bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of Peripheral Dose for Varian Trilogy Linear Accelerator
Authors: Yang Bo , Pang Tingtian , Sun Xiansong , Dong Tingting , Li Rui , Hu Ke , Zhang Fuquan , Qiu Jie
Published: March 2021

Objective To measure and evaluate the peripheral dose(PD) for Trilogy linear accelerator in different setup condition and investigate the feasibility of the diode dosimetric system to measure the peripheral dose.Methods Peripheral dose were measured using a CC13 ionization chamber and the diode dosimetric system in a set of solid water phantom. Measurements were performed for different depths, field sizes, physical and virtual wedge, radiation beam energy and up at distance of 1cm to 31cm beyond the field edges. PD is separated into PDleakage and PDscatter by measure peripheral dose with or without scattering phantom. CRIS phantom was used for this research with the diode dosimetric system at the interest points of the breast, thyroid, and lens.Results All the measure data were normalized to isocenter. The measured PD decreases exponentially as a function of distance up to 31cm from the edge. PD shows no significant relevant to depth and it increases with the increased field size. As the physics wedge angle increase, PD increases about 1%, but enhanced dynamic wedge decreased 2-3% compared with open field. As the beam energy increase, PD decreased. All PD data difference less than 1% between CC13 ionization chamber and diode. The PD of CRIS phantom for Volume Modulated ARC Therapy (VMAT) is minimum and the mean dose for breast、thyroid and lens is 6.72 mGy、2.90 mGy and 2.37 mGy respectively.Conclusion The diode dosimetric system provides an sufficient assessment in peripheral regions of 6MV X-ray beam. PD changes because of field size、depth、beam energy etc and the assessment of PD would be helpful to evaluate the dose received by the relevant critical structures near the treatment field. Furthermore it is advantaged to use external shielding for critical organs.
Basil Polysaccharide Reverses Development of Experimental Model of Sepsis-Induced Secondary Staphylococcus Aureus Pneumonia
Authors: Chen Xi , He Yue , Wei Qiang , Wang Chuanjiang
Published: March 2021

Background: Basil polysaccharide (BPS) represents a main active ingredient extracted from Basil (Ocimum basilicum L.), which can regulate secondary bacterial pneumonia development in the process of sepsis-mediated immunosuppression.Methods: In this study, a dual model of sepsis-induced secondary pneumonia with cecal ligation and puncture and intratracheal instillation of Staphylococcus aureus or Pseudomonas aeruginosa was constructed.Results: The results indicated that BPS treated mice undergoing CLP showed resistance to secondary S. aureus pneumonia. Compared with the IgG treated group, BPS treated mice exhibited better survival rate along with higher bacterial clearance rate. Additionally, BPS treatment attenuated cell apoptosis, enhanced lymphocytes and macrophages recruitment to the lung, promoted pulmonary cytokine production, and significantly enhanced CC receptor ligand 4 (CCL4). Notably, recombinant CCL4 protein could enhance the protective effect on S. aureus-induced secondary pulmonary infection of septic mice, which indicated that BPS induced CCL4 partially mediated resistance to secondary bacterial pneumonia. In addition, BPS priming markedly promoted the phagocytosis of alveolar macrophages while killing S. aureus in vitro, which was related to the enhanced p38MAPK signal transduction pathway activation. Moreover, BPS also played a protective role in sepsis-induced secondary S. aureus pneumonia by inducing Treg cell differentiation.Conclusions: Collectively, these results shed novel lights on the BPS treatment mechanism in sepsis-induced secondary S. aureus pneumonia in mice.
GaAs Periodic Half Octagonal Cut Based Nano Texturized Hexagonal Shaped Nanopillar Array Structure for Highly Responsivephotodetector’s Performance
Authors: Baruah Smriti , Maity Santanu , Bora Joyatri
Published: March 2021

Efficient light absorption is the most crucial factor for high spectral responsive photodetection phenomenon. Nanopillars for photodetection constitute a great opportunity in enhancing the light absorption efficiency along with reducing the electrical cross-section of the device. Here an analytical investigation of a proposed periodic GaAs material based half octagonal cut based vertically oriented hexagonal nanopillar array deployed over a 5um x 5um front detector’s surface has been done for attaining an optimum light absorbance by reducing the surface reflectivity of the incoming photons. The geometrical analysis of the proposed model exhibits a 0.999 absorbance and 0.97A/W photoresponsivity along with 86% EQE at 1um operating wavelength.
Radiographic and Clinical Outcomes of Surgical Treatment of Kümmell’s Disease With Thoracolumbar Kyphosis: A Minimal Two-Year Follow-Up
Authors: Cheng Hao , Wang Guo-dong , Li Tao , Liu Xiao-yang , Sun Jian-min
Published: March 2021

