bluuebunny/crossref_metadata_2025 huggingface dataset:
The Application of PRIMET For Pesticide Registration and Monitoring in Ethiopia
Authors: Teklu Berhan , Yakan Sevil Deniz
Published: April 2021

Pesticide registration is an activity often not supported with proper risk assessment procedures in developing countries like Ethiopia. In this study, we tried the PRIMET (Pesticide Risks in the Tropics for Man, Environment and Trade), a tool developed to assess the risks to non-target protection goals believed to assist the pesticide registration and monitoring activities in Ethiopia. For this study, seven pesticides (imdacloprid, difenoconazole, metalaxyl, dimethoate, thiamethoxam, nicosulfuron and bupirimate) were selected randomly and their data of physico-chemical characteristics, toxicological information and pesticide use were mined from either the information given on the dossier or PPDB (Pesticides Properties Database). Results indicated that imidacloprid, dimethoate and thiamethoxam are highly risky to bees when bee hives are present inside the field of the sprayed crop, while Thiamethoxam is highly risky at when hives are present in and off field crop situation. Another outcome was that imidacloprid and dimethoate are expected to have high acute risk for birds, while difenoconazole, metalaxyl, dimethoate showed high acute and chronic risks to the aquatic ecosystem, respectively. Future studies should give emphasis on how the results of risk assessment can be practical to help the registration processes and how the results are compared with actual measurement values.
Water Removal Cycle-By-Cycle During Automated Peritoneal Dialysis: Assessment by Remote Patient Monitoring and Modelling of Peritoneal Tissue Hydration
Authors: Stachowska-Pietka Joanna , Naumnik Beata , Suchowierska Ewa , Gomez Rafael , Waniewski Jacek , Lindholm Bengt
Published: April 2021

Water removal which is a key treatment goal of automated peritoneal dialysis (APD) can be assessed cycle-by-cycle using remote patient monitoring (RPM). We analysed ultrafiltration patterns during night APD following a dry day (APDDD; no daytime fluid exchange) or wet day (APDWD; daytime exchange). Ultrafiltration for each APD exchange were recorded for 16 days using RPM in 14 patients. The distributed model of fluid and solute transport was applied to simulate APD and to explore the impact of changes in peritoneal tissue hydration on ultrafiltration. We found lower ultrafiltration (mL, median [first quartile-third quartile]) during first and second vs. consecutive exchanges in APDDD (-61 [-148—27], 170 [78—228] vs. 213 [126—275] mL; p<0.001), but not in APDWD (81 [-8—176], 81 [-4—192] and 115 [4—219] mL; NS). Simulations in a virtual patient showed that lower ultrafiltration (by 114 mL) was related to increased peritoneal tissue hydration caused by inflow of 187 mL of water during the first APDDD exchange. The observed phenomenon of lower ultrafiltration during initial exchanges of dialysis fluid in patients undergoing APDDD appears to be due to water inflow into the peritoneal tissue, re-establishing a state of increased hydration typical for peritoneal dialysis.
Modelling and Forecasting the Impact of Air Temperature on Global Warming: Karachi as a Case Study
Authors: Zafar Asma , IMRAN MUHAMMAD , Uddin Vali , Aamir Muhammad
Published: April 2021

The world has experienced extreme climate changes and global warming. It also causes high temperature, droughts, rising sea level and flooding. In Karachi, the construction activities and transportation caused most of the Green House Gases (GHG) and carbon dioxide (CO2) emission. In the paper, the data under consideration is 60 years mean monthly maximum and minimum air temperature of Karachi ranging from 1961 to 2020 has been used to forecast the temperature impact over time. The minimum and maximum temperature data were observed, forecasted city temperature. ARMA (p, q) model used to modelling and forecasting the behaviour of Karachi maximum and minimum air temperature using Pakistan Metrological Department (PMD) data. The results show that the Theil’s U-Statistics values of each month lie approaches to zero shows that the air temperature is strongly correlated to previously observed values. The results of this study are very beneficial for observing the influence of air temperature on the global warming.
Utility of Next Generation Sequencing in Genetic Testing and Counseling of Disorders Involving the Musculoskeletal System–Trends Observed From a Single Genetic Unit
Authors: Iyer Gayatri R , Kumar Roshan , Poornima Subhadra , Priya Aruna , Juturu Keerthi , Bhatnagar Lekhanga , Arora Srinka , Suresh Vaishnavi , Utage Prashanth , Bailur Sarah , Pujar Akhilesh N , Hasan Qurratulain
Published: April 2021

Background: Disorders involving the musculoskeletal system are often identified with short stature and a range of orthopedic problems. The clinical and genetic heterogeneity of these diseases, with several characteristic overlaps, makes specific diagnosis difficult for clinicians using conventional tests, hence molecular testing becomes essential for appropriate diagnosis and management. Methods: Next Generation Sequencing (NGS) based testing has become common in current day clinical practice. To do genetic counseling in cases with disorders in musculoskeletal system, classify and refer for appropriate genetic testing and to assess utility of NGS based testing for molecular diagnosis. Detailed pre and posttest genetic counseling, NGS based clinical exome testing, genotype-phenotype correlation, and segregation analysis. Results: This manuscript reports a molecular spectrum of variants in 34 orthopedic cases referred to a single genetic unit attached to a tertiary care hospital. The diagnostic yield of NGS based tests coupled with genetic counseling and segregation analysis was 79% which included 7 novel variants. Cases which benefited or will get a benefit in the near future were 53% (i.e. 18/34 cases), as eight underwent prenatal diagnosis, since they were either in their early gestation or had planned a pregnancy subsequent to molecular testing, while ten cases were premaritally/prenatally counseled for the families to take informed decisions as they were in the reproductive age. Conclusions: The report highlights the importance of NGS based tests even in a low resource setting as it helps patients, families and health care providers in reducing the economic, social and emotional burden of these disorders.
Characterization of Mariner transposons in Rhus gall aphids (Hemiptera: Aphididae: Eriosomatinae)
Authors: Ahmad Aftab , Wallau Gabriel Luz , Ren Zhumei
Published: April 2021

