pb were calculated and found to be within tolerable limits, but children are more susceptible to cancer and non-cancer risks than adults.
Efficient Metrics for Data Recovery at Perception Layer: e-health Case Study
Authors: Afzaal Rabia , Jan Saeedullah , Ponum Mahvish , Sana Saba , Adnan Kiran , Jameel Aqsa
Published: September 2022

The Internet of Things (IoT) is one of the most innovative technologies, which promises to improve and optimize daily life using sensors and smart devices. Semantic Web of Things (SWoT) is an extension of IoT that makes it possible for devices to enhance communication between each other by behaving intelligently. The SWoT comprises seven-layer architecture, where the perception layer is one of the most important layers, which is used for collecting data from devices and for ensuring communication with the devices and associated layer. Due to insufficient resources, unpredictable link, noise, collision, and sensor faults, data loss can occur at sensor nodes of perception. This paper defines the recoverability metric for the perception layer of the SWoT architecture. The contribution of this paper is three folds. First, it describes the main challenges for data communication in the perception layer. Second, it focuses on the recoverability metric that recovers the missing data at the perception layer. Finally, the recoverability metric is evaluated and compared with the ISO-9126-1 standard design quality metrics. To develop the design quality of SWoT, different measures, including efficiency, availability, and recoverability, are considered and proved with e-health case study. The results are statistically proven and demonstrate that the application of the proposed metric can enhance the SWoT performance and overcomes the problem of temporal loss of information.
Ingenuity of overlap esophagojejunostomy using a linear stapler in laparoscopic total or proximal gastrectomy
Authors: Hirahara Noriyuki , Matsubara Takeshi , Hayashi HIkota , Takai Kiyoe , Hyakudomi Ryoji , Yamamoto Tetsu , Zotani Hitomi , Taniura Takahito , Ishitobi Kazunari , Tajima Yoshitsugu
Published: September 2022

Background
Intracorporeal esophagojejunostomy in laparoscopy-assisted total or proximal gastrectomy is highly difficult. We developed ingenuity of overlap esophagojejunostomy using a linear stapler to avoid stapler-related intraoperative complications.
Methods
After lymph node dissection was completed, the esophagus was transected in the anterior-posterior direction. The jejunum was divided with a linear stapler approximately 20 cm distal to the ligament of Treitz. A small enterotomy was then created at 5 cm distal from the elevated jejunal stump to insert the linear stapler cartridge. A full-thickness incision was created with an electric knife using the tip of the nasogastric tube (NGT) pressed against the posterior wall side of the esophageal stump as a guide. Full-thickness sutures were applied on both the anterior and posterior walls of the entry hole in the esophageal stump to prevent mis-insertion of the anvil fork into the submucosal layer of esophagus. The thread on the posterior wall side was guided to the outside of the abdominal cavity through the port, into which the linear stapler was inserted to perform side-to-side anastomosis. A 45-mm cartridge fork and an anvil fork were inserted to the entry holes of the elevated jejunum and the esophageal stump, respectively. The esophageal stump was gently grasped. The thread on the posterior wall side was pulled from outside of the abdominal cavity through the port to eliminate the gap between the esophageal wall and the jejunal wall. The linear stapler was fired to create anastomosis after confirming that the anvil fork was not mis-inserted into the submucosal layer of esophagus and there was no gap between the esophagus and the elevated jejunum. The insertion hole was closed with hand-sewn sutures or linear staples to complete the esophagojejunostomy.
Results
Seven patients received this procedure with no stapler-related complications.
Conclusions
This method enables us to perform an easier and more stable esophagojejunostomy.
Study on the Influence of Matrix on Mechanical and Failure Properties of Miscellaneous Fill
Authors: Chen Yu , Qu Xiao , Zhang Fuhai , Liu Zhengrong , Wang Jiahui
Published: September 2022