Background: To evaluate the short to mid-term radiographic and clinical outcomes of the restoration of normal spinal alignment and sagittal balance in the treatment of Kümmell’s disease with thoracolumbar kyphosis. Methods: Between February 2016 and May 2018,30 cases of Kümmell’s disease with thoracolumbar kyphosis were divided into two groups (A and B) according to whether the kyphosis was combined with neurological deficits.All of the cases underwent surgical treatment to regain the normal spinal alignment and sagittal balance.And the radiographic outcomes and clinical results of these 30 patients were retrospectively evaluated.The sagittal imaging parameters including sagittal vertebral axis (SVA),thoracic kyphosis (TK),thoracolumbar kyphosis (TLK),lumbar lordosis (LL),pelvic incidence (PI),pelvic tilt (PT),and sacral slope (SS)of the whole spine before operation,immediately after operation,and the last follow-up of each group were measured and evaluated.The clinical results included the Oswestry Disability Index (ODI) and the Numerical Rating Scale (NRS) of the two groups .Results: The average follow-up period of group A and B were 34.2 and 38.7 months respectively.The parameters of both groups such as SVA,TLK,and thoracolumbar Cobb angle after surgery and at the last follow-up were significantly improved compared with those before surgery.The ODI and the NRS of the two groups at the last follow-up were also significantly improved. Conclusion: In the treatment of Kümmell’s disease with thoracolumbar kyphosis,to restore the normal alignment and sagittal balance can obtain a satisfactory radiographic and clinical short and medium-term effects.
Yoda1 Activates Piezo1 in Vitro to Simulate the Upregulation of Piezo1 in the Infected Brain: Piezo1 Participates in the Immune Activation of Microglia.
Authors: Luo Heguo , Liu Hailin , Bian Wengong , Chen Bochao , Yang Dongxia , Yang Mingmin
Published: March 2021

Aim: The expression of Piezo1 in reactive glial cells in the peripherally infected patient's brain was upregulated. This study aimed to determine whether Piezo1 is involved in the immune activation of microglial cells induced by bacterial lipopolysaccharides.Materials and methods: BV2 cells were used as a model of brain microglia. In vitro, Yoda1 was used to activate Piezo1 in BV2 cells, and Piezo1 was simulated for LPS-induced Piezo1 activation to evaluate the role of Piezo1 in microglial inflammatory activation.Key findings: In vitro, LPS upregulates the expression of Piezo1 in microglial cells through TLR4. In the absence of LPS, Yoda1 treatment of microglia produced similar immune function changes as LPS treatment. This indicates that Piezo1 plays a role in LPS-induced microglial immune activation. Specifically, Piezo1-mediated Ca2+ signals are involved in the immune activation of microglia. Piezo1-mediated Ca2+ regulates multiple signaling mechanisms downstream of TLR4, including the JNK1, mTOR and NF-κB signaling pathways, which are related to the immune activation of microglia.Significance: Piezo1 is involved in the immune response of microglia to LPS. Changes in Piezo1 activity may play an indispensable role in the immune response of microglia, and mechanical environmental changes may affect neuroinflammatory progression through Piezo1.
Collaborative Care in Secondary Prevention of Cardiovascular Disease in India: Findings From A Multi-Stakeholder, Qualitative Analysis
Authors: Singh Kavita , Huffman Mark D. , Tandon Nikhil , Devarajan Raji , Prabhakaran Dorairaj , Mendenhall Emily
Published: March 2021

Background. Cardiovascular disease (CVD) is pervasive in India, and little is known about the perception of patients and providers about collaborative care in secondary prevention of CVD. To fill this gap, we performed a needs assessment and investigated the barriers and facilitators of the collaborative quality improvement (C-QIP) strategy for secondary prevention of CVD in India.Methods. Between September 2019 – February 2020, we conducted semi-structured in-depth interviews with providers, health administrators, patients and caregivers to understand the challenges and facilitators of the C-QIP strategy consisting of electronic health records-decision support system (EHR-DSS), non-physician health worker and text messages for healthy lifestyle. Also, data were analyzed from the lens of consolidated framework for implementation research (CFIR) to guide effective implementation of the C-QIP strategy. We used an iterative approach for qualitative data analysis based on the framework method. Results. We interviewed 38 physicians, 14 non-physician health workers (nurses, community health workers, pharmacists), 4 health administrators, 16 patients and their caregivers. Challenges perceived from providers’ and health administrators’ perspectives to implement quality in CVD care were related to CFIR actors and inner and outer settings: high patient volume, too few specialists, time-constraints, physician burnout, lack of robust communication system or referral linkage, paucity of electronic health records, lack of patient counsellors, polypharmacy and lack of sustainable financing schemes for outpatient services. In addition, low health literacy, high cost of treatment, misinformation bias, and difficulty in maintaining lifestyle changes were key barriers from patients’ and caregivers’ perspectives. Potential benefits of the C-QIP strategy emerged, such as standardized treatment protocol to minimize variation in care, reduced medication errors, improved physician-patient relationships, and enhanced self-care management. However, concerns were raised about feasibility, adoption, and implementation of EHR-DSS across heterogenous healthcare settings, including related to interoperability, patient confidentiality and data security, appropriateness across diverse patient groups, and care delivery costs.Conclusions. Our findings reveal context-specific, patient-, provider- and health system factors that will influence C-QIP strategy implementation in India. Strategies to optimize chronic care of CVD need to be low-cost, culturally acceptable, targeted, and integrated into existing systems and care pathways to be successful.
Endoscopic Injection Sclerotherapy Improves Liver Function Compared with Endoscopic Variceal Ligation
Authors: Hayashi Tsuguru , Watanabe Tatsuyuki , Shibata Michihiko , Kumei Shinsuke , Oe Shinji , Miyagawa Koichiro , Honma Yuichi , Harada Masaru
Published: March 2021