Background: Transposable elements (TEs), also known as jumping genes, are widely spread in the genomes of insects and play a considerable role in genomic evolution. Mariner family belongs to class II transposable elements, were searched in the genomes of seven species of Rhus gall aphids belonging to six genera. Mariner-like elements were characterized for the first time in Rhus gall aphids and classified in to respective subfamilies.Results: In total, one hundred twenty-one MLEs were detected in the genomes of the seven investigated species of Rhus gall aphids, which showed a wide distribution of MLEs in both close and distant related species. The sequences of MLEs ranged from 1kb to 1.4kb in length and the structural analysis of the MLEs showed that only five copies were potentially active with intact open reading frame (ORF) while the remaining were classified as inactive MLEs according to absence of single intact ORF or terminal inverted repeats (TIRs). Based on the MLEs in Rhus gall aphids as well as the well characterized MLEs in other organisms from GenBank, the phylogenetic analysis showed that all the one hundred twenty-one MLE sequences belonged to four subfamilies, i.e., thirty from Maurutiana subfamily, twenty-six from Drosophila subfamily, thirty-three from Vertumana subfamily and thirty-two from Irritans subfamily, among which Drosophila and Vertumana subfamilies were reported in aphids for the first time. Moreover, the phylogenetic relationship suggested possible horizontal transfer events of MLEs between aphids and other insects.Conclusion: Our present report revealed the diversity and distribution of MLEs in Rhus gall aphid genomes sequenced by shotgun genome skimming method. This study further expanded our understandings on the characterization of transposable elements in aphid genomes, which might be useful as genetic markers and tools and would play an important role in genomic evolution and adaptation of aphids.
Impact of COVID-19 Lockdown on Glycaemic Control and Lifestyle Changes in Children and Adolescents with Type 1 And Type 2 Diabetes Mellitus
Authors: Cheng Hooi Peng , Wong Jeanne Sze Lyn , Selveindran Nalini M , Hong Janet Yeow Hua
Published: April 2021

Aims: Malaysia implemented nation-wide lockdown from 18th March till 5th May 2020 to mitigate the spread of coronavirus disease (COVID-19). This study aimed to examine the impact of the lockdown on glycaemic control and lifestyle changes in children and adolescents with type 1 (T1DM) and 2 diabetes mellitus (T2DM) aged less than 18 years old.Methods: In this cross-sectional study, interviews and a standardised questionnaire comparing lifestyle changes before and during the lockdown were performed in follow-up clinic visits after the lockdown. Anthropometry measurements and glycated haemoglobin (HbA1c) values were compared three months prior and after the lockdown.Results: Participants were 93 patients with T1DM (4.64 ± 3.10 years) and 30 patients with T2DM (11.08 ± 3.47 years). Male gender, T2DM and pubertal adolescents were found to have a significant deterioration in glycaemic control. A significant increment of HbA1c was observed in patients with T2DM (8.5 ± 0.40% vs 9.9 ± 0.46%), but not in patients with T1DM (8.6 ± 0.28% vs 8.7 ± 0.33%). Contrarily, there was an improved glycaemic control in pre-pubertal T1DM children likely due to parental supervision during home confinement. Weight and BMI SDS increased in T1DM patients but surprisingly reduced in T2DM patients possibly due to worsening diabetes control. Reduced meal frequency mainly due to skipping breakfast, reduced physical activity level scores, increased screen time and sleep duration were observed in both groups. Conclusions: Adverse impact on glycaemic control and lifestyle were seen mostly in patients with T2DM and pubertal adolescent boys.
[18F]FDG PET/CT Imaging Disproves Renal Allograft Acute Rejection in Kidney Transplant Recipients with Acute Kidney Dysfunction: A Validation Cohort
Authors: Lovinfosse Pierre , Weekers Laurent , Pottel Hans , Bouquegneau Antoine , Bonvoisin Catherine , Bovy Christophe , Grosch Stephanie , Hustinx Roland , Jouret Francois
Published: April 2021