Urban miscellaneous fill is a particular type of heterogeneous soil with complex structure and various components, and its mechanical and failure properties are related to matrix characteristics. Using the laboratory medium-sized triaxial test, we carried out 100, 200, and 400 kPa confining pressure tests on clay, silt and sand matrix miscellaneous fills with the stone content of 30%, respectively, and analyzed the influence of the matrix on the mechanical properties of the miscellaneous fill. The results reveal that the miscellaneous fill (σ1-σ3)～εa the relation curve can be considered as hyperbola. The miscellaneous fill with clay and silt matrix always shows shear shrinkage. When the confining pressure is 100kPa, the miscellaneous fill with sand matrix shows shear shrinkage first and then shear dilatancy. When the confining pressure is 200 and 400kPa, it shows shear shrinkage. Furthermore，We used the particle flow method to carry out the biaxial test of three kinds of matrix miscellaneous fill under confining pressure of 200kPa, and analyzed the influence of miscellaneous fill on the failure properties. The test result shows that in the initial loading stage, the specimen is dominated by compaction deformation. As the load increases, the deformation of the specimen is dominated by compaction and particle rotation. When the matrix is clay, the shear zone is obvious and the shear failure surface is stable. When the matrix is silt, the contact cracks become thinner and the shear bands increase. When the matrix is sand, compared with clay matrix, the overall crack is finer and the shear fracture surface is irregularly distributed. Relevant research results can provide theoretical guidance for urban miscellaneous fill landfill.
Identification of cuproptosis-related lncRNAs Prognostic Signature in Gastric cancer and Its Impact on the Tumor Microenvironment
Authors: Zhang Jianming , Yang Yan , Li Zuyin , Ding Qi , Song Jiahong , Wan Ziang , Li Tengfei
Published: September 2022

Background: There is extensive genetic and transcriptional heterogeneity in Gastric cancer (GC). Increasing evidence has demonstrated that cuproptosis could exert an important function in tumor progression. Long noncoding RNAs (lncRNAs)，which exert a pivotal function in the development of GC, especially involving in tumor-associated immune progression. Thus, it is indispensable to establish a cuproptosis-related lncRNAs (crlncRNAs)signature.
Methods: Based on 19 genes associated with cuproptosis, to investigate whether lncRNA was markedly associated with cuproptosis, Pearson correlation analysis came in handy. To identify characteristics of copper death-related lncRNAs and build predictive models, univariate Cox regression and least absolute shrinkage and selection operator (LASSO) analysis were used to identify 6 key cuproptosis-related lncRNAs (crlncRNAs). To validate the predictive power of the signature, Cox regression on the univariate and multivariate data, Kaplan-Meier survival analysis, receiver operating characteristic curves (ROC), area under the curve (AUC) are used in the training, testing, and total sets. We further examined the functional enrichment, the status of immune cells, immune cell infiltrations, landscape of mutation status, Tumor Immune Dysfunction and Exclusion (TIDE) score, correlation and drugs sensitivity among the different risk groups.
Results: 16 prognostically related crlncRNAs(PRcrlncRNAs) were filtered to make the prognostic signature, 6 key crlncRNAs were included. The risk score was the independent parameter in predicting OS (Overall survival) according to Cox regression on the univariate and multivariate data and it is acceptable in predicting prognosis concerning the accuracy of the model, which is confirmed by ROC analysis in GC patients. Differences in median OS and PFS (progression-free survival) between high- and low-risk groups were statistically significant. The TIDE score was higher in high-risk patients, which could predict less chemosensitivity with some drugs in the light of the TIDE analysis.
Conclusions: Our study is innovative to develop and validate a novel STAD-associated crlncRNAs model that could effectively instruct the prognosis, as well as participating in the immune microenvironment in STAD, which would provide a new insight in the development of molecularly targeted therapies associated to cuproptosis.
Effect of water vapour and oxygen partial pressure on oxidation of Fe and Fe-Cr alloys
Authors: Chen Jiarui , Shen Zhao , Zhang Jianqiang
Published: September 2022

Pure iron and binary Fe-Cr alloys containing 5-30 wt% Cr were exposed to Ar-20O2, Ar-20H2O and Ar-20O2-20H2O (vol%) for 10, 100 and 300 h at 700°C. For pure iron, three typical oxides (Fe2O3, Fe3O4 and FeO) were formed in all gas conditions with a thick FeO layer beneath the thin Fe3O4 and Fe2O3 layers. The presence of water vapor led to a thicker FeO with an increased adherence with the metal surface. For Cr-containing alloys, the oxidation kinetics and oxide morphologies depended strongly on reaction condition (water vapor and pO2) and Cr concentration. Water vapor was found to markedly accelerate the oxidation rate and increase the critical Cr concentration for protective chromia formation, from 10-20 wt% Cr in the dry gas to more than 30 wt% Cr in both wet gases. In addition, water vapor enhanced the oxygen inward diffusion and oxygen permeability, leading to the formation of a thicker inner oxide layer and better scale adherence. By comparing results in H2O-only and H2O + O2 gases, the change of oxygen partial pressure did not affect much on the oxidation rate, but affected the scale morphology by forming much less Fe2O3 on the top of oxide scale in H2O-only gas. For high Cr alloys where a chromia scale can form, the co-existence of water vapor and oxygen led to chromia volatilization, reducing the stability of the chromia. These phenomena were discussed based on the interaction of water vapor on diffusion processes and its effect on oxide formation and stability.
Heavy Metal Concentration and Pollution Status of Cross River in Afikpo Catchment Area, Ebonyi State, Nigeria
Authors: Anya Chibuike Benjamin , Odo Gregory Ejikeme
Published: September 2022