Liver function is a most important prognostic factor in patients with liver cirrhosis. Also, portal hypertension is a fatal complication of liver cirrhosis and variceal treatment is indispensable. However, changes of liver functions after endoscopic variceal treatments are still unknown. The aim of this study was to evaluate liver functions after endoscopic injection sclerotherapy (EIS) and endoscopic variceal ligation (EVL). A total of liver cirrhotic 103 patients who underwent prophylactic EIS and EVL were enrolled. Liver functions were assessed by blood test taken at before and 3 months after EIS and EVL. In EIS group, albumin and prothrombin time improved significantly (p < 0.01), which led to improvement of Child-Pugh score, ALBI score and MELD score (p < 0.05). However, these factors did not improve in EVL group. Overall survival (OS) rate was significantly higher in EIS group than EVL group. Subsequently, in EIS group patients who improved albumin showed significantly better OS than those who did not improved. In multivariate analysis, improvement of albumin at 3 months after EIS was associated with better prognosis (HR: 0.38, 95% confidence interval: 0.19- 0.77, p = 0.007). These results revealed that EIS could improve liver functions and prognosis.
Maternal Region of Origin and Small for Gestational Age: A Cross-sectional Analysis of Victorian Perinatal Data.
Authors: Grundy Sarah , Lee Patricia , Small Kirsten , Ahmed Faruk
Published: March 2021

BackgroundBeing born small for gestational age is a strong predictor of the short- and long-term health of the neonate, child, and adult. Variation in the rates of small for gestational age have been identified across population groups in high income countries, including Australia. Understanding the factors contributing to these population group differences may assist clinicians to reduce the morbidity and mortality associated with being born small. Victoria, in addition to New South Wales, accounts for the largest proportion of net overseas migration and births in Australia. The aim of this research was to analyse how migration was associated with small for gestational age in Victoria.Methods This was a cross sectional population health study of singleton births in Victoria from 2009 to 2018 (n = 708,475). The prevalence of being born small for gestational age (SGA; < 10th centile) was determined for maternal country of origin groups. Multivariate logistic regression analysis was used to analyse the association between maternal region of origin and SGA.Results Maternal region of origin was an independent risk factor for SGA in Victoria (p < .001), with a prevalence of SGA for migrant women of 11.3% (n = 27,815) and 7.3% for Australian born women (n = 33,749). Women from South East Asia, South Central Asia, or Sub Saharan Africa, OR 1.75 (95%CI: 1.70 to 1.8), women from North and North East Africa, Middle East, OR 1.40 (95%CI: 1.35 to 1.45) and migrant women from the Americas, Europe, and Oceania, OR1.06 (95%CI: 1.02 to 1.12) more likely to birth an SGA child in comparison to women born in Australia.Conclusions Victorian woman’s region of origin was an independent risk factor for SGA. Variation in the rates of SGA between maternal regions of origin indicates additional factors such as, a woman’s pre migration exposures, the context of the migration journey, settlement conditions and the social environment post migration impact the potential for SGA. These findings highlight the importance of intergenerational improvements to the wellbeing of migrant women and their children. Further research is required to identify modifiable elements that contribute to birthweight differences across population groups.
Clinical utility of metagenomic next-generation sequencing in suspected central nervous system infectious pediatric patients with empirical treatment: a cohort study
Authors: Guo Bin-Fang , Ding Meng-Xiao , Xue Jing-Ru , Yan Dan-Ni , Sun Su-Zhen
Published: March 2021

Background: Metagenomic next generation sequencing (mNGS) is becoming an increasingly available diagnostic method used to identify a broad range of pathogens. However, the optimal role of mNGS in clinical diagnostic schema remains uncertain, especially in pediatric patients suspected central nervous system (CNS) infection and treated with empirical antibiotic. The purpose of this study was to investigate the usefulness of cerebrospinal fluid (CSF) mNGS in the pediatric patients.Methods: We performed a retrospective review of suspected CNS infection patients who had CSF mNGS test from April 2019 to December 2020. Results and clinical impact of mNGS test were collected. We investigated the usefulness of CSF mNGS in clinical impact and diagnosis. Results: We enrolled 57 pediatric patients with empirical treatment. A total of 39 CNS infection patients were diagnosed, and 27 patients were identified by mNGS that only 2 of 27 were co-identified by CSF culture. In all of the patients, 75.4% (45 cases) had changed (addition or de-escalation) in antimicrobial therapy according to the results of the mNGS test. By each CSF mNGS test as a whole, the positive and negative percent agreement were 69.2% (95% CI: 54.1-84.4%) and 61.1% (95% CI: 36.2-86.1%), respectively, and true negatives of negative mNGS tests were 50% (95% CI: 27.3 – 72.7%).Conclusion: In this study, CSF mNGS test improved the diagnosis of neurologic infections and adjusted antibiotic therapy in the vast majority of cases. Consequently, for patients with empirical treatment, CSF mNGS should be used more in pathogen diagnosis and clinical therapy.
Study the Structure and Dynamics of Antifungal Agent Ketoconazole by CSA and Site-Specific Spin-Lattice Relaxation Time Measurements
Authors: Dey Krishna Kishor , Ghosh Manasi
Published: March 2021