Purpose. [18F]FDG-PET/CT may predict the absence of acute allograft rejection (AR) in kidney transplant recipients (KTRs) with acute kidney injury (AKI). Still, the proposed threshold of 1.6 of the mean of mean standardized uptake values (mSUVmean) in the renal parenchyma needs validation. Methods. We prospectively performed 86 [18F]FDG-PET/CT in 79 adult KTRs who underwent per cause transplant biopsy for suspected AR. Biopsy-proven polyoma-BK nephropathies (n=7) were excluded. PET/CT was performed 192 ± 18 minutes after administration of 254.4 ± 30.4 MBq of [18F]FDG. The SUVmean was measured in both upper and lower poles of the renal allograft. One-way analysis of variance (ANOVA) and Tukey’s studentized range test were sequentially performed. The receiver operating characteristic (ROC) curve was drawn to discriminate “AR” from non-pathological (“normal” + “borderline”) conditions. Results. The median age of the cohort was 55 [43; 63] years, with M/F gender ratio of 47/39. The mean eGFR was 31.9 ± 14.6 ml/min/1.73m². Biopsies were categorized in 4 groups: “normal” (n=54), “borderline” (n=9), “AR” (n=14) or “others” (n=2). The median [min; max] mSUVmean reached 1.72 [1.02; 2.07], 1.97 [1.55; 2.11], 2.13 [1.65, 3.12] and 1.84 [1.57; 2.12] in “normal”, “borderline”, “AR” and “others” groups, respectively. ANOVA demonstrated a significant difference of mSUVmean among groups (F=13.25, p<0.0001). The ROC area under the curve was 0.86. Test sensitivity and specificity corresponding to the threshold value of 1.6 were 100% and 30%, respectively.Conclusion. [18F]FDG-PET/CT may help noninvasively prevent inessential transplant biopsies in KTR with AKI.
The Genetic Diversity Mice Models in SARS-CoV-2 Infection
Authors: Wang Xinpei , Liu Yunpeng , Qu Yajin , Hou Rui , Liu Jiangning , Gao Ran , Bao Linlin , Deng Wei , Cao Yunlong , Li Li , Qi Feifei , Lv Qi , Li Fengli , Liang Xujian , Cheng Yu , Zhang Lingyan , Ye Fan , Lao Lanlan , Lu Tianyu , Song Zhiqi , Yu Xuan , Qin Chuan
Published: April 2021

The SARS-CoV-2 has led to a worldwide health crisis. The ACE2 has been identified as the entry receptor in a species-specific manner. Classic laboratory mice were insusceptible since the virus cannot use murine ACE2 orthologue. Animal models rely on gene modification on the virus or the host. However, these mice were restricted in limited genetic backgrounds and did not support natural infection. Here we showed two wild-type inbred lines (CAST and FEW) from Genetic Diversity mice supported authentic SARS-CoV-2 infection, and developed mild to moderate interstitial pneumonia, along with infiltrating inflammatory cells. Particularly, FEW featured age-dependent damages, while CAST charactered by pulmonary fibrosis. Genome and transcriptome comparative analysis suggested the mutated ACE2 was not responsible for SARS-CoV-2 infection in CAST and FEW, and the differential gene expressions in immune response and immune cell may be risk factors for the infection. In summary, the GD mice, derived from the multi-parental panel, provided promising murine models for exploring sophisticated pathogenesis in SARS-CoV-2.
The Prognostic Impact of Left Ventricular Thrombus Resolution after Acute Coronary Syndrome and Risk Modulation via Anti-Thrombotic Treatment Strategies
Authors: Hofer Felix , Kazem Niema , Schweitzer Ronny , Horvat Patricia , Winter Max-Paul , Koller Lorenz , Hengstenberg Christian , Sulzgruber Patrick , Niessner Alexander
Published: April 2021

Background: Left ventricular thrombus (LVT) is a rare but dreaded complication during the acute phase of acute coronary syndrome (ACS). However, profound data on long-term outcome and associated anti-thrombotic treatment strategies of this highly vulnerable patient population are scarce in current literature. Methods: Patients presenting with ACS were screened for presence of LVT and subsequently included within a prospective clinical registry. All-cause mortality and the composite of MACE and thrombo-embolic events were defined as primary and secondary endpoint. Results: Within 43 patients presenting with LVT, thrombus resolution during patient follow-up was observed in 27 individuals (62.8%). Patients that reached a resolution of LVT experienced lower incidence rates of death (-23.9%; p=0.022), MACE (-37.8%; p=0.005) and thrombo-embolic events (-35.2%; p=0.008). Even after adjustment for clinical variables, thrombus resolution showed an independent inverse association with all-cause death with an hazard ratio (HR) of 0.14 (95%CI: 0.03-0.75; p=0.021) and as well as with MACE with a HR of 0.22 (95%CI: 0.07-0.68; p=0.008) and thrombo-embolic events with a HR of 0.22 (95%CI: 0.06-0.75; p=0.015). Triple antithrombotic therapy (TAT) with ticagrelor/prasugrel showed a strong and independent association with thrombus resolution with an adjusted HR of 3.25 (95%CI: 1.22-8.68; p=0.019) compared to other strategies. Conclusion: The presented data indicate a poor outcome of ACS patients experiencing LVT. In terms of a personalized risk stratification, thrombus resolution has a strong protective impact on both all-cause death and MACE with the potential to tailor treatment decisions – including an intensified anti-thrombotic treatment approach – in this patient population.
Antioxidant and Antibacterial Study of 10 Flavonoids Revealed Rutin as a Potential Anti-Biofilm Agent in Klebsiella Pneumoniae Strains Isolated From Hospitalized Patients
Authors: Wang Zhibin , Ding Zixuan , Li Zhaoyinqian , Ding Yinhuan , Jiang Fan , Liu Jinbo
Published: April 2021