Heavy metals are notable chemicals that threaten river ecosystems and freshwater supplies from surface waters. The levels of some heavy metals-Mn, Fe, Zn, Pb, Cu, Cr and As-in Cross River were monitored over twelve months in 2018 to establish the pollution status and potability of the river. Water and sediment samples were collected from three stations of the river and analysed according to standard procedures. The result reveals that the heavy metals detected in the surface water and bottom sediment of the river showed temporal patterns of variation. The decreasing order of heavy metal concentration in the water was Fe > As > Pb > Zn > Mn > Cr > Cu, while that of the sediment was Fe > Mn > Zn > Pb > As > Cr > Cu. The bottom sediment was observed to contain higher concentrations of heavy metals than the surface water, signifying the accumulation of these chemicals in the bottom sediment. Fe, Pb, As and Cr in the surface water correlated significantly (p < 0.05) and positively with their respective type in the bottom sediment. Most of the heavy metals (Fe, Mn, Pb, As and Cr) were detected at higher levels above the SON, WHO, EU and USEPA permissible limits, hence, the water was polluted with these metals and that made the potability of the river objectionable.
Gene detection in a family with monilethrix and observation of the treatment effect with 5% topical minoxidil
Authors: Shen Qingli , Fu Zhonghua , Du Pengqiang , Wang Jianbo
Published: September 2022

ObjectiveTo determine the causative gene mutation in a family with monilethrix and observe the therapeutic effect of minoxidil topical, 5% liniment.MethodClinical data from a family with monilethrix were collected. Peripheral blood samples were taken from the proband, the parents, and 100 unrelated healthy controls. Genomic DNA was extracted. The genetic variation sites were screened with genome-wide exome sequencing and verified by Sanger sequencing. The proband was treated with minoxidil topical, 5% liniment (1mL twice daily). Hair quality was examined by dermoscopy before and after treatment.ResultsThe proband and her father have the heterozygous missense variant c.1204G>A (p.E402K) in exon 9 of theKRT86gene. However, the mutation was not found in the mother and healthy controls. The proband was treated with minoxidil topical, 5% liniment. Hair density and hair shaft quality improved significantly after six months of treatment. No adverse events occurred during treatment.ConclusionThis study shows that p.E402K is a mutation “hotspot” in patients with autosomal dominant monilethrix in China. Treatment with topical minoxidil, 5% liniment, is safe and effective.
Augmented reality HUD vs. conventional HUD to perform a navigation task in a complex driving situation
Authors: Chauvin Christine , Said Farida , Langlois Sabine
Published: September 2022

This study aims at investigating the added value of an augmented reality head-up display (AR-HUD) in relation to a conventional head-up display (C-HUD) to perform navigation tasks in a complex road situation. The notion of complexity was defined according to two main factors: infrastructure and traffic. It was used to identify and select real road situations presenting different sources of complexity. This study focuses on one of these situations, which was reproduced on a simulator and broken down into three use cases. A total of 32 participants performed three navigation tasks, using the AR-HUD or the C-HUD. Both objective and subjective data were collected. Data analyses, using linear mixed model analyses of variance and multilevel logistic regression, indicate a slight advantage of the AR-HUD. Participants using the AR-HUD make fewer errors and drive faster on average. Moreover, the AR-HUD is assessed to be more useful and easier to understand than the C-HUD. However, this interface shows limitations, in particular because it does not enable drivers to anticipate the manoeuvre to be conducted. The study raises questions about the design of an instrument system that would help drivers not only identify, but also build a representation of a forthcoming manoeuvre to be performed.