An azole antifungal agent, ketoconazole, is widely used in the treatment of mucosal fungal infections related to AIDS immunosuppression, organ transplantation, and cancer chemotherapy. The structure and dynamics of ketoconazole are thoroughly studied by chemical shift anisotropy tensor and site-specific spin-lattice relaxation time measurements. The molecular correlation time at crystallographically different carbon sites is calculated by considering that the spin-lattice relaxation mechanism for the 13C nucleus is mainly governed by chemical shift anisotropy interaction and hetero-nuclear dipole-dipole coupling. The CSA parameters at the crystallographically distinct sites of ketoconazole are determined by two-dimensional phase adjusted spinning sideband (2D PASS) cross-polarization magic angle spinning (CP-MAS) solid-state NMR experiment. The site-specific spin-lattice relaxation time is measured by the Torchia CP experiment. The spin-lattice relaxation rate is slow for all the carbon nuclei sites except C2, C3, C4, C5, and C26 carbon nuclei reside on the piperazine ring and the methyl group. It suggests the close-pack arrangement of the molecule due to π-π stacking interaction. The molecular correlation time of all the carbon atoms reside on the benzene ring, 1,3-dioxolane ring, imidazole ring, and the 2,4-dichlorobenzene ring is of the order of 10-4 s, while it is of the order of 10-7 s for carbon atoms reside on the piperazine ring. The CSA parameters of the carbon nuclei on the piperazine ring (C2, C3, C4, C5), and the methyl group (C26) are very low compared to other carbon nuclei. The CSA parameters are very high for carbon nuclei reside on the benzene ring, imidazole ring, and the 2,4-dichlorobenzene ring due to the presence of π-electrons. A huge variation of the spin-lattice relaxation time and the molecular correlation time are observed for numerous carbon nuclei situated on the side-chain of ketoconazole. The spin-lattice relaxation time varies from 500 s to 8 s, and the molecular correlation time varies in the range of 10-4s to 10-7s. These types of investigations portrayed the correlation between the structure and dynamics of the antifungal drug ketoconazole, which will help to develop the advanced antifungal drugs. Additionally, the CSA information of the drug molecules will be immensely useful for NMR crystallography.
Aspartate Aminotransferase to Alanine Aminotransferase Ratio is Associated with Frailty and Mortality in Older Patients with Heart Failure
Authors: Maeda Daichi , Kagiyama Nobuyuki , Jujo Kentaro , Saito Kazuya , Kamiya Kentaro , Saito Hiroshi , Ogasahara Yuki , Maekawa Emi , Konishi Masaaki , Kitai Takeshi , Iwata Kentaro , Wada Hiroshi , Hiki Masaru , Dotare Taishi , Sunayama Tsutomu , Kasai Takatoshi , Nagamatsu Hirofumi , Ozawa Tetsuya , Izawa Katsuya , Yamamoto Shuhei , Aizawa Naoki , Yonezawa Ryusuke , Oka Kazuhiro , Momomura Shin-ichi , Matsue Yuya
Published: March 2021

Frailty is a common comorbidity associated with adverse events in patients with heart failure, and early recognition is key to improving its management. We hypothesized that the AST to ALT ratio (AAR) could be a marker of frailty in patients with heart failure. Data from FRAGILE-HF study were analyzed. A total of 1,327 patients aged ≥ 65 years with hospitalized heart failure were divided into three groups based on their AAR at discharge: low AAR (AAR < 1.16, n = 434); middle AAR (1.16 ≤ AAR < 1.70, n = 487); high AAR (AAR ≥ 1.70, n = 406). The primary endpoint was one-year mortality. The association between AAR and physical function were also assessed. High AAR was associated with lower short physical performance battery and shorter 6-minute walk distance, and these associations were independent of age and sex. Logistic regression analysis revealed that high AAR was an independent marker of physical frailty after adjustment for age and sex. During follow-up, all-cause death occurred in 161 patients. After adjusting for confounding factors, high AAR was associated with all-cause death (low AAR vs. high AAR, hazard ratio: 1.57, 95% confidence interval, 1.02–2.42; P = 0.040). In conclusion, AAR is a marker for frailty and prognostic of all-cause mortality in older patients with heart failure.
Extracellular Volume Quantification using Synthetic Haematocrit Assessed from Native and Post-contrast Longitudinal Relaxation T1 Times of a Blood Pool
Authors: Opatril Lukas , Panovsky Roman , Machal Jan , Holecek Tomas , Masarova Lucia , Feitova Vera , Kincl Vladimir , Hodejovsky Marek , Spinarova Lenka
Published: March 2021

Background: In terms of cardiovascular magnetic resonance are haematocrit values required for calculation of extracellular volume fraction (ECV). Previously published studies have hypothesized that haematocrit could be calculated from T1 blood pool relaxation time, however only native T1 relaxation time values have been used and the resulting formulae had been both in reciprocal and linear proportion. The aim of the study was to generate a synthetic haematocrit formula from only native relaxation time values first, calculate whether linear or reciprocal model is more precise in haematocrit estimation and then determine whether adding post-contrast values further improve its precision.Methods: One hundred thirty-nine subjects underwent CMR examination. Haematocrit was measured using standard laboratory methods. Afterwards T1 relaxation times before and after the application of a contrast agent were measured and a statistical relationship between these values was calculated.Results: Different linear and reciprocal models were created to estimate the value of synthetic haematocrit and ECV. The highest coefficient of determination was observed in the combined reciprocal model “-0.047 + (779/ blood native) – (11.36/ blood post-contrast)”.Conclusions: This study provides more evidence that assessing synthetic haematocrit and synthetic ECV is feasible and statistically most accurate model to use is reciprocal. Adding post-contrast values to the calculation was proved to improve the precision of the formula statistically significantly.
Moving Forward from the “Boot Camp Method” To Learning-Curve Development in Simulation-Based Paracentesis Training For Undergraduate Medical Students
Authors: Inzunza Martin , Tejos Rodrigo , Villagrán Ignacio , Fuentes Eduardo , Contreras Caterina , Vela Javier , Pizarro Margarita , Alseidi Adnan , Varas Julian , Riquelme Arnoldo
Published: March 2021