Background: The emergence of multidrug resistance (MDR) and extensively drug-resistance (XDR) of Klebsiella pneumoniae strain has brought great threaten to traditional antibiotics. Previous studies showed that plant-derived flavonoids have inhibitory functions on pathogens. However, In K. pneumoniae, the antibacterial activities of different flavonoids on the growth and biofilm formation remains a mystery. The aim of the present study is to evaluate the antioxidant abilities of different flavonoids and to identify their inhibitory effects on K. pneumoniae growth and biofilm formation. Results: Totally 10 flavonoids representing 4 major categories were screened and used in this study. The antioxidant capacity of each flavonoid was evaluated through a DPPH assay. Rutin showed highest free radical scavenging capacity, followed by kaempferol, luteolin, quercetin, apigenin, hesperidin, sinensetin, naringenin, naringin and 3,5,6,7,8,3',4'-heptamethoxyflavone. The inhibitory effect of rutin and naringin on bacteria growth were compared. The antibacterial activity of flavonoid is highly correlated with the antioxidant capacity. Among these flavonoids, rutin showed the best inhibitory capacity against both the growth curve and biofilm production. The lowest value of MIC was found in rutin against K. pneumoniae ATCC700603 (1024μg/mL) and E.coli ATCC25922 (512μg/mL). The MBIC were not found. The expression profiles of 15 genes were analyzed in biofilm cells both with and without rutin treatment. The correlation analysis showed the mrkA gene expression was positively correlated with the biofilm biomass accumulation. Conclusions: Our study indicated that flavonols showed stronger antibacterial activities. The biofilm production is correlated with several gene expression rather than one. Rutin is a potential agent to inhibit the K. pneumoniae biofilm formation.
Consistency Analysis of Intraoperative Blood Loss Assessment Between Surgeons and Anesthesiologists
Authors: Liu Jian , Ma HongBao , Wang Faxuan , Wang Xuewei , Wang Chaoran , Wang Linan , Gao Yubo , Niu Ningkui
Published: April 2021

Objective: To explore the consistency between intraoperative blood loss recorded by surgeons, anesthesiologists and standard blood loss. Methods: The clinical data of 200 patients who underwent posterior lumbar interbody fusion (PLIF) from January 2019 to December 2020 in the Department of Spine Surgery of a Grade III Level A hospital were selected, including 109 males, aged 34-84 years, with an average of 56.40 ± 11.21 years, and 91 females, aged 27-78 years, with an average of 57.48 ± 11.40 years. The preoperative Hb, HCT, APTT, Pt, INR, intraoperative blood, and fluid infusion of patients were recorded. The standard blood loss of the patients was calculated by the formula and compared with the intraoperative blood loss recorded by the surgeons and the anesthesiologists separately for analysis. Results: 1. When the standard blood loss was less than 400ml, there was no statistical difference between the intraoperative blood loss recorded by surgeons and the standard blood loss (P > 0.05), which is considered to be consistent. 2. When the standard blood loss was between 400ml-800ml, the intraoperative blood loss recorded by surgeons and anesthesiologists was less than the standard blood loss,there was statistical difference between the intraoperative blood loss and the standard blood loss (P < 0.05), but the intraoperative blood loss recorded by surgeons was more accurate than that recorded by anesthesiologists; 3. When the standard blood loss was more than 800ml, the intraoperative blood loss recorded by surgeons and anesthesiologists was less than the standard blood loss,There was no consistency between the intraoperative blood loss recorded by anesthesiologists and the standard blood loss (P < 0.05), but the intraoperative blood loss recorded by anesthesiologists was more accurate than that recorded by surgeons. Conclusion: 1. There are differences between surgeons and anesthesiologists in recording intraoperative blood loss. 2. The accurate recording of intraoperative blood loss needs to be done jointly by surgeons and anesthesiologists, especially when the blood loss is more than 400ml, which is conducive to perioperative fluid management.
The Impact of Preoperative Biliary Drainage on Postoperative Outcomes of Patients with Malignant Obstructive Jaundice: A Retrospective Analysis of 290 Consecutive Cases at a Single Medical Center
Authors: Zhihui Gao , Jie Wang , Sheng Shen , Xiaobo Bo , Tao Suo , Xiaoling Ni , Han Liu , Yueqi Wang , Lihong Huang , Liu Houbao
Published: April 2021

BackgroundThe efficacy of preoperative biliary drainage (PBD) has been debated for several decades, and indications for PBD are still a controversial topic. The aim of this study was to compare the efficacy of PBD among patients with malignant obstructive jaundice in current clinical settings.MethodsAll consecutive patients with malignant obstructive jaundice who underwent radical resection from June 2017 to December 2019 at Zhongshan Hospital were analyzed retrospectively. The study population was divided into two groups: a PBD group (PG) and direct surgery group (DG). Subgroups were chosen by site of obstruction.ResultsA total of 290 patients were analyzed. Postoperative complications occurred in 134 patients (overall rate: 46.4%). Patients in group PG had a lower overall rate of postoperative complications as compared to group DG, with perioperative total bilirubin (TB) identified as an independent risk factor in multivariate analysis (hazard ratio = 1.004; 95% confidence interval 1.001–1.007; P = 0.017). Subgroup analysis showed that PBD reduced the complication rate in patients with proximal obstruction. In the proximal-obstruction subgroup, a preoperative TB level >162 μmol/L predicted postoperative complications.ConclusionsPBD may reduce the overall rate of postoperative complications among patients with proximal obstructive jaundice.Trial registrationClinicalTrials.gov, 2018ZSLC 24. Registered May 17, 2018, https://clinicaltrials.gov/.
Analysis of Elasto-plastic Thin-shell Structures using Layered Plastic Modeling and Absolute Nodal Coordinate Formulation
Authors: Li Jiachen , Liu Cheng , Hu Haiyan , Zhang Shixiong
Published: April 2021

A new elasto-plastic thin shell finite element of the absolute nodal coordinate formulation (ANCF) allowing for large deformation and finite rotation is proposed based on the Kirchhoff-Love theory and layered plastic model. The von Mises yield criterion of plane-stress with linear isotropic hardening is adopted in constitutive description of elasto-plastic material. Owing to the plane-stress constraint, special treatment should be given to the stress update algorithm for plasticity. To accommodate the plasticity formulation, the Gauss-point layered integration is inserted into the thickness of the element to produce the internal force. Then, the Jacobian of internal forces is deduced by deriving the consistent elasto-plastic tangent moduli. To accurately track the load-displacement equilibrium path in the buckling analysis of elasto-plastic thin shells, the arc-length method is used. The dynamics of the thin shells is also studied by using the generalized-alpha algorithm. Finally, several static and dynamic examples are presented to verify the accuracy of the proposed formulation.
Trend Analysis of Malaria Prevalence in Bati District, Northeastern Ethiopia (From 2015 to 2020): A Retrospective Study
Authors: daba chala , Kebede Edosa , Atamo Amanuel
Published: April 2021

Background: Malaria is the leading cause of morbidity and mortality in developing country including Ethiopia. Ethiopia is one of on ways to minimize the incidence of malaria by 40% as per its 2020 malaria reduction strategy since 2016. Thus, this study aimed to analyze six-year trend analysis of malaria prevalence in Bati district, Northeastern Ethiopia.Methods: Institutional based retrospective study was conducted to determine six-year trend analysis of malaria prevalence in Bati district. All malaria cases reported from 2015 to 2020 were carefully reviewed by trained laboratory technologist from the laboratory record books of Bati hospital and health center.Results: A total of 84,269 and 22,185 of malaria suspected patients were requested for blood films and Rapid diagnostic test (RDT) respectively. Of this, 12,032 (11.3%) malaria cases were microscopically confirmed. Plasmodium falciparum were the most dominant parasites detected, which accounted 57.6 %. Malaria has been reported from all age groups; however, age distribution showed that the majority of cases were adults’ age 15 years (57.2%). Even though there was fluctuation of malaria prevalence in the study area, the highest peak of malaria cases was reported during summer season which accounted 47.2%.Conclusion: Malaria is still a major public health problem in Bati district and the overall trend of total confirmed malaria cases were decreased in the past six years (2015–2020) with exception slightly increased cases from 2015 to 2016. Therefore, government, all healthcare workers and community should strengthen and scale up malaria prevention and control strategies in the study area
Performance Evaluation of RDT, Light Microscopy, and PET-PCR for Detecting P. Falciparum Malaria Infections in the 2018 Zambia National Malaria Indicator Survey
Authors: Mwenda Mulenga C. , Fola Abebe A. , Ciubotariu Ilinca I. , Mulube Conceptor , Mambwe Brenda , Kasaro Rachael , Hawela Moonga B. , Hamainza Busiku , Miller John M. , Carpi Giovanna , Bridges Daniel James
Published: April 2021

BackgroundZambia continues to advance on the path to elimination with significant reductions in malaria morbidity and mortality. Crucial components that have contributed to progress thus far and are necessary for achieving the national malaria elimination goals include properly identifying and treating all malaria cases through accurate diagnosis. This study sought to compare and assess the diagnostic performance of RDTs and LM with PET-PCR as the gold standard using 2018 MIS data across Zambia to better understand diagnostic accuracy metrics and how these vary across a transmission gradient. MethodsCross-sectional samples collected in a nationally representative survey from 7 provinces in Zambia were tested for the presence of malaria parasites by light microscopy (LM), rapid diagnostic test (RDT) and the gold standard PET-PCR. Diagnostic performance was assessed including sensitivity, specificity, negative- and positive-predictive values across a wide malaria transmission spectrum. Diagnostic accuracy metrics were measured, and statistically significant differences were calculated between test methods for different outcome variables. ResultsFrom the individuals included in the MIS, the overall prevalence of P. falciparum malaria was 32.9% by RDT, 19.4% by LM, and 23.2% by PET-PCR. Herein, we compared RDT and LM diagnostic performance against gold standard PET-PCR and found that LM had higher diagnostic accuracy than RDTs (91.3% vs 84.6% respectively) across the transmission spectrum in Zambia. However, we found that the performance of both diagnostics was significantly reduced in low parasitemia samples. Consistent with previous studies, RDT diagnostic accuracy was predominantly affected by a high rate of false positives.ConclusionWhile LM performance is overall superior to RDTs, the additional requirements for its implementation such as high-quality staining, microscopes, and additional manpower, means that its application will remain at the health facility level. In contrast, while RDTs overestimate prevalence as they have a higher false positive rate, their ability to be rapidly deployed makes them an excellent community level tool. Overall, we found that the performance of both diagnostics was acceptable, and their use should be continued.
Multiple Simultaneous Embolic Cerebral Infarctions 11 Months After COVID-19
Authors: Advani Rajiv , Strømsnes Torbjørn Austveg , Stjernstrøm Espen , Lugg Sebastian Thomas
Published: April 2021