Background: Abdominal paracentesis is an essential competence for physicians. Simulation-based mastery learning (SBML) programs lead to developing these skills for medical students. Most programs are structured as short boot-camps, without assessing skills' retention mid and long-term or learning curves.Aim: To assess the learning curve of paracentesis through an SBML program for medical students and compare this learning curve-based program with the boot-camp method.Methods: A prospective quasi-experimental study was conducted. A cohort of medical students participated in an SBML program with successive sessions until proficiency criteria were met while their learning curve was assessed (LC group). A control group received an SBML boot-camp intervention (BC group). As a proficient group, gastroenterology fellows (GF group) performed a paracentesis on the simulated model. The skills of the three groups were compared using technical/proficiency scores. Learning curves and cost analysis were performed.Results: 100% of the LC group achieved proficiency in the fourth session, with a flattening learning curve between third-fourth sessions. Comparing the initial and final sessions of LC group showed a significant improvement in their scores. When comparing the three groups, statistical differences were found in the skill scores, with the BC group having the lowest. The overall cost per participant was highest for the LC group.Conclusion: This study identifies a learning curve for paracentesis with an SBML program. The LC group significantly improved their skills, comparable with the GF group’s performance. SBML focused on a learning curve ensured better skills acquisition than the “boot-camp method.”
The Safety of Non-Transport Decisions Made by Ambulance Personnel: A Retrospective Study of Subsequent Hospital Admission and 30-Day Mortality
Authors: Amundsen Kjersti , Elden Marie Svanes , Myrmel Lars , Assmus Jörg , Lange Audun , Brattebø Guttorm
Published: March 2021

BackgroundAmbulance missions do not always result in the patient being transported to a doctor or hospital after evaluation at the scene by ambulance personnel. Sometimes a patient is discharged at the scene but should have been transported for further examination and treatment. In this study, we aimed to identify and describe this group, and to investigate subsequent hospital admission within 72 hours and 30-day mortality, which may indicate the safety of leaving a patient at the scene after examination. MethodThis retrospective study was carried out in the Bergen health trust in western Norway and included ambulance missions from 2018. For each mission, we recorded the patient’s demographic information (age, gender, time of day), initial reason for contacting the emergency medical service (EMS), hospital admissions after non-transport, and time of death if within 30 days, in addition to some other variables. ResultsAmong 33,183 included acute and urgent ambulance missions, 7.3% of the patients were discharged at the scene after evaluation by ambulance personnel. The median age in this group was 47 years (IQR 28–70 years), compared to 64 years (IQR 39–80 years) for all included missions. Following a non-transport decision, 4.8% of the patients were admitted to a public hospital within 72 hours (median age, 59 years; IQR 35–76 years), with mental and behavioral disorders (ICD-10 chapter V) being the most common reason for admission (24.8%). The 30-day mortality rate following non-transport mission was 2.4%. In this group, the median age was 83 years (IQR 73–90 years), and the most common reasons for contacting EMS were breathing difficulties or lung diseases (25.4%), and injuries or fractures (18.6%). ConclusionOur present analysis revealed low rates of hospital admission within 72 hours, and 30-day mortality, among patients left at the scene following evaluation by ambulance personnel. These findings do not suggest an unsafe rate of non-transport in the Bergen EMS. There remains a need for further evaluation of the factors involved in the decision not to transport a patient, and the safety of these decisions.
Ongoing Epidemiological Changes in Hand, Foot, and Mouth Disease Following the Introduction of Enterovirus 71 Vaccines in Yunnan Province, China, 2008-2019
Authors: Jiang Li , Jiang Hongchao , Tian Xin , Xia Xueshan , Huang Tian
Published: March 2021

Background:Since 2016, enterovirus 71 (EV71) vaccines have been approved for market entry, and litter is known about how the epidemiology of hand, foot, and mouth disease (HFMD) has been affected by the introduction of the vaccines in Yunnan Province. The study describes the ongoing epidemiological changes in HFMD following the introduction of EV71 vaccination in Yunnan.Methods:Surveillance data collected between 2008 and 2019 were analyzed to produce EV71 vaccination coverage, epidemiological distribution on cases, and etiologic composition as well as to compare these characteristics before and after EV71 vaccination.Results:A total of 1,653,533 people received EV71 vaccines from 2016 through 2019 in Yunnan. The cumulative EV71 vaccination coverage rate was 68.14%. After the introduction of EV71 vaccines, the overall incidence of HFMD increased and reached over 200 cases per 100,000 population-years in 2018 and 2019. However, the case severity and case fatality rate decreased and remained lower than 1% and 0.005% after 2016, respectively. EV71-associated mild, severe and fatal cases sharply decreased. The predominant viral serotype changed to non-EV71/non-CV-A16 enteroviruses which were detected across the whole province.Conclusions: EV71 vaccination helped to reduce severe HFMD. However, other enteroviruses became the predominant strain and let to a higher incidence. Expanding EV71 vaccination and strengthening laboratory-based surveillance could further decrease the burden of severe HFMD and reveal the existence of emerging enteroviruses.
A continuous conversion technology from top coal caving into multi-slice mining for thick bifurcated coal seams
Authors: Deng Xuejie , Liu Hao , Feng Jianye , Li Yu , de Wit Benjamin
Published: March 2021