BackgroundThe coronavirus disease (COVID-19) pandemic has led to an unprecedented worldwide burden of disease. However, little is known of the longer-term implications and consequences of COVID-19. One of these longer-term complications is a COVID-19 associated coagulopathy that can present as a venous thromboembolism (VTE) and, as yet unreported, multiple paradoxical cerebral emboli. Case PresentationA 51 year old man presented to the emergency department with multiple simultaneous embolic cerebral infarctions 11 months after mild COVID-19. In the subacute phase of the COVID-19 illness the patient developed increasing shortness of breath and was found to have an elevated D-dimer and multiple bilateral segmental pulmonary emboli. He was subsequently treated with 3 months of anticoagulation for a provoked VTE. The patient then presented 11 months after the initial COVID-19 diagnosis with multiple simultaneous cerebral infarctions where no traditional underlying stroke etiology was determined. A patent foramen ovale (PFO) and an elevated D-dimer were found indicating a paradoxical thromboembolic event due to an underlying coagulopathy. ConclusionsThis case report highlights the one of the potentially more serious complications of long-term COVID-19 where VTE due to a persistent coagulopathy is seen almost a year after the initial illness. Due to the highly prevalent nature of PFO in the general population, VTE due to COVID-19 associated coagulopathy could lead to ischemic stroke. This case report therefore highlights the challenge posed by the underlying COVID-19 associated coagulopathy which can persist for many months and beyond from the initial illness.
Quinolin-2-one-pyrimidine Hybrids Acting as Potent Reversal Agents on the P-gp-mediated Multidrug Resistance: Insights into Structure-activity Relationships and the Binding Mode
Authors: Laiolo Jerónimo , Lanza Priscila Ailin , Parravicini Oscar , Barbieri Cecilia , Insuasty Daniel , Cobo Justo , Vera D. Mariano Adolfo , Enriz Ricardo Daniel , Carpinella María Cecilia
Published: April 2021

P-gp-associated multidrug resistance (MDR) is a major impediment to the success of chemotherapy. With the aim of finding non-toxic and effective P-gp inhibitors, we investigated a panel of quinolin-2-one-pyrimidine hybrids. Among the active compounds, two of them significantly increased intracellular doxorubicin and rhodamine 123 accumulation by inhibiting the efflux mediated by P-gp and restored doxorubicin toxicity at nanomolar range. Structure-activity relationships showed that the number of methoxy groups, an optimal length of the molecule in its extended conformation, and at least one flexible methylene group bridging the quinolinone moiety favored the inhibitory potency of P-gp. The best compounds showed a similar binding pattern and interactions to those of doxorubicin and tariquidar, as revealed by MD and hybrid QM/MM simulations performed with the recent experimental structure of P-gp co-crystallized with paclitaxel. Analysis of the molecular interactions stabilizing the different molecular complexes determined by MD and QTAIM showed that binding to key residues from TMH 4–7 and 12 is required for inhibition.
Brain-Dead and Coma Patients Exhibit Different Serum Metabolic Profiles: A Novel Diagnostic Approach in Neurocritical Care
Authors: Dawiskiba Tomasz , Wojtowicz Wojciech , Qasem Badr , Łukaszewski Marceli , Mielko Karolina Anna , Dawiskiba Agnieszka , Banasik Mirosław , Skóra Jan Paweł , Janczak Dariusz , Młynarz Piotr
Published: April 2021

There is a clear difference between severe brain damage and brain death. However, in clinical practice, the differentiation of these states can be challenging. Currently, there are no laboratory tools that facilitate brain death diagnosis. The aim of our study was to evaluate the utility of serum metabolomic analysis in differentiating coma patients (CP) from individuals with brain death (BD). Serum samples were collected from 23 adult individuals with established diagnosis of brain death and 24 patients in coma with Glasgow Coma Scale 3 or 4, with no other clinical symptoms of brain death for at least 7 days after sample collection. Serum metabolomic profiles were investigated using proton nuclear magnetic resonance (NMR) spectroscopy. The results obtained were examined by univariate and multivariate data analysis (PCA, PLS-DA, and OPLS-DA). Metabolic profiling allowed us to quantify 43 resonance signals, of which 34 were identified. Multivariate statistical modeling revealed a highly significant separation between coma patients and brain-dead individuals, as well as strong predictive potential. The findings not only highlight the potential of the metabolomic approach for distinguishing patients in coma from those in the state of brain death but also may provide an understanding of the pathogenic mechanisms underlying these conditions.
High-sensitivity biosensor for simultaneous detection of cancer and diabetes using photonic crystal microstructure
Authors: Sani Mojtaba Hosseinzadeh , Ghanbari Ashkan , Saghaei Hamed
Published: April 2021

In this study, we propose a refractive index sensor for the simultaneous detection of cancer and diabetes based on photonic crystals (PhC). The proposed PhC composed of silicon rods in the air bed arranged in a hexagonal lattice forms the fundamental structure, and two tubes are used to place the cancerous or diabetic samples for measurement. The sensor's transmission characteristics are simulated and analyzed by solving Maxwell's electromagnetic equations using the finite-difference time-domain method for samples under study. The diagnosis of three types of cancer and diabetes is based on changing the samples' refractive index by applying the laser source centered at 1550 nm. Our results demonstrate that the proposed structure's quality factor and sensitivity can be adjusted by changing the sensor's geometry. They reveal that the transmission power is between 91% ~ 100%, depending on the sample. The sensitivity range is also between 1294 and 3080 nm/RIU. The maximum figure of merit is about 1550.11 RIU− 1 with a detection range of 31×10− 6 RIU. The small biosensor area of ​​ 61.56 µm2 makes it a suitable device for various applications in compact photonic integrated circuits.
Sarcopenia, Severe Anxiety and Increased C-Reactive Protein Are Associated with Severe Fatigue in Patients with Inflammatory Bowel Diseases
Authors: Tasson Laura , Zingone Fabiana , Barberio Brigida , Valentini Romina , Ballotta Pamela , Ford Alexander , Scarpa Marco , Angriman Imerio , Fassan Matteo , Savarino Edoardo
Published: April 2021