This paper presents a mining technology that enables the continuous conversion from top coal caving (TCC) to multi-slice mining (MSM). The technology helps operations overcome challenges with mining thick bifurcated coal seams, particularly the challenge of rock-parting seams affecting the caving of TCC mining methods. Findings show that the relationship between the rock-parting thickness and the caveability of top coal can be divided into 3 phases, including a complete caving phase, a transition phase, and a stable phase. This continuous conversion technology was applied in the Zhongwei Coal Mine in which TCC was used to extract the initial 260 m of the study area where the rock-parting seam was relatively thin before a transition to MSM was made due to the rock-parting seam becoming significantly thicker. The continuous conversion to MSM involved the working face advancing upward at an angle of 10 degrees until the rock-parting seam could serve as the immediate floor for the upper slice of the coal seam. The rock-parting seam floor also acted as the immediate roof for the working face of the subsequently mined lower slice. The application of this continuous conversion mining technology obtained good application results.
Exogenous Application of Silicon Can Help Augment Drought Tolerance in Wheat (Triticum aestivum L.) by Enhancing Morpho-physiological and Antioxidant Potential
Authors: Aurangzaib Muhammad , Ahmad Zahoor , Jalil Muhammad Imran , Nawaz Muhammad Faheem , Shaheen Muhammad Rashid , Ahmad Maqshoof , Hussain Azhar , Ejaz Muhammad Kashif , Tabassum Muhammad Adnan
Published: March 2021

Drought stress is considered one of the most severe stresses, which can result in devastating yield reduction in agriculture crops. There are many approaches recommended by the researchers and adopted by the farmers to minimize the devastating effect of drought. However, exogenous application of growth regulators in combination to plant nutrients is the innovative attitude to ameliorate the shocking effects of drought stress. So we planned a study to investigate the ameliorative effect of exogenously applied potassium silicate wheat (Triticum aestivum L.) crop under water deficit conditions. The current study was conducted at the Agronomic Research Farm area, Faculty of Agriculture and Environment, The Islamia University of Bahawalpur. RCBD-Split plot design with four repeats was used. The treatments consist on “T0” (Control), “T1” (exogenous application of potassium silicate @ 1% solution), “T2” (exogenous application of potassium silicate @ 2% solution), “T3” (exogenous application of potassium silicate @ 3% solution). The results of our study revealed that drought stress can significantly affect crop yield as a result of the reduction in chlorophyll-a (1.07), chlorophyll-b (0.49), total chlorophyll contents (1.62), flag leaf area (38.33 cm2), plant height (100.17cm), number of nodes per plant (3.91), tiller height (92.42), number of tillers m− 2 (191.17), spike length (7.58 cm), number of spikes per plant (10.25), number of grains per spike (25.08), 1000-grain weight (36.66g), total dry weight per plant (309.75g), biomass yield (23424kg/ha) and grain yield (4564.2 kg/ha). On the other hand, the exogenous application of potassium silicate at 2% solution showed promising results in terms of ameliorating the drought effect by significantly enhancing chlorophyll-a (1.21), chlorophyll-b (0.64), total chlorophyll contents (1.92), flag leaf area(45.25 cm2), plant height (123.50cm), number of nodes per plant (5.25), tiller height (99.42), number of tillers m− 2 (276.26), spike length (12.92cm), number of spikes per plant (14.25), number of grains per spike (38.33), 1000-grain weight (44.33g), total dry weight per plant (385.00g), biomass yield (24000 kg/ha) and grain yield (5074.8kg/ha). These findings led us to conclude that the exogenous application of potassium silicate has a great ability to compensate for the detrimental effects of drought in wheat crops.
Incidence and Challenges of Helicopter Emergency Medical Service (HEMS) Rescue Missions with Helicopter Hoist Operations: Analysis of 12,000 Daytime and Nighttime Missions in Switzerland
Authors: Pietsch Urs , Knapp Jürgen , Mann Michael , Meuli Lorenz , Lischke Volker , Tissi Mario , Sollid Stephen J.M. , Rauch Simon , Wenzel Volker , Becker Stefan , Albrecht Roland
Published: March 2021

ObjectiveWe aimed to investigate the medical characteristics of helicopter hoist operations (HHO) in HEMS missions.MethodsWe designed a retrospective study evaluating all HHO and other human external cargo (HEC) missions performed by Swiss Air-Rescue (Rega) from 1 January 2010 to 31 December 2019.ResultsDuring the study period, 9,963 (88.7%) HEMS missions with HHO and HEC were conducted during the day, and 1,265 (11.3%) at night. Of the victims with time-critical injuries (NACA ≥4), 21.1% (n=400) reached the hospital within 60 min during the day, and 9.1% (n=18) at night. Nighttime missions, a trauma diagnosis, intubation on-site, and NACA Score ≥4were independently and highly significantly associated with longer mission times (p<0.001). The greatest proportion of patients, who needed hoist or HEC operations in the course of the HEMS mission during daytime, sustained moderate injuries (NACA 3, n=3,731, 37.5%) while practicing recreational activities (n=5,492, 55.1%). In daytime HHO missions, the most common medical interventions performed were an insertion of a peripheral intravenous access (n=3,857, 38.7%) and administration of analgesia (n=3,121, 31.3%). ConclusionsNearly 20% of patients, who needed to be evacuated by a hoist, were severely injured, and complex and lifesaving medical interventions were necessary before the HHO procedure. Therefore, only adequately trained and experienced medical crew members should accompany HHO missions.
Cloning and Identification of a New Repressor of 3,17β-Hydroxysteroid Dehydrogenase of Comamonas Testosteroni
Authors: Xie Weiqi , Xia Qin , Chen Ling , Xiong Guangming , Gao Yuwei , Yu Yuanhua , He Xiuxia
Published: March 2021

3,17β-hydroxysteroid dehydrogenase (3,17β-HSD) is a key enzyme that can degrade steroid compounds in Comamonas testosteroni. Tetracycline repressor (TetR) family, repressors existing in most microorganisms, may play key roles in regulating the expression of 3,17β-HSD. Previous reports showed that three TetR genes were located in the contig58 of C. testosteroni ATCC 11996 (GenBank: AHIL01000049.1), among which the first TetR gene encoded a potential repressor of 3,17β-HSD by sensing environmental signals. However, whether the other proposed TetR genes acts as repressors of 3,17β-HSD is still unknown. In the present study, we cloned the second TetR gene and analyzed the regulation mechanism of the protein on 3,17β-HSD using electrophoretic mobility shift assay (EMSA), gold nanoparticles (AuNPs)-based assay, and loss-of-function analysis. The results showed that the second TetR gene was 660-bp, encoding a 26 kD protein, which could regulate the expression of 3,17β-HSD gene via binding to the conserved consensus sequences located 1100-bp upstream of the 3,17β-HSD gene. Furthermore, the mutant strain of C. testosteroni with the second TetR gene knockout has good biological genetic stability, and the expression of 3,17β-HSD in the mutant strain is slightly higher than that in the wild type under testosterone induction, suggesting the mutant can efficiently degrade steroids as carbon sources. The mutant generated in this study can be used to treat environmental pollution caused by steroid hormones.
"The Alarm Was Grass Fire": Emergency Services' Perceptions of Chemical Incident Mobilization in Sweden - a Focus Group Study
Authors: Westman Anton , Saveman Britt-Inger , Björnstig Ulf , Hylander Johan , Gyllencreutz Lina
Published: March 2021

Background: In chemical incidents, infrequent but potentially disastrous, the World Health Organization calls for inter-organizational coordination of actors involved. Multi-organizational studies of chemical response capacities are scarce and testable hypotheses are largely lacking. We aimed to describe chemical incident experiences and perceptions of Swedish fire and rescue services, emergency medical services, police services, and emergency dispatch services personnel.Methods: Eight emergency service organizations in two distinct and dissimilar regions in Sweden participated in one organization-specific focus group interview each. The total number of respondents was 25 (7 females and 18 males). A qualitative inductive content analysis was performed.Results: Three types of information processing were derived as emerging during acute-phase chemical incident mobilization: Unspecified (a caller communicating with an emergency medical dispatcher), specified (each emergency service obtaining organization-specific expert information), and aligned (continually updated information from the scene condensed and disseminated back to all parties at the scene). Improvable shortcomings were identified, e.g. randomness (unspecified information processing), inter-organizational reticence (specified information processing), and downprioritizing central information transmission while saving lives (aligned information processing).Conclusions: It is inferred that sensitivity, specificity and time-effectiveness in the flow of information may be improved by automation, public education, revised dispatcher education, and use of technical resources in the field. It is further inferred that inter-organizational coordination may be improved by inter-organizational training and revised standard operating procedures. We propose systematic assessments of chemical incident probabilities in Sweden.
The Mesoscale Crystallinity of Nacreous Pearls
Authors: Gim Jiseok , Koch Alden , Otter Laura , Savitzky Benjamin , Erland Sveinung , Estroff Lara , Jacob Dorrit , Hovden Robert
Published: March 2021

A pearl’s distinguished beauty and toughness is attributable to the periodic stacking of aragonite tablets known as nacre. Nacre is a naturally occurring mesocrystal that remarkably arises in the absence of translational symmetry. Gleaning the inspiring biomineral design of a pearl requires quantifying its structural coherence and understanding the stochastic processes that govern formation. By characterizing the entire structure of pearls (~3 mm) in cross-section at high resolution, we show nacre is a medium-range mesocrystal formed through nanoparticle assembly processes. Self-correcting growth mechanisms actively remedy disorder and topological defects of the tablets and act as a countervailing force to paracrystallinity (i.e. long-range disorder). Nacre has a correlation length of roughly 16 tablets (~5.5 µm) despite persistent fluctuations and topological defects. For longer distances (> 25 tablets, ~8.5 µm), the frequency spectrum of nacre tablets follows f-1.5 behavior suggesting growth is coupled to external stochastic processes—a universality found across disparate natural phenomena which now includes pearls.
How Many Trials Are Needed in Kinematic Analysis of a Reach-to-Grasp Task? - a Study in Persons With Stroke and Non-Disabled Controls
Authors: Frykberg Gunilla Elmgren , Grip Helena , Alt-Murphy Margit
Published: March 2021