Background: Fatigue is defined as an overwhelming sense of tiredness not responsive to rest or sleep, and it affects every day occupations, social functioning, and work. Patients with inflammatory bowel disease (IBD) report fatigue more frequently than healthy population, but the precise mechanisms underlying its presence are unknown. This study aimed to evaluate the prevalence of fatigue in IBD and its relation with potential causative factors. Methods: A survey consisting of different questionnaires that aimed to evaluate fatigue, depression, anxiety, sleep disorders, and the presence of sarcopenia and malnutrition, was sent by email to 244 IBD outpatients of the Gastroenterology Unit of Academic Hospital of Padua . Demographics and clinical data, including the levels of fecal calprotectin (FC) and C-reactive protein (CRP), and current pharmacological treatments were obtained from patients’ medical records. Results: Ninety-nine (40.5%) subjects answered the survey. Ninety-two (92.9%) patients reported fatigue, with sixty-six having mild to moderate fatigue and twenty-six severe fatigue. After univariate analysis, subjects reporting severe fatigue were more likely to have abnormal values of CRP (OR 3.6) and to demonstrate scores suggesting the presence of sarcopenia, malnutrition, anxiety, depression, compromised sleep quality, and lower quality of life scores. Multivariate analysis showed that abnormal values of CRP (OR 5.1), severe anxiety (OR 3.7) and sarcopenia (OR 4.4) were the factors independently associated with severe fatigue. Conclusion: Fatigue has a high prevalence in subject affected by IBD. Subjects with altered CRP, sarcopenia and severe anxiety appear more at risk of severe fatigue.
Silver Coordination-Polymer based of 4,6-Diamino-2-pyrimidinethiol as Organic Ligand: a Highly Reusable Heterogeneous Nanocatalyst for the Asymmetric Hantzsch Synthesis of Polyhydroquinolines under Green Conditions
Authors: Hussain-Khil Noorullah , Ghorbani-Choghamarani Arash , Mohammadi Masoud
Published: April 2021

A highly efficient and stable heterogeneous coordination polymer (CP) was successfully prepared by hydrothermal combination of silver and 4,6-diamino-2-pyrimidinethiol. The prepared coordination polymer was characterized by FT-IR, XRD, TGA, SEM, EDX, X-ray mapping and Nitrogen adsorption-desorption analysis. The prepared Ag-CP exhibit excellent catalytic activity in multicomponent Hantzsch synthesis of polyhydroquinolines under mild reaction conditions in relatively short reaction times. The heterogeneity of the catalyst was confirmed by the hot filtration test; also, the catalyst was reused for at least four times under the optimized reaction conditions without any significant loss of its catalytic activity.
Association Between Epidural Analgesia and Cancer Recurrence or Survival After Surgery for Renal Cell Carcinoma: a Propensity Weighted Analysis
Authors: Yen Fang-Yu , Lin Shih-Pin , Lin Tzu-Ping , Chang Wen-Kuei , Tsou Mei-Yung , Chang Kuang-Yi
Published: April 2021

Whether epidural anesthesia and analgesia (EA) is beneficial for postoperative cancer outcomes remains controversial and we conducted this historical cohort study to evaluate the association between EA and long-term outcomes following surgery for renal cell carcinoma (RCC). We collected patients receiving RCC surgery from 2011 to 2017 and followed up them until February 2020. Patient attributes, surgical factors and pathological features were gathered through electronic medical chart review. The association between EA and recurrence-free and overall survival after surgery was evaluated using Cox regression models with inverse probability of treatment weighting (IPTW) to balance the observed covariates. The median follow-up time for the 725 included patients was 50 months (interquartile range: 25.3–66.5) and 145 of them (20%) received perioperative EA. We demonstrated EA use was associated with better recurrence-free survival (IPTW adjusted hazard ratio (HR): 0.64, 95% confidence interval (CI): 0.49–0.83, p < 0.001) and overall survival (IPTW adjusted HR: 0.66, 95% CI: 0.49–0.89, p = 0.006) in patients receiving surgical resection for RCC. More prospective studies are needed to verify this connection between EA and superior cancer outcomes after RCC surgery.
Iris Image Acquisition and Real-Time Detection System Using Convolutional Neural Network
Authors: Hu Yuan , Si Xiaoyong
Published: April 2021

The aim is to further improve the efficiency of iris detection and ensure real-time iris data acquisition. Here, the light field refocusing algorithm can collect the data in real-time based on the existing iris data acquisition and detection system, and the DL (Deep Learning) CNN (Convolutional Neural Network) is introduced. Consequently, an iris image acquisition and real-time detection system based on CNN is proposed, and the system for image acquisition, processing, and displaying is constructed based on FPGA (Field Programmable Gate Array). The spatial filtering algorithm can compare the performance of the proposed bilateral filters with common filters. The results indicate that the proposed bilateral filters can pick out qualified iris images in real-time, greatly improving the accuracy of the iris image recognition system. The average time for real-time quality assessment of each frame image is less than 0.05 seconds. The classification accuracy of the iris image quality assessment algorithm based on DL is 96.38%, higher than the other two algorithms, and the average classification error rate is 3.69%, lower than the average error rate of other algorithms. The results can provide a reference for real-time iris image detection and data acquisition.
Can global models provide insights into regional mitigation strategies? A diagnostic model comparison study of bioenergy in Brazil
Authors: Köberle Alexandre C , Daioglou Vassilis , Rochedo Pedro , Lucena André F. P. , Szklo Alexandre , Fujimori Shinichiro , Brunelle Thierry , Kato Etsushi , Kitous Alban , Vuuren Detlef P. van , Schaeffer Roberto
Published: April 2021