Background Kinematic analysis of the 3D reach-to-grasp drinking task is recommended in stroke rehabilitation research. The number of trials required to reach performance stability, as an important aspect of reliability, has not been investigated. Thus, the aims of this study were to determine the number of trials needed to reach within-session performance stability and to investigate trends in performance over a set of trials in non-disabled people and in a sample of individuals with chronic stroke. In addition, the between-sessions test-retest reliability in persons with stroke was established. MethodsThe drinking task was performed at least 10 times, following a standardized protocol, in 44 non-disabled and 8 post-stroke individuals. A marker-based motion capture system registered arm and trunk movements during 5 pre-defined phases of the drinking task. Intra class correlation statistics were used to determine the number of trials needed to reach performance stability as well as to establish test-retest reliability. Systematic within-session trends over multiple trials were analyzed with a paired t-test. Results For most of the kinematic variables 2 to 3 trials were needed to reach good performance stability in both investigated groups. More trials were needed for movement times in reaching and returning phase, movement smoothness, time to peak velocity and inter-joint-coordination. A small but significant trend of improvement in movement time over multiple trials was demonstrated in the non-disabled group, but not in the stroke group. A mean of 3 trials was sufficient to reach good to excellent test-retest reliability for most of the kinematic variables in the stroke sample. Conclusions This is the first study that determines the number of trials needed for good performance stability (non-disabled and stroke) and test-retest reliability (stroke) for temporal, endpoint and angular metrics of the drinking task. For most kinematic variables, 3 trials are sufficient to reach good reliability. This knowledge can be used to guide future kinematic studies.
Association of Organizational Culture and Climate With Variation in the Clinical Outcomes of Collaborative Care for Maternal Depression in Community Health Centers
Authors: Williams Nathaniel J , Russo Joan , Vredevoogd Melinda , Grover Tess , Green Phillip , Proctor Enola , Bhat Amritha , Unutzer Jurgen , Bennett Ian M
Published: March 2021

BackgroundOrganizational culture and climate may help explain variation in the effectiveness of evidence-based practices implemented in primary care settings; however, this hypothesis has not been well tested. This study tested the relationship between organizational culture and climate and variation in clinical outcomes of the evidence-based collaborative care model (CoCM) for maternal depression implemented in primary care health centers serving low income populations.MethodsOrganizational cultures and climates of ten community health centers providing collaborative care for depression among women in pregnancy and parenting were assessed using the Organizational Social Context (OSC) measure. Three-level hierarchical linear models tested whether variation in culture and climate predicted variation in improvement in depression symptoms from baseline to 6.5 months post-baseline for N=468 women who initiated care in the year before and after the OSC assessment. Depression symptomology was measured using the Patient Health Questionnaire (PHQ-9).ResultsAfter controlling for patient characteristics, case mix, center size, and implementation support, patients served by health centers with more proficient cultures improved significantly more from baseline to 6.5 months post-baseline than patients served by centers with less proficient cultures (mean improvement = 5.08 vs. 0.14, respectively, P<.05), resulting in a large adjusted effect size of dadj = 0.78. A similar effect was observed for patients served by centers with more functional climates (mean improvement = 5.25 vs. 1.12, P<.05, dadj = 0.65). Growth models indicated that, on average, patients served by centers with more proficient cultures recovered after four months of care and remained stabilized below the clinical cutoff at 6.5 months post-baseline, whereas patients served by centers with less proficient cultures improved after four months but then deteriorated to above the clinical cutoff by 6.5 months post-baseline (P<0.05). A similar pattern was observed for functional climate.ConclusionsVariation in clinical outcomes for women from vulnerable populations receiving collaborative care for maternal depression was associated with the organizational cultures and climates of primary care health centers. Implementation strategies that target proficient culture and functional climate may improve the implementation and effectiveness of integrated behavioral health care for depression by reducing this variation.
A novel gene LbHLH from the halophyte Limonium bicolor enhances salt tolerance via alleviating osmotic stress and reducing root hair development
Authors: Wang Xi , Zhou Yingli , Xu Yanyu , Wang Baoshan , Yuan Fang
Published: March 2021

Background

Identifying genes involved in salt tolerance in the recretohalophyte Limonium bicolor could facilitate the breeding of crops with enhanced salt tolerance. Here we cloned the previously uncharacterized gene LbHLH and explored its role in salt tolerance.
Results

The 2,067-bp open reading frame of LbHLH encodes a 688-amino-acid protein with a typical helix-loop-helix (HLH) domain. In situ hybridization showed that LbHLH is expressed in salt glands of L. bicolor. LbHLH localizes to the nucleus, and LbHLH is highly expressed during salt gland development and in response to NaCl treatment. To further explore its function, we heterologously expressed LbHLH in Arabidopsis thaliana under the 35S promoter. The overexpression lines showed significantly increased trichome number and reduced root hair number. LbHLH might interact with GLABRA1 to influence trichome and root hair development, as revealed by yeast two-hybrid analysis. The transgenic lines showed higher germination percentages and longer roots than the wild type under NaCl treatment. Analysis of seedlings grown on medium containing mannitol with the same osmotic pressure as 100 mM NaCl or LiCl with the same ionic effect as 100 mM NaCl demonstrated that overexpressing LbHLH relieved osmotic stress.
Conclusion

These results indicate that LbHLH enhances salt tolerance by alleviating osmotic damage under NaCl stress.