The usefulness of global integrated assessment model (IAM) results for policy recommendation in specific regions has not been fully assessed to date. This study presents the variation in results across models for a given region, and what might be behind this variation and how model assumptions and structures drive results. Understanding what drives the differences across model results is important for national policy relevance of global scenarios. We focus on the use of bioenergy in Brazil, a country expected to play an important role in future bioenergy production. We use results of the Stanford University Energy Modeling Forum’s 33rd Study (EMF-33) model comparison exercise to compare and assess projections of Brazil’s bioenergy pathways under climate mitigation scenarios to explore how 10 global IAMs compare to recent trends in the country. We find that, in their current form, global IAMs have limited potential to supply robust insights into regional mitigation strategies. Our results suggest fertile ground for a new research agenda to improve regional representation in global IAMs with improved spatial and technological resolutions.
Identification and Validation of Hub Genes Related to Meniscus Senescence Based on Gene Expression Profiling Analysis
Authors: chen ming , Zhou Siqi , Shi Huasong , Gu Hanwen , Wen Yinxian , Chen Liaobin
Published: April 2021

Background: The incidence of meniscal injury is on the rise, partly due to the general aging of the population. The compositional change in the meniscus with aging would increase the tissue vulnerability of the meniscus, which would induce meniscus tearing. Here, we investigated the molecular mechanism of age-related meniscus degeneration with gene expression profiling analysis.Methods: The GSE45233 dataset, including 6 elderly meniscus samples and 6 younger meniscus samples, which were obtained from patients undergoing arthroscopic partial meniscectomy, was downloaded from the Gene Expression Omnibus (GEO) database for subsequent bioinformatics analysis. To screen the differential expression of mRNAs, identify the miRNAs targeting hub genes, and forecast the potentially toxic drugs, we completed a series of bioinformatics analyses, including functional and pathway enrichment analysis, protein-protein interaction network, hub genes screening, construction of a lncRNA–miRNA–mRNA network, and molecular docking of potential drugs. Furthermore, hub genes were examined in human senescent menisci, mouse senescent meniscus tissues and mouse meniscus cells stimulated by IL-1β.Results: In total, the most significant 4 hub genes (RRM2, AURKB, CDK1, and TIMP1), 5 miRNAs (hsa-miR-6810-5p, hsa-miR-4676-5p, hsa-miR-6877-5p, hsa-miR-8085, and hsa-miR-6133) that could regulate such 4 hub genes and potential toxic drugs (Cladribine, Danusertib, Barasertib, Riviciclib, and Dinaciclib) that may have a targeting effect on these genes, were finally identified. The functional enrichment results showed that hub genes were mainly concentrated in aging and regulation of the cell cycle process. Further pathways enrichment analysis of these miRNA revealed that these miRNAs were involved in the synthesis of glycosaminoglycans. The hub genes were decreased in meniscus cells in vitro and meniscus tissues in vivo, which indicated that hub genes were related to meniscus senescence.Conclusions: In a word, our current study would provide a basis for finding markers of the aging meniscus to a certain extent.
Patient Empowerment Through a User-Centered Design of an Electronic Personal Health Record: A Qualitative Study of user Requirements in Chronic Kidney Disease
Authors: Toni Esmaeel , Pirnejad Habibollah , Makhdoomi Khadijeh , Mivefroshan Azam , Niazkhani Zahra
Published: April 2021

Background To improve chronic disease outcomes, self-management is an effective strategy. An electronic Personal Health Record (ePHR) is a promising tool with the potential to support chronic patient’s education, counseling, and self-management. Fitting ePHRs within the daily practices of chronic care providers and chronic patients requires user-centered design approaches. We aimed to understand users’ needs and requirements in Chronic Kidney Disease (CKD) care to consider in the design of an ePHR to facilitate its implementation, adoption, and use.Methods A qualitative study was conducted in a major Iranian nephrology center including inpatient and outpatient settings in 2019. We conducted 28 semi-structured interviews with CKD patients, nurses, and adult nephrologists. To confirm or modify the requirements extracted from the interviews, a focus group was also held. Data were analyzed to extract those requirements that can facilitate implementation, adoption, and sustained use based on the PHR adoption model and the Unified Theory of Acceptance and Use of Technology.Results Participants requested an ePHR that provides access to up to date patient information, facilitates patient-provider communication, and increases awareness about patient individualized conditions. Participants expected a system that is able to cater to low patient e-health literacy and high provider workload. They requested the ePHR to include purposeful documentation of medical history, diagnostic and therapeutic procedures, tailored educational content, and scheduled care reminders. Messaging function, tailored educational content to individual patients’ conditions, and controlled access to information were highly valued in order to facilitate its implementation, adoption, and use. Conclusions We focused on the ePHR’s content and functionalities in the face of facilitators and/or barriers envisioned for the implementation and adoption of an ePHR in nephrology care. Different users' requirements should inform the design and implementation of ePHR system especially in the context of CKD care. The insights gained can help ePHR designers and implementers to better support CKD patients in self-